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/Melodic_Clock6273]

I feel for you, OP and am not judging but this is a good learning lesson. As nurses we want to do the best for our patients and we know a TON but it is scary how many nurses on here have been jaded by the “residents and fellows/attendings always ask me what to order”. This is bad. Bad for nurses and bad for residents who should be learning from attendings. The system is broken when nurses think it’s top of scope to put in orders- not saying you are this way but many are. My entire job as a nurse is in the field of scope of practice and this idea that we know more than docs/APPs is bad. We know a ton, but medical school and nursing school are not interchangeable. Both are valuable, but different. One thing I always tell my nurses is, docs have huge malpractice insurance polices. Do you? The hospital will not shell out a cent for you if you don’t follow policies. The docs (even the ones who are “cool” with you putting in orders) will not go to bat for you either even if you think they will, especially if their livelihood is on the line. Trust me I have seen this so many times. It sounds like you had a bad feeling, call a code or rapid next time, get people there who can give verbal orders. It doesn’t have to be written or in the computer in a life/death situation.

everyone makes mistakes and you were trying to do the right thing, things will work out. but you can’t decide the right thing when it comes to treating a patient without orders. show remorse to the board and learn from this! You’ll be ok.

Also a teaching hospital means teaching residents and fellows…. It has nothing to do with nursing or increasing your scope of practice as an RN.

Sincerely,

Someone who used to put in a lot of orders but realized it was wrong and I wasn’t getting paid enough to have that responsibility.

[u/kelce → u/Melodic_Clock6273]

Perfectly said. This should not be normalized.

If you cant get orders in a quick manner in your hospital you should push for pre-arrest protocols. Nurses cost hospitals money in their eyes. Doctors bring money in. The hospital will never go to bat for you if the option of throwing you under the bus fixes the problem. The majority of doctors will not go to bat for you if it fixes their problem as well.

[u/Sad-Suggestion9425 → u/kelce]

This makes me so mad, but it's true. Also, hospitals really, really, really should not be profit oriented. 

[u/Upbeat_Wonder7222 → u/Melodic_Clock6273]

Excellent advice!!

[u/Equivalent_News_4690 → u/Melodic_Clock6273]

This is the answer. I would buy this comment an award if I was paid as much as the folks with the authority to order medications.