Question

You’re a phlebotomist in the local clinic and are asked to see a patient for what you believe is a routine blood draw on a patient. While you are performing the blood draw, the patient asks you to review the results of her previous blood work with her since she has a history of anemia and has been tired and has had some nausea lately. She states the she has not had a chance to review the results yet with her doctor. You notice that the results are not that of anemia but indicative of acute leukemia.

What other questions would you ask your patient to confirm your suspicions that the results are indicative of leukemia? Knowing that you can’t discuss the results or your suspicions with the patient, how would you respond to your patient if they ask, “why you are asking me these questions?”

Answer 1

What other questions would you ask your patient to confirm your suspicions that the results are indicative of leukemia?

You can ask the patient if she feels constant tiredness, short of breath and weakness in general which is also a symptoms of leukemia along with anemia. The next you can ask whether she had an persistent bruising or bleeding that has not healed in normal time-frame (thrombocytopenia). Next you can ask if she regularly falls ill with fever and routine encounters with infection (leukopenia). Other symptoms that we can ask about is significant weight loss, headache, joint pains, swollen or bleeding gums, night sweats, etc These symptoms if given largely by the patient then it leads to a chronic leukemia diagnosis and confirm our suspicion

Knowing that you can’t discuss the results or your suspicions with the patient, how would you respond to your patient if they ask, “why you are asking me these questions?”

It is unethical and not within the preview of the phlebotomist to deliver the patient her diagnosis except from the physician who ordered the blood works or the treating physician. If the patient is curious about your questions then we can politely respond and explain her that it is a part of routine questioning regarding optimum test results and discussion. You can ensure her that this is a general inquiry for her well being and as a medical professional we care for the patient. As far as the diagnosis and interpretation of the results is concerned then we must politely explain as it is the jurisdiction and the responsibility of a trained and expert physician to explain you the result along with the other results of the test that are being ordered and they physician can more competently explain you knowing your medical history, your treatment plan and regimen and it is inappropriate to interpret any results or draw any conclusion. Rest assured we must positively advise her to talk directly and only to the treating physician for a complete and clear interpretation of results and treatment for anemia or other illness.