So i feel awful about the whole thing. I received a transfer feom the icu the other night around 10 pm, i assessed him, and his fistula in his right arm was fine. We were short staffed in the morning and another nurse helped by getting all the vitals. I had never checked to make sure the patient had a no bp bracelet on, since he was aox3 and had been in the icu for 3 days. The rn took the blood pressure in the right arm and the pt started screaming at everyone. The supervisor and doctor were notified. Tje dr came in and said he didnt think any damage had been done to the fistula. The renal dr wanted an incident report filled out by both myself and the other rn who got the bp. I blame myself for not checking for an armband i should have. On the other hand idk how the nurse didnt notice the fistula, and the patient was alert and only 40 he could have said something. I feel horrible that i made such a dumb mistake I have never had to fill out an incident report. I pray the fistula is ok. Is there any chance I could get sued for this or my license could be in jepardy? Maybe I am overreacting, the supervisor didnt seem too concerned, but i can not stop worrying about it.
Aug 3, '12
The concern is one of clotting of the fistula but one BP probably will not cause harm.The patient should be instructed to monitor his fistula and notify his MD should he lose the thrill and the clot can then be removed. I agree..... the patient needs to advocate for himself and should have told the nurse not to use that arm but we all know how passive some patients can be. Fistulas once matured can last quite awhile. Honestly, I have seen so so many nurses start IVs in arms with grafts and fistulas that I later had to re-site to the opposite arm and I never saw any damage occur unless it was persistent and severe. You will be OK...you are NOT responsible for another's actions..the nurse who took the BP should have checked...I would be upset if they wrote me up for something I did not do.