The art and science of drawing blood

ALPENA – From the snap of the sterile gloves to the final thank you, more than 25 steps are involved when a phlebotomist draws blood from a patient. Even the hand positions are choreographed and the words are scripted to make the process smooth and efficient, Nancy Erickson, a Detroit educator, said.

She was in Alpena this week to teach seven area residents the art of drawing blood- a valuable skill needed in many fields, including medicine and sports, law enforcement and blood donation drives.

But it isn’t easy to maintain a professional demeanor when unrolling sticky tape with gloved hands for the first time. So Erickson used a combination of compliments, encouragement and coaching to train three men and four women in a classroom at Alpena Community College.

“I learned on patients, unfortunately,” said Erickson, who started drawing blood in 1992 while assisting a dietician at a Dearborn hospital.

“I was nervous the first time,” she said. “I was intimidated and most importantly fearful that I would hurt the patient. I was providing an invasive procedure on a patient sticking a sharp needle in a person’s arm.”

Since then Erickson has drawn thousands of samples, and in the last 13 years has taught thousands of students. Her experience is so extensive, she also is a budding expert witness, providing testimony nationwide in court cases involving phlebotomy injuries.

During Tuesday’s six-hour session at Van Lare Hall, students worked in pairs to rehearse the procedure over and over in mock sessions. They were scheduled to begin drawing each others blood during the evening session.

One student sat in a chair and extended an arm, while another practiced the protocol. But instead of puncturing the skin, a plastic tube just under the surface of a foam rubber cylinder served as the target.

When nuclear medicine technician Kevin Szymanski took his turn, he stood in front of fellow student Stacey Snyder and identified himself quietly. Following the protocol set by the Clinical and Laboratory Standards Institute, he checked Snyder’s information as the patient, then asked her for a few minutes so he could prepare. When ready, he pretended to apply a tourniquet, then felt for a vein in the mock arm with his gloved hands.

“You’re going to feel a poke,” he said.

But instead of touching her arm, he inserted a needle into the tubing, changing out mock tubes.

At one point, Erickson gently stepped in, encouraging him and adjusting the position of his fingers slightly to support the vial.

Even the final step, thanking the patient, was important. Erickson watched, praising another student and then reminding her to look into her mock patient’s eyes to make sure he wasn’t light headed.

When one student struggled to unspool some tape while wearing rubber gloves, Erickson bent closer.

“I love it when people make this mistake,” she said gently.

She repositioned the student’s pressure on the needle, freeing up several fingers. With more digits available, 20-year-old Katie Habermehl was able to tear off what she needed.

Beginning phlebotomists can make $10 to $13 an hour, Erickson said. To be certified, though, they must complete 120 hours of training, perform 100 blood draws under supervision and pass a national test.

The most important skill is professionalism, Erickson said.

“Professionalism comes from the heart, because sick patients want kindness and caring and gentleness,” she said.

Betsy Lehndorff can be reached via email at or by phone at 358-5693. Follow Betsy on Twitter @bl_alpenanews.