getting blood drawn; insensitivity

Post Reply New Topic

When I get blood drawn I squeeze my leg with my free hand to create more pain elsewhere so I don't notice the pain in my arm. The more the needle hurts, the harder I squeeze my leg.

I find this works well for me.

My 4 year old Aspie daughter has also used this diversion tactic instinctively since she was about 2; if she injures herself, she squeezes elsewhere (usually just below the site of injury) to control the pain herself.

I guess we're both control freaks!

I hate needles, they say it is only a bee sting but it is a lie, jeez I get realy jumpy when I know I am getting one. I said this once when I was getting blood drawn and they laughed at me, I got realy snappy and stuff.

I've never really liked being touched, but can handle it when I know it's coming. As a kid, I had to have blood drawn several times. I never really felt the needle, although I could feel the elastic band they wrapped around my arm. Only once have I had a problem of the needle bothering me when blood was being removed from my body. I was donating blood, and the person taking it kept pulling the needle out, because she couldn't find the vein. After about the 5th or 6th jab, I said enough. Now, except for the very first time I donated blood, they haven't been able to get enough out of me to use. They usually can only get about half a pint, and it simply stops flowing.

I cried quietly when I had my blood drawn to test for thyroid problems (which is actually the beginning of what led to my diagnosis of Asperger's Syndrome). It's very icky to have something cold and hard in your vein.

Now, the one thing that I am completely and utterly uncooperative about at the doctor's is tongue depressors. I will go ballistic on anyone that tries to put one in my mouth.

Oops, bit of a confusion here.

Actually, I've only had the butterfly a few times...the thing that collapses my veins is something else...vaccume something or other. I had a butterfly the other day (even though I requested a syringe) and it was fine, aside from some slight bruising.

Oh my gosh, I'm getting the heebie jeebies just reading that

Someone who shares my fear of tongue depressors...! :'D

My family never understood why I was so afraid of them. I hate them because they make me gag. I hate the feeling and sound of gagging, so there you go.

I draw blood for a living so I'll wade in here.

First off... it's not 'acting childish' to have a fear of needles, squirm in your seat, cry, close your eyes, tense up, hold your breath, etc. when having your blood drawn. For those of you who talk about 'acting adult'... your full of it! Why don't you be more mature and realize this is an invasive action that DOES illicit pain which is felt differently by each individual.

I really dislike ignorant people who play up the fact that they can 'handle it' and put other people down because of their different reaction.

I have little children who sit there... not saying a word.. not crying... not moving.. while I draw their blood, yet have adults of all ages, sizes and backgrounds who barely handle the procedure. It varies with the individual.. not with their gender/age/body size/political leanings/religious belief or lack of/etc.

When getting your blood drawn here's a few tips I can relate that might help you and the person drawing your blood...

1. Remember that every person who works in the medical field is human just like you. Although we try to be very calm, considerate, and exact in our jobs, we are still susceptible to our human emotions and physical being.
We have our good days and our bad days just like patients and their families.

- Having said that though, I do believe a medical professional should strive to be as polite and considerate as possible to each and every patient.

2. It really does not work in your favor to carry on about how difficult your veins are and to be questioning the skill and experience of the person drawing your blood. Here's a few tips concerning this comment...

- Every person I have ever worked with has been concerned with doing a good job when drawing blood. The people I currently work with all feel bad when they miss a stick. We really do not enjoy sticking any patient twice or more.

- Just because one or two people may have had a difficult time getting blood from you once, doesn't mean your veins are crummy or hard to stick... refer back to #1. (I get a bit pissed at other phlebotomists/nurses who automatically blame the patient's veins when the problem was with the blood drawer.. not the patient!)

- It's fine to alert the blood drawer that people have had difficulty in the past getting blood from you, but please don't get pushy putting on an angry face and sternly telling the person they "ONLY GET ONE TRY!". If you approach this person with respect and in a friendly manner... you'll be less likely to make them defensive.. remember... defensiveness is a human feeling so anyone can have it.
If you're dealing with a person who does not have a lot of years experience, you may very well make them nervous, which could make a simple easy-to-accomplish blood draw turn out to be a multiple stick scenario.

- People who draw blood for a living are better at it than many nurses and doctors who only do it sometimes... as in having blood drawn at a clinic instead of a laboratory.

3. The Apparatus.....

You will be drawn by one of several methods...

Vacutainer This is the plastic hub to which a needle is screwed on. After the needle is inserted into the vein successfully, tubes are pushed up into the hub. The needle is a double-ended needle ... one point goes into your arm, the other pierces the rubber stopper on the tube and the vacuum in the tube along with your blood pressure, bring blood into the tube.
* This is the method that most people seem to have trouble with because while the blood drawer is holding the needle in place inside your vein, he/she is also pushing and pulling a tube in/out of the hub. You have to be careful when pushing in a tube so you don't advance the needle through the vein (sometimes if you recognize this has happened you can pull back the needle and continue with the blood draw... but not always). Also, when withdrawing the tube in preparation for placing another tube in, you may accidently pull the needle back out of the vein or even the arm.

