Emergent, RN 2 Articles; 4,109 Posts Specializes in ER. Has 30 years experience. Nov 20, 2014 I think, if you were worried enough to call for help, seek support from your charge nurse, because the pt was lethargic, then you should have notified the doctor. If the charge nurse advised you to only leave a note on the chart, then you definitely needed to chart something like 'Pt very groggy at 0300, held Dilaudid. Notified charge nurse. Called RR team for further assessment. Jane RN stated that no other action needed at this time. Charge nurse advised to leave note for MD in AM, note left on chart. Pt arousable, but groggy. Follows commands, but seems sleepy. PERRLA, grips equal and strong, oriented x 3, will continue to closely monitor, placed on continuous O2 sat monitor'. After that, document every hour checks to show you followed up.