"The fear of offending others"  

Sam has conversations where people don't usually think about race because they don't want to be "offensive." Disclaimer: Sam is NOT claiming that all people of darkly pigmented skin have difficulty - he's asking people if they had conversations in the health care industry that might be worth looking into for better health care for all people. For instance, different "tricks" to get blood (skin tones as an example). Everyone's bodies are different, this is just an example. Joins us live on Tuesdays and Thursdays! Right here on RU-vid! Full Lecture Here! ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-Dbjfdzlw4Vw.html Class Reflection Videos: ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-zSYLixlP_XM.html ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-uAP3oi3CV20.html ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-hpF2pF8eo5M.html

When I was in CNA class, we discussed how a patient's skin can give health information, like hypoxia or anemia. My dark skinned classmate asked our teacher, "what does a pale anemic white person look like? I haven't taken care of or been around sick white people before." Her question then resulted in a fantastic open conversation about caring for humans with different skin tones. We LEARNED without fear, asking sensitive questions without fear because we knew our conversation would save a life.

Retired phlebotomist here. I got lucky. My class instructor was a darkly pigmented lady who clued us all in on all the tricks of the trade. Also, I took my class in Oakland, CA. About 30% of the class was similarly pigmented. I’m white enough that my veins look blue, most white people aren’t that white. In phlebotomy we go by feel. I should be able to take your blood in the dark with my eyes closed no mater what color you are. That is the secret.

It's getting to the point where just noticing minor differences between races, is now considered racism.

As a Canadian nurse and someone who says it like it is, I was talking to one of the staff who happened to be a black male, and he was asking me health related questions. I asked him if he has his blood pressure checked regularly as black men have a much higher rate of hypertension and cardiac events. My white colleagues were horrified at my comment to him, mentioning his skin color, but guess what? He had very high blood pressure and came to me regularly for me to monitor his BP. I was a cardiac nurse, and was happy to do that. We became friends and he appreciated my speaking truthfully, because he got treatment.

I take blood for a living. You don't use your eyes to feel the veins. It's done by touching, if you try to find veins by sight you will miss 3/4 of the time no matter the skin pigment

You dont look for veins, you feel for them.

In medicine we actually NEED to talk about "race" a lot. Because there are many, many differences between people with different ethnics backgrounds in terms of symptoms in case of disease, susceptibility to certain diseases and especially outcomes.

Those kids were probably so busy being offended that they didn't even fully realize what he's saying.

Anybody in medical knows you feel for veins. You never go completely by sight.

Their veins are in the same place , you feel for them. Not every white persons veins can be seen either.

Nurses are taught to feel for a vein not look for it because veins are sometimes not visible

As everyone keeps saying, you don’t look for veins, you feel for them, and I promise ever race FEELS the same.

In paramedic school our instructor did talk about the difference between light and dark skin while doing blood draws and placing an IV. But she mostly used it as a way to point out that you cannot rely on sight only etc.

I’m a nurse and have been working for 44 years, I can tell if you are black, brown, olive doesn’t matter. You can see the blood vessels anyway and in some people you can’t see them but you can feel them as I said no matter what colour the skin has.

I was a phlebotomist and half my class was black if not more we learned no tricks to make it easier for white or black people we just learned what to feel for and what to look for across the board this is straight up a nonissue

I remember a white lady who was the parent of a student in my class asked me can you see your vains in your arm. I turned my arms and showed her the green colored viens running through my arm. I wasn't offended because of how she asked was like a child. Never be afraid to ask questions.

There are tricks of all trades. Not all are rooted in racism

This is such a great question. I love it. I’m brown and have had people “feel for the vein” and pierce right through it MANY times. I’m a former heroin addict and it’s hard not to say here lemme show you how it’s done 😂🤷🏻‍♀️

From what i get from this clip is that what may apply to some wont always apply to another. Feeling for a vein - some have deep veins meaning it's much harder to draw blood or get the right area. Some people have literally thicker skin, bumps, rashes which does make a difference definitely when it comes to diagnosis as it's not always so obvious or as easy as feel and jab and so knowing the different types of skin and ways as well as a open mind to options etc allows one to universally apply knowledge effectively than picking a spot and technically hoping for the best.

As someone who draws blood, drawing blood from a black person is a no different process for drawing blood from a white person. You use the same methods to find the vein, stick the vein, and bandage the wound.

Ain’t no damn trick. You FEEL for veins!! That’s the best way to draw bloods.

When taking blood it’s more about feeling for the vein rather then looking for the vein

We’re reaching a point where we care more about feelings, than the safety & well being of others

As a person who takes blood from chemotherapy patients, it works for all skin types that I've encountered. It has nothing to do with skin and everything to do with the vein, unless you haven't got a tourniquet. Then it's a bit more complicated, those are specific tests though.

I was getting ready for non life threatening surgery and I have anxiety. Although I am light skinned , my veins are hard to see. So my nurse poked me several times trying to find a vein. I was very nervous and started clenching up. I was also on my period and I have a fear of needles. It was not possible for me to calm down at that time. Thankfully a more experienced female nurse came in and quickly inserted the iv in my other arm. It is absolutely important that nurses be taught the best way to insert an iv on all their patients. Patients should not have to suffer if it is easily avoidable.

That speaks to the QUALITY of your instructors! I’m a recently retired LPN, I went to a very tough technical school program, and my instructors were tough, and I thank God for it. They were “ realist”, they practiced their craft and professions for years Before teaching others, they KNEW what they were talking about. We also had ppl of various ‘shades’, and 1 black student, and We were taught what to look for, including, what to look for in athletically built ppl, dehydrated ppl, and so on. And because we are LPN’s most places wouldn’t let us draw blood, but when the RN or phlebotomists were in trouble, they always came to those of us who graduated from the same school.😄

I'm super white and pale and have extremely hard veins to find. I was in the hospital for a few weeks in my early 20s and when the nurses figured this out they actually went and got the newbies. They said "if you can get his veins you can get anyone's." Lol thankfully I had a high pain tolerance so it wasn't that bad... They poked me a lot.

This is wha5s known as scrapping the bottom of the barrel in search of racism.

Whats he talking about? I doubt he was a phlebotomist. I was an arny medic and took blood from black troops..I didn't need tricks to take blood. What is he talking about. Is he making them think there needs to be tricks

this dude is awesome. So many people bring up race constantly when it’s not relevant, he brings it up when it’s extremely relevant and nobody talks about it.

I drew blood from both light, in between and dark people. Never learned about differences, never had a problem, treated everyone the same

They didn't really talk about that. My heart weeps at that statement.

There is only one race. - HUMANITY

I have insomnia. After an entire night awake, it's so nice to finally see something positive.

39 years ago when I was a 2nd year nursing student, we talked about how to find a vein in a darkly pigmented patient. We didn't have anyone to learn on, but we did talk about it. (people with darkly pigmented skin made up about 1% of Australia's population then) Now since we've had a lot of Sudanese and Somalian refugees settle in my hospital's catchment area, I'm glad we had that training. It's just healthcare and individual differences, that's all.

Racism, little supply huge demand.

As a nursing student I never learned anything about this. I'm open to tips if anyone has them.

Discussing race without fear is super important

When I was 16. One of the first times I can remember ever having my blood taken by a nurse. She stuck the needle in missed then pulled it out halfway turned it diagonally then stuck it in and missed agian. Took her about four times sticking it in halfway pulling it back out and going back in before I had enough and told her to stop. She didn't listen I had literally grab her hand and pull the needle out of me. I want it so bad to knock her own her ass. Then the doctor comes in and takes him 30 seconds and didn't hardly feel any pain. This video rang true for me brought back a horrible memory. What pisses me off the most is I'm Spanish and I'm fairly light skin She had no clue what the hell she was doing no matter what color I was.

This panderer tryna make something out of nothing. I have drawn (blood) and accessed 1000's of people of color and the only difference is tougher skin. Which was covered in the classroom.

In basic training my stick buddy was a huge black guy, I was a 17yo Portland native trying not to offend and he stopped me and cussed me out for poking around, and I learned a valuable lesson that day

As a nurse of 26 years… the process is the same. Because we are people. Period.

This professor speaks with so much genuine joy and peace, that everyone is disarmed by him, even discussing controversial topics

to have an honest conversation there has to be a risk of offending people!

It's absolutely true. As a former E.M.T. Nobody wanted to offend. I missed a few times too. Now it offers me that everybody is offended. Lol

Several years ago I had blood drawn and the nurse was very efficient. She did it with her eyes closed because she said she learned to do it by feel and knocked by sight. Her instructor must have been awesome

In 2002 I was taking an EMT course. We learned specific techniques of accessment specific to skin tone and vitals accessment.

Yep! Same thing happened when I first became an EMT and continued when I was a paramedic

Most of the time it's by feel/touch. My mom has been a phlebotomist so long she can draw blood in the dark

I am a phlebotomist in South Africa. Taking bloods from all people is equally difficult/easy doesn't matter the colour. But his point is relevant though. Never be afraid to offend anyone.

I'm a retired nursing professor, I taught my students to go by feel, not sight. The advantage of seeing a vein comes while locating the vein, before the stick.

So true. The fear of offending people constantly prevents us from having the real conversations about what is going on and impedes progress to actually improve anything!

Think about that. The entire idea is to HELP people. But instead, we hurt them with our own ignorance instead of learning. Great job!

I've never once taken blood by sight alone, I feel for the darn things, if you go by sight only you are definitely going to miss.

We’ve been teaching people how to second-guess themselves quite a long time. Self loathing, fear and doubt too

As a registered nurse, veins are in the same spot in every human being.. we actually mostly go by feel not by sight...

Taking blood isn't from sight, it's from palpations. A blind person can draw blood.

I have had the opportunity to have blood removed from my person quite a few times. The ones who don't best aren't looking at what they are doing, their fingers tell all. I can't imagine skin color has a huge effect.

I’m glad it never occurred to me that I should be concerned.

Bill Sit I was a registered nurse for forty years every person is different finding a vein that is good for blood draw or IV IS AN INDIVIDUAL decision and skill LEARNED by basics but protected by the SKILL of PRACTICE

Virtue signal received loud and clear

It doesnt really matter what your skin color is. Its what we can feel NOT what we see!

Anatomy is the same no matter the skin tone so veins are usually in the same places and you're taught feeling for the vein works best. It is taught that viewing a vein in dark skin is more difficult.

I am a fire-rescue member. In class they talked about people who have lost a lot of blood or having bad circulation problems looking very white. The one dark man in the academy who is Jamaican said "not me" as kind of a smart alec response. But I wanted to know how to rate darker people for blood loss in case of an event. The instructors got a little bit uncomfortable with my question but I got the answer I needed (darker people get an ashen grey in that case). I despise the thought of a darker person losing their life or being in pain longer due to the fear of offense.

I have a Clinical laboratory science background, and one of the first things we were taught in our phlebotomy courses and rotation was to locate the vein first by tourniquet. Never rely on sight alone. I get what he's saying. But at the same time...

Coming from everyone I know who’s a medical professional, you don’t look for veins using your eyes. You feel the pulse

Personally, I just "close" my eyes and palpate (feel) for the vessel. Even if you can see the vessel that does not mean you'll get the stick, but if you feel it first you'll know better if it's likely to roll and other details which can help. Then "open" the eyes, map out what you've found to the surface by touch and then trust your skills and practice.

Ummm....as a former phlebotomist and a nurse for years. You feel, FEEL for a vein. Veins feel the sane in all skin colors.

I’m black and dark chocolate and I never knew there was an issue! Lol They usually find my veins just fine.

When I first met my rheumatologist we had an awkward moment after she mentioned I didnt have the red rash that is a characteristic of my condition. Idk if it was my facial expression or a light bulb going off in her head but she paused for a few seconds and decided to do a more thorough inspection.

It's been over 20 years ago since I was getting lessons in drawing blood. We each had a partner for our classes, mine was a black man. No one ever said anything about pigmentation. We were taught to palpate (feel) for a good vein. I have "deep veins" myself, so my fair complexion doesn't make it any easier to draw blood on me either. I miss the old days, when race wasn't about everything.

