The phlebotomist should always carefully observe the patient for clues that indicate the patient's mental and physical readiness for the procedure prior to performing a blood collection. This alertness must continue throughout the blood collection process. When the patient expresses needle phobia or a "fear of needles," it may help to offer strategies to help the patient get through the procedure safely. Sometimes, the anticipation of the needlestick may cause anxiety, and sometimes seeing the blood filling the tubes makes a patient uneasy.
It may be helpful to engage the patient in conversation during the venipuncture to keep the patient's mind off the procedure. In some instances, the phlebotomist may seek assistance from a qualified associate to distract the patient with conversation or provide comfort and support by offering to hold the patient's hand. If this is an outpatient, your observations and questioning may lead you to conclude that the best solution is to have the patient lie down during the venipuncture procedure.
Remember that the patient does have the right to refuse to have blood drawn and the phlebotomist should respect that patient right.