Blood Tests - Buttefly Needles

Any phlebotomists out there? I am curious about something...why do phlebotomists get mad at me for requesting a Butterfly?

I have horrible deep veins that do not like to cooperate. Before I found out about Butterflies, every time I'd had blood drawn, they'd miss or go clear through the vein, they'd dig around in my arm with the needle hoping to find the vein, and/or I'd end up getting stuck in both arms and the back of the hand, and I'd leave with nice big bruises or hematomas. I gave up on donating blood because many times they couldn't get a good enough stick to collect a full unit of blood. But since I've been asking for Butterflies, blood draws are a piece of cake! They always hit the vein on the first try and I get a lot less bruising.

So am I out of line for asking? I ask nicely. And I'm not trying to imply that the phlebotomist doesn't know what they're doing. Here was the response to my request this morning:

<sarcastic tone> Well, if you INSIST that I use a Butterfly, then I guess I have to. I've been doing this for 22 years, but it sounds like you're the expert.

Nice. Anyway, I guess I was insistent enough because she used one and hit the vein right away and I only have a quarter sized bruise.

I have to have blood taken a few times a year and usually they can do it on the first or second attempt with a standard needle. However, last time she had to use a butterfly needle and seemed pretty put off by it. What I noticed was that it took a little longer to get the amount of blood that they needed.

I am just guessing here of course, but maybe it is because it takes a little longer and/or they feel "inadequate" because they couldn't do it the normal way. In fact when she could not use a standard needle despite multiple attempts on her side and pain on mine she said "I guess we have to use the needles we use on babies" :( Thanks for making me feel comfortable

I had a phlebotomist tell me I should always ask for butterflies.

Took me a while to learn the best way for me to ask, and now I each time I have a draw I run down my spiel:

"My veins are very thin and rolly, but they do work. I've been told I should always ask for a pediatric needle, but use whatever you like. My veins do work, really."

Since developing my spiel, I always get a butterfly needle. Before, when I would ask specifically, half the time they'd ignore me and start with a regular needle and make a horrible mess (I tried to pass out more than once) and then have to use a pediatric anyway.

Maybe Rollie you're one of the occasional patients who asks for something so specific. I wouldn't get angry at the person drawing your blood. Not worth it.

It's not fair of us to judge so harshly for people who must deal in their daily work with physical sensitivies and pain (however slight) of their clients/patients. Most times, the workers are trying their best. Best be respectful of their nature of their work ...for little public glory.

One of my sisters worked for several years as a receptionist for one of the blood testing lab companies right in the heart of downtown Toronto amongst several major teaching hospitals. They dealt with alot of patients who can't stand having their blood drawn for minor tests. Patients who faint, who don't listen to instructions, etc. All kinds of stories.

I dislike having my blood drawn for testing. I cannot even look at the blood sucking up in the vials while it's being drawn from me. I have not donated blood for many years now, partially because I don't like things sticking inside of me and also because of my slim weight/history of occasional anaemia, I should not give blood.

I have small veins that are difficult to find in my arms to stick in any needle for blood drawing. (vs. my veins on my upper hands which bulge out in heat, like right now.) A few weeks ago, the lab technician gave up trying to locate a spot on each arm. She drew blood from 1 arm for 2 sets of blood tests within a 2 hr. period, which meant poking a 2nd hole in same arm. (it was for glucose level testing, iron testing, etc.)

i used to always ask for them too. I used to argue when they said they didn't have them.
They're nice, I agree. Now i usually just get my finger stabbed. better all in all.

Quote:

---

Originally Posted by KnottedYet

I had a phlebotomist tell me I should always ask for butterflies.

Took me a while to learn the best way for me to ask, and now I each time I have a draw I run down my spiel:

"My veins are very thin and rolly, but they do work. I've been told I should always ask for a pediatric needle, but use whatever you like. My veins do work, really."

Since developing my spiel, I always get a butterfly needle. Before, when I would ask specifically, half the time they'd ignore me and start with a regular needle and make a horrible mess (I tried to pass out more than once) and then have to use a pediatric anyway.

---

Good point...maybe I should develop a new way to ask. Or maybe I should ask my doctor to write it on the lab order.

