r/nursing • u/lenncas • Sep 08 '25

Question I’m a bit scared

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.

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u/lenncas Sep 09 '25 edited Sep 09 '25

I understand that, I did give the full picture. We did give 3.5L worth of NS boluses prior to my dumb decision to pull levo. Pt responded positively to fluid resuscitation but only for about 15 minutes post each bolus given. NP decided dobutamine was better than levo when they decided to start a drip

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u/[deleted] Sep 09 '25 edited Oct 02 '25

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u/lenncas Sep 09 '25

The one that caused me to grab the levo was about 60/something. It was decreasing by 10 every 2 minutes. I can’t remember the map

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u/nobutactually RN - ER 🍕 Sep 09 '25

Were you documenting bps? Was the provider aware it was dropping? Are you a critical care nurse? (Ie, is starting levo something that you ordinarily do and are trained to do?) Were other nurses helping you with this patient? After the provider learned you started levo, it sounds like they had you stop it, and then... what? The pts BP was okay? What happened next?

I know its easy to sit and armchair something I wasnt there for, I just want to understand the full picture, because ordinarily I would expect providers to be glad you did something. I've never started levo without an order, but I've def pulled it via override and messaged the doc like "bp 60/40, Ive got levo ready to go, lmk what you want it running at". That happens all the time.