STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

BOARD OF NURSING, )

)

Petitioner, )

)

vs. ) CASE NO. 77-1198

)

VERONICA J. BLOOD GOODNER, )

)

Respondent. )

)

RECOMMENDED ORDER

Pursuant to notice, the Division of Administrative Hearings, by its duly designated Hearing Officer, G. Steven Pfeiffer, conducted a public hearing in this case on February 16, 1978, in Ft. Pierce, Florida.

The following appearances were entered: Julius Finegold, Jacksonville, Florida, for the Petitioner, Florida State Board of Nursing; and Edwin B. Arnold, Ft. Pierce, Florida, for the Respondent, Veronica J. Blood Goodner.

On or about June 13, 1977, the Florida State Board of Nursing issued an Administrative Complaint against the Respondent, Veronica J. Blood Goodner. The Respondent requested a formal hearing, and in accordance with the provisions of Section 120.57(1)(b)(3), Florida Statutes (1977) the Board of Nursing forwarded the matter to the office of the Division of Administrative Hearings for the assignment of a hearing officer and the scheduling of a hearing. The final hearing was originally scheduled to be conducted on January 11, 1978, but it was continued upon motion of the Respondent, and rescheduled as set out above.

At the final hearing the Board of Nursing called the following witnesses: Joyce Raupp, a Registered Nurse who was formerly employed at the Ft. Pierce Memorial Hospital; James Andrew Kraft, a pharmacist who is employed at the Longwood Medical Center (formerly Ft. Pierce Memorial Hospital) as Chief Pharmacist; Iva Jean Albritton, who is employed at the Longwood Medical Center as a Medical Record Librarian; and Martha Dwyer, a Registered Nurse who is employed at the Longwood Medical Center. The Respondent appeared as a witness on her own behalf, and called the following additional witnesses: Geraldine B. Johnson, the Board of Nursing's Coordinator of Licensing and Investigation; and Patricia Nieman, a Registered Nurse who is employed at the Longwood Medical Center. Hearing Officer's Exhibits 1-5, and Petitioner's Exhibits 1 and 2 were offered into evidence at the final hearing and were received. Petitioner's Exhibits 3, 4, and 5 were marked for identification but were not received. The parties were invited to submit Post-Hearing Legal Memoranda, but have not done so.

FINDINGS OF FACT

1. The Respondent is a Registered Nurse who is presently registered with the Florida State Board of Nursing, and is licensed by the Board to practice her profession in Florida. The Respondent has been a Registered Nurse since 1965.

   Until she was suspended in April, 1977, the Respondent had been employed on a periodic basis for 12 years at the Ft. Pierce Memorial Hospital. The Ft. Pierce Memorial Hospital has recently moved to a new facility, and it is now known as the Longwood Medical Center.

   
   

2. Nurses are frequently called upon to administer drugs which due to their narcotic or other dangerous propensities have been classified as controlled substances. The procedure followed in administering such drugs to patients at the Ft. Pierce Memorial Hospital has, at all material times, been as follows: If a patient requests medication, or the need to administer the medication otherwise comes to the attention of a nurse on duty, the nurse will check the patient's chart to make sure that the patient's physician has approved use of the drug, and to determine whether it is timely to administer it. The nurse will then go to the nursing station, pick up the appropriate drug, and sign out for it on a narcotic control sign-out record. The nurse will then administer the drug and note the dosage and the time on the patient's chart. Failure to properly log and chart the use of controlled substances can have serious consequences. Such failures could result in drugs being removed from the hospital premises, and used for illicit purposes. Failure to properly chart administration of the drugs can result in misdiagnosis of the patient's condition, or in the administration of overdoses of drugs.

   
   

3. During April, 1977, the Respondent failed to properly chart and account for controlled substances on numerous occasions. On April 8, the Respondent signed out for a dosage of Meperidine, or Demerol, a controlled substance, on the narcotic control log, but she failed to chart administration of the drug to the patient. On April 9, the Respondent signed out for 3 dosages of Meperidine, and 1 dosage of Numorphan, a controlled substance, and failed to chart administration of the drugs. On April 12, the Respondent signed out for 5 dosages of Meperidine, 3 dosages of Numorphan, and 1 dosage of Dilaudid, or Hydromorphone, a controlled substance, and failed to chart administration of the drugs. On April 17, the Respondent signed out for 6 dosages of Meperidine, and

   1 dosage of Morphine, a controlled substance, and failed to chart the administration of the drugs. On April 18, the Respondent signed out for 1 dosage of Meperidine and 1 dosage of Morphine and failed to chart administration of the drugs.

   
   

4. The Ft. Pierce Memorial Hospital was understaffed during April, 1977. Nurses were pressed for time, and that could account for occasional errors in record keeping. The understaffing could not, however, justify as many errors as the Respondent committed, especially in view of the potentially grave consequences of such errors. Charting errors were apparently made by other nurses at the hospital during this time, but not remotely to the extent of the charting failures committed by the Respondent.

   
   

5. Hearsay testimony was offered at the hearing to the effect that the medications which the Respondent failed to chart were actually not administered to the patients. This could give rise to an inference that the Respondent was putting the controlled substances to an illicit purpose. There was, however, no direct testimony that would support a finding that the Respondent failed to administer the drugs, but only that she failed to properly chart the administration of the drugs.

   
   

6. Prior to April, 1977, the Respondent had always received good to very good evaluations from her superiors. When the charting failures were discovered, the Respondent was suspended from her employment at the hospital. As a result she has been unable since that time to find employment as a nurse,

   and she has effectively been suspended since April, 1977 from practicing her profession.

   
   

   CONCLUSIONS OF LAW

   
   

7. The Division of Administrative Hearings has jurisdiction over the parties to this proceeding and over the subject matter. Section 120.57(1), 120.60, Florida Statutes (1977).

   
   

8. Section 464.21, Florida Statutes (1977) provides:

   
   

   1. GROUNDS FOR DISCIPLINE. The board [Florida State Board of Nursing] shall have the authority to . . . discipline the holder of a license . . . who has been heard and found guilty by the board of:

      * * *

      (b) Unprofessional conduct, which shall in- clude any departure from, or the failure to conform to, the minimal standards of accep- table and prevailing nursing practice, in which proceeding actual injury need not be established.

      
      

      The charting failures committed by the Respondent show a departure from minimal standards of acceptable and prevailing nursing practice. The Respondent is guilty of unprofessional conduct.

      
      

9. In view of the fact that the Respondent is capable of performing within acceptable standards, and the fact that she has already effectively suffered a one-year suspension from practicing nursing, it is appropriate that her license now be suspended for a period of six (6) months.

RECOMMENDED ORDER

Based upon the foregoing Findings of Fact and Conclusions of Law, it is, RECOMMENDED:

That the Florida State Board of Nursing enter a final order finding the Respondent guilty of unprofessional conduct, and suspending her license, to practice nursing for a period of six (6) months.

RECOMMENDED this 21st day of March, 1978, in Tallahassee, Florida.

G. STEVEN PFEIFFER Hearing Officer

Division of Administrative Hearings Room 530, Carlton Building Tallahassee, Florida 32304

COPIES FURNISHED:

Julius Finegold

1005 Blackstone Building

233 East Bay Street Jacksonville, Florida 32202

Edwin B. Arnold, Esquire Post Office Box 4361

Ft. Pierce, Florida 33450

Docket for Case No: 77-001198

Orders for Case No: 77-001198