bel far niente: March 2013

Just feel that I should blog about the incident that happened this afternoon.

I went for my clinical placement this afternoon. There are a few events that I would like to reflect on.

So I was asked to answer the phone by one of the staff nurses just now. That person called us to send two patients from our ward for MRI. I didn't pay attention to memorize the names of the patients so i couldn't answer properly when the staff nurse asked me. I realized that I often give replies like "I forgot", "I'm not sure" when people asked me something.

If the same thing happens again in the future, please remember to write down the names in your small notebook! "I forgot" is such an irresponsible answer!

As usual, we were to help to take the vital signs of the patients. Another staff nurse told my friend and I to take the vital signs of patients in room1, room2 and other beds (which I couldn't recall again :( ). So after room1 and room2, my friend said we have to check bed 6.

Unfortunately, I couldn't record patient's blood pressure as I couldn't hear anything. I tried for the second time but to no avail. I got a little bit nervous at that time as my supervisor, a staff nurse and the relatives of the patient were looking at me. My supervisor then called me aside and asked me where did I put the cuff. She then told me that, I wasn't supposed to measure the blood pressure from patient's right arm as she might have something inserted in her veins in her right arm for dialysis, and that was the reason why i couldn't take the readings.

I felt really really bad at that time. I was really afraid that something bad would happen to the patient due to my ignorance.

I felt much more relieved after my supervisor explained to us and assured that nothing will happen to the patient.

My friend then told me that she hopes she didn't remember wrongly the bed number that we are supposed to check. I can't blame her because I am supposed to remember it when the nurse told us. I can only blame myself. However, the patient's arm looks normal to me as i didn't realize any incision. I feel really really really guilty for what had happened just now.

Some information that i found online..

Fistula
A fistula (also called an AV fistula) is a place where one of your arteries connects to one of your veins. Your fistula would be created during a minor surgery and would need time to heal and “mature” before it can be used. Then, during dialysis treatments, needles will be put into your matured fistula.

In most cases, your fistula will be placed in your non-dominant arm. This means that if you are right-handed, your fistula would likely be in your left arm.

A fistula is the best kind of access. It is the least likely to get clots or infections. Fistulas also tend to last longer than other types of access. But, because fistulas can take longer to heal, it is important to plan ahead. Talk to your doctor about your options and whether a fistula is right for you.
Graft
A graft (also called an AV graft) is a special tube that connects an artery and a vein in your arm. Like with a fistula, a graft would be placed under your skin during a minor surgery. Your graft will need time to heal, too, but it probably won’t take as long as a fistula to be ready. During dialysis treatments, needles will be put into the graft.

In most cases, your graft will be placed in your non-dominant arm. This means that if you are right handed, your graft would likely be in your left arm.

Grafts are not as safe as fistulas. They are a little more likely to have infections or get clots. Still, many people do well with grafts. Talk to your doctor about your options and whether a graft is right for you.

To care for fistulas and grafts:

Keep the area clean
Use your access only for dialysis
Do not have blood tests or check blood pressure on your access arm
Avoid having tight clothing or jewelry near your access
Protect your access from bumps and cuts
Avoid lifting heavy objects
Try not to lay or sleep on your access
Learn how your needles will be placed for dialysis (The staff at your dialysis center can help you with this.)
Make sure that the staff at your dialysis center checks your access at each treatment
Tell your doctor right away if you notice any swelling, redness or other changes in your access

I am really hoping that nothing will happen to the patient. I am really really sorry..

* * * * *

Just got a text from my supervisor. She said that the patient is ok and went for her haemodialysis in the morning.
Thank god...I am really glad that the patient is ok..I hope she will be discharged soon. ..