Syringe with Fixed Needle I use this most often if the volume of blood I need can fit in a 10cc syringe (the most common size we use). Basically it's just a straight needle attached onto the end of a syringe.
Again, some push/pull factors may result in the draw ending too soon... holding the syinge/needle in place while pulling the plunger back.
Pulling too hard on the plunger can cause the red cells to break up causing hemolysis. This can ruin a sample for many tests if the blood is too hemolyzed, which will necessitate a repeat draw. Using too small of a needle can also cause this to happen.

Syringe with a Butterfly Needle Too many patients have learned to ask for a butterfly needle. Far too many patients have erroneously learned that using a 'Butterfly' needle is equal to using an extremely tiny needle that supposedly hurts less and makes blood drawing eaiser. I'll try to correct these false assumptions...

- Butterfly needles are called such because of the plastic 'wings' attached to them.
- The needles are generally shorter than regular hypodermic needles but come in the EXACT SAME bore sizes as any other needle. So you may ask for a butterfly, but be getting the same bore size as a needle someone may have used on you before and not gotten blood.
- Another physical difference between butterfly needles and hypodermic needles is the tubing that attaches the butterfly to the hub that attaches to the syringe. This tubing is probably the greatest benefit/advantage to using a butterfly because you no longer have that Push/Pull issue described in the other procedures above.
With a butterfly, I can hold the needle in place with one hand while operating the syringe with my other hand. If the patient moves their arm... even slightly... I can probably move the needle with them and keep the connection patent (patients moving their arms.. even slightly... is another reason blood draws go bad).

We use butterflies on children and adults.. because of the movement issue and because it sounds 'cuter' saying Butterfly rather than Needle. It really has NOTHING to do with SIZE of needle unless the place where you are having your blood drawn only stocks butterflies of one size... which is not common. We have butterflies in three sizes which equal the sizes of all our other needles. If the person drawing your blood claims butterflies are better because they are smaller... their F.O.S.!

Line Draws Sometimes a patient will have a 'line' through which they receive medication, fluids, and through which blood is sometimes drawn. I want to make a clear distinction here by what I am calling a Line Draw... it's invasive lines like PIC lines, Shunts, etc. you see these in patients undergoing dialysis, chemo, and in cases where the nurses/doctors cannot maintain a standard I.V. line. I.V. lines are generally not drawn through although in some cases they can be.

The problem with drawing through an I.V. port or line is the mixing of I.V. fluids with the blood and contaminating the specimen for testing. Even if you just have an I.V. port in and no fluids running, it's still better not to mess with these ports if we don't have to. There is always risk of moving the catheter for various reasons and 'blowing' the I.V., and the possibility of contaminating the I.V. site which would require starting the I.V. over again.

* A person who starts an I.V. has a much harder job than someone who draws blood. I often have patients tell me that they are hard to draw blood from, but upon further questioning it is actually an experience with I.V.'s they are remembering and the blood draw goes just fine.

For line draws like the PIC line and shunts... only persons authorized to handle these lines will be drawing blood from them.
There are special needles for some of these lines that only nurses and doctors (or dialysis techs) use.

Finger Sticks Sometimes we can get blood samples by pricking the finger/earlobe/toe or heal (on an infant). The problems with this type of blood draw include: slow blood flow which allows clots to form in the specimen causing blockage to some testing equipment, excess cellular fluid from squeezing too hard when trying to milk drops of blood out, and too small a volume to allow repeat testing.

Some blood tests require a certain amount of blood that is not possible to obtain from a fingerstick or they require a special tube(which has an ingredient inside to mix with the blood) which cannot be used to collect blood from a fingerstick. So sometimes, even though you might want us to just poke your finger... we cannot.

Hmmm, my ADD/HD is kicking in and I'm starting to lose my place.... hehehe...

Blood draws can be broken up into two categories... venous and arterial.
Venous draws can be done any place you can find a viable vein with the exception of patients with special medical conditions. Diabetics are one group of people we have to be careful with when drawing blood. A diabetic who has not been managing their condition very well may have poor circulation in their lower extremeties(legs/feet) and the risk of infection from poking down there is greater so we stay away from there except in emergencies. There are other folks like ladies who have had mastectomies (clotting issues), etc.
I've drawn blood from some very interesting places on people in the years I've been doing it... to include the forehead on a baby with hydrocephaly (a patient we knew well and was an extremely difficult stick).

