Without giving too much info, I just need to know if I could have/should have handled this situation better.
Pt came in with sickle cell crisis. Morphine ordered 10mg IV Q3H PRN pain. Also had a few other meds but only the morphine would touch his pain. He was tearing up, sweating, moaning--obviously in severe distress, altho O2 sat spot check was ok (we don't have cont monitoring). When I took report on him and then went in to check him out, I had that feeling about him...so I propped his door for the evening and stayed nearby to do all my charting, etc. He was snoring loudly, and I could his his rate creeping up--it had been 24, went up to 36 (about 2 hours post-morphine)...HR was 144, grabbed the sat monitor---28%
Threw a simple facemask on him and cranked up the O2 and he got up to 58% sat. It would go higher if I could get him to talk to me, but he was really sleepy. Finally got him up to 90's. We ended up transferring him to a higher acuity floor.
I had much more seasoned nurses (I am a new grad) tell me that I had oversedated. Well...I don't really agree with that because his rate was UP up up--his drive wasn't gone. He was able to wake up and request more meds (he was still in pain). I haven't had a sickle cell patient before, and if I handled things poorly, I'd like to know so I can provide better care next time.