Hi everyone! I am in need of some encouragement here. I've only been a nurse for about a year and so I feel stupid like I missed something and can't forgive myself. On my first night working this week, I had an older adult female (patient A) 61y.o. that was assigned to me. The day shift nurse told me that the patient was somewhat confused at times (alert to person and place most of the time but couldn't tell you the date), and that she could walk to the bedside commode with assistance, but that she was a big lady and really needed persuading to get her out of bed instead of using the bedpan like she prefers. She had a colon resection the day before and did have SCDs and TEDs on. Upon entering the room at the beginning of the night, the lady demanded (not asked) that she have some Ativan because she was feeling very anxious, so, after assisted her up to the BSC and back to bed, I gave her 1mg to help her anxiety. Anyways, as the night progressed, the lady tossed and turned in bed, and tried to get up a few times unassisted so I put her bed alarm on and continued to check on her frequently throughout the night (at least one to two times an hour). I checked her vitals around 0400 and I had a little difficulty obtaining her bp, but that's no surprise because our vital machines malfunction frequently (old pieces of crap), so I got her vitals manually and didn't note anything unusual for her. I gave her bath around 0600, and checked on her again around 0650 She made it fine until the end of my shift and after I had passed off report at 0700 and got ready to leave, a nurse tech went to go check on her and do the morning vitals and found patient A unresponsive and blue. After calling a code, we tried to resuscitate her and managed to long enough to get her down to ICU where they put her on a vent. When they did a CT scan they found that she is severely brain damaged due to hypoxia and her family decided to remove life support. Now, it's been three days since this event and I keep replaying events in my mind over and over, trying to figure out what I missed. I had just thought that the lady's agitation was related to possible sun-downers or that she had reacted strangely to the Ativan. Now maybe I think she was in distress and I didn't even notice. I feel so stupid and inadequate. The doctors said that they think that she may have had a PE and said that there was not much I would have been able to do anyways, but I still feel terrible. The family came up to our floor and thanked us for trying our hardest to save her. I just keep thinking wouldh've/couldh've/shouldh've and it's hard for me to let it go.
Now I'm scared to go back to work for fear that I'll miss something again.