Respiratory Distress - How would you have handled it?

[eskimoRN]

This is my first post here, I am in my first year of nursing, working part-time in LTC. I have a patient that has been weighing heavily on my heart all week. I keep running the situation over and over in my mind, can't sleep, still feel like the panic of the situation is with me. Prior to this the only patients I have had actively dying were DNR/hospice which I feel I managed well. This pt was a full code and I just keep wondering did I do enough? Would a more experienced nurse have been able to change the course of events? My coworkers and unit manager said that I handled it well but I don't feel that way at all. I feel guilty/incompetent/full of self-doubt though I don't know why. So I would like to pose the scenario to some experienced nurses on here to see if you come up with something I missed:

You have elderly male, recently admitted from hospital for COPD exacerbation, hx of a fib, on 2L o2... night before he desatted to mid 80s resolved with neb tx to low 90s (baseline). Aspiration precautions, nectar liquids, trialing thin liquids. He was turned up to 3l when you come in o2 at 99, you bring it down to 2l he is stable at his baseline low 90s again. He desats on you in the afternoon, responds well to neb, O2, Vs, everything looks fine but pt has anxiety, requests transfer to hospital, during transfer process he desats again mid80s becomes somnolent, not arousable... go from here:

What kind of assistance do you call? Code, supervisor, another nurse, none?

What do you do for oxygen and what equipment do you use?

Before the somnolence when he was stable after the neb would you have held his afternoon meds? verapamil?

Do you think this event was related to the COPD or from the a fib (possible PE, MI, etc?)

[systoly]

your coworkers and unit manager have much better info than you could

possibly post and they said you did ok, but for some reason you have

difficulty coping with the outcome

does your employer offer any counseling or can you confide in your manager?

[eskimoRN]

I'm not sure if they offer counseling... I brought it up to my unit manager and she said I did fine, I wrote a good note, and the family was happy with my care and attentiveness during the respiratory distress (family member was in the room at the time)... I just feel like Im going over it in my head so much I thought if i go over it like a case study scenario it might give me fresh insights and help ease my mind... I have brought it up with a few coworkers who I trust and Ive gotten conflicting information on how to handle it (dont call a code because they have a pulse, are breathing bs call a code because you want help right there if you need it)... also saw conflicting info on these boards on whether to give high flow o2 or not due to co2 retention/losing hypoxic drive etc... and wondering how seasoned nurses handle these types of patients? He didnt code in the facility but watching someone crash and not feeling 1000% sure of everything you are doing is a scary feeling...