Im looking for some advice. The other night I had a patient who abruptly had a change in their respiratory status and suddenly became tachypneic and had increasing hr. I wanted to call the md because I knew something was up and I asserted this multiple times to the charge nurse, who kept stating that it was too late at night to call and I should wait. The patient ended up decompensating (and wouldnt you after 3hrs of working to breathe?) and had to be intubated shortly after I left. I feel like it's my fault because I should have some how asserted myself differently to the charge nurse, but on the other hand, I also need to be respectful of the charge nurse who has more experience.
How can I respectfully go against the recommendation of the charge nurse next time? I feel like I made my point multiple times each hour that I wanted to call and I was worried she was worsening. I understand that in most cases, I should trust the charge nurse, but what about those times (like this time) when you just know that something is up with your patient? How can I do better next time? I definitely still need to ask before I call, but how can I get around it if they say no and I really really feel like I need to call?
