Pretending to palpate pulses

Nurses General Nursing

Published

I know that nurses are often time crunched and some pulses are often hard to palpate, but...

I had a patient in clinicals who had just had iliac stent placement for PVD, so palpating pulses distal to this stent were vital to the assessment. I informed the nurse that I couldn't feel the politeal and asked if she could check. She comes in and places 2 fingers on the patient's knee and says "Yeah, I can feel it really lightly."

:confused:

Now, if my understanding of anatomy is correct- is the politeal not palpated BEHIND the knee???

I reached over to feel what she claimed to be feeling and she smiled and walked away to document positive pulses. Aarrggg!

Specializes in Community Health, Med-Surg, Home Health.

Never had to search for a distal pulse except once in my clinic; hypertensive patient to receive clonidine 0.1mg po. One arm was used for dialysis, the other was formally used, but was still damaged, so, the doctor left instructions to take the pressure on a leg. I had to dig really deep for the popliteal before I discovered something really faint and attempted. I had gotten 180/98 and I still didn't think I was right. Asked another nurse and she told me to 'just use the electronic b/p". I had to go to a few before finally, someone told me I can better feel the popliteal by laying the patient down on the exam bed. The RN that told me this took over and did the rest.

Next time I work on the floor, I will try and find a pedal pulse to get a bit of practice. Hope there is a doppler around just in case.

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I'm not asking a question. I KNOW where the pulse is. I am just shocked that a nurse would not- but would pretend to.

I think it is horrifying that someone would disregard such a vital component of this patient's care!

:twocents:As a patient advocate, did you address your concern directly to this nurse colleague? (IMO and experience nurses are willing to listen to criticism if it's presented in a way that lets them save face.) The the nurse in question might not be tempted to cut corners, and care rendered to his/her patients improves. idk but that's what I would have done.

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Specializes in Operating Room Nursing.
:twocents:As a patient advocate, did you address your concern directly to this nurse colleague? (IMO and experience nurses are willing to listen to criticism if it's presented in a way that lets them save face.) The the nurse in question might not be tempted to cut corners, and care rendered to his/her patients improves. idk but that's what I would have done.

Not a good idea. Do not confront this nurse about it directly because she may get defensive and set out to make your clinicals a nightmare. You can advocate for you patient by reporting this to your clinical facilitator and letting them deal with it. Some nurses may perceive this as a student underming qualified nurses and take it out on the student. It shouldn't be this way but unfortunately it is in real life. And by bringing this to the facilitator puts the responsibility into their hands and if something does happen to the patient you have done the right thing by reporting it to a senior person.

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Not a good idea. Do not confront this nurse about it directly because she may get defensive and set out to make your clinicals a nightmare. You can advocate for you patient by reporting this to your clinical facilitator and letting them deal with it. Some nurses may perceive this as a student underming qualified nurses and take it out on the student. It shouldn't be this way but unfortunately it is in real life. And by bringing this to the facilitator puts the responsibility into their hands and if something does happen to the patient you have done the right thing by reporting it to a senior person.

Agree. Ideally if it were just about providing safe pt care my idea would work. Sadly, it's rarely that simple.

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