What's a phlebotomist?

If you’ve ever visited a lab for a blood draw or test, it’s likely that you’ve interacted with a phlebotomist. But what, exactly, is a phlebotomist?

In the most general sense, a phlebotomist (sometimes known as a “phleb”) is a person who draws your blood (also known as venipuncture). At One Medical, your phlebotomist is responsible for much more than that — we’re also dedicated to giving our members the highest quality care we can deliver.

Training and certification varies from state to state. In California, phlebotomists go to school to obtain a phlebotomy license (more specifically, a CPT-1 license) and national certification. There are two parts to getting trained as a phlebotomist: a classroom portion and hands-on clinical training. Depending on the program, it can take anywhere from a few months to over a year to complete the two parts. Once you’ve finished, you can take an exam to get certified as a phlebotomist.

At One Medical, the role of a phlebotomist can be different from most healthcare settings. Although extended scope services vary depending on the state, some of the responsibilities One Medical phlebotomists perform include collecting vital signs (e.g., blood pressure, body temperature, weight), administering vaccines and medical injections, performing electrocardiograms (EKGs) and ear lavages, placing and reading purified protein derivative (PPD) skin tests (better known to most as tuberculosis tests), urine testing, and collecting swabs, urine, and stool. Our offices that offer pediatric care also have phlebotomists who specialize in pediatric procedures and needs.

But it isn’t just tests and procedures that we focus on as phlebotomists. We understand that sitting in that lab chair can be nerve-racking and difficult for some people — and trust us, we can relate. Many of us have had difficult experiences of our own, and we want to make your visit as comfortable as possible. All of our office spaces are designed to be welcoming, we purposely avoid white lab coats to make it feel a bit more like home, and we have some great tricks to take your mind off of the needle.

What can I do to prepare for my lab visit?

The best thing patients can do is hydrate! Drinking a good amount of water before your lab visit will make your veins more visible. Also, keep in mind that there are requirements for some tests — you may need to fast for certain tests, and STI testing often requires not urinating for an hour beforehand. Not sure if these apply to you? Reach out to your provider to confirm.

Make sure you allow enough time for your lab visit — it’s helpful for both you and the phlebotomist. If you’re curious how long your lab visit will be, we’ll do our best to give you an accurate estimate.

What does fasting actually entail?

Fasting usually means not eating or drinking anything for 10 to 12 hours. Water is almost always allowed and encouraged, but there are a few instances where fasting means you can’t have water either. Reach out to your provider for clarification if you’re unsure what your specific fasting requirements are.

I usually faint from blood draws. Is there anything I can do to avoid this?

Feeling lightheaded or faint from blood draws is a completely normal and common physiological reaction known as a vasovagal response. Although we may not be able to eliminate this response entirely, there are a few things we can do to reduce the intensity of the reaction and any unpleasant symptoms.

All of our labs are equipped with chairs that recline. We also keep apple juice, water, snacks, and ice packs on hand. If you’re prone to vasovagal reactions, please tell your phlebotomist so we can use these resources to help you have the best possible lab experience.

How come some test kits have to be collected at home (e.g., stool kits and saliva kits)?

Although phlebotomists provide our patients with materials and collection instructions for stool kits, those samples cannot be collected in office due to the risk of exposure for patients and employees.

Other kits such as saliva test kits or 24-hour urine tests also need to be completed at home because the collection process is often spread over an extended time period. While these are completed at home, we’re happy to go over the instructions with you to make the process as seamless as possible.

If I want to add tests to my lab order, how can I go about that?

Sometimes people think of tests they want run after their appointment or after their lab visit, and that’s okay! Unfortunately, phlebotomists don’t have the clinical authority to add tests to lab orders. You can reach out to your provider, and they’ll have a conversation about whether those tests are appropriate. Remember that these tests come with risks as well as benefits, so they may not be recommended. Please be aware that some tests have special specimen requirements, so you may have to come back for another lab visit to complete these tests.

An important note: If a test is not clinically appropriate for you, it’s likely your insurance won’t cover it, potentially leading to large bills. The best way to find out what is covered under your health insurance plan is to directly contact your insurance company.

Thank you to Julie Lopez and Alec Ballesteros, One Medical phlebotomists in San Francisco, for writing this article.