A renal failure patient presents to the renal unit for a follow-up exam for a UTI. The nurse places a BP cuff on the patient’s arm, and at that moment, detects the thrill from a dialysis fistula. As...

A renal failure patient presents to the renal unit for a follow-up exam for a UTI. The nurse places a BP cuff on the patient’s arm, and at that moment, detects the thrill from a dialysis fistula. As she removes the BP cuff, the doctor, seeing what she has done, reprimands her in front of the patient and the patient’s friends, stating abruptly, “The patient has a fistula in that arm.” The nurse is embarrassed but does not speak to the doctor about the situation. Later that day, the same doctor asks another team member, a nurse, for a report on one of his patients. The nurse proceeds with the report but is unable to recall the patient’s BP or pulse. Another nurse who knows of this information chooses not to share it with the doctor for fear he will reprimand her for speaking up. You are an in charge nurse of the renal unit. The nurse should obtain information that clarifies the nature of the problem and suggests possible solutions. Discuss ways the this situation could have been avoided and the clinical reasoning skills are needed for effective clinical decision in this scenario?