Phlebotomist

Experiences in "needle work"

Photo by Marek Studzinski on Unsplash

My first concert experience was the band Lifehouse playing at a small venue in Salt Lake City. My sister, friends, and I were standing within spitting distance of the stage, but spitting was not on my mind. I was positively marveling at the impressive VEINS on a couple of the band members’ arms. This is not as morbid as it sounds.

For months, I’d been working as a phlebotomist at the hospital in Bozeman, Montana. At least back then, training for this position happened largely on the job. Please accept my apologies if this makes any of you even more apprehensive about future blood draws.

Thankfully, I wasn’t completely inexperienced at sticking needles in other humans. I was just rusty. Two years prior, I had taken an EMT-Intermediate course with my best friend Heidi, and our friends Jonathan, Krista, and Kirsten. Our instructor, Chad,¹ taught this class with his mom and a couple siblings and siblings-in-law. We were never quite sure how they were all related; we just knew they were. EMS was a family affair for them, as were their obsessions with beer and Lake Powell.

The five of us friends carpooled together, quizzed each other on course material, and stuck needles in each other’s arms. At that time, the EMT-I curriculum included extensive training on IV insertions. Our carpool group definitely preferred to be practiced upon by each other but, however reluctantly, we would also let classmates of sometimes-questionable intelligence practice sticking 16- or 18-gauge (AKA “big”) needles in our arms.

And hot off the press, a memory regarding “questionable intelligence” has just landed. In this memory, Chad or one of his relatives is slowly and deliberately reading the answers to that evening’s quiz.

“One: A.”

“Two: C.”

“Three: A.”

He’d just begun to say “Four…” when he was interrupted by one student.

“Whoa, whoa, WHOA! SLOW DOWN and start over.”

I digress. In this course, one of the skills we developed was the ability to provide constructive feedback. If the “EMT” had the needle stuck into your arm closer to a 90 degree angle than the requisite 20ish, you’d wince and say, “I think you’re too deep.” Or, like you might provide directions to a blindfolded participant of an obstacle course, you’d say “A little to the left…now to the right.” How on Earth were they missing your 5-star vein?

Sometimes they just went fishing for a vein, or punctured the vein entirely. This allowed blood to flow into surrounding tissues, causing swelling and bruising. We took sick pleasure in showing off our latest bruises to appreciative roommates. I say “they” like I was never the offending EMT, but I was.

Once the needle was in place and the catheter advanced into the vein, the EMT would then hold the needle nice and steady while successfully occluding the vein,² taking off the tourniquet, and hooking up the plastic tubing. Theoretically.

One red-letter day, I inserted the catheter in everyone’s favorite place to have a catheter placed (it’s not)—the superficial cephalic vein on the thumb side of the wrist—and moved on to the the other steps. Turns out I wasn’t occluding the vein as much as I thought I was. Blood ran down his arm, pooled on the plastic Costco table, and onto the carpeted floor. Whoops.

In the end, though, most of us passed muster. I’m not sure about Quiz Lady, but for me that concluded my opportunity to stick needles in people, or so I thought. My real-life EMT experience continued on a volunteer basis, and our protocols didn’t include anything to do with needles.

But then I became a phlebotomist two years later, and routine blood draws became exactly that. Our team of phlebotomists would trot all over the hospital, carrying white trays containing our tools of the trade: blood tubes, tourniquets, alcohol swabs, gauze, needles. Our lab coats were not cool ones like doctors wear, but more industrial and plasticky, as if we were going to get bodily fluids on us. Hazards of the job!

We were also the ones no patient wanted to see in their room in the wee hours, waking them up for lab draws so test results were ready for early physician rounds. It’s generally considered rude to stick a needle in the arm of a sleeping person, so we tried to get at least a grunt of consent. As gently as possible, we would also check their wristband to ensure we were drawing blood from the right person since that was generally preferred.

And we took turns working weekends. On my only weekend shift, a teen survivor of a gruesome car accident was brought in and needed to have their blood typed—STAT—for transfusion purposes. My small but critical role on the “trauma team” was to push my way through the crowd of life-saving professionals to draw blood and get it back to the lab for typing. Talk about intimidating. Especially for a non-confrontation formerly-shy kid. However, I had my orders and wasn’t going to shirk my duty. At the last minute, a nurse offered to draw the necessary vials off the IV line she’d just placed, and I was off the hook for everything except for rushing it back to the lab. Phew.

One of these days, I might write a TV sitcom that’s a fusion of The Office and Gray’s Anatomy. Plenty of shows have focused on the medical professionals in the fancy lab coats; the world might be ready for a show about the lower echelons of the medical profession.

My experiences at least provide the makings of a great show. We had co-worker drama in spades, mysterious pathologists we almost never interacted with, despite them working literally 20 feet away. There were many crushes and a falsely cheerful coworker with dyed blonde hair who looked like a glamour girl out of a 1980s JC Penney studio and who I swear was sometimes drunk. Titles for this show welcome.

Don’t my “needle-work” experiences capture the way most of life goes? We do stuff that’s super intimidating and figure out we can actually do it—even if we have to literally spill blood to do so. We learn stuff the hard way and practice all kinds of things on each other—hurting each other plenty in the process. Sorry to all those I’ve hurt in my learnings. We rise to challenges, and receive help from unexpected directions. And kind of like those bruises our EMT carpool group bragged about, we never know when we’re picking up the most interesting “bruises”—memories we’ll have and share for the rest of our lives.

Isn’t life cool and aren’t people interesting? See you in the next one…

For the hundreds of you who read & enjoy my essays each week, thank you. I know it’s not in everyone’s budget to be a paid subscriber, but your appreciation in other ways—especially comments & likes (♡) on these posts—helps me grow this publication. I’m so glad you’re here. Emily

1. You met Chad, as well as Heidi and Jonathan, in an earlier piece. Hence, here is the link to to it.

2. I would like to compliment my brain for effortless remembering this term 23 years later. Sometimes I absolutely ASTONISH myself…