As someone who takes blood routinely from patients. Your pigment doesn't matter. You have to feel the vein to know if it's there and if it's a good one. You don't just put the needle in on a visual. Veins are generally in the same place person to person...

A lot of people in these comments seemed to have missed the video description...

My class learned by palpating the veins and the surrounding tissues. The feel is quite different regardless of the color of the skin.

This has long been a problem in hospitals. Twp RNs I know developed a hand held doppler for locating arteries in darkly pigmented patients, especially for ABGs.

As a phlebotomist, we go by what we feel, not by what we see. That’s why some can draw blood quickly

Retired MT here , dark skin not an issue, no tricks, its about feel of veins not by sight.

I'm an ER nurse and have never had trouble finding a vein on someone simply bc they are black. Also, you go by touch, not sight, when looking for a vein.

Properly trained phlebotomist doesn't have problem with doing blood draw. It's more by "feel" of that vein in a light or dark skin. Yes, I've trained several phlebotomists.

I draw blood by feel not sight. And I've been a nurse for 22 years.

You are 100 percent right. Fear of offense!

Reminds me of the time I placed an IV in the middle of a black tattoo, when a vein is beefy it doesn’t matter, but harder sticks I can understand why additional methods should be taught.

We once had a black IT guy at our company. During the Black Lives Matter times, we were being extra careful not to offend him accidentally. I mean we had meetings to make sure people don’t say inappropriate things.. but in the end, we were so afraid of offending him, we just gave him difficult tasks and fired him for lack of performance. We decided it was not worth the risk.

I once was working at a company that manu. a special type of vein viewing machine. The tech that had run a test on a variety of ethnic people for this machine, noted down that people from Asia backgrounds had significantly different sizes of then the other groups. It's not a bad thing to note down differences in groups, it is beneficial to understanding

You never decide where to draw blood by looking for the vein, as a former phlebotomist we are trained to feel for a vein, skin color is irrelevant. It's always, by feeling for a vein. Even on white skin I would use my finger to feel and look away in order to concentrate better because looking is deceptive. And yeah, basically every phleb teaches themselves how to draw because it's truly a learned skill, not taught exactly.

To a good phlebotomist, skin color makes no difference. If I had difficulty drawing blood from someone it was because of their weight and overall health.

Because physical discomfort and pain is better for them than the possibility of hurting their feelings.

As someone that went through phlebotomy, you shouldn't be taught to seek a vein by sight but by feel. So the color of the person's skin should not matter. Most of the veins you can see are superficial and not good to use for a blood draw.

NEVER knew this was a thing but I always noticed the people of color were the best at this in my experience

Veins have a certain bounce when touched, you should be able to locate a good vein by feel alone regardless of what color someone's skin is. If you don't believe me go ahead & close your eyes & with your pointer finger slowly start tapping your skin on your arm especially in the inside of your elbow with your arm fully extended & on the top of your forearm you will feel a little bounce back when you locate a vein. I have more than my fair share of medical problems & have blood drawn often & I can say with confidence that the best Phlebotomists I have ever had locate the vein they are looking for while looking in the other direction seemingly on purpose.

ER nurse here. I'm a good stick but I don't really rely on sight. Always go by feel. The texture is the same between black and white people and I have success with both.

It's crazy how people are so scared of being offensive that they can actually do more harm by denying basic truths.

Refuse to acknowledge that there was any difference at all, out of fear. Sounds about where we are.

The same people who tell us "embrace diversity and find strength in our differences" are the same people who will call you racist the moment you make even the most neutral observation on race.

I asked my black neighbour if he got sunburned. He was offended, but I always thought people with darker complexions could handle the sun better. I'm white with freckles and fair skin, but my younger sister is a little darker-complexioned and she never burned in the sun. She just turned a darker shade, but I burned and my freckles multiplied and then I would develop a tan.

As an RN I teach people to draw blood and start IVs. I teach them to find the vein with their feel not their eyes for just thus reason AND I tell them why!

I know I'm not the only one that heard that. "I feel bad for all tho nnn"

So worried about not being offensive that they become offensive. This is the type of differences that HAS TO BE TAUGHT as it effects the positive outcomes that medicine requires.

As a previous phlebotomy instructor we never went by sight it was always feel for the vein