Today I basically said "I was wondering if you could please use a Butterfly. My veins don't like to cooperate...they like to roll and collapse...and it seems like butterflies really help with this". Then after her reply, I told her how I've had trauma in the past with multiple sticks and hematomas and nerve pain up and down my arm and that Butterlies seem to prevent these problems. But by then it was clear she was super annoyed.

I'm sure phlebotomists feel especially under appreciated...they work on strangers for 2 minutes and never see them again, and most people don't look forward to being poked with a needle. However, I wasn't being rude or demanding or unreasonable, and afterwards I did thank her and tell her how much I appreciated that she used the Butterfly. So I'm not sure I'm being judgemental. Although I guess I don't understand why a healthcare professional would have a problem with doing something quick & easy to prevent their patient from suffering.

Rollie, I could have written your original post. I always have trouble with blood draws, although no one has ever mentioned using butterflies. I will never forget when I was in labor with my daughter and the nurse was trying to find a vein so they could give me an epidural. She tried 4 times and the vein kept disappearing. I finally told her to stick the damn thing in my neck if she had to. They ended up having to go for a vein in my hand. Its a real bummer because I have O neg blood and they always tell me I should donate because I am a universal donor. If blood draws weren't so hard, I would happily do it.

Another good trick for the thin veins is to put a hotpack on the spot they want to use for blood. I had a phlebotomist once look at my elbows and say that neither was gonna work, even with a butterfly. She whipped out one of those instant hotpacks and put it in my elbow, said "Don't leave!" and came back a few minutes later.

The elbow was much more sensitive, but the heat made the vein big enough she could get it. I only had a little bruise from that one.

Also try drinking extra water for the hour before the draw to avoid any possible dehydration and running up and down the steps a few times to heat up before you walk in the lab. (more tricks phlebotomists have told me over the years)

I just wish they could draw from the big varicose vein in my leg... I keep offering, but they can't use it, darn! :rolleyes: (risk of throwing a clot is too high)

Quote:

---

Originally Posted by ttaylor508

Rollie, I could have written your original post. I always have trouble with blood draws, although no one has ever mentioned using butterflies. I will never forget when I was in labor with my daughter and the nurse was trying to find a vein so they could give me an epidural. She tried 4 times and the vein kept disappearing. I finally told her to stick the damn thing in my neck if she had to. They ended up having to go for a vein in my hand. Its a real bummer because I have O neg blood and they always tell me I should donate because I am a universal donor. If blood draws weren't so hard, I would happily do it.

---

Wow, so we're kindred spirits in the blood draw department! I hope you can try a Butterfly the next time you have to have blood taken. I also have O- blood and I'm CMV negative (cytomegalo virus...not sure on the spelling) so I can donate to preemie babies. I too would happily become a blood donor again if there was an easier way to get blood out of me!

Gah, the blood center called me yesterday asking for blood (O+).

I'm always a "challenge" for them. Oh well. Beggars can't be choosers ;)

What Knott said works well for me - drinking lots of water beforehand. At least then they have a better shot at my veins.

I'll also try the jogging trick, thanks.

I'm a certified phlebotomist, though I don't do it much. I trained with the ladies in the lab who just stick people for 8 hrs a day. Some of them for some reason get ornery with patients they can't stick like everybody else- and some of them are really good and don't need butterflies even for rolly veins. Some are just ornery because they have to stick people 8hrs a day (not a very appreciated job!) But if you request it, we would do that. There are pluses and minuses to both types of needle- butterflies aren't as long, so if it's truly a deep vein, they might not reach. They also require a bit more coordination. I think the main reason they hurt less is the needle itself it a higher gauge (lower diameter) than standard vacutainer needles.

Best advice is like Knot said- drink lots of water! After my training, I'll look at the veins in the backs of my hands sometimes any they're just shriveled! No way a phlebotomist can get blood if someones that dehydrated. Best to stack the deck in your favor.

Phlebotomists are people- sometimes we miss and we hate when that happens about as much as you do, but it's our job to get the blood and try not to waste too much of your time doing it. And I have been on the receiving end of a horrible phlebotomist when I was really little and didn't understand, so I hate having it done too. I think it makes me better at doing it as painless as possible because I know how much it sucks when it goes wrong.

Anytime I've had blood taken I do the same. I've only ever heard "oh wow your veins are teeny!" or "wow, you were right, your veins do NOT like to get poked!" or something like that. They've never given me attitude or been snarky.

