A nursing student complained about being partnered with an overweight classmate for a mutual blood pressure taking exercise.
After unsuccessfully finding a pulse on her "arms as wide as watermelons," she employed thigh cuffs and still failed to get an accurate blood pressure reading, which ended in her dismissal from the program.
"So I'm a nursing student and we're doing pulses and blood pressures in a test off setting."
"We are matched with other students to do our pulse and blood pressure we only have one try and if we fail we get kicked out of the program."
"So I get matched with this girl I'll call Patty. Patty is at least 350 pounds and her arms are as wide as watermelons."
"So I had to do her pulse well if you don't know anything about doing pulse on an extremely obese patient it's hard to find because there are so many layers of fat."
Studies have shown that overweight patients can be falsely diagnosed as hypertensive if the arm cuffs are the wrong size. There are increasing demands for manufacturers to include different sizes in sphygmomanometry kits.
Special cuffs with small dimensions known as wide-range cuffs linked to oscillometric devices are known to yield more accurate BP results on patients who cannot use the the appropriate sized cuffs.
It seems many MDs and RNs have much more to learn.
Evidence-based BP measurement is lacking in MANY studies. We have found that most MDs and RNs are not even aware of… https://t.co/oada8vgdbQ— AnneAlexandrovPhD (@AnneAlexandrovPhD) 1566164943.0
The OP had to ask for assistance, but even the teacher found it to be a challenge.
"So the teacher and I were trying to find her pulse and we both were struggling."
"We finally got it and the teacher lost it half way through so I had to start over."
"I mean this is a teacher with many years of nursing experience who couldn't find this girls pulse because she was over 350 pounds."
After assuming there were limited resources available, the OP found herself having to improvise.
"So I'm on a time limit right. So her arm is too big for the regular blood pressure cuff. So I had to find the thigh cuff that people use on thighs on her arm."
"Well when you pump them up it's really hard because of all the resistance so I could hardly pump it up too which gave me a wacky blood pressure reading."
As a result of the failed test, the OP complained about the unfairness of being coupled with Patty.
"I told the teacher it was unfair that I was partnered with Patty because she was so obese and that I was given an impossible task."
"I told her that I shouldn't be out of the program when other people had partners who were a normal weight that they could actually palpitate their pulses."
Was it the manner in which she pleaded her case that led to this response?
"My teacher said that was rude but I think it's true so AITA?"
Some Redditors were skeptical about the strict pass or fail guidelines the OP had mentioned.
"I'm in an accelerated LVN program. Skills tests are pass/fail and missing more than two days of any course will get you dropped from the program and have to wait for another available slot to redo the semester."
"We also have three chances to pass medication conversion math tests. They really don't mess around in nursing school."
The same user, however, said that the OP's attitude could affect her overall performance in the class.
"I will say this, failing someone over pulse and BP makes me wonder about their general attitude in class and how well they get along with their instructors if they act that way towards a classmate."
"Based off OPs username, I think their attitude is the issue more than the skill test."
"I can tell you I sucked at my BP test but my instructor knew I'd get better at clinicals. And I did." – instant_chai
This Redditor also believes a student's attitude could determine whether or not a student remains in the program.
"IMO they were failed over their attitude, not their inability to do the assignment."
"You're going to have obese patients, you need to be able to treat them with respect and not blame them for not being able to get a reading." – jhaz622
This user agreed about equal respect for all patients but sided with the OP with a bulleted list.
"Imo, that line of thinking doesn't apply in this context. I agree that OP should treat obese people with the respect everyone deserves."
"However, OP wasn't necessarily complaining about the student's obesity, but rather the task they were given to perform on the student."
"I can imagine how obesity would make this particular task much more difficult, as it would create restricted access to the blood vessels."
"1. Special equipment had to be used."
"2. Even an instructor struggled with the assigned task."
"3. Given the above reasons, this doesn't seem like a fair thing to ask of a student in a timed/pass or fail/get kicked out of the program situation."
"4 OP was not complaining about the obesity, they were complaining about the impact it had on the ability to complete the task."
