Pretending to palpate pulses

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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!

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Specializes in ICU/Critical Care.

Did she even bother to palpate the pedal pulses? Posterior tibial? I hardly ever palpate the popliteal because IMHO, if the patient has a PT and DP pulses then they obviously are getting arterial flow to the extremities.And I've never known the popliteal pulse to be palpated anywhere besides the back of the knee.

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The patient had a BKA, so this was really the only assessment point for this extremity!

:uhoh21:

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Specializes in ICU/Critical Care.
The patient had a BKA, so this was really the only assessment point for this extremity!

:uhoh21:

Oh...:stone

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Well, I guess that answers Michigan's question. ;)

I often have trouble finding distal pulxes, at least, strongly enough to count them. But no, I don't fake finding them. I ask another to assess and expect that they really will.

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[[/b]

the patient had a bka, so this was really the only assessment point for this extremity!

:uhoh21:

omg......hmm....that is just ahuge patient safety issue. i mean that is someones mother, brother, father, sister , child or friend lying there......that patient is somebody special to someone.......and that is just wrong. i hate that you had to witness that...and i hope the patient is ok. i mean those stents can occlude etc etc etc...bad things can happen.

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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!

I'm assuming you're a student here (and that it can be intimidating to question a staff nurse's assessment/intervention).... You don't say what happened afterwards other than the staff nurse charted a + popliteal pulse on a site that wasn't correct to assess (and smiled about it.... what was that all about, I wonder?). You also don't mention any assessment of the stump (color/temp)... Anyhoodles, I hope you discussed the whole popliteal thang with the nurse.

Never be afraid to question! Sometimes the students know more than the nurses!

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Specializes in SICU.

As mentioned above color, blanching, temp, mottling, are all other signs of blood flow status. Not every one is as adept at palpating as another. There have been patients that I have felt a weak pulse and another nurse said they were doppler only (and vice versa). I have had patients where I could feel them half of the time and could only doppler them the other half. The nurse should have used this as a teaching opportunity, and then you probably wouldn't be asking this question. That all goes back to the fact that some nurses are just not teachers. I can always tell the poor nurses that orient with them because they are great at the "tasks" but they are very unsure of their assessment skills ( more so than normal of course as a new nurse...lol)

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The nurse should have used this as a teaching opportunity, and then you probably wouldn't be asking this question.

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!

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:chuckle

Im sorry, I couldn't control myself.

Maybe she was a new grad. Or an old one, Im not sure if they emphasize on teaching pedal/popliteal/femoral pulses.

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The nurse should have used this as a teaching opportunity, and then you probably wouldn't be asking this question.

You can't teach what you don't know!

That nurse obviously didn't have a clue, so if she were to take this as an opportunity to teach, then she would have been passing on the dummy torch of pseudo-knowledge!

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Specializes in SICU.

You are probably right about the dummy torch... but it really bugs me that so many nurses can't simply say, "I don't know". If that was the case, she should have directed the student/poster and herself to someone that did. There is no place for egos when someone else's well being is concerned. It is not a sign of weakness or stupidity, but I dare say a sign of intelligence and compassion to seek out answers to make sure you are providing competent and safe nursing care, and teaching a new nurse how to do the same.

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