Long story short I work in a private surgical hospital, no doctors onsite overnight. Patient load 1:5. The pm handover nurse handed over what seemed to be a routine spinal fusion on a morphine PCA, handover had nothing unusual to report, she said the patient was sleeping most of the shift and was low maintenance. I went to see the patient after report and their resp rate was 4. I got it verified by two other RNs as I wasn’t sure if I was missing some shallow breaths but no, it was fucking 4. Last recorded observation was half an hour earlier and the resp rate was 14 and the patient recorded as ‘asleep’. Patient rouses upon sternal rub quickly drifts off. You can imagine how the rest of my night shift went. Never have I seen a patient’s respiratory rate on a PCA deteriorate like this in a matter of half an hour, but hey, maybe it’s a possible. Total use was 43mls between 2100-2300hrs which made me say something along the lines of ‘that’s a lot’ at handover which the pm nurse said ‘yeah she’s fine though and not nauseas’. I naturally want to speak to the handover nurse about this, but she can be quite defensive and arrogant from my previous interactions with her. My colleagues have told me not to bother as she will just report you for ‘bullying’, as this has happened recently with another colleague. Unsure how the fuck this got missed with her, but my usual practice before doing an incident form is speaking to the nurse first, to make sure the facts are straight. Should I just skip that conversation and report?   submitted by   /u/Misszoolander [link]   [comments]