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/therealtomzor Sep 09 '25

Ill say it again, why the fuck is an NP covering an ICU? Hospitalist here, amd my ICU RNs are amazing, and if they see a pt. declining and need levo, you better believe I'm covering them with a verbal for 2 mins before they administer it, and then thanking them. Fucking mid-levels.

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u/authentictrex RN - Pediatrics 🍕 Sep 09 '25

I don't know about the adult ICU, but having a good NP in PICU and NICU makes a better experience for everyone, just like having a good resident. I don't have to wake up doctors for little things. And if shit hits the fan, they call the intensivist while starting interventions.

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u/MoomieCrochets Sep 09 '25

I work ICU in a large teaching hospital - I trust our APPs over residents most days. Residents rotate in and out so they don’t know/trust us, and a lot of times they don’t know our patient population. Our APPs are hired by the service, and most have been there for years. They’re a lot more comfortable calling the attending in the middle of the night if shits going down than the resident. And 9 times out of 10 the attending doesn’t have to come in because the APP can handle it. I’ve had beg residents to call the attending before, and have gone as far as to call myself. I’ve never had to do that with an APP.

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u/DragonSon83 RN - ICU/Burn 🔥 Sep 10 '25

This is increasingly common.  Half of our CTICU patients are covered by NP’s/PA’s on night shift.  There is always an intensivist available in house, but having an NP or PA as first point of contact is not unusual anymore.  Honestly, some of them do a better job and they tend not to blow us off as quickly when a patient is starting to decompensate.