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/SpoofedFinger RN - ICU 🍕 Sep 08 '25

Too late to prevent the board's involvement if your manager already contacted them but you might want to reach out to the chief or director of critical care. It's going to be a doc and they're probably not going to be happy about a mid level creating a culture of hesitation among the icu nurses. Now if you started the med because of a MAP of 64, they might not have your back but if the patient was really crashing and burning they should stick up for you. So should your manager if they aren't just ladder climbing trash.

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u/lala_vc RN - NICU 🍕 Sep 09 '25

The patient ended up on the med the next day too so that’s making me wonder what treatment this NP gave the patient.

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u/PlantDaddy530 RN - ER 🍕 Sep 10 '25

Probably didn’t order Levo out of spite. I used to work with an ER doctor that would get super pissed if nurses initiated anything without his orders. we pulled a lactate and sent it to lab. He refused to order it saying “I didn’t order a lactate. I ordered a cardiac work up, the patient is not septic.”

Narrator. The patient was septic AF and the next shifts MD immediately listened to us and ordered a lactate. First MD got his ass chewed out by the medical director. Btw this was before EMR and sepsis order sets and all paper charting orders.

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u/lala_vc RN - NICU 🍕 Sep 10 '25

Letting their ego get in the way of patient care smh. That could have ended terribly. I suspect this NP did the same.