Officially a Trained Phlebotomist

I have finished all my training for my new job. I started November 7th, 2016. UBS trained me in two parts. The first part is called interview only training, which involves being trained in class for 3.5 weeks in class, 2 weeks in the field with a trainer, and 2 weeks in the field without a trainer. Interview only is the process of determining if the donor is eligible. 
This is an intensive training in using the computer program and checking the donors vitals. You must enter a donor into the program, update their demographics or create one for new donors, register for their donation, and then proceed in reviewing their medical questionnaire. Once that part is finished, you take their vitals, blood pressure, pulse, and check their hemoglobin levels in a finger stick. If there are any questions or vitals that don't fall into our requirements, I must defer the donor for a specific amount of time required for that particular trait. If they do meet all requirements, then I take them, their paperwork, and a blood bag to the phlebotomy area where the phlebotomist takes over. Training for this reminded me much of being in college. A lot of information is bombarding your brain and exhausting your body. It's a clusterfuck of things to take into account, it requires a great deal of critical thinking, observation, and computer skills. I absolutely loved this part. It's all nerve wracking but for a good cause. After being out in the field I started to feel more and more confident. I love it because I got to meet and talk to several dozen of people everyday. It is also nerve wracking because you must not make any errors. Errors are a big deal in this job. It is very important not to send people away that actually are eligible and even more vital not to take donors that are in fact not eligible. The best and easiest way to describe this is basically the FDA considers blood going to a patient to be medicine, therefore it is regulated by the FDA, if you take blood/medicine that is no good and give it to a patient that is in great need of blood, you could compromise the health of that patient. That is an enormous responsibility. There are many circumstances to come across that may require you to get a second set of eyes to make sure you are doing the right thing, but regardless, your name is on that stamp of approval and if you have done something incorrect, it falls on you. Everything is tracked.

I have learned so much. Here's some things I've learned: vital numbers actually mean something to me now. I know what is too much or too low, granted each individual has their normal rates. I understand blood volume and hemoglobin. I have learned about diseases that I would have never been able to pronounce in the past. I have a better understanding of each blood component, red cells, platelets, plasma, etc. I know that people that get paid to donate plasma are only donating plasma to be tested by other companies whether for medicines, cosmetics, etc. and that blood does not help patients directly. UBS and Red Cross are blood companies that give blood to local and other patients in need of blood. I also know that we are always in short supply of blood. I also know that UBS is not for profit, thus everything is not as good or as advanced as it could be. You have a computer program that only has so many limits and a human has to work with that program, therefore errors still can exist. Which is unfortunate, but has still come quite a long way from the past.

After all the interview training and fieldwork, I went back to class for phlebotomy training. In class training was only for 1 week to learn the computer program used for that and some techniques on actual phlebotomy. The act of taking blood isn't something you can learn in a class, thus they put you in the field with a trainer for 2 weeks in hopes that you get at least 50 sticks. By the end of my field training, I got 55 sticks. We worked in a center where the donors are frequent and regular. Most donors are willing to let trainees learn on them, but not all. I was insanely nervous at the beginning. My nerves were intense and caused me to be shaky. Thankfully, the only time I was not shaking was when the needle was in my hand. Setting up the blood bag, the shaker, the paperwork, and the computer program (known as the PDA), was where I my hands where shaky. I was graceful enough that I don't think donors noticed. I also got some good feedback from donors. If we ever come across a difficult vein, we could ask our trainer to do it instead. So long as the donor had a good vein, we had to attempt phlebotomy. My trainer was very good at her job, she's been doing it for 20 years, but she only sometimes gave critical feedback, it was something I had to specifically ask for if I did not have a successful stick. I'm proud to say I did not hurt anyone, bruise them, infiltrate veins, or give them a hematoma. I did not contaminate any units as far as I knew either. As I heard from my trainer, I tended to put my needles in at a deep angle, part of that is my left handedness, but I have improved on that. My trainer gave me challenges whenever the opportunity presented itself. There was one particular donor that had thick arms and a vein that was somewhat deep, she told me, knowing my skills, that I could do it. I did it with no problems. During my training, I did have one donor who had a reaction. He felt ill during his donation and I had to pull the needle out early. Unfortunately I did contaminate that unit only because I didn't know that it could of still been useful. But now I know what to do.

I finished my training and then went out on mobile drives without a trainer. This past week was my first out on my own. I am mobile staff, but most my experience so far as been at fixed centers which run quite different from mobile drives. Mobile drives require staff to meet at a fixed location, or headquarters, and we then drive a truck to the where ever the drive is held. We usually stop at a QT and have our 30 minute lunch break, and this is could be at any time of the day. Most shifts start very early in the morning. I've woken up as early as 3am. Lunch break that early in the morning is definitely something to take time to get used to. Once our lunch is over, we drive to the site, unload the truck, set up all the equipment, and start taking donors. The assistant supervisor is the boss of the drive, they assign staff to start at either interview or phlebotomy, and then if we manage to get a 10 minute break halfway through the drive, we switch positions after the break. If the drive is busy, we may not get a break, but they usually try to switch your position at least. We are supposed to stop taking donors at a predetermined end drive time. But we must stay until all donors are done donating or until any donor that is having a reaction feels good to leave. Then we break down all the equipment and load up the truck and drive back to headquarters, clock out and leave. There are several drives everyday and cover the entire state. We tend to not go to Tucson very much as Red Cross is located there. Some drives are even out of town and require us to stay at a hotel for up to 5 days. If I am correct at reading my schedule, I'll be out of town for 1 to 2 days this upcoming week. I'm personally looking forward to out of town drives because I love hotels. Granted this can be hard on employees that have families at home, but the only arrangements I need to make is to make sure my guinea pig is fed while I'm gone.

