Vampire Job

Taking blood was one of the basic practical skills we learned the first week. We didn't even have pig's feet to practice on for it, all we got were crudely-made fake arms. So it's the skill I am the least confident in. Last week I had a few chances to do it on our patients.

Like everything else in human anatomy, veins come in different sizes and shapes. There are the plump and juicy pencil-sized ones that you could take blood from with a pen, and there are tiny collapsed ones on dehydrated patients that you could barely make out even with the tourniquet pulled tight enough to collapse their arteries. There are patients who would merrily chat away and not even bat an eye while you jab away at them, and there are patients whose whole body would tense up and start to hyperventilate at the sight of the blood collection cart. I had a go at them regardless. The trick, I learned, was to act with confidence, like I knew what I was doing, like I'd done this a million times before, and the patient would be that much more calm. But that was after a rocky start at the art of venepuncture.

One day last week I was asked to take blood from a patient for some tests. I was told that the patient was an IV drug user who had wanted her blood tested for "poisons." I walked into the consult room and saw that the patient, a woman in her twenties, was nervous and shifting in her seat. This being my first time taking blood and the fact that the patient was an IV drug user, I was advised to double glove. Trying to small talk but got no response, I put on the first pair of gloves. Then I started to put on the second pair of latex gloves and, being powder free, they started to stick to the first pair. As I struggled to put them on the best I could, I sensed that she was getting more nervous. Finally, the gloves were on.

I asked her which arm she preferred. She said softly, "Doesn't matter, you can use the left." I looked at both of her arms. The needle marks on her right arm clearly indicated which one she'd used for injecting. I put the tourniquet on her left arm and tried to palpate a vein in her left cubital fossa. The thickness of two layers of gloves made it extremely difficult to feel the vein. After finding what I felt was a good vein, I pushed the needle in. I was using Vacutainers, which minimized the chances of contact with blood but didn't give the user confirmation of the needle being in the vein. Not sure whether I was in the vein, I got nervous and pulled out the needle. I apologized to the patient and set up a normal syringe and needle. The woman pointed to the new needle and said, "Oh my god, what's that? What's on that needle?" She then accused me of not using a sterile needle. I assured her that we never re-use our needles but she was having none of it. At this point, my supervisor came in to the room to my rescue. He used the syringe and took blood from her right arm, the one she'd use to inject and probably had much better veins. Afterwards, we told the patient to come back in a couple of days for her results and she left in a rush.

And that was how I miserably failed at my first attempt to take blood. After that, I started using normal syringes and needles, which give the comforting flashback - a little bit of blood showing at the syringe end of the needle when it goes into the vein. That and with a little bit of bluffing to put the patient at ease, this blood-taking business became much easier for me.