i work in outpatient surgery, and all of the procedures are conscious sedation with fentanyl and versed. i am a new grad, this is my first job and i have been there for one month, and i am admittedly embarrassed to say that i do not know our standing policy and procedure for what happened today, and i am curious as to what yours are or what you would do.
the patient in for the procedure was very petite, and had a history of being a light weight with meds. she had had a similar procedure with us a year ago, and took an hour to wake up fully afterward. the nurses/doctor were made aware and they proceeded. she was given a small amount of each drug, and it wasn't touching her. she was jumping off the table. they pushed a little more, and she was out. her resps were still 14, sats 100%, bp 110/72, pulse 80. everything was totally normal, she was just sleepy. the nurse pushing and dr decided to reverse the versed, but not the fentanyl. she was then arousable with loud voices and shaking. all of her vitals were still normal. when we took her to recovery, the nurse there asked the dr if she could give narcan, and he said no. vitals remained the same and she had a bag of 1000ns hanging and runnning. recovery nurse stated she was giving narcan regardless, and she did. she ordered me to get 02 on her, and i froze- her sats were 100%, and i did not know why we would give o2 so i said i was not comfortable doing so, so told her so. she then put it on herself. patient was not becoming any more arousable with the narcan, vitals still stable. so, she starts sternal rubbing her. HARD. i looked to my manager, the dr, and the nurse who pushed and said "i am not ok with this". my manager said i was right, and told me to clock out and go home (it was our last patient of the day).
so. what do you do when this happens? i really don't know, and the recovery nurse was blatantly defying the drs orders- he said she was stable and would arouse soon and did not want the nurse to do this. i was/am pretty upset about my patient being sternal rubbed so freaking hard, and was crying when i left. any advice/tips/procedures you would share?