Phlebotomists Answer the Call When Fluid Tests are Key

Phlebotomist Samantha Howell, left, and Clinical Lab Scientist Suzette Del Mundo load blood samples into a centrifuge in the NorthBay Medical Center laboratory.

Morning arrives early for hospital patients. Long before the sun is up, phlebotomists are making their rounds, drawing blood from nearly every patient before they have a chance to eat or drink.

These fasting blood samples, taken between 3:30 and 4:30 a.m., are delivered to the clinical laboratory for testing so the results are ready for doctors who arrive between 7 and 8 a.m.

Phlebotomists, also called lab technicians, are trained to draw blood from a patient for clinical or medical testing, and at NorthBay Medical Center they are available 24 hours a day.

Phlebotomist Samantha Howell has worked every shift during her eight years at NorthBay Medical Center. It’s a job she began right after graduation from high school, thanks to a five-month vocational program sponsored by the county. She is licensed by the state and must renew her license every two years.

“I found a career I love,” Samantha says. “My job is fast-paced, and every day is different.”

When she arrives at 6 a.m., her first goal is to help other techs finish their work and then she begins time studies. Time studies are performed when the blood has to be drawn on a patient at a set time. For instance, if a person is given a medication at 7 a.m., their blood has to be drawn before the medication is given and again at 7:30 a.m. to make sure they’ve received the correct dose. Some antibiotics and anticoagulation medicines fall into that category.

The lab has a rhythm built around physicians’ orders, sent via computer and printed out as labels in the lab. The labels are sorted by time sensitivity to build the day’s priorities.

In addition to drawing 20 to 30 blood samples a day, Samantha prepares it for examination by the clinical lab scientists. But she doesn’t just work with blood. Phlebotomists prepare all bodily fluids, including spinal fluid, joint fluid, urine, stool and abdominal fluid for examination.

Phlebotomists drop everything to respond to all trauma codes, as well as calls of Code Blue, Code Stroke and Code STEMI (heart attack).

“When I respond to a stroke code, for example, the blood sample I draw will tell the doctor how the patient’s blood is clotting so they know whether it is safe to give a blood thinner for a potential blood clot in the brain,” Samantha explains.

She has even drawn blood while a patient received CPR. “Trauma is different, every time,” she says. “When a trauma code is paged, we (phlebotomists) communicate with each other to see who can most quickly respond. If more than one patient is involved, a second phlebotomist responds.

“When we respond to a trauma case, we wait to see where we’re needed. If the trauma is severe and there is a lot of blood, we suit up in gowns and eye protectors. We work very quickly because the results of the blood tests can provide the ER physicians with critical information.”

Phlebotomists also respond to cardiovascular operating room patients. After a patient has open heart surgery, the lab is called and notified when the patient will leave the operating room. “At that time we go up to the ICU and wait for the patient to arrive,” Samantha says. “The nurse will draw the blood for us from their arterial line and we are required to bring it back to the lab, process it, and have it resulted in 30 minutes or less.

“Each day is different and brings new challenges. I’m still learning, every day. I’ve seen babies born and lives end and everything in between. It is all very special to me.”