STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

STATE OF FLORIDA, DEPARTMENT OF ) PROFESSIONAL AND OCCUPATIONAL ) REGULATION, BOARD OF NURSING )

)

Petitioner, )

)

vs. ) CASE NO. 79-113

) OLLIE MAE WILLIAMS, L.P.N., )

)

Respondent. )

)

RECOMMENDED ORDER

Pursuant to notice, a hearing was held before Charles C. Adams, a Hearing Officer with the Division of Administrative Hearings, on April 11, 1979.

APPEARANCES

Julius Finegold, Esquire, 1107 Blackstone Building, 233 East Bay Street, Jacksonville, Florida 32202, for the Petitioner. Ollie Mae Williams, L.P.N., 2125 West 39th Street, Jacksonville, Florida 32209, Respondent.

ISSUES

1. Whether on or about October 8, 1978 while employed as a Licensed Practical Nurse at Florida Christian Health Center, the Respondent committed numerous medication charting errors, with respect to controlled substances and other medications, including but not limited to:

   
   

   1. Signing out on a narcotic control record for controlled substances and other medications on said date and indicating the hour to be

      9:00 p.m., when in truth and fact, Respondent was not on duty at said hour on said date, having left the facility before the completion of her shift at approximately 6:35 p.m.

   2. Failing to record in the patient's medication administration records narcotics signed out for the patient.

   3. Charting in the nurses notes that she had administered medications to patients at 9:00 p.m., a time when she was not on duty on October 8, 1978.

   4. Charting on the patient's administration record the administration of drugs when there was no entry or record of said drugs being signed out on the narcotics control record.

   5. In the matter of patient, Aileen Scheuster, signing out on two separate narcotics

      control sheets for the controlled substance,

      Tylenol #3 at 5:00 p.m. and 9:00 p.m. for

      a total of four (4) tablets for the same date and time, and failing to account for the excess.

   6. Failing to chart in the nurses notes and/or medication administration record for all medications signed out by the Respondent on the narcotic control records.

      
      

2. Whether on or about October 21, 1978, at approximately 5:10 p.m., Respondent left her assigned duties at Florida Christian Health Center and went home without notifying her supervisor of this fact, leaving the facility inadequately staffed for the 3:00 p.m. - 11:00 p.m. shift, which Respondent was working.

(The items set forth in paragraphs 1 and 2 of the issue statement allegedly constitute a violation by the Respondent of Subsection 464.21(1)(b), Florida Statutes, in that the Respondent is accused of unprofessional conduct.)

FINDINGS OF FACT

1. This case has been presented for consideration based upon the Administrative Complaint of the Petitioner, State of Florida, Department of Professional and Occupational Regulation, Florida State Board of Nursing, dated December 20, 1978. The Respondent, Ollie Mae Williams, L.P.N., has challenged the accusations set forth in the Administrative Complaint and requested a formal hearing pursuant to Subsection 120.57(1), Florida Statutes. In response to that request for formal hearing, the case has been referred to the Division of Administrative Hearings for consideration and the formal hearing was held on April 11, 1979.

   
   

2. The Petitioner, State of Florida, Department of Professional and Occupational Regulation, Florida State Board of Nursing, is an agency of the State of Florida which has the responsibility to license and regulate members of the nursing profession who practice in the State of Florida. The authority for such activity on the part of the Petitioner is found in Chapter 464, Florida Statutes.

   
   

3. The Respondent, Ollie Mae Williams, L.P.N., is a Licensed Practical Nurse, licensed by the Petitioner, Florida State Board of Nursing, and at all times pertinent to the Administrative Complaint held such license.

   
   

4. The Petitioner has charged the Respondent with certain violations and the content of those allegations are as found in the issue statement of this Recommended Order.

   
   

5. The facts reveal that Respondent was employed by the Florida Christian Health Center as a Licensed Practical Nurse, during the month of October, 1978.

   
   

6. One of the patients whom the Respondent was attending in October, 1978, was the patient, Aileen Scheuster. Ms. Scheuster's physician prescribed for her the substance, Tylenol #3, to be taken one tablet every six hours PEN (as needed or required). The Respondent, while working the 3:00 p.m. to 11:00 p.m. shift on October 8, 1978, signed out two tablets for each record on two separate individual patient narcotic records for the period 5:00 p.m. to 9:00 p.m, which made the interval of medication four hours instead of the six hours prescribed by the treating physician and exceeded the authorized number of tablets to be

   given. The medication record for the patient indicated that the Tylenol tablets were given at 5:00 p.m. and 9:00 p.m. but only showed two tablets being given.

