Thursday, February 18, 2016

Blood draws in four-legged and two legged children.

Unfortunately, this week my family had a minor traumatic medical experience.

First, to give you some veterinary info on blood draws-  Some owners want to be present when their beloved pet is getting a blood draw.  I don't really recommend this.  Unless your presence significantly calms your pet, your presence could just add more anxiety for all around.  There's something about the nervous energy of an owner who doesn't want to see their family member get hurt that makes the experience more stressful for everyone.  Then there are those pet owners who pass out at the sight of the needle.  That's the last thing we want to have to deal with, we don't need human patients in addition to our furry patients.

I sometimes ask to take pets in back because there is better lighting in the back and you are out of the room with all the stress pheromones.  Some people get nervous having their pet out of their sight, but really it can be better for them.  As a matter of fact, I often have my colleagues take my own pets to a separate room from where I am so they don't pick up on my stress, and I'm a vet!

Sometimes people will ask us, the veterinarians, to draw blood on their pet instead of a staff member.  I will be honest, they are often quite a bit better than I am at it because they have more practice.  In a well-managed, well-staffed hospital, I rarely do blood-draws.  Sometimes,  I am the phlebotomist of last resort (staff like to do this, because often if I'm doing a blood draw on a 2 pound kitten or other difficult to do patient I will quickly figure out a way to decrease the amount I need and be strategic about testing).  Most of the time our veterinary nurses are a lot better than doctors are because they just do it so much more frequently.  I typically am busy diagnosing, coming up with a treatment plan and filling out paperwork, so adding doing a blood draw to my tasks just puts me behind all the more.  I typically have a two-poke rule.  If I haven't obtained a sample in two pokes, I move on to a different person to do it.

So those are just a few pieces of info about blood draws in the vet world.  I would say our profession is particularly good at what we do.  We have to obtain laboratory samples from all sorts of species and all sizes and we can't explain to them that we are actually trying to help them.  We probably are similar to the pediatric profession in this type of way.

To get back to my two-legged child.  He had to get his blood drawn this week.  I had strategically scheduled the blood draw so my husband would be present to help and that it would be done at a facility that specialized in pediatrics.  Unfortunately, we were told that our insurance explicitly told our doctor they were not allowed to do the blood draw and we had to go to a corporate service.  I was not happy about this.

The last time we did this it didn't go well and I had had personal experience with this company that was not good.  It made me understand my patients' plight a lot more and vow to be even more compassionate to them.  The lady had been poke-poke poking multiple times into my arm, and stabbing and doing "search and explore", a technique I vow not to use.  She did this and I was bruised for a week in that arm.  I used all my patience and self control not to hit her.  She then looked at me and asked, "does that hurt".  Fortunately, I'm not in the habit of using expletives, but in her case I was tempted to.  Anyways, this corporate service was not one I wanted my son to have to go to.  The doctor explained if we didn't go there, it would cost hundreds more out of pocket.

So we made an appointment and we went there.  They didn't even have a changing table in their restroom to change my son's diaper.  Then we finally went back for the blood draw.  Initially when we were there, I told my husband we should treat our son to something special, maybe Krispy Kreme or going out to lunch, he needed some type of reward.  My husband didn't seem enthusiastic about this.  He sat down and then my son sat on his lap, fortunately not remembering his last experience.  The lab technician came in, and speaking Spanish to another coworker, was talking about how she was afraid to draw blood on my son.  She, like so many others, didn't know that my husband and I understand Spanish.  My two year old even knows how to count to ten in Spanish.

I was in a mixture of shock, anger and trying not to pass on my fear to my son and husband.  The technician tried to get blood on my son and my son went hysterical.  Understandably so.  She only got a little bit of blood and then stopped.  She told us we would have to go across the street to the hospital (not where our insurance wanted us to go).  I tried to tell her that wasn't an option.  Then my husband told me I was the medical person, so the decision was on me.  I didn't want him to have to go through this whole experience again, so I told them to keep trying.  Fortunately, two technicians walked in that looked like they had more experience behind them.  Success.  Needless to say though, throughout this process my son ended up getting Cheeburger, Cheeburger, a vanilla shake and Krispy Kreme's promised to him.  He collected.  We thought we would get out of the Krispy Kreme promise, but our son has a good memory and he was brave, so he got what was promised.

I had been very upset by the experience and called the lab back up and asked to speak to the manager (who happened to be one of the two techs that came in and were successful).  She felt awful about what had happened and was grateful for my feedback.  She said she was going to deal with it right away.  She also told me you ALWAYS have the right to ask for the most experienced tech and that in the future we should always ask for Lynn.  That is what we will do from now on and hopefully this lesson might help you.

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