Your timing on this post is ironic. I just had one of these on my last two shifts. We all just *knew* things weren't right. He looked like crap, his gases sucked, his labs were way out of wack, he was becoming less responsive. On my fifth phone call to the doc, he started again to brush up my concerns and I stopped him and said "you need to come down here NOW". (He was sleeping in the call room.) I swear he didn't recall any of my previous calls to him that night...."ohmigosh, his calcium is really low" -- uh, yeah, I think I stressed that when I called you with a critical value THREE HOURS AGO! The pt died several hours after my shift ended.
Yeah, I did document, document, document. But honestly, it still breaks my heart that, as a nurse, I can do everything right and I'll still have to hope that a clueless, bonehead doc doesn't drop the ball. And then, of course, I play the was-there-something-else-I-could-have-done? game. It's a tough game.