Wait for interviewer to ask first question…
Phlebotomist Response 1: Morning labs are ordered by the provider for the 5:30 AM “bulk draw”. The “bulk draw” means all the labels we stick on tubes print at 4:00 AM, an entire ward of patients is drawn, marked as complete in the computer, and then all the blood is sent to the lab for processing at the same time. It sounds archaic, but our computer system is so old it takes too long to mark each individual patient’s blood draw as “complete” in the morning. If we did that, it would take an additional 3-4 minutes per person. To get around this we group an entire ward together and mark that whole unit as “complete” at once and remove the 1 or 2 patients who might not have been drawn due to being off the ward. The downside is that there are up to 20 patients on one floor so the first patient’s blood might have been drawn 1-2 hours ago and still be sitting on the cart waiting to be sent to the lab.
Wait for interviewer ask second question…
Phlebotomist Response 2: There’s a few important things to know. All blood draws and IV’s are done by a phlebotomy team and not by bedside nurses per our union contract. Phlebotomy staffing is split into two shifts, night and day shift, both of which are 12 hour shifts that begin at either 5:00 AM or 5:00 PM. Three phlebotomists are assigned to the night shift, five are assigned to day shift. We’re a bit short-staffed right now as four phlebotomists recently retired. I looked at some data before our meeting and in the past 6 months, on an average morning, we draw blood from 72 patients. When we have a full staff of 5 phlebotomists then we are each assigned our own ward. When we arrive at 5:00 AM, we get our assignment, prep the lab draw cart which takes about 15 minutes and head off to begin collections by 5:30 AM. We each draw our entire ward of patients. If any patient isn’t in their room we usually check again before we leave the floor and if they still are not present then we complete a rollover slip and retry again at the 10:00 AM bulk draw time.
Wait for interviewer ask second question…
Phlebotomist Response 3: The night phlebotomy team is on until 5:00 AM and the bulk draw labels print at 4:00 AM. This means there is an hour of their shift they can help out. It’s poorly managed, however, there are no real “rules”. Typically, the night shift phlebotomists each choose five patients at their own discretion on which to draw labs. The night shift phlebotomists cherry pick the easy patients. You know, the patients with a central line or something. They also “count” an attempted draw as one patient, even if they were not successful. So they may only end up getting blood from 3 patients with central lines and have 2 “attempts" and they are done. It’s not uncommon for the night shift to only draw a total of 6 out of 80 patients who need labs for the bulk draw.