For those that didn't see my post, I had a patient come in after surgery who was very sedated, however...didn't meet the criteria for using narcan. He had serious sleep apnea so his pulse ox went from the 70-90's dependant on what part of the snore he was on, had good color, breathing about 18-20. I had called the MD, I did everything correctly...I even came on here and discussed my actions which no one said I was incorrect for holding narcan for a pt with hx of being overly sensitive to IV medications, post large back surgery, and it being near 11pm! I was of the mindset to let him sleep it off, and I will monitor closely instead of stripping his opiate receptors and leaving him in uncontrolled pain!
The nurse after me used the narcan X3!!!!!!!!! (did she wait to tritrate to effect long enough???!!!) And since she used narcan it needs to be investigated (protocol). She pointed the finger at me being at fault (just like I thought she would!). She said I didn't tell her about the pulse ox ...OMG yes I did, ad nauseum infact...and told her about the differences between breaths and I put him on 4L of O2, and that if she uses the pulse ox to wait a while and watch the trend. Guess she didn't. Also she said she couldn't wake the pt...I could...so I wonder what is up with that?
SO again...I was called into the managers office to discuss this. My boss seemed very perplexed about the pointing of fingers...and I said I was not suprised at this at all...and told her my side of the story...quoting my own documentation, people that were with me for reference..and my clincial opinion of the situation. Needless to say that my documentation was beyond efficient (two pages of details), and the managers were all on my side! The poor pt had to go through 2 days of uncontrolled pain because of the narcan...and we will start up incident reports on that soon!
Anywhooooooo they are going to talk to the nurse and get her side of the story...but in her documentation in the chart she actually wrote that I was at fault! That is not cool and I believe since it wasn't my fault...that is false documentation and proably more!
I was very professional and to the point and stood behind my choice! Everyone was so proud of me! Including me!!!!!!!!