#1....Always, always, ALWAYS go with your gut! If you feel something is wrong, it could be! In this case, nothing was. You didn't do anything wrong, and you were able to think what to do next. When I worked as a LPN in LTC, I had a pt who was acting weird. My CNA's kept telling me something was wrong. The pt had been to the ER earlier in the day and they found nothing wrong, and sent him back. On assessment, I, too, thought something was wrong so I called the doc on call to see if I could sent pt back to the ER and he said "No, he's already been to the ER and the found nothing, so I won't give you the VO to send him." So, I got my charge nurse, explained to her I was sending him anyway, and I did. We get a call a few hours later from the ER doc who wanted to know why our on call doc wouldn't let us send him, and I told him. Then the ER doc tells me "Good, I am glad you sent him. His troponin level is off the charts!" Then we get a call a few hours later from our on call doc who was mad that I sent him without his ok....I don't know what he said to my charge nurse, but she was mad. He obviously didn't like me going against him. He didn't apologize for his behavior, but he hasn't been very nice to me since then. Oh well.....things could have ended differently, and the blame would be squarely on me, not him!
#2....always question. Everything. You learn more that way. Sometimes the hard way!