Procedure, blood, or needle phobias

Treatment requires venesection on a regular basis, where a large bore needle is inserted into a vein and approximately 450mls of blood is removed. For some people this is a terrifying experience. People can experience intense anxiety about the procedure, others it is because of a fear of seeing blood or needles. It is important as health care professionals to realise that this can occur, and that the severity of anxiety experienced when confronted with blood, needles or procedures varies from person to person. Some people when they see blood or needles can experience a vasovagal. This is when there is a drop in blood pressure which causes them to feel lightheaded and they can faint (syncope), often feeling nauseous either just before or just after they faint.

It is important as nurses that we should consider that some people will have a procedure, blood, or needle phobia. In these instances, it is important that the patient stays in control. This can be assisted by allowing the patient to:

• have someone accompany them
• ask them if they would prefer to lie down or sit down
• Ask if they wish the nursing and medical team to talk to them during the procedure or remain quiet?
• Ask if they wish to hold your hand?
• Do they wish to be distracted?
• Consider administering local anaesthetic

Distraction techniques can be utilised such as:

• Listening to music
• Reading a book or magazine
• Talking to a friend, relative or member of the medical/nursing team
• Texting or playing a game on a phone or tablet

Watch this video (35 minutes), with Dr Dr Haris Yennadiou, Highly Specialist Clinical Psychologist at Guy's & St Thomas' NHS Foundation Trust. Dr Yennadiou explains what BII phobia is, the range of therapies available and how to support patients through treatment.

Learning points

• With all patients undergoing venesection, consider the possibility of procedural anxiety (which can develop over time) and needle and blood phobias.
• Offer distraction techniques or other ways in which the patient can stay in control.
• Consider administering local anaesthetic to site, as this is often not considered.
• If patient suffers from anxiety, ask them to undertake breathing exercise to help try and relax them.

Next steps

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