If you are the nurse on duty, it really is your responsibility to update orders with the MD, although in some agencies (and more so in the past), the case manager (or clinical supervisor) takes on more of this role. In the case of the IV infusion, no, the infusion nurse should be doing it. S/he is more qualified to discuss specifics of an IV order with a doctor and they are responsible for carrying out that order. However, if there are other nurses on the case, the nurse on duty when everything transpired is supposed to handle the nuts and bolts of the paperwork. The manager is looking to you to do it, because the other nurses can’t be relied upon, and she does not have the time to do this herself. Nevertheless, the last part of your post indicates that the case manager is dumping too much on you. Sleeping patient is no excuse for her not to manage the case.