I have a question which I feel is a stupid one but I just need some confirmation on something that happened today at work.
As an LPN, when there are changes in a patients status, we are to make the charge nurse aware, correct? Then from there the charge nurse gives the action to take??
Today I had a patient take a downhill turn (had an increase in an analgesic).I made CN aware of what was going on and told her I was concerned and asked if Dr should be contacted. CN was not concerned,only saying her condition was probably due to medication. I kept assessing patient, charting observations, etc. and when a resident came onto unit then CN decided to report my findings.
Low and behold that patient required O2 and continuous O2 monitoring (respiratory depression due to medication). I feel this was not taken care of in a timely manner and wanting to know what I could have done differently. I didn't want to step on CNs toes, especially after hearing her get after a coworker for calling a doctor without asking her first. Any feedback??
So if a patient has an increase in their narcotic dosage it is not unusual to have some respiratory depression. We know this.
You say the patient's saturations went below 92%, this in itself is not ominous, you do not mention the respiratory rate. Now, if a patient is actually having a serious respiratory depression post narcotic analgesia Fiona is correct and the narcan protocol (if your workplace has one) should be followed.
Even if you don't have such a protocol, you as the bedside nurse should be able to start a little O2 therapy and continuous sat monitoring if you are really concerned.
If, however, the patient's saturations remained above 90% and the respiratory rate was adequate, it probably was appropriate to wait until the MD was rounding.
Again, I don't have the details, but there are actions to take as the bedside nurse in this situation besides charting values, take matters into your own hands.
Last edit by CodeteamB on Feb 11, '14
Thanks for all the replies
Last edit by mLPN79 on Feb 18, '14