I currently work on a medical-surgical unit. I had a 53-year-old male patient who came to the ER for severe intractable nausea and vomiting... His PCP had increased his Ozempic dose from 1mg to 2mg. Pt also complained of mild back pain X one month. CT of this patient's abdomen revealed multiple "lytic lesions" of pelvis, hips and spine. This patient had zero clue he had cancer. Second night of caring for pt, his wife called for "help". I arrived to see this patient sitting on the side of the bed, then losing consciousness and slumping to the left, almost hitting his head on the footboard. Pt was unable to communicate or focus on commands. He was now suddenly mute. His temp had spiked to 103f AXILLARY, and he was tachy at 140-150. I did not have my communication device on me since I responded emergently, but I had motioned my Clinical supervisor to assist. I asked her to call a rapid response. I am very much an evidence-based practice RN and although my facility does not utilize MEWS scores, I chalked up a score of 15 in my head. However, instead of calling an RRT, she unilaterally decided to call the house Nursing supervisor instead, and THEY decided to just call the Nocturnist instead of escalating this man's situation. Needless to say, I left my shift after 15 hours because I did not have the support of an RRT and didn't even eat a cracker. Am I wrong to insist that it was only MY call to decide on the treatment path?? FYI, day shift MD came in, and immediately escalated this man's situation (what I tried to do with ZERO respect or support). The pt was emergently transferred to a proper facility where he was escalated finally and dx with multiple myeloma. Am I wrong for thinking it is my license and also MY judgement call?? PS I am a 30-year vet. Do I need to retire?? Have I lost my touch?