   The nurses notes for the patient showed that one tablet had been administered at 5:00 p.m. and another at 9:00 p.m. Moreover, there was a further discrepancy in the matters of charting, because the Respondent only worked from 3:00 p.m. to 6:35 p.m. on October 8, 1978.

   
   

7. Aileen Scheuster's physician had also ordered Valium, 5 milligrams, for the benefit of the patient QID (4 times a day). The individual patient's narcotic record showed two tablets signed out for Ms. Scheuster, one at 5:00

   p.m. and one at 9:00 p.m., on October 8, 1978. The 9:00 p.m. sign-out being at a time when the Respondent was not on duty.

   
   

8. On the sane date, October 8, 1978, John Solomon was a patient in the facility. One of the medications prescribed for Mr. Solomon was Darvoset N-100, PRN, for pain. There was a tablet signed out for 3:00 p.m. and a tablet signed out for 9:00 p.m. These tablets for the benefit of Mr. Solomon were charted in the appropriate records, but as indicated before, the Respondent was not in attendance in the institution at 9:00 p.m., notwithstanding evidence to the contrary found in the records of the patient, John Solomon.

   
   

9. Another patient who was residing in the facility on October 8, 1978, was Ms. Rose Davis. Her doctor had ordered the drug, Chloral Hydrate, to be given at bedtime, PRN. The patient's individual narcotic record indicates that the Respondent gave Rose Davis one of the tablets at 9:00 p.m., a time when the Respondent had already left the facility. Further, the drug, Chloral Hydrate, was not charted on the nurses notes as required.

   
   

10. Helen Parmenter was a patient being treated in the facility on October 8, 1978. Her doctor had prescribed five milligrams of Valium, HS (hours of sleep, 9:00 p.m.). The patient's individual narcotic record showed that the Respondent had given the patient, Helen Parmenter, one of the tablets at 9:00 p.m., and this event in time was also indicated on the medication and administration record signed by the Respondent. Again, the Respondent was not in attendance at 9:00 p.m. on October 8, 1978.

    
    

11. Lena Kelsey was a patient in the facility who was there on October 8, 1978, and her physician had prescribed the drug, Butisol. The patient's individual narcotic record shows that the Respondent gave two tablets of Butisol to the patient at 9:00 p.m., and this was also indicated on the patient's medication administration record. In fact, the Respondent did not administer these two tablets at 9:00 p.m. because she was not in attendance at the institution.

    
    

12. Viola Snider was a patient in the facility who was there on October 8, 1978. Her physician had prescribed Dalmane, which is a sleeping pill. There is an indication on the medication administration record of the patient that she was given one of the pills at 9:00 p.m., October 8, 1978. There is no indication on the patient's individual narcotics record that such a pill was given and, had the pill bean given, it should have bean noted on the patient's individual narcotic record, as a sign-out. Again, the Respondent was not available to give the substance, Dalmane, to the patient, Viola Snider, as is shown, contrary to what the records reflect. In addition, on October 5 and 9, 1978, the Respondent has made an entry on the medication administration record of the patient, Viola Snider, to the effect that the substance, Dalmane, had been administered, but there is no corresponding record on the individual patient's narcotic record which shows the sign-out of that medication.

13. Finally, one of the patients who was being treated in the facility on October 8, 1978, was a John Copeland. Mr. Copeland's physician had prescribed the drug, Meprobamate, 200 milligrams, one tablet QID. There is an indication in the patient's individual narcotic record to the effect that a tablet was signed out at 5:00 p.m. and 9:00 p.m., and the medication record shows these tablets as being administered at the same time. The Respondent was not available to have given the tablet at 9:00 p.m. The substances, Valium, Darvoset, Chloral Hydrate, Butisol, Dalmane and Meprobamate are controlled substances in terms of drug classification.

    
    

14. The Petitioner has charged the Respondent with violations of Subsection 464.21(1)(b), Florida Statutes, for the events that transpired on October 8, 1978. That provision states:

    
    

    464.21 Disciplinary proceedings.--

    * * *

    (b) Unprofessional conduct, which shall include any departure from, or the failure to conform to, the minimal standards of acceptable and prevailing nursing practice, in which

    proceeding actual injury need not be established.

    
    

    A full consideration of the facts presented indicates that the Petitioner was guilty of unprofessional conduct in the charting entries, to the extent of falsifying those medical records in some instances.

