Oxygen levels possibly hurt pt?!

[samiam4]

I was switching my patients nasal cannula over to a nonmask rebreather with a PCA tech. The pt must be on oxygen at all times so I had someone help me. When the PCA switched patient over from nasal cannula to nonmask rebreather I somehow accidently plugged in the wrong O2...Somehow I replugged the nasal cannula tube back into the air supply. After a few seconds I noticed the nonmask rebreather was not inflating with oxygen so I quickly saw my mistake and switched the tube quickly back to the nonmask rebreather. Pt. oxygen went from 85 to 60(when we were switching his oxygen) back up to 88-90. (pt. was on 15L nonmask rebreather and 12L nasal cannula)

I feel really bad that I caused his oxygen level to get that low due to my mistake in plugging in the wrong tube. After that mistake pt was fine, he was laughing, joking around, no problems. About 36hrs later, I found out patient had passed away. Could I have caused a problem? I am a nursing student and I feel awful. Since his death I think about everything I did that day from "did I hang the correct IVPB", "did this O2 level cause something bad to happen", he also had gotten insulin (BS 298) and he ended up not eating his lunch except for a few peaches so I think "what if I bottomed pt. out and he went into a coma...." I always think worse case scenario. I keep talking about it and I try to figure out my day and what I did and I keep blaming myself for his death because I feel like I had a horrible day at clinical.

I don't want to contact my instructer again about it because I think she'll think I'm crazy. I talked to her and she said "you did nothing to cause this man's death." Though she doesn't know about the O2 instance. My thoughts are becoming very obssessive, and I cry about it. Can someone give me some advice on how to deal? What do you think about my scenario?

[psu_213, BSN, RN]

My instructor said that it looked like his body was shutting down- due to his lab values......

I really dislike this phrase (the italics part). If you ever watch the 'true' medical shows on TV (e.g. Mystery Diagnosis) they use this phrase way, way too often. In this case, you had a pt who was very sick. In addition to his respiratory issues it sounds like he also developed increased cardiac issues and AKI--not sure if the kidney issue was secondary to poor cardiac function or vice versa. Not to minimize his death, but there is a lot of interesting patho going on. Regardless, it was his chronic illnesses that caused his death, not a few seconds without supplemental oxygen.

[blueheaven]

You didn't make him sicker. He was dying. If you can't get through this, please talk with someone about it. A friend of mine with PH was on 100% non rebreather and talking to me and in a manner of minutes he was gone when he had an episode of coughing.