Wednesday, February 01, 2006

Johns Hopkins Knows Where You Live

Was at JHU yesterday getting my bone marrow groove on. Unbelievable medical facility, unbelievably smart doctors. Not so great phlebotomy, but we'll get to that later. The major point of this post is that JHU has a Spielbergian card ID system that lets them know where you are at all times in the building. You are given a card with a barcode at Admitting and every time you enter a room or clinic or department, you have to run it through a card reader that then reads out "Thank you, First Initial-Last Name." And then as if by magic, people come out of a door and call you in before you even have your butt in the waiting room seat for 5 minutes. Now, I'm all for efficiency, but how can you trust doctors who DON'T make you wait 2 hours to see them?! Are they just in the back doing sudoku puzzles until the card reader tells them that you have entered their air space? How can such (albeit kinda creepy) efficiency be permitted in American medicine?! These madmen must be stopped or else Americans will start to actually think that they are entitled to doctor's appointments that aren't synonymous with 3 hours of reading outdated Field and Streams sitting in chairs manufactured circa Ollie North's congressional hearings.

So back to the phlebotomy. I didn't get a chance to eat my breakfast bar before getting called in to phlebotomy, so I was getting blood drawn on an empty stomach. I've done it before, so it's generally no big deal. But this time I got That Lab Tech. You know The One. The one, out of all the phlebotomists, who just basically sucks at drawing blood from other humans' veins. Think about it. Every industry, every office, every department of every company in America has The One; the person who is skating by, not quite competent, but managing to muddle through regardless. The only difference being that their job is not to jam needles into the veins of other humans at 7 freakin' AM, so they can stay under the radar without necessarily doing a great deal of harm to themselves or others. Not so the phlebotomist. She was nice enough, but almost in that studied way that belies her hope that perkiness will make up for incompetence.

First the right arm. Puts the needle in while giving me a play by play: "okay, deep breath, big pinch, I'm in!" I was like, "are you telling ME or are you telling yourself?!" She then proceeded to narrate to me how the needle was just "bouncing off" my vein and not actually penetrating it, so just hang on and we'll "reposition" it. Reposition. Sounds kind of strategic, doesn't it? Like how the Pentagon would reposition troops or perhaps an armored aircraft carrier. Methodical, strategic, precise. Yes? Yeah, NO. By "reposition" she meant "root around in your arm for any part of the vein I can catch." It was horrifying. I have had so much blood taken, so many needles in so many places, but even I was starting to feel unwell. I finally said, "how about we try the other arm?" She almost relievedly said yes.

So we go to the left arm. I'll spare you the play-by-play by just telling you to reread the previous paragraph. At which point I was REALLY not feeling well and said so. Unfortunately, I wasn't feeling well enough to say "I'm feeling Barfy Lightheaded as opposed to Passout Lightheaded" so she calls for help and they shove those smelling salts under my nose which of course almost ENSURES that I'm now definitely going to barf, which luckily I didn't. During this time she has managed to get some blood into the vials and I am walked over to a bed where I can lay down in all my Lightheaded Shame to recover.

Alas my suffering was not yet complete. Apparently she had drawn my blood into the wrong type of vial. Different tests require different types of vials, some with certain proteins in the bottom to react with the blood. That is why each type is clearly marked with a particularly colored cap. Purple for one kind of test, green for another, etc etc. Apparently, Perky Phlebotomist drew my blood into a green top rather than a purple top, thereby rendering the sample useless. Oh dear god. Timor mortis conturbat me. Get me out of here! This woman's gonna kill me! Finally another phlebotomist came over and drew my blood, managed to find a vein first time, drew the blood without incident, and told me, "You got to eat before getting your blood taken, baby. I am so sorry about this." She was sweet and I could tell she was not happy with Perky Phlebotomist, a feeling I wanted to further inflame in the hopes of getting her fired.

Really! How can you be a phlebotomist and not be adept at taking blood?! In the past 5 years I have never had a phlebotomist at a major/leading medical institution require more than one stick to get what they need. There was one woman at NIH who stuck me (and I assume others) three times, but I never saw her again after that day because NIH "disappears" you if you don't get your sh*t together. Think about it, if your life's work involves putting needles in someone's arm to get blood and you can't actually do it--even and especially the challenging ones--why are you there? Shouldn't you go sell shoes or something? Especially something like phlebotomy which is generally (after Admitting) the first place all new patients have to go and which therefore sets the tone for the patient's experience at your institution, and which requires people who are most likely already suffering enough to undergo further physical pain. It's almost morally incumbent on a medical facility to make sure their phlebotomists are at the top of their game. After all, I can make an attempt to somehow dodge the Orwellian Human Locater Machines, but I cannot dodge the phlebotomist.

1 comment:

Joe Tornatore said...

i must be living in the last century. Spielbergian card surprised me but then again, my daughters just explained what sudoka was only yesterday.