As far as my personal adjustments and mood state is going, I'm doing a fair job. I'm already used to the strange and varying hours. I wake up usually between 3 and 5am, I pack a snack for my break or for the hunger that usually strikes me at the end of a drive. I only have to drive 4 minutes to headquarters which is a big plus. I haven't had much of a personal life since I started though, I'm fully immersed so I'm only sleeping and working so far until I get used to this. My hours are different everyday and can change every day too. So my schedule is far from fixed. If I am able, I still work with my cousin's kids between once or twice a week or sometimes not at all. I always plan my time and get plenty of sleep every night. I have had to go to bed as soon as 7pm, which isn't too bad so far. The nice thing is getting off during the day, so if there are things I need to do or appointments to make, I am able to do them after work. I get one weekday off and one weekend day off and those are fixed unless I volunteer to work extra hours. The biggest adjustment that I only have so much control of is my stomach. My IBS, in the past, always flares when I wake up very early, typically before 6am. But now I can see that my stomach is getting used to it, thank goodness! I do take medicine everyday to calm my insides. For the most part I can find my way to a bathroom but not always in the most convenient of times. I have been very careful of what I eat while I work and I do not drink alcohol during my work week. Alcohol always affects my stomach, so I've just quit as much as I can. I only drink on the weekends and I can already tell that I can't handle as much alcohol as I once could because I've cut down so much. So far I always by food at QT for our lunch breaks because my appetite is very limited so early in the morning. Once my body gets more accustomed, I plan to make my lunches. But that also will require a whole new food preparation process. Because we eat our lunches essentially in the truck, we don't have access to a fridge or microwave, this limits my options. I did purchase an amazing lunchbox that keeps food cold for about 12 hours, and if we do stop at QT there are microwaves there, or I can microwave my food at headquarters before we drive. These are my options. Salads and sandwiches are the best choices but not things I tend to be hungry for at the wee hours of the morning...yet.

Since starting this job, I've been much happier. I am less stressed and feel light. There were days, of course, where I felt overwhelmed and very anxious, but that's part of the adjustment. Plus, I've passed my training with flying colors so I no longer have to worry about keeping my employment as much. Everyday proves to be a new challenge, yet it is new, and still not nearly the unwavering eternal stress that I dealt with at my previous job. I've overcome so much that I'm stronger now. The challenge I face still is meeting all the staff and learning to work with them. Donors are pleasant enough most of the time. The staff, in general, are helpful but a majority of them are immature. I keep to myself when I can and stay on people's good side the most I can. I also have to let them know that I am hard of hearing, which it can be difficult to hear others in our environments and people move much quicker than I can since I'm so new. Most of the staff have heard of me prior to meeting me because my cousin who works there has told a lot of them about me, so that gives me a bit of an advantage. It's nice having someone on the inside that I trust too, at least once a week I text my cousin and tell him how I'm doing, ask questions about the job and about the people I've worked with. He is invaluable to me. Him and the other new girl that I've been trained with are the only people I trust so far with the exception of my two trainers who I will rarely see in the field. It also needs to be reiterated that the benefits this job offers are wonderful, I cannot wait to take advantage. The pay is much better than when I worked at the school, but it finally dawned on my that I still took a pay cut since I no longer work two jobs simultaneously each day of the work week. I have to rework my budget and make adjustments in that aspect too. Oh! I almost forgot, I also donated blood for the first time a couple weeks ago while on my shift. So I got paid to donate, in a way. I donated platelets and red cells. It took me 88 minutes and I experienced very little symptoms and went right back to work after.

Phlebotomy is still a skill I'm working on. I still need help if I don't get blood flow, I have made mistakes still, but as my trainer reminded me over and over, it is a learned skill. It will take time. I'm still very nervous about it and generally mentally avoid it, but it is something I have to overcome. Saturday is the end of my work week and that was the first day where I really did an overall great job. I got the most donors in one day than I have so far, I helped a donor overcome a reaction, and I air contaminated a unit for the first time too. Oh well. Learning process. Another important note about phlebotomy is that if the donor is noticeably nervous, it affects me strongly. Typically these things don't bother me if I know the person will be fine, such as during the interview process it's easy for me to calm donors down and not feel affected by their fear of the process. But when I'm about to put a needle in someone, my empathy is working too well and I have to stop it so that it doesn't affect my performance.

So that about sums it up so far. Blood is still very awesome and I love seeing the boxes we fill of blood that will help lives. I cannot wait to donate again too.

No comments: