Page 1 of 6 Guide for Phlebotomists in California May also be called: Certified Phlebotomy Technicians; Donor Phlebotomy Technicians; Limited Phlebotomy Technicians What Would I Do? Phlebotomists collect blood samples and units for laboratory tests, transfusions, donations, or research. Human health depends to a large degree on the precision and professionalism of Phlebotomists. Physicians diagnose major medical conditions based upon blood samples, including many kinds of cancer, diabetes, thyroid disease, allergies, and pregnancy. In addition, donated blood and platelets collected at blood centers account for thousands of lives saved every year in California. It is the Phlebotomist who must safely collect blood samples, identify them accurately, and preserve them properly until needed for testing or transfusion. There are three ways to collect blood: Venipuncture is the most common means of collecting a blood specimen. It involves placing a needle in a vein, typically at the bend of the arm or back of the hand. Skin punctures involve piercing skin tissue that will bleed to collect a small amount of blood for minimal testing. An example of a skin puncture would be a finger prick. Arterial blood gas puncture (commonly referred to as an ABG) involves drawing blood from an artery, typically in the wrist. This kind of draw is rare, and as a rule done on patients who have a respiratory condition. Phlebotomists who work in medical clinics and hospitals are called Certified Phlebotomy Technicians (CPTs) and generally collect blood samples based on a physician’s order. The blood specimen, once taken, is then sent for diagnostic testing in a laboratory. Phlebotomists who work for blood centers or blood banks are sometimes called Donor Phlebotomy Technicians. They can work at one location, or may be a member of a traveling team holding blood drives at schools, businesses, and community organizations. In addition to the technical part of the job, Phlebotomists must be aware of the patient’s well-being before, during, and immediately following the blood collection. Their work requires explaining each procedure to patients and donors, as well as communicating with other staff and laboratory personnel. Tools and Technology Phlebotomists use a variety of tools in the course of their work. These include syringes, centrifuges, and blood analysis machines such as cuvettes, scales, vials, blood pressure monitors, and disinfectants. They may use computer recordkeeping programs and calendars to update patient and donor information. Page 2 of 6 Important Tasks and Related Skills The tasks in the table below are common to Phlebotomists. Some duties require a higher level of certification to be performed in California. Each task is matched to a sample skill required to carry out the task. Task Skill Used in this Task Match laboratory requisition forms to specimen tubes. Perceptual Speed Explain fluid or tissue collection procedures to patients. Speaking Collect blood sample from veins by vacuum tube, syringe, or butterfly venipuncture methods. Collect blood from capillaries by dermal puncture, such as heel or finger stick methods. Draw blood from arteries, using arterial collection techniques. Document route of specimens from collection to laboratory analysis and diagnosis, or to blood bank. Determine donor suitability, according to interview results, vital signs, and medical history. Conduct hemoglobin tests to ensure donor iron levels are normal. Monitor blood or plasma donors and patients during and after procedures to ensure health, safety, and comfort. Organize or clean blood-drawing trays, ensuring that all instruments are sterile and all needles, syringes, or related items are of first-time use. Dispose of blood or other biohazard fluids or tissue, in accordance with applicable laws, standards, or policies. Dispose of contaminated sharps, in accordance with applicable laws, standards, and policies. Process blood or other fluid samples for further analysis by other medical professionals. Serve refreshments to donors to ensure absorption of sugar into their systems. Arm-hand steadiness Coordination Finger Dexterity Clerical Active Listening Near Vision Monitoring Information ordering Public Safety and Security Problem Sensitivity Operation Monitoring Customer and Personal Service Source: U.S. Department of Labor Occupational Information Network (O*NET) at online.onetcenter.org. Working Conditions Working conditions vary with the size and type of employment setting. Medical centers, hospitals, and blood centers are generally well lighted, temperature-controlled, and clean. Proper methods of needle disposal, infection control, and “universal precautions” are necessary to avoid occupational hazards. Workers must wear gloves and change them between patients or donors. Occasionally, they need to wear gowns when working in a controlled environment. Phlebotomists may spend a great deal of time on their feet, especially those in blood centers. Those working for hospitals and medical centers generally work a 40-hour week. Some blood centers have limited hours and employ Phlebotomists on a part-time basis. Some Phlebotomists belong to unions such as the Service Employees International Union. Page 3 of 6 Will This Job Fit Me? The job of Phlebotomist will appeal to those who enjoy communicating with and assisting others. Those who are caring and kind, and who are good at recognizing problems and remembering details, might like this type of work. What Wages and Benefits Can I Expect? Wages A formal salary survey is not available for Phlebotomists. Advertised job listings for Phlebotomists in California show a wide range of earnings, between $11 and $25 per hour. Phlebotomists who work for insurance companies or mobile medical companies often earn “per draw” fees of between $20 and $42. Generally, workers in large cities earn higher wages than those who work in small towns and rural areas. Benefits Employers may provide health and life insurance, sick leave, vacation, and retirement plans. What is the Job Outlook? Employment opportunities for Phlebotomists are expected to be comparable to the demand for skilled laboratory personnel. Overall, the need for these workers is expected to increase over the next decade due to the rapidly growing older population and the resulting demand for testing that requires blood specimens. According to California’s Department of Public Health, there are approximately 50,000 workers who hold active Phlebotomy certificates. How Do I Qualify? Education, Training, and Other Requirements The minimum education requirement to enter a training program is a high school or general equivalency diploma, or proof of higher education in lieu of high school graduation. Students must also be at least 18 years old. Phlebotomists who work in hospitals, medical centers, or laboratories must first complete a stateapproved training program and serve a minimum of 40 hours of phlebotomy practice to qualify for the certification exam in California. Training programs generally take 3-6 months and cover basic hematology, venipuncture techniques, appropriate site selection, routine processing, safety, and infection control procedures. The 40 hours phlebotomy practice includes at least 50 venipunctures and ten skin punctures. Phlebotomists who work for licensed blood centers or banks can be trained in house by their employer, although the blood center must meet all state, federal, and organizational training requirements. Blood center Phlebotomists are sometimes called donor phlebotomy technicians and their work is limited to working at blood banks, drawing blood through skin or venipuncture methods. Early Career Planning High school students interested in becoming a Phlebotomist will benefit from taking courses in English, biology, and health. There are California Regional Occupational Programs (ROPs) available for this occupation. To find a local ROP program, go to the California Association of Regional Occupational Centers and Programs Web site at www.carocp.org/carocps.html. Page 4 of 6 Continuing Education Phlebotomists must keep their skills current over the years, as well as update their knowledge of current health and safety regulations. To renew certification, which is required every two years, they must take six hours of continuing education approved by the Laboratory Field Services division of California’s Department of Public Health. Certification California’s Department of Public Health (CDPH) requires any Phlebotomist who draws blood for laboratory and medical testing to obtain certification by passing an exam given by a state-approved organization. There are currently three levels of state certification: Limited Phlebotomy Technician – Authorized to perform skin puncture blood collection only. Certified Phlebotomy Technician I – Authorized to perform venipuncture and skin punctures. Certified Phlebotomy Technician II – Authorized to perform venipuncture, arterial puncture, and skin punctures. Phlebotomists who work in licensed blood centers do not need to be state certified as long as their work is limited to drawing blood from donors through skin or venipuncture methods. They are sometimes called donor phlebotomy technicians in these establishments. They can be trained in house by the blood center, and must meet the training requirements established by the medical director. Some blood centers require their donor phlebotomy technicians be state certified, and some workers voluntarily gain certification to better achieve recognition and demonstrate competence. To see a list of the currently approved certifying agencies, go to http://www.cdph.ca.gov/programs/lfs/Documents/PhleboCertExamsApproved08Feb05A.pdf. To obtain certification, applicants must submit an application, pay the appropriate fees, and pass the certifying organization’s examination. Certificates are valid for two years. For more information, go to the U.S. Department of Labor’s Career InfoNet Web site at www.acinet.org and scroll down to “Career Tools.” Click on “Certification Finder” at www.acinet.org/certifications_new/default.aspx and follow the instructions to locate certification programs. Where Can I Find Training? Training programs for Phlebotomists exist at community colleges, adult schools, and private training institutions. There are two ways to search for training information at www.labormarketinfo.edd.ca.gov/?Pageid=1013: Search by Field of Study to find what programs are available and what schools offer those programs. You may use keywords such as phlebotomy and blood. Search by Training Provider to find schools by name, type of school, or location. Contact the schools you are interested in to learn about the classes available, tuition and fees, and any prerequisite course work. Where Would I Work? Phlebotomists work in hospitals, medical centers, outpatient clinics, blood banks, or medical laboratories. Some work for insurance companies or for a mobile phlebotomist company that administers exams for insurers. Finding a Job Page 5 of 6 Direct application to employers remains one of the most effective job search methods. Hospitals advertise openings in newspaper classified ads, Internet job listings, and some also recruit through private employment agencies. Job seekers can apply directly to hospital or blood center personnel departments throughout California. Online job opening systems include JobCentral at SM www.jobcentral.com and CalJOBS at www.caljobs.ca.gov. To find your nearest One-Stop Career Center, go to Service Locator at www.servicelocator.org. View the helpful job search tips at www.labormarketinfo.edd.ca.gov/occguides/JobSearchTips.pdf for more resources (requires Adobe Reader). Yellow Page Headings You can focus your local job search by checking employers listed online or in your local telephone directory. Below are some suggested headings where you might find employers of Phlebotomists. Blood Banks Clinics Hospitals Medical Centers Find Possible Employers To locate a list of employers in your area, use “Find Employers” on the LaborMarketInfo Web site at www.labormarketinfo.edd.ca.gov/aspdotnet/databrowsing/empMain.aspx?menuChoice=emp. Select Search for Employers by Occupation. Select a geographic area. Search for an occupation by keyword, occupation, or category. Select one of the top industries that employ the occupation. This will give you a list of employers in that industry in your area. Click on “View Filter Selections” to limit your list to specific cities or employer size. Click on an employer for the street address, telephone number, size of business, Web site, etc. Contact the employer for possible employment. Where Could This Job Lead? With experience, Phlebotomists can move into supervisory roles. Advancement to related occupations such as medical assistant requires taking additional education and state licensure. The field is sometimes considered a good starting point for people to decide if they would like to continue in the medical field and pursue training as a medical assistant or nursing career. Related Occupations Other medical professionals draw blood as part of their daily tasks. Below is a list of occupations related to Phlebotomists: Licensed Vocational Nurses (SOC 29-2061) Medical and Clinical Laboratory Technicians (SOC 29-2012) Medical Assistants (SOC 31-9092) Veterinary Technologists and Technicians (SOC 29-2056) Other Sources California Department of Public Health, Laboratory Field Services www.cdph.ca.gov American Association of Blood Banks www.aabb.org Page 6 of 6 These links are provided for your convenience and do not constitute an endorsement by EDD. For the Career Professional The following codes are provided to assist counselors, job placement workers, or other career professionals. System Code SOC – Standard Occupational Classification at www.bls.gov/soc 31-9097 O*NET – Occupational Information Network at www.online.onetcenter.org Phlebotomists 31-9097.00 TOP – Taxonomy of Programs at http://www.cccco.edu/Portals/4/AA/TopTax6_rev0909.pdf ) Phlebotomy 1205.10 The California Occupational Guides are a product of: The California Employment Development Department Labor Market Information Division www.labormarketinfo.edd.ca.gov Published: February 3, 2012