Eh... this is getting too long so I'll close it up here.

Basically, my job drawing your blood is made that much easier if you do a few simple things....

1 - Drink water enough to keep you normally hydrated. For some reason, clinics sometimes forget to tell a patient who has to fast for 12 hrs for blood work that FASTING does not equate NPO (or Nothing By Mouth). Also, there seems to be a trend among some medical personnel towards insisting the patient drink "LOTS OF WATER!"... just be normally hydrated if you can please... any more water than that and you're just going to be peeing it out anyway.

2 - If you are taking medication(s), ask your doctor if you should continue to take it even if it's immediately prior to getting your blood drawn. In the lab, we don't know you or your condition, most times, and cannot advise you on this matter unless you are having your medication levels checked, in which case there are rules as to how long before your blood draw you should take it.

3 - Please show up a little bit early. In my facility, we draw not just the outpatients but emergency room/ICU/Med-Surg Ward/OB - GYN patients also. You may be in a hurry because you didn't leave ample time to register and wait to be called, but that does not mean we have to see you immediately. Also, as you can tell from the comments in this thread, there are some people who have pretty heavy reactions to blood drawing and sometimes they need a moment to remain seated (or even be reclined) before they get up and walk out. We need to be able to tend to these people with the respect and dignity they deserve even if that means the other outpatients will have to wait a few more minutes themselves.

4 - If you have experienced problems with blood draws in the past whether it's a reaction you have or a problem with your veins.. please mention it politely. I would hope that no matter where you are being helped, the people working there would be considerate and put their own egos aside in order to properly address your concerns (and sad-to-say, but I have seen some medical professionals whose egos really got in the way).

Do not tell us you, "Need the most experienced person there!", because generally, everyone in the drawing room is probably very experienced unless they have had new hires of inexperience folks recently. Oh.. and you're not the only person to come in that day and make this request! Oh.. Oh.. and you have to realize you can request someone by name but they may not be there that day or may be busy with another patient or even out to lunch... so having you then ask me "Are you any good?" puts me on the defensive... I'm human and it's just a natural reaction to a challenge like that. Plus, I've seen some new people who just seem to have a knack for the job and people with many years of experience miss veins.

5 - No matter if you are a 85lb teenage girl or a 230lb 6'5" adult male, if you get nervous, light-headed, sick-to-your-stomach... PLEASE let us know. There should be nothing embarrassing about it... you are among probably at least half the patients we see... especially those with body-piercings and tatoos! (yeah... they DO NOT like needles... unless it's for decorative purposes )

6 - If you are cold, try to wear something to help warm you up. When a person is cold and exposed, their body will shunt blood to the core, leaving the extremeties with less blood flow resulting in less volume and consequently veins that do not show up as good as when that person is warm.

7 - When the physician hands you your order for lab work.. if you cannot read the tests and determine if there is a urine test as well as blood testing, ask the doc or nurse before leaving. We have many females who show up with an order for a urine test and when we mention it they invariably say, "OH! I just went to the bathroom!"... happens more often to women who are pregnant.

8 - If you like to have your blood drawn from the anticube area of the arm (the inside space opposite your elbow) that's fine... we generally like that area also.. but sometimes we cannot find a vein we like there and we may see one in the forearm or hand. Yes... these areas are more sensitive to most patients... but sometimes drawing there will be better than sticking you twice when the place you insist we draw from does not work that time.

9 - Please DO NOT....
----- HOLD YOUR BREATH
----- HOLD A CONSTANT FIST (sometimes pumping the hand will make the muscles push more blood up towards the tourniquet which MAY (or may not) cause the vein to distend (swell). A constant fist can actually press the vein up against the skin resulting in a flattening of the vein which then makes it harder to place the opening of the needle inside the vein properly.
----- BLOW ON THE AREA WE JUST CLEANED WITH THE LITTLE ALCOHOL PAD OR AMPULE OF BETADINE! We cleaned it for a reason and having you spit on that area pretty much undoes all that hard work!

I could probably think of more but these will do for now

10 - If you need your results faxed somewhere, be sure to have the fax number and the name of the person to whom these are being sent. If you want to get your own results to have for what ever reason, please be aware that in the U.S., we now have HIPPA. Basically you can no longer receive confidential information over the phone or through any other means by which we cannot be sure you are the actual person receiving this information. Some places will mail/fax the results to a patient if the patient signs a release form stating specifically which number/address to use. You cannot call in and just say..."I'd like you to send my results to this number/address", because we cannot make positive identification over the phone and the law requires such.

11 - If you have to collect urine/stool/sputum please make sure you understand how to collect it... how to keep it viable until we get it... and how to properly label it. Again.. .with the labeling... it's required by law! If we get a specimen (even from a nurse in the hospital) and it is not properly labeled we have to throw it away! It is all about ensuring we have the correct specimen and are providing the correct results to the patient's physician. This is extremely important... so don't blow it!