"I'm with OP." – bsmorley
"A simple meeting in the office might have solved the issue without even using the word obese all the OP would have to say 'we had to get a special piece of equipment and even you had problem trying to get the pulse that's why I think I deserve a chance to try again on someone else.'" – Gamergeek57
"Are they going to kick a student out for failing to do something the teacher couldn't even do? Th at doesn't seem fair." – repthe732
One self-proclaimed "friggin giant person" did not mince words and said most of the comments criticizing the OP were "bonkers."
"I'm ... a friggin giant person at 6'4 and heavily into powerlifting. Things are never really 'normal' for me."
"I'm aware of this. These soft a$holes in the comments complaining about her attitude about fat people is stupid. She did fail because the girl was either fat or it is hard to take her pulse."
"This person was given a task that was not controlled across the class and the instructor failed to do it correctly... the instructor should be able to breeze through the assignment."
"She failed because the person was fat. She's early in her training and these a$holes decided to provide her a more difficult task than her peers that could get her kicked from the program. F**k that."
"Yes she will encounter an obese person. But she won't be under a pressured time constraint to do so and will have far more experience."
A nursing school graduate made an assumption based on the OP's competence level.
"As someone who just graduated nursing school I don't believe that this tutor had trouble finding a pulse, it was probably test conditions and they didn't want to influence."
"The fact the OP didn't know where the bariatric cuffs were kept with in the lab probably counts against her, we always had to know where everything was in our labs."
"Finally 350pounds is very big but is actually with in normal ranges of bariatric equipment such as a BP cuff."
"What OP showed was that she was unable to asses vital signs. Normally this type of test is just before clinicals, so it is unsafe for OP to be released on real patients." – coolplantsbruh
"OP could have also taken the BP from the forearm which, while it doesn't seem like that's what was exactly wanted, it would have been something instead of throwing their hands up in the air and giving up."
"I really think this is a made up story but also I know a lot of nursing students with the same attitude so who knows."
"Edit: not to mention I can't imagine a nursing program that would kick someone out over not being able to find someone's blood pressure." – lasyers
While measuring the BP from the forearm is occasionally seen as an acceptable alternative, a study concluded that the differences between arm and forearm BP measurements were "clinically outstanding" and determined that forearm BP measurement "does not seem advisable in obese patients."
Aside from alternative BP measurement methods, the answer to the OP's question was an obvious one for this professional nurse.
"As a nurse, bedside manner and humility is EVERYTHING."
"It says a lot when OP makes her lack of skills the patient's fault."
"You're a nursing student. There are things you need more practice with. That's not a bad thing. Just practice."
"But NEVER make your mistakes the patient's fault." – jossysmama
"But rather than accept failing and point out the teacher had a lot of difficulty in order to retain their place, they'd rather blame their patient than their lack of equipment or skill." – Jonatc87
Excuses will not get you far.
"They were complaining about the fairness of a real world situation they will face often that they must overcome or risk killing someone."
"No one's gonna give a damn about 'fattythrowaways' excuses on the job."
"'The patient is obese'"
"'And?'" – Burlesque_Djin
This person said the OP ultimately failed and not solely because of the test.
"I do wonder though, how that private conversation went with the teacher. If OP was as obviously disgusted with fat people in that conversation as in this thread, I can see why the teacher said they were rude."
"You can't just dismiss people who need medical attention, even if they are 'fattys with watermelon sized arms.'"
"OP-your attitude sucks. I feel like this should have been crystal clear to you before signing up to work in healthcare, but just to be sure: Don't go into this field if you are only expecting to help thin, healthy people."
"You are dogging Patty when, at the end of the day, YOU FAILED. She didn't make you fail."
"I understand your point and I agree NTA based only on that. But for f***s sake, at least try hide your prejudices a little better in a professional setting."
"I feel bad for Patty more than anyone here. I am sure your charming personality made her feel truly cared for." – itsjustmebee
"Don't just hide the prejudice. Preconceptions and biases against fat patients decrease quality of care, increase risk of misdiagnosis or severity of disease, cause fat people to avoid doctors, and contribute to higher morbidity and mortality."
"OP needs to do some reading and be better." – Oleanderphd
So, what do you think?