Swallowing Pride

[CountryMomma, ASN, RN]

I like to think I am a fairly independent, intelligent, got-my-stuff-together nursing student. I'm confident, I'm capable, I'm on my way up.

Until today, when I had to swallow my pride and ask my instructor to help me find my client's apical pulse.

I looked all over. I counted rib spaces. I tried APETM, I even asked him to hold his breath. Nothing doing. I was stumped, and I have never felt so embarrased and dumb as when I had to ask for help doing something we learned the third week of class.

That didn't last long, as she was unable to find it too! I was so relieved to see her looking more and more perplexed, because it meant I wasn't incompetent. She shook her head and smiled, and then told me that he was the third person in her nursing career in which he was obviously living, relatively stable and healthy, yet was near impossible to find the apical pulse.

She also confirmed my impression that the man's pedal pulses played hide and go bump to the point where counting them was impossible. Oddly enough, he had great cap refill.

Anyone else have that moment, when you just need to swallow your pride and ask, "What is going on here?!" ?

(My instructor said when you run into cases like this, having the client lean forward a bit while sitting can increase the PMI, or you can attempt to listen from the back.)