12 - Some tests are not done at local facilites. Some tests are shipped across the country (in the U.S. anyway) to be run with samples from facilities spread across the country who also do not have the equipment to run these special tests. The results for these tests can take a few days to over a week to get back... then sometimes another couple of days to get to the physician... so please be patient.

13 - DO NOT ASK US TO INTERPRET YOUR RESULTS!! !
We are not physicians... we generally do not know your medical history and complaint so we do not know the significance of your results relative to your medical issue. Yes... we can recite 'normal values', but these are not necessarily YOUR normal values as dictated by your condition and what your physician is looking for. ASK YOUR DOCTOR, P.A., OR NURSE PROVIDER! Thank you!

I will, in turn, try to be respectful, mindful that you are not here because you are feeling the BEST you have ever felt in your life (perhaps the complete opposite! ), and professional in my mannerisms, dress, and skill.
I am there not because it's the only job I could find... but because I do enjoy helping people!
If I am having a bad day at work.. like, say I just came back from a tough trauma case in the E.R., or just had an argumenty with a co-worker or the boss, or if I have personal issues on my mind.. oh... like maybe... a divorce pending, bills that are due and not enough to cover them all, an illness of my own or affecting a family member, I just got a call from my kid's school saying there has been a problem..... I really will try to put all that aside and give you my full attention... but I'm human and may not do that very well. Hopefully if something is causing me to not be in my best shape for working, I will take the day off or at least go away for a break to recover.

As a patient you deserve all the respect and attention necessary to help you feel well taken care of and to help you have your medical issues dealt with appropriately working towards better health for you... but we can't please everyone 100% all the time. Wish it were better but that's life.


Oh... and I almost forgot about allergies....

Latex - our hospital system is going to a completely latex-free system (well, as much as we can anyway) including gloves, tourniquets, and tape. Latex-Free items in the U.S. are recognizable by their color... BLUE... this is for gloves and tourniquets. Tape still comes in white.

Tape - some patients have skin reactions to the adhesive on certain tapes... nylon or paper, and also regular old Band-Aids.
In these cases we use an elastic wrap which goes by various maker's names... Coban, Vet-Wrap, Co-Flex, etc.
This is expensive stuff ... just like the butterfly needles.. and if you really don't need it.. please do not ask for it.
The Coban also comes in Latex-free varieties.

I'm not here much anymore... not that anyone has noticed in the last month or so.. hehehe... , but I do drop in and read posts sometimes. I may not be back here soon.. or I may... if you have any questions of me about any of this feel free to ask either here or my PM.

I have worked in the medical field since 1976 (Search and Rescue as a teenager), in hospitals emergency rooms and laboratories, blood banks, and driving ambulances. I don't claim to be an expert, but I am happy to pass on my knowledge if requested.

Oh... and a story I like to relate concerning fear of needles...

About 3 yrs ago a 26 y.o. female came to our E.R. because she wasn't feeling well. She had several piercings in her face.
I walk into her room and announce, "Hello, I am WSMAC. I'm from the lab and I need to get some blood from you for tests."

Her response..... "Are you going to use a needle?"

Mine.... "Hmmm, well, yes"

Her.... "Well, I don't want it then... I'm scared of needles!"

She refused, I left, she left the E.R. without completing her care.
I did see her a week later in the lab. She seemed to have gotten over her fear.. somewhat.. and allowed me to draw her blood. Afterwards, she commented that it wasn't as bad as she thought it would be... I, of course, offered to do it over until she was happy (I was just joking with her).

With that.. I will bid you adeu!

Thank you for that resopnse, Wsmac, very informative and helpful!! !

I used to donate blood because I found it relaxing. LOL. It's unusual because I was always terrified of needles. It's like I knew I was doing a good thing, and I was fine.

But... I just went for a blood test a couple weeks ago and it was so bad I was screaming and crying, I had bruises afterwards for a long time.

Now I am wishing I had water to drink. I really don't drink water but I know it would have helped.

Every time I have to have a needles injected into me, I just look away. One time I looked and it was amazing how I saw blood flow into it. If you don't move, you should be fine. Just look away when they do it.


I used to be really terrified of them I always had to be held down. I hated having my shots they hurt like heck every time because I was moving. The nurses were always telling me I won't feel anything if I hold still. Well guess what, I was 12 and I had to get a shot and I held still and discovered it didn't hurt. I didn't mind them since then.
But the one I got yesterday did hurt because of the medicine. Thank god I chose to have it done in my hip instead of in my arm. The nurse said the pain would have been a lot worse there.