As healthcare professionals nurses have broad responsibilities to advocate for the best interests and health outcomes of their patients.

The stories on this page demonstrate the complexity of blood donor screening and the broad skills that are necessary to safely complete that task.

Care has been taken to protect the anonymity of both the donor and the nurse. The events described below are factual.

Nurse spots shortness of breath and 'flushed' skin colour, symptoms not reported in a donor's questionnaire
"I clearly remember the young woman who came to donate blood. I reviewed her donor questionnaire and completed her vital signs (temperature, blood pressure, pulse) which showed it was alright for her to donate blood. But she was slightly short of breath and looked flushed (her face was slightly red) so I started to ask more questions about her health.

On her questionnaire the donor did not report she had recently stopped taking a blood pressure medication because it caused a reaction. Her doctor was about to try another medication. She was also booked for a stress test.

My nurse's training helped me notice subtle symptoms and I didn't allow the blood donation, which if taken could have caused extra shortness of breath or more serious conditions."
CBS nurse, Western Canada

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Artificially low blood pressure could have harmed a donor
"Some time ago I was doing a health interview with a donor. I took her blood pressure, pulse and temperature and everything looked fine on paper. The donor's medication wouldn't prevent a donation.

But something didn't seem right. The donor's size and weight should have put her blood pressure on the high end of the acceptable range, but instead it was at the very low end of the range.

I began probing and she disclosed she had more than doubled her dosage of blood pressure medication that morning so her blood pressure would be acceptable and she could make her regular donation. She felt it was very important for her to help others by donating blood.

I didn't allow the donation because her blood pressure was already artificially low. Making a donation would have lowered it further and could have created an unsafe situation for her. I counseled the donor to take care of herself first before making a donation to help others and stressed the importance of taking her blood pressure medication as prescribed by her doctor to ensure her own wellbeing.

Even though the donor's situation looked fine on paper, it was my training and experience as a nurse that caused me to dig deeper. Without those skills the donation would have proceeded and the donor could have experienced chest pain, loss of consciousness and a seizure."
CBS nurse, Atlantic Canada

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Nurse finds unreported cancer screening that prevented blood donation
"A man came to our clinic to make a blood donation. After checking his vital signs and reviewing his screening questionnaire he fell within acceptable criteria to donate blood. I was about to approve his donation when I noticed a very slight bruising on his arm in a location where blood would normally be drawn.

I thought I should dig deeper and ask if he had given blood recently or had other blood work done. None was reported on his questionnaire. The donor said he was being checked regularly for prostate cancer through PSA tests. The bruising on his arm was a result of blood being drawn for those tests.

I would not allow the donation, but someone without a nurse's education and experience would likely not notice the slight bruising on his arm that discovered unreported health problems."
CBS nurse, British Columbia

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Stress test leads to donor deferral
"During the screening process I noticed the donor was short of breath. Her vital signs were within acceptable guidelines and answers on her questionnaire looked OK.

I started talking to the donor about her shortness of breath and discovered she was about to have a stress test. The donor didn't understand that having a stress test meant she was 'under a doctor's care.' If she did understand that connection she would have answered the questionnaire differently.

I took the opportunity to talk with her about the stress test, her health issues and ways she could improve her health."
CBS nurse, Ontario

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