When longtime Red Cross phlebotomist Sotheary Chet, 61, was first exposed to the historic nonprofit organization, it wasn’t because she was applying for a job.
It was in the late 1970s, when she and her family were stuck in a Thailand refugee camp for Cambodians fleeing a genocide at the hands of their ruler that killed at least 1.7 million people by execution, overwork, disease and famine. That was just after the civil war from 1968 to 1975.
These days, Chet, who immigrated to Clark County in 1981, has the fastest “stick” in the West.
Or at least at the Vancouver Red Cross Blood Donation Center, where she has worked with platelet donors for the past nearly 15 years. “Stick” is a term that phlebotomists frequently use to refer to the moment when they insert the needle into the vein, which can be a tricky process depending on the person.
“I think everybody here has their own special (strengths). Sometimes I stick and look at my supervisor and I’m like, ‘How did I do that?’ ” Chet said.
‘All the veins that nobody wants to do’
John Reinhardt was first in the 10 a.m. round of platelet donors on Thursday. He laid down on a small bed, his feet dangling off the end, where he would stay for at least two hours.
The platelet donation process takes much longer than the typical “whole blood” donation. The hollow needles take out blood through one arm, then return red blood cells and plasma that aren’t needed back into the other arm. As it’s happening, an Amicus-brand machine works to separate the platelets and plasma.
He put on a pair of headphones and began watching “Crazy Rich Asians” on a TV placed at the foot of the bed while Chet raced around, arranging tubes and placing stickers and barcodes with his information on bags where his fluids would eventually be stored.
Then came the time for the dreaded “stick.” Chet said Reinhardt has been a regular for years. Those who frequently donate tend to build up scar tissue, which can make finding the vein more difficult.
“I pretty much get all the veins that nobody wants to do,” Chet said, noting that in addition to scar tissue, issues can include thick skin and deep veins. “I mean the whole process, the procedure, starting a donor, you should be done in 15 minutes. Some (phlebotomists) take a half hour.”
And for a platelet phlebotomist especially, time is of the essence. Platelets have a meager five-day shelf life before they are no longer usable, and that shelf life begins from the moment the needle goes into the arm.
“By the time we test it and get it out to the hospitals, there’s typically only about three days left,” said site manager Karen Ellis, adding that the Vancouver center is one of the highest-performing sites for platelet donations. “That’s why it’s really important to know the start times.”
Ellis said Chet has great attention to detail and many regular donors. Her attention to detail, Ellis said, also is required for a highly-regulated operation, including by the Food and Drug Administration, American Association of Blood Banks, OSHA and the Red Cross.
“Missing a single detail could mean we can’t use the product, that the product wouldn’t be safe for a patient. And that is what we do this for — the patients that need them,” Ellis said, adding that many users of platelet donations are cancer patients.
Chet dove into the man’s arm with the needle, and he only barely winced, not taking his eyes off of the 2018 romantic comedy. He clasped onto a lime green ball to keep the blood building up in his veins.
“Platelet (donations) are a growing demand in the medical community,” said Ellis, who has worked with Chet for at least 10 years. “Red cells have been on the decrease. Hospitals have been using blood management and trying not to infuse as many red cells or blood products into patients. They would prefer that the patients are able to produce their own.”
Last year, the Vancouver Blood Donation Center collected 5,263 units of platelets. One person can donate platelets up to 24 times a year, depending on their height, weight and hemoglobin count.
Platelets, as described by Dr. Marlene Williams on the Johns Hopkins Medicine website, are the “cells that circulate within our blood and bind together when they recognize damaged blood vessels.”
The tiny, granular-sized platelets bind to the “site of a damaged vessel” and cause a blood clot to help stop bleeding.
‘We were in shock’
Before coming to the United States after being stuck in the refugee camp — where she became ill with malaria, she said — she didn’t even know Red Cross functioned as anything but a disaster-response agency.
“The Red Cross I had been exposed to was mostly disaster services. I didn’t even know this existed,” she said.
As she recovered from the mosquito-borne disease, a Mormon church sponsored her immigration to the United States in 1981, she said.
“We were in shock —everything was completely different. To look back now, it’s like wow, I didn’t speak a word of English.”
Chet said she studied business at Clark College and held a variety of jobs, including at SEH America, where she was eventually laid off. While her husband worked, she said a friend of hers introduced her to blood donation. But she couldn’t donate, and still can’t, because she routinely travels back to Cambodia to visit family. Travel outside of the United States can bar someone from blood donation, especially to a country such as Cambodia, where risk of exposure to malaria is high. Instead, she began volunteering at the donation center in Portland, where a part-time position had opened up.
As Reinhardt relaxed and continued to watch the film, his tubes were copper colored with his blood. The Amicus machine hummed as it worked through the platelet separation process.
Blood donation center
Location: 5109 N.E. 82nd Ave., Vancouver
Budget: Information for the Vancouver site specifically was not readily available, but the 2019 expenses budget for the Cascades Region was $4.2 million.
Number of employees: 7 phlebotomists and a site manager
Bureau of Labor Statistics job outlook: Annual mean wage for Southwest Washington nonmetropolitan area: $18.28 an hour or $38,020 per year, a top-paying area for phlebotomists. The Portland/Vancouver/Hillsboro region’s mean wage is $19.42 an hour or $40,400 a year. According to the BLS: “Employment of phlebotomists is projected to grow 25 percent from 2016 to 2026, much faster than the average for all occupations. Hospitals, diagnostic laboratories, blood donor centers, and other locations will need phlebotomists to perform bloodwork.”
Local phlebotomy training information
There are several routes to become a phlebotomist. Clark College has a phlebotomy program that isn’t a degree but a certification. Once students complete it, they can apply for the Washington certification, which is required to work as a phlebotomist in Washington.
“Graduates are also eligible and fully prepared to apply for and take a national certification exam, which is required to work in Oregon,” said Clark College spokesperson Hannah Erickson. Enrollment over the past few years in their program has fluctuated between 17 and 24 (the maximum capacity). It’s a two-term cohort model, meaning that everyone who enrolls for fall takes the same classes together through completion at the end of winter term, she said.
The college also convened a Phlebotomy Advisory Committee, which posts information about meetings on its website. According to the most recently available meeting minutes — May 2018 — students were having difficulties getting state licenses due to the $145 application fee. Other difficulties cited: Many businesses will only hire nationally-certified phlebotomists. The minutes also mention efforts for the college to better communicate to prospective students that the program isn’t covered through traditional financial aid, however there are grants and scholarships.
He asked for a blanket to be pulled up when he became chilly and Chet quickly saw to his comfort.
Because clients arriveon their own free will to donate needed fluids, she likes to make sure they’re completely comfortable.
Chet has many regulars, she said, including one who will only see her, making sure to take a photo of her schedule.
“I love the people. The donors are just like family; they want to be here to save lives,” she said. “And my job is just to make sure that everything’s successful. In my 15 years, I only had one who did not come back. That’s OK.”