Morning came much faster that I thought it would. We began class with me demonstrating how to hold the vacutainer and needle properly. Having obtained a willing volunteer, I showed them how to have the patient sit as comfortably as possible, while I verified the information and explained how many tubes would be collected-in this case and for the class, just one. I advised everyone that it was rarely just one tube but for the first stick it was one, we would learn about changing tubes another day. I advised the patient that it would hurt a little because I did have to insert a needle but that it would feel like a bee sting or tiny prick. I also instructed them to leave the dressing on for at least an hour and not heavy lifting with that arm for at least two hours.

"Are you ready, Miss Andrea?"

"Yes Ma-am."

And so with her permission I proceeded with the specimen draw, putting on my gloves, tying the tourniquet in place above the elbow, feeling for the vein, cleansing the area with an alcohol swab, uncapping the needle, having the tube in my other hand, inserting the needle, attaching the tube, untying the tourniquet, removing the tube, rotating it in the time it took me to lay it down, grabbing the gauze and placing it over the injection site, applying slight pressure as I drew the needle out and discard it in a sharps container, I increased the pressure when the needle is out and reach for the tape.

"Wow, that was so smooth, I hardly felt it at all. I hope I can learn to be as good as that." Andrea commented.

"Everyone will do fine, the more you do, the better you get and once you have done one you will never forget."

I got up and moved the waste basket to be beside Michelle's desk. The sharps container and the specimen rack where placed on the desk next to her.

"I have a question that is not really related but I am curious. When nurses start IVs how come some get a little blood on their gloves and the patient, and others don't have any blood at all?"

"Tomorrow, I will bring in an IV needle that you can look at, but for now let me explain. An IV needle has a latex free plastic sheath covering the needle, when it is inserted the needle is then pulled out and there is a backflow of blood from the vein, if you press on the plastic cannula that is in the arm you will cut off the blood flow and you hook up the IV tubing with your other hand and tape the site. Years ago, there were no cannulas, so we placed the arm on an arm board to prevent movement. Does that answer your question, Peter?"

"Yes ma-am, I can picture it in my head."

"Okay, everyone, take a ten-minute break and then we shall start."

When they were all back, I announced the plan.

"Michelle will do her three draw first, then she will become the third patient for the next drawer. Fred will be her second patient. Henry will be the second drawer, Fred will be third and Henry will be his third patient. I have a list of who is drawing and who will be patients. Trust me everyone will get to draw and to be a patient. I would like everyone who is not actively participating to stand where you can see the activity but not be close enough to interrupt the person drawing. I will be sitting on the side close to the patient, so I am available for both parties. I will offer guidance, correction and assistance as needed. If you are doing everything correct I will not interrupt. If you get tired of standing you may wander to stretch your legs, but I have learned that the more you watch the better you become."

Everyone nodded and rose to stand around Michelle, who was rather pale.

"William, would you be our first patient, please?"

He ambled up and sat in the empty chair that had been placed for him. I had the students place one on each side of her desk for patients, as well as a another beside those, where I would sit. Since this area was organized, it would be the draw site and each student would sit there. They would bring their supplies with them.

"When a patient comes in, it is appropriate to ask them if they have a choice of which arm to use for the draw. The chairs are equipped with an arm rest for each arm, but here we will just have the students pick a chair since the desk will be the arm rest."

Michelle took a deep breath and let it out.

"Hi, Mr. William, my name is Michelle. Dr. Smith has ordered some lab work for today. I will only need to draw one tube. It will hurt a little, but I will be a gentle as I can. Do you have any questions or concerns?"

"Have you been doing this for a while? I would hate to have a first timer doing this." He asked with a serious looking face.

I smiled at him, but I smiled even bigger at Michelle's response.

"Now, don't you worry one bit, I am very familiar with drawing blood. Shall we start."

I knew that I was allowing them more verbal time than a tech would have, but this was important. William nodded.

I was close by as she went thru each step with perfection, even remembering to turn the bevel or needle opening upward on insertion. When she was finished, she took another deep breath and let it slowly out.

"That was great, Michelle, I have had lots of labs drawn and you did it perfectly, as far as I am concern." William said with praise in his voice. I nodded in agreement.

"Fred, I believe you are the next patient. Michelle this is your child and I would suggest that everyone use the butterfly today for their child. I am thinking that way each arm and one hand will get stuck."

He stepped up and took his seat. Michelle went through each verbal and physical step without a hitch and Fred managed just fine. He did flinch a little when the needle went in, but he kept breathing by talking about the weather.

I called on Betty next and once again Michelle did a great job, she even remembered the trick to use with rolling veins. When she was done she stood up, sighed and fanned herself. She had a big smile.

"Henry you are the tech and your first patient is Ralph, get yourself organized."

He did great following Michelle's example. His next patient was Andrea and I suggested that she was the child. Again, he did well. Although I did note that he was perspiring, small beads had formed on his forehead. His last patient was Michelle, and I sat close to her and reminded her to watch me, not Henry and what he was doing. They both survived. He was smiling as he moved out of Fred's way.

It was Fred's turn as tech, his first patient was Andrew and things went smoothly. Peter was his second patient and the child. Henry was his third. He did very well on all three. I had suggested that if Henry needed he could look away, but he didn't, he was fine.

We had another ten students as techs before I advised them to take a lunch break. Every student had been stuck once and they were all chatting about it as they went out. Things were going well. I was so proud of them.

After lunch we continued with the rest of the students as techs. Their techniques were exceptional. At the end of the day, I suggested they each reread the short bit about changing tubes for tomorrow. Some of them would have a single change and others would have up to three changes. They no longer looked fearful and as if they were dreading tomorrow.

"Michelle, Fred, Henry could the three of you stay for a few minutes, please."

When the other students had left, I turned to the threesome.

"Well, what do you each think? Shall we call it quits and I will talk to the Dean? Shall we push on? The three of you did fantastic today both as a tech and as a patient. You were awesome. I sort of suspected. Henry, that you were expecting a little more than 'good job' or 'well done' after your draws, but I play fair with everyone. But you all did super jobs."

All three spoke eagerly at the same time. I was hearing three conversations that were all saying the same thing, that they would continue. I smiled as they left.