I donated blood last week and it got me thinking about how much the process of blood donation has changed over the years.  My first donation was in high school, in the ’70’s, when a clinic came to our school.   The process back then was pretty simple, as I recall: the biggest barrier for most students was that you had first to want to give blood; the notion of having a large needle inserted into the arm was off-putting for many of my classmates.   Once committed, you were asked if you’d eaten breakfast and then female students were given a test to check iron levels.  If all was well, you moved over to a cot where a nurse tied a rubber band a bit like a soft rubber hose around your arm and poked you with the needle.  Some ten to twenty minutes later, you were done, and got to move over to the table where they plied you with juice, cookies and doughnuts – almost making the donation worth it.  

I was no stranger to blood donation, having accompanied my father a few times as a girl, primarily for the free cookies.  The donation clinic would be set up in a municipal building with a number of temporary cots and a few tables and chairs for intake and for post donation recovery.   Queuing was minimal in those days, as the procedures were much simpler than nowadays. White smocked women would set up the blood drip while I stood by my father’s cot, waiting for the bag to fill up.  I guess I became acclimated to the process at an early age, so wasn’t put off by the idea when I had my first opportunity to donate.

Like my father, I have RH positive A-type blood, a little less common than the more ubiquitous O-type blood or so-called universal donor. Once in the blood donation system, I was called periodically over to make a donation, and over the years, gave less and more regularly depending on circumstances.  For the first year of my full-time job, a clinic would be set up in the lobby of Place Bell, the building adjacent to my office and it was easy to give blood during lunch time.  I was soon working in the plant of Gatineau and then later in the suburbs at our R&D headquarters and donation became less automatic.   I didn’t give for quite a time, and then when I got back to it, I was struck with how it had changed.

These changes took place in the years leading up to and following the Krever Inquiry into the “blood scandal”, where thousands of Canadians were infected with hepatitis and HIV by tainted blood collected by the Red Cross.  It became clear that the screening process must be changed dramatically, and indeed the approach has been altered radically.  A detailed list of  questions posed by a nurse in a face-to-face private cubicle – what one volunteer described to me on a recent donation as the “sex and drugs questions” – has been added in addition to ones which query your medical and travel history.  I am always amused about the question regarding whether you handle monkeys or their fluids, but presumably it is felt to be enough of a risk to appear on the list.  They now have you make a specific recommendation on using your blood (yes or no) on the form, nicely privatized with a bar code sticker that you remove after the nurse leaves the room so that no one but you knows your decision.

The clinics I have attended varied in size and shape.  The main donation centre in Ottawa had a tranquil permanent set up with comfy La-Z-Boy-like reclining chairs in a washable white vinyl.   For the last several years, I gave at the Blood Mobile that parked in our west-end office parking lot; this was a true study in efficient space use.   A camper-sized van was packed with a small waiting area for 2-3 people, two private rooms with doors for the nurse interviews, four bed, room for another 2-3 in the recovery area as well as every available space possible in use for storage for the accoutrements of the donation business. But most typically I would be in a temporary clinic set up in a cafeteria, fire hall, or most recently for me, in the show room of a car dealership.

The technology used in blood donations has changed dramatically as well.  A pen-like lance applies a miniature prick to your finger with a click to allow the intake staff to verify blood type.  An electronic meter measures hemoglobin levels replacing the old tube with the coloured fluid into which your blood was floated.  The bags are placed in a digital collection unit that continuously rocks to prevent the collected blood from clotting, while measuring the increasing weight of the bag, and ringing a bell if the collection rate slows or stops before the bag is full.   All major aspects of the donation are timed, including the time for the disinfectant to dry to the time you apply pressure to the puncture after the donation.

These clinics have become more complex with several waiting stations in advance of the actual blood donation.  The cheerful appointment schedulers who call to set you up suggest you plan for an hour for a donation, but in my experience this can easily double in something goes wrong.  As it invariably does – for example, two fewer than required beds were shipped to the clinic at the fire hall; another time bad weather meant the clinic was understaffed, and bewilderingly, staff tend to go on meal breaks at the busiest times of the clinic.  The queuing system is better than it was, but still imperfect – you’re given a number on entry, but that only follows you to the first station.  You then have a card with your name that you’re to drop into a usually well-hidden box from which the nurses select the next donor to be interviewed.  But often folks don’t see the box, especially if they are infrequent donors, and things get out of sequence.  Once through the nurse interview, your card is placed in another box for the line-up for the actual donation, but often the clinic staff here bypass the box especially if the line-up is small; if you’re not vigilant, you can be left behind.

Still the folks that work these clinics are on the whole efficient and cheerful; I’m sympathetic to their long days which include set up and take down of each clinic as well as transportation to and from the clinic site back to a central location before they can go home.  I am committed to donating blood because when my father was dying of a rare blood cancer similar to leukemia, he received many transfusions that gave him an improved quality of life in those difficult days.  This is my way of repaying the kindnesses of the people in those days who had it in them to give.

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