Short passages about learning how to work in a laboratory.
|1. Just Stick the Needle In
What is phlebotomy? ▼
Why did you have to learn venipuncture? ▼
There is something that I don't like about phlebotomy. It's not a fear of needles or blood. I'm not afraid to have my blood drawn, and in fact I have always found it interesting. I sometimes weird the phlebotomists out by staring intently at my blood as it gushes into the tube. I certainly don't have a problem with blood; I have found it interesting long before I started handling tube after tube on a semi-regular basis. While I may not be fond of working with patients, I've worked in retail and I can deal with people (as long as it's not on a regular basis, I can handle it).
No, my problem with phlebotomy is that I just don't like sticking a needle into someone's arm, hand, or wherever else. It's a bad start when you take one look at the fake arm, and cringe at the thought of stabbing it with a needle. Fake arms do not feel pain when you slide the needle in. You could practice your tourniquet tying technique all day, and they won't become impatient with you. Most critically, you can't damage the nerves permanently by going too deep.
"It's easy," I was told. "You worry about it, then you do it, and it's fine." This did not reassure me in the least. But the one thing you cannot do is be nervous. You will drop tubes onto not-so-sterile floors, fumble the tourniquet, or stab yourself with the needle. Sticking a sterile needle is not something you want to do, much less jabbing yourself with a contaminated needle. Don't just think of HIV, which is fatal but has a low transmission, but start thinking about Hepatitis.
Some people were very enthusiastic about the endeavor. They looked ready to uncap the needle and start stabbing away at the fake arm. Their angles of entry (which should be about thirty degrees) were far too steep (closer to ninety). Then we watched a video on all the things that could go wrong;excessive bleeding due to inattention, accidentally slicing through the vein by probing side to side, mislabeling samples, or permanent nerve damage. Our enthusiasm waned. I went from 'somewhat nervous' to 'about to fall to pieces'. Even the cowboys in the room suddenly became more cautious.
I quickly learned to tie a tourniquet. You should be able to easily pull it open with one hand. It's took practice until I could make it tight enough, but I managed. Skill number one was mastered, until I had to do it while being watched. I fumbled, took far too much time, but managed to successfully tie it off.
It wasn't hard figuring out which site to draw from. I may have mixed up the veins on the laminated cards we were given, but there were so many holes in one spot it was obvious where I needed to insert the needle. Some of the arms were so bad, that when you put the needle in blood would leak out some of the other holes. After miming cleaning the site in a circular motion, I uncapped the needle and stabbed wildly. My angle of entry was good, everything else was not. I wobbled and pushed the needle in a good centimeter or two as a I tried to push the tube on. With every tube I put on, the problem worsened.
If this had been a real patient, I wouldn't have simply gone through the vein. I probably would have gone halfway through their arm. After what felt like several hundred tubes, I'd fixed the problem, except that I now wobbled side to side. This was completely unacceptable. After an hour or so of practice, I seemed to have reached a point where I wasn't at risk of stabbing myself with the needle.
By this point, the bag of fake blood looked like it had lost a few pints. The poor hypothetical patient was by now, severely anemic. The only comfort was that I no longer forgot to remove the tourniquet before finishing. My hypothetical patient was no longer going to be squirting blood like a fountain.
Several weeks later, with an hour of practice each week, and I didn't seem to be doing much better. Even the poor professor was bewildered, because I seemed to forget everything I was supposed to do whenever she tried to assess my technique. I was nearly in tears. My mind started thinking illogical thoughts such as "You'll always be terrible" and "Leave the program, and avoid the phlebotomy requirement."
I started to chant a mantra "Pass the competency, finish one rotation." It stopped me from having a meltdown. Eventually, something seemed to click. She showed me one more time, and it no longer felt awkward. The way I was holding the needle and the tube felt natural. When practicing, I found I could draw without thinking. I passed the competency with a good grade, and then went out on rotation.
Later, I would once again feel anxiety as I had to deal with real, live patients for the first time. But for now, I'd won. Me: One. Fake Arm: Zero.
2. Here, Pee In This Cup
3. Pinch Your Nose, and Poke With a Stick
When your professor asks you, "Do you have a large dog?" it is usually a very ominous sign. When she asks you to bring in a sample of his feces to class, then you know what is coming. Dark, very smelly days will soon be upon you.
I had an inkling of what was coming, of course. It's dealt with smelly diapers, cleaned up after my dog after he'd done his business, and shoveled out stalls. I was ever so familiar with the noxious smells. What I was unprepared for, was the concept of smearing chunks of it onto a small card.
4. Sniff the Plate of Pseudomonas
It is a known fact that certain species of bacteria have distinct features, such as colony morphology, pigment production, or smell. Mind you, it doesn't always smell the way the book says it should smell. Pseudomonas, for example, has a distinctive grape odor. It has always smelled like latex to my uncultured nose. (Sorry about the bad pun.) Proteus smells of burnt chocolate cake. Yeast smells like fresh baking bread, as it should. Bread yeast, alas, the only microbe that smells the way it should. I feel legally obligated to remind you to never, ever take a deep whiff of growing mold. And for safety reasons, you should never, ever open a plate containing a growing colony.
My microbiology professor, a kindly lady, and a favorite amongst students, was honest about the results of sniffing the bacteria. "They'll tell you that a colony should smell a certain way, but you'll sniff it and go 'that smells nasty!'". At least I knew that my nose wasn't completely defective.
5. Beer's Law
6. Don't Light Yourself on Fire
7. The Cloned Dinosaur Ate Your Clone
8. Laboratory Murder Mystery