"Most people don't have a clue of the complexities involved for the person drawing blood," says Dennis Ernst, a medical technician who runs the Center for Phlebotomy Education Inc. and is coordinator of the nonprofit Coalition for Phlebotomy Personnel Standards, which is pushing for states to require that staff with blood-collection responsibilities meet minimum training standards and be certified or licensed. At present, California is the only state with minimum training and certification requirements, and many hospitals require only rudimentary experience for phlebotomists or train them on the job. "If you don't know the standards and don't perform the procedure correctly you can really hurt patients and subject them to medicines and treatments that are unnecessary," Mr. Ernst warns.

Incorrectly drawn samples can cause hemolysis -- a rupture of red blood cells that effectively ruins the specimen, rendering it useless for diagnostic tests. To improve the quality of specimen collection, Memorial Regional Hospital in Hollywood, Fla., put all staffers who draw blood through a 40-hour course at a local community college and required them to perform 30 needle sticks under the guidance of a lab supervisor. Last fall, the emergency department brought in its own dedicated phlebotomy team, which draws blood for almost 300 patients a day. Since then, the rate of hemolyzed samples has dropped to under 2% from 2.4%, and fewer blood samples are being rejected by the lab because of "short draws" that don't produce enough blood, according to Melinda Stibal, administrative director of emergency and trauma services.

At Naples Community Hospital in Florida, where phlebotomists are required to undergo a seven-week training program, patients are randomly surveyed after procedures about the quality of the experience, including how well the phlebotomist communicated with them.

"Phlebotomists are being permitted to perform an invasive procedure," says Helen Ogden-Grable, clinical educator for the DSI Laboratories unit of the hospital's parent, NCH Healthcare System. "They have to realize that they hold the happiness and satisfaction of the patient in their hands."

The special IV team at the University of Kansas Hospital in Kansas City, Kan., which includes nurses skilled in infusion therapy, created a process that allows staffers to summon the nurse on duty with the greatest expertise in accessing a patient's veins when a patient like Mr. Glover has been identified as a "hard stick," according to Tammy Peterman, senior vice president of patient care. Since the team was created last September, the hospital's scores for "skill of the person who took my blood" went from the bottom quarter to the top quarter of all U.S. hospitals, and the scores for "skill of person who started IV" rose from the bottom half to the top 20% of all U.S. hospitals.

But some patients still experience pain no matter how skilled the technician -- and asking for relief can still be a challenge. Patients may be charged a $10 to $25 co-pay depending on health-plan coverage for newer fast-acting anesthetic patches. But the.1 3en't yet in wide distribution, and traditional numbing creams like Emla, which hospitals generally have on hand, take about an hour to work. "Right now, 80% of kids don't get anything, and adults are even further down the pecking order because no one thinks the pain is a big deal, and hospitals don't want to take the extra time or spend extra money" on anesthetics, says William Zempsky, associate director of pain relief at Connecticut Children's Medical Center in Hartford. (Dr. Zempsky has conducted clinical trials with new fast-acting topical anesthetics and worked as a consultant for some manufacturers.)

One strategy is to plan ahead, especially for children. Karen Porter, whose daughter Amy is being treated for a form of leukemia at Connecticut Children's, says the eight-year-old was terrified of the needle sticks required for blood draws and chemotherapy, and would scream whenever she saw a needle until the hospital gave her some topical cream to take home and apply an hour before she was due for the next procedure. "It has really decreased her fear," says Ms. Porter. "She calls it her magic cream."