jimihendrix

In the long-term care facility where I work with pt's with profound disabilities, I had a pediatric resident with a hx of frequent chest infections. Our normal practice there has been to call the MD if none in house, and antibiotics would be ordered. Last week, this girl started up, as I have seen her many times before. HR 130's, RR 30's, T 38, congested. Sats dropped to 80's, I started O2, increased to 5 L, and brought her sats up to 92%. Eventually transferred to ER about 5 a.m., and now I am in big trouble because I was asked why I didn't transfer her 3 hours sooner. There has been a change in our DON recently, and she is really gung-ho about cleaning up the quality of nursing in our facility. Now all of a sudden, I am being investigated. I was told the girl was dehydrated by the time she got to hospital. This is the only place I have worked. I feel that my lack of experience is to blame for not recognizing the seriousness of this pt's VS. Could someone please help me - how bad was it that this pt had a HR in the 130's for several hours? Apparently she was stabilized later that day, and off the O2. BTW, she has a DNR order. Any comments would be appreciated.