7 Sep 2015
First and foremost, I am a professional. I've been around ever since it was discovered that our blood holds deeply complex secrets about human health. Today, thousands of tests are performed on the blood I carefully extract from dozens of patients every day. I perform venipunctures and capillary punctures, two very specialized and highly detailed procedures that are not as simple as I make them look. It took years to perfect my technique, but I make it look like there's nothing to it. I own phlebotomy. I live it, I breathe it, and I have built my professional life around perfecting it as an art form. My art is phlebotomy, the most commonly performed invasive procedure in healthcare. It's conducted on every newborn within the first hours, and performed throughout life until the final breath is drawn. Because of the procedure I have mastered physicians are able to assess wellness and disease, monitor and adjust medications, treat life-threatening infections and conditions, and orchestrate the activities of nearly every other healthcare professional involved with every patient I draw. Although many attempt diminish my expertise by calling me "just a phlebotomist" or referring to me as simply "lab," the truth of the matter is without me healthcare cannot function. Physicians can't diagnose, nurses can't medicate, surgeons can't operate, hospitalists can't consult, and laboratory scientists have nothing to test. I am indispensable. Despite my importance to every patient, practitioner, and laboratory scientist, my earnings are among the lowest of all healthcare professions. Adding insult to injury, I lack respect from those whose livelihoods depend on what my expertise provides. I provide it regardless. That's because my rewards come from within. Every patient I encounter gets my A-game, the only game I have. At the core of my being is the stark realization that if I don't sweat the details every time I draw blood, I can change how my patients are managed, even in ways that can end their lives. No lack of recognition will diminish the satisfaction I receive by knowing my contribution to every patient's care is incalculable. Realizing my patients' diagnosis, medication, and management depends heavily on my grasp of the procedure, and that most medical decisions are based on the quality of the samples I draw and submit for laboratory testing affirms for myself I'm doing meaningful work. Others may minimize my importance, but I never will. I am a professional. I am a perfectionist. Phlebotomy looks deceptively simple. But beneath the surface are hundreds of details that, if not learned, retained and practiced, can wreak havoc on the patient, the sample and the results the lab reports. Details like preventing nerve injury, mixing tubes slowly and deliberately, not letting the patient pump his fist, reclining patients who have a history of fainting, filling each tube fully and in the proper order, assuring test requirements are met, taking plenty of time to assure bleeding from the vein has stopped before bandaging, and preventing the myriad ways a sample gets hemolyzed, contaminated or otherwise corrupted. If you don't have perfectionists drawing blood samples, you don't have accurate laboratory results and patients get hurt. Some die. Because I'm a perfectionist, I can quote the standards and our facility's procedure manual by chapter and verse. I don't make exceptions to the rules. If my next patient is my sister, I make her tell me her name. If she wants me to look up her baby's last bilirubin result, I tell her to ask her physician. If she wants to leave before I bandage her, I make her stay until I know the bleeding has stopped. And if she's not my sister, I treat her as if she were anyway because everyone is someone's loved one. I realize the standards are not merely suggestions, but a well-established process based on the body of scientific knowledge and input from reputable authorities. I don't add my own flair. My flair is the standard of care. I'm a perfectionist. I am a phlebotomist. I've worked under many titles over the years. Although the term "phlebotomist" did not emerge until the mid-1900s, every physician, nurse, medical assistant and healthcare professional who ever took blood from a vein has been a phlebotomist, at least for the duration of the procedure. Attempts to eradicate me by giving my procedure to other professions rarely succeed because the complexity of what I do is so vastly underestimated. I've been shuffled around to other departments, had my name changed to "patient-care assistant," and given a multitude of other tasks. Change my title if you like, but I will always be a phlebotomist because I specialize in the procedure my profession was born to perform. Because phlebotomy is a gateway profession, the doors to many other healthcare professions are wide open to me. The option I prefer, though, is to stay right where I am. I know my work is critical to every patient. I also know not everyone who goes by the title is as dedicated to patients and sample quality as I am. I love my patients too much to let just anyone else draw their blood. I am uniquely qualified to do my job. I make dozens of decisions in the course of every draw. I call on my vast understanding of the standards, the nature of laboratory medicine, and my impact on the quality of care every patient receives. Most of all, I call on the burning desire to help people get well and stay well. My work is noble. My work is important. My work directs the healthcare decisions of every patient I serve. I am proud of what I do; even more so, I am humbled by what I get to do. I'm a professional. I'm a perfectionist. I'm a phlebotomist. This article was adapted from "Characteristics of a Valued Phlebotomist" written by Dennis J. Ernst and published in the June/July 2015 issue of Advance for Medical Laboratory Professionals.