    
    

15. The Petitioner has filed a second violation against the Respondent and accused the Respondent of unprofessional conduct for allegedly leaving her duty station at Florida Christian Health Center on October 21, 1978, without notifying her supervisor, thus leaving the facility inadequately staffed. The facts reveal that the Respondent did notify an appropriate person and even though her absence worked a hardship on the management of the facility, it did not constitute unprofessional conduct on the part of the Respondent.

    
    

    CONCLUSIONS OF LAW

    
    

16. The Division of Administrative Hearings has jurisdiction over the parties and the subject matter in this cause.

    
    

17. Based upon a full consideration of the facts herein, it is concluded as a matter of law that the Respondent is guilty of unprofessional conduct within the meaning of Subsection 464.21(1)(b), Florida Statutes, for the events which transpired on October 8, 1978, involving charting errors, and thus is subject to the penalties set forth in Chapter 464, Florida Statutes.

    
    

18. Based upon a full consideration of the facts herein, it is concluded as a matter of law that the Petitioner has failed to prove those allegations of October 21, 1978, pertaining to the Respondent's alleged abandonment of her duties and failure to notify the supervisor of her departure; therefore, the Respondent is not guilty of unprofessional conduct per Subsection 464.21(1)(b), Florida Statute.

RECOMMENDATION

It is recommended that the license of the Respondent, Ollie Mae Williams, L.P.N., be suspended for a period of one (1) year on the basis of these events

which transpired on October 8, 1978, pertaining to the charting errors. It is further recommended that the action under Count II of the Administrative Complaint pertaining to the events of October 21, 1978, be dismissed.

DONE AND ENTERED this 11th day of May, 1979, in Tallahassee, Florida.

CHARLES C. ADAMS, Hearing Officer Division of Administrative Hearings Room 101, Collins Building Tallahassee, Florida 32301

(904) 488-9675

COPIES FURNISHED:

Julius Finegold, Esquire 1107 Blackstone Building

233 East Bay Street Jacksonville, Florida 32202

Ollie Mae Williams, L.P.N. 2125 West 39th Street Jacksonville, Florida 32209

Geraldine B. Johnson, R.N. Florida State Board of Nursing Richard P. Daniel State Building

111 East Coast Line Drive Jacksonville, Florida 32202

================================================================= AGENCY FINAL ORDER

=================================================================

BEFORE THE FLORIDA STATE BOARD OF NURSING

IN THE MATTER OF:

Ollie M. Ellis Williams 2125 W. 39th Street

Jacksonville, Florida 32209 CASE NO. 79-113 As a Licensed Practical Nurse

License Number 31453-1

/

ORDER

This matter came on for final action by the Florida State Board of Nursing on the 26th day of June, 1979, at 111 Coastline Drive East, Suite 508 Jacksonville, Florida.

The Board, having reviewed the entire record, including all pleadings, exhibits admitted into evidence, the transcript of hearing proceedings, the Findings of Fact, Conclusions of Law and Recommended Order of the Hearing Officer, adopts the Findings of Fact and Conclusions of Law of the Hearing Officer and IT IS THEREFORE:

ORDERED AND ADJUDGED that the licensed practical nurse license number

31453-1 of the Respondent, Ollie M. Ellis Williams, be suspended for a period of two (2) years. However, it is ordered said suspension be stayed after a period of one (1) year and the licensee be placed on probation for the remaining period of one (1) upon the following terms and conditions:

1. That the Respondent shall forthwith return license number 31453-1 and current renewal receipt issued to practice nursing as a licensed practical nurse to the Florida State Board of Nursing. The failure to comply shall be deemed a violation of this condition of the probation.

   
   

2. That the Respondent refrain from violation of any law, Federal, State, or Local.

   
   

3. That the Respondent attend and successfully complete a course in charting and administration of medication and legal aspects of nursing and upon completion of such a course to submit verification of successful completion to the Florida State Board of Nursing.

   
   

4. That the Respondent inform, in writing, the Florida State Board of Nursing every three (3) months of her current address and place of employment.

   
   

5. If employed as a nurse during the period of probation, that the Respondent have her employer to provide the Board with an evaluation of her nursing performance every three (3) months during the period of this probation. Such evaluations must prove to be satisfactory to the Board.

   
   

6. The failure to comply with the terms of said probation shall be deemed a violation of this order.

DONE AND ORDERED this 11th day of July, 1979, at Jacksonville, Florida.

FLORIDA STATE BOARD OF NURSING

By: Dorothy C. Stratton, R.N. President

BOARD SEAL

COPIES FURNISHED:

Ollie M. Ellis Williams 2125 39th Street

Jacksonville, Florida 32209 Julius Finegold, Esquire

Docket for Case No: 79-000113

Orders for Case No: 79-000113