Had something bother me about a pt's condition. I'd cared for her 3 nights in a row, and on the third shift something wasn't right. Something was different. She'd been an in-patient for 2 weeks and I was familiar with her. SLEEPY the whole shift from start to finish which was totally unusual. Some sleep apnea which was new also. Her baseline was confused at night with repeated attempts to get out of bed. I monitored her every hour.......nothing I could put my finger on, or point to that was serious enough to wake a Doc at 3A. She was a COPDer on 02 with a history of crappy ABGs. Spent some time in ICU.About 4Am I had to call about another pt, and while I had the MD on the phone I mentioned my concerns about the little old lady who kept wanting to fall asleep...even when talking. NNO of course, I didn't expect any. Just wanted to let the MD know somethink hinky going on since I would leave at 7AM and there was no guarantee the day nurse would report the increased lethargy. So guess what. The little old lady wakes up at 6:30am, sits up in bed with no signs of the difficult to rouse pt I'd had all night. Of course my assessment skills would be questioned. The little old lady I'd stewed about all night was nowhere in sight.Has this every happened to you? What did you do?