I would not of have changed the route without an order to do so. I have had several doctors say that they are ok with you using your brain,but then when it comes down to an incident with that patient they will turn on you and hang you out to dry.... You will then be wrote up as practicing medicine out of your rhelm of practice...crazy I know,but you can't go on having a good relationship with them. Because believe me it will be you without a license not them... I work at teaching hospitals all over the US and you have a little autonomy, but I have seen RN's be written up for route changes for electrolyte coverage and other meds that shouldnt have been an issue..