I'm sure my usual "oh WOW you made that look so easy and painless, much better than that one horrible time, thank you so much!" doesn't hurt either. My mom's a retired nurse, and I've learned throughout the years that it doesn't hurt to lay on the sweetness real thick.

Some phlebotomists just don't like to have any requests thrown at them. And some just don't like not getting blood on X number of draws. My PCP's phlebotomist refuses to draw my blood because she's never gotten a full tube successfully within her self imposed 2 tries limit. :confused:

On the other hand, I've been spoiled by infusion nurses.. they're the best :). They can find ANY vein, but even they need to stick multiple times on occasion. And the heating pad/hot pack trick is awesome.

From what they've told me, some people need the butterfly. Others don't. Some, like me don't do well with vacutainers connected directly--causes the vein to contract and quit giving blood. Seems most phlebotomists connect straight to the vacutainer because it's faster and less waste, so they think my veins just don't "give".

the reason butterflies don't hurt as much is because when you change from one vial to the next, you are not yanking on the needle, you're yanking on a flexible tube. That's why they're so great! (for me)

Quote:

---

Originally Posted by lo123

Some phlebotomists just don't like to have any requests thrown at them. And some just don't like not getting blood on X number of draws. My PCP's phlebotomist refuses to draw my blood because she's never gotten a full tube successfully within her self imposed 2 tries limit. :confused:

---

This is actually a standard procedure to protect the patients from undue harm. Not sure if it's law, but we all follow this guideline.

What are butterfly needles???

Quote:

---

Originally Posted by crazycanuck

What are butterfly needles???

---

http://en.wikipedia.org/wiki/Butterfly_needle

My phlebotomist is great and he said that he can use a butterfly needle for mostt things but if he needs to do specific tests it does require a larger needle because the smaller needle does something to the blood. I don't argure...I am just glad he uses them everytime without anyone asking. This is my oncologists office though and they see many sick people all the time.
Tina

Quote:

---

Originally Posted by mayanorange

This is actually a standard procedure to protect the patients from undue harm. Not sure if it's law, but we all follow this guideline.

---

Definitely not law... when I was in the hospital last year, I had one nurse try 4 times before calling in someone else. My mom was stuck 9 times recently...

Most phlebotomists/nurses I've had will either try 3 times or 2 and have someone else try the third. Was at my GP's office yesterday and she has a new phlebotomist--yay! the old one refused to even try last time I was there. :mad: Said she wouldn't try and that I had to go to the hospital (30 minutes away) to get blood work done.

Quote:

---

Originally Posted by lo123

Most phlebotomists/nurses I've had will either try 3 times or 2 and have someone else try the third. Was at my GP's office yesterday and she has a new phlebotomist--yay! the old one refused to even try last time I was there. :mad: Said she wouldn't try and that I had to go to the hospital (30 minutes away) to get blood work done.

---

Maybe that's why they have a new phlebotomist? ;)

9 times is a bit much- I have done 3 before, but it's usually try both arms, then resort to an obvious one on a hand.

Quote:

---

Originally Posted by lo123

Definitely not law... when I was in the hospital last year, I had one nurse try 4 times before calling in someone else. My mom was stuck 9 times recently...

Most phlebotomists/nurses I've had will either try 3 times or 2 and have someone else try the third. Was at my GP's office yesterday and she has a new phlebotomist--yay! the old one refused to even try last time I was there. :mad: Said she wouldn't try and that I had to go to the hospital (30 minutes away) to get blood work done.

---

My rule for IVs is three tries--if I don't get it in by the third stick, it's time to get someone else. I think that's pretty standard--not law, but a generally accepted guideline to avoid making our patients feel too much like human pincushions.

I worked as a phlebotomist in a large family practice. I never hesitated to use the butterfly when 1) it was a pediatric patient 2) the veins were very small 3) the veins were roly poly and 4) it was a someone who was about to pass out at the site of a needle. Anytime my patients requested a butterfly I was happy to oblige. I don't know why other phlebotomists would not accommodate their patient's request. :confused:

Coming in way late here, but the main reason is because butterfly needles have the highest 'stick' rate for health care workers. Don't know why, as I personally love using them, but among needle stick risks, this one is the highest!