By Darryal Ray
After spending almost half her life in the profession and training 300 phlebotomists how to do it right, one can’t blame Tracy Johnson for taking phlebotomy training seriously. To her, becoming a phlebotomist is the smart thing to do.
“I was born to this,” says Johnson, who underwent her first phlebotomy training 21 years ago when she found herself a divorced mother of two with few skills other than waitressing. “I love it.”
Now 44 and working for a 160-bed teaching hospital in northern California, Johnson often oversees the training of students interested in becoming phlebotomists. Some are nursing students; others simply walk in off the street and ask for a job.
But don’t think for a minute that just anyone can be a phlebotomist — it takes a lot of work, and in California, you’ll have to pass a state-mandated test to earn your certification. Without it, you can’t work in phlebotomy.
It’s been that way for about six years now, ever since a phlebotomist was found reusing needles after soaking them in bleach. “The company she worked for only gave her five butterflies a day, and if you have 40 patients … so, she was putting them in bleach and reusing them,” Johnson recounted. “Once they caught her doing that, they started the phlebotomy program in California.”
As a result, every phlebotomist in California must undergo a comprehensive training program. Some get that training in special phlebotomy schools; others get it at teaching hospitals like the one where Johnson is employed.
“There are a lot of different schools that do schooling for phlebotomy. Unfortunately, it can cost $2,000 to $3,000 for students to go to one of those schools,” said Johnson. “But if they were to come to us at the hospital, what we do is have them sign a contract that they’ll work for us for one year and we pay them while they are training. Once they pass their phlebotomy certification, we give them a $3 an hour raise. So the difference between a school and us is that we’re going to pay them while they are learning, and then we give them a big raise. All they have to do is sign a contract saying they’ll work for us for a year, and they don’t have to pay a dime for anything other than their license. They don’t have to pay for any schooling.”
Among the requirements are 50 successful “sticks,” including five pediatric sticks, 10 finger sticks, 20 hours of online training and another 20 hours of lecture. At her hospital, aspiring phlebotomists must pass three tests administered by the facility — and score 75 or greater on each — before taking the state test.
After that, students get two chances to pass the state-mandated test. Fail the first one, and you must wait three months to take the second. “And if you fail the second one,” says Johnson, “that’s it — you’re done. You’re not going to be able to work as a phlebotomist.”
Those who do pass the state test must earn six hours of continuing education units (CEUs) every two years to maintain their license.
On average, says Johnson, the whole training process takes roughly three months. “Some people fly through the training like it’s nothing at all, but it’s hard for other people — especially if they have no medical background because they have to learn the terminology and all,” says Johnson. “But we do have a lot of nursing students who work while they are going to school to become RNs (registered nurses), and it really helps them out a lot because they know the full process. They’ll work several years for us and then they go on to become an RN or whatever.”
The toughest part of the training for Johnson, she says, was the study of anatomy. “You have to learn about the heart, how it circulates, how the veins are taking the blood back to the heart and to the lungs to get oxygen,” she says. “The sticking was, for me, the easiest part. … The hardest part was learning where the veins are vs. the arteries vs. the nerves — you don’t want to hit a nerve because you can really damage it. You can really hurt somebody.”
Even so, Johnson says she believes California’s certification requirement for phlebotomists is a good thing. “It’s valuable because it protects the patient,” she says. “You have to know the order of draw; otherwise, you can get some solution from one vial mixed up in another vial and get false results. If the phlebotomist does not draw the blood correctly, then the scientist has a bad specimen or it’s going to show bad results.”
“So it’s very, very important that there is some sort of training for phlebotomists because it’s a very, very hard job, and you have to know a lot,” she said. “You have to know what’s in the tubes, what kind of anti-coagulant is in the tubes, how you have to draw them, some have to be on ice, some doesn’t. There’s a lot of training. Even the nurses, the RNs, who have been through three or four years of schooling don’t understand why we must do things the way we do them.”
For those interested in becoming a phlebotomist, Johnson says it’s a good career move. “I would say it’s a good career, and there’s a lot of advancement,” she says. “It’s good money, and it’s a career. All you have to have is a high school diploma or GED. You don’t have to have any college education. So, it’s fairly easy to get into it because all you do have to have is your high school diploma. And you know that you are going to have a job for a long time because there’s always going to be sick people.”
