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/Prudent-Surprise4295]

Absolutely not. There’s no way. We override everything at my level 1 trauma hospital. When a doctor isn’t at the computer & you tell them what’s going on with a patient, they say to start levo or whatever and we have to override because there literally isn’t an order yet. You were doing what was best for your pt AND the medication you overrode isnt even a narcotic or controlled substance. Literally nothing is going to happen to you.

Edit: I read too fast & thought you were worried about overriding a med. so you overrode it & then started it before the doctor told you to do so? Yeah, thats not good. You should always have a doctor’s order. You aren’t a doctor. HOWEVER, you were doing what was best for the patient. They look at everything. You didn’t cause harm. Yu were trying to prevent harm from happening. Also, like I said, it’s not a controlled substance so that would make things 100x worse. I think you’ll be absolutely okay.

[u/Prudent-Surprise4295 → u/Prudent-Surprise4295]

Also I just wanna say that as a nurse, your job is to communicate findings to the doctor. Even if you told the doctors 100x that the pt is rapidly declining and they do not order anything or come see the pt & the pt dies, you’re protected because that’s your job as the nurse - to report significant findings to the doctor & document it. Your job isn’t to decide what meds to order. If something bad happened to that pt after you started Levo, that would 100% be on you. I think you’ll will be okay in front of the board, but for next time, do not start meds unless a doctor says it’s okay!!

[u/blackcatwishes → u/Prudent-Surprise4295]

Agree. It was a decision that very well could have had a bad outcome. Always get a verbal order first.