YOU ARE NOT A FAILURE. I REPEAT, YOU ARE NOT A FAILURE!!!!!!!
You can take this experience as a learning lesson and grow from it
I am a new nurse myself, so take what I say with a grain of salt lol. I do have some questions though. Since your patient was on a cardizem gtt, how long was your patient in afib? What was the previous rhythm before it converted into afib? The patient is already compromised because of the lost of the atrial kick due to the atrium ineffectively contracting. That in it of itself decreases cardiac output. Do you remember what rate range the patient was in? Anything above 100bpm is a rapid ventricluar response and further decreases the cardiac output. The patient is also at risk for developing a clot. Does your floor monitor their own patient's heart rhythm or is it centralized to a location like rhythm central where they watch the essentially even patient on tele heart rhythms? Regardless, did anybody call to notified you of an alarming change in rhythm? In my current role as a nurse tech until I transfer later this month, I also have monitor duties where I monitor the patient's heart rate in my unit and other unit. More so than not, when a patient is brady-ing down rather quickly, I notify the nurse and they are prepare to code the patient. There is only one time I had a patient code without a rhythm change, it was a respiratory code. However, that patient was in a sinus rhythm. I'm not sure how it would apply since your patient was afib on a gtt. Cardizem suppresses the cardiac function, hence it's use to convert afib to a sinus rhythm. I don't think it overly suppress your patient's status to cause a code, but just be mindful of the adverse effects.
Second, you mention that the patient's oxygen sats were low. We already know CO is low, so we don't have enough tissue perfusion and gas exchange. How did you guys address the low O2? What were his vitals like? How was the patient's outward apperance? Was this patient also a COPDer? Was the patient anxious? Any signs of respiratory distress (labored, rapid, shallow breathing)? Did you call RT? If oxygen was place through what method (NC, face mask, Non-rebreather) and how many liters of O2 used? Did it correct the problem? At anytime before the code, was the physician noted about the change in patient status? Any new orders given?
When you went in to hang fluids, do you check to see if the patient was still breathing? You know, just the quick check to see the rise and fall of the chest since he was having oxygen issues earlier.
During report, did the see any abnormal labs, radiology, or anything that may of concern you? If so, did the previous nurse address those issues with the physician before the end of his/her shift?
As for the code is, if your glasses were falling off during compressions, quickly put it in your pocket and continue doing compressions. Also, it is important for you to get on the bed with your knees against the patient. This will allow you to more to apply more downward force onto the chest. This is what they taught us during our skills day. I've done chest compressions in a code once and remembered to hop onto to bed and started pushing. Were ABGs drawn? Were you able to find out the results of the ABGs?