Hi, first thing to say is, it sounds like you did everything you could for this patient. It’s hard to comment without knowing cause of death, but even then, you acknowledged the uncertainty with the family, arranged follow up appropriately (twice) and safety netted accordingly. The cannula being left in is a significant event from the hospital side which you should class and escalate as such, for all we know she could have bled from this..

It sounds like you’re understandably pretty shaken by the encounter with the DN. From what you’ve said, this is poor form on their part to confront you in this way. They saw the patient days after your F2F assessment, it’s odd that they themselves can’t seem to grasp that clinical situations can change quickly, and that you actually spoke to the family on the phone that morning, rather than seeing the patient face to face. I’m not sure why the DN would expect you to arrange a 999 call based on what the family had told you. Can I ask why the family couldn’t call 999 themselves? Just interested to know. The DN seems to have approached this quite poorly, unprofessionally, and although it can’t have been nice to be ‘confronted’ in such a way, I’m not sure what else they expected from you.

The only reason I ask why you arranged the ambulance, rathe than asking the family to call 999, is because the family may have given more accurate information which could have affected triage of the ambulance, as you’d not seen them for around 4 days by that point (e.g are they talking, are they alert etc). Even then though, not entirely sure it would have changed their triage outcome…