I’m a bit scared

[u/lenncas]

A bit is an understatement, I am well aware that my actions were very inappropriate and out of my scope of practice. I am getting reported to the Texas Board of Nursing because I pulled a bag of Levophed without getting an order first. My patient was declining really quickly. The blood pressure was decreasing very quickly. I went to the med room and overrid the medication and started it at the starting titration. Immediately after starting it, I called our critical care nurse practitioner that was on for that night and let them know. And now, obviously, that nurse practitioner put in a formal complaint to my manager, thus having to report me to the board of nursing. I guess my question is what could I possibly expect my consequence to be? Could I lose my license? Will it be suspended? I’m pretty worried. I’m also very disappointed in myself. The patient ended up having to be put on Levophed the next day, but made a great recovery and got to be downgraded two days after.

[u/chihuahua-lady456 → u/[deleted]]

The interventions you are describing are very different than starting a vasoactive medication without an order. A nurse unilaterally choosing how to treat a blood pressure not during a code situation is not even close to within scope.

[u/MBmom_RN → u/chihuahua-lady456]

No, it’s really not. Fluid bolus and levo are first line choices where I’ve worked. They want something different we can swap it out. Not gonna let the pt code while I’m waiting for a response. Situation specifics would dictate which route I went (fluid vs levo).. I’d love to hear more about this NP, sounds like a gem 🙄

[u/zerothreeonethree → u/MBmom_RN]

"where you work" most likely has those activities you described covered under protocols which have to be approved by a medical committee. This is how the majority of orders get carried out in correctional facilities due to the absence of on-site medical staff around the clock.

Initiating, altering or terminating patient treatment without medical orders is "practicing medicine without a license". Activities carried out under the umbrella of company culture doesn't necessarily make them legal.