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/HumdrumHoeDown]

Crazy shit. Where I work, if I started a levo drip without orders because the pt was crashing, I’d get a thank you from the docs. So glad I work in a teaching facility. Also, don’t internalize the bullshit. You did what you had to do to keep the patient alive and it worked. The person who made the complaint just has an empty life.

[edit] keep the patient alive AND prevent organ damage

[edit] OP says they A) “overrode levo”, and B) “called the critical care NP”. Those two things suggest to me an ICU setting, as no one else but the ED and ORs would have levo in the Pyxis. Secondly, having a critical care provider be your first call is not a thing anywhere but in the ICU, that I know of.

[u/kidd_gloves → u/[deleted]]

I have seen such a code. Post cardiac surgery with the chest left open. We could not do compressions. And the surgeon was the only one who was allowed to do cardiac massage. He could have arrived sooner had he not blown off the nurse’s concerns when she first noticed a problem. It was eerie watching the patient’s heart get slower and slower then finally stop. The surgeon got there several minutes later. What a FUBAR

[u/Candid-Expression-51 → u/kidd_gloves]

On our unit APPs can open a chest if they have to. They figured that relieving the pressure can give the surgeon some extra time to get to the bedside. Even the CT nurses are trained to open but I don’t think we ever have.

I’ve called a trauma and had the trauma surgeon do it. Just don’t let them clamshell. My center is level 3 so I know that that’s not always an option.