STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

FLORIDA STATE BOARD OF NURSING, )

)

Petitioner, )

)

vs. ) CASE NO. 79-212

)

JANE MARIE MILLER, )

)

Respondent. )

)

RECOMMENDED ORDER

Pursuant to notice, an administrative hearing was held before Diane D. Tremor, Hearing Officer with the Division of Administrative Hearings, on June 28, 1979, in Room 931 of the Broward County Courthouse, Ft. Lauderdale, Florida. The issue for determination at the hearing was whether the respondent's registered nursing license should be disciplined for the reasons set forth in the administrative complaint dated December 15, 1978. The transcript of the hearing was received by the undersigned on July 19, 1979.

APPEARANCES

For Petitioner: Julius Finegold

1107 Blackstone Building

Jacksonville, Florida 32202 For Respondent: No appearance

FINDINGS OF FACT

Upon consideration of the oral and documentary evidence adduced at the hearing, the following facts are found:

1. By an administrative complaint dated December 15, 1978, respondent was charged with unprofessional conduct in violation of Florida Statutes, Section 464.21(1)(b). The respondent timely requested an administrative hearing which was granted. The envelope which contained the request for hearing was mailed from Buffalo, New York, but the return address was 717 Breakers Avenue #3, Ft. Lauderdale, Florida, with the notation "Note: Address Change." All future correspondence was sent to this address, including the notice of hearing dated May 16, 1979. The hearing was scheduled to commence at 9:30 a.m. At approximately 9:50 a.m., the hearing proceeded without the appearance of the respondent.

   
   

2. On July 20 and 21, 1978, the respondent Miller was employed as a registered nurse on the 11:00 p.m. to 7:00 a.m. shift at Cypress Community Hospital in Pompano Beach, Florida. At 3:55 a.m. on July 21, 1978, respondent signed out for 75 milligrams of injectable Meperidine (Demerol), a Class II controlled substance, for patient Frank Mantovi, and then walked into the patient's room with the substance.

3. Another registered nurse on duty, Oletta Jones, observed that the patient was sleeping at the time. Nurse Jones called her supervisor, Anita Johnston, and they awakened the patient and inquired whether he had requested or received any medication for pain. He replied in the negative. The patient appeared oriented and alert, and his vital signs were stable and not indicative of receiving 75 milligrams of Demerol. The administration of Demerol was not charted on the patient's medication record, as it should have been had it been administered.

   
   

4. Nurses Jones and Johnston then confronted respondent Miller in the nurses' lounge. At first respondent told them that she had administered the Demerol intermuscularly, but then said she had given it by I.V. push.

   
   

5. The doctor's order sheet for patient Mantovi contained a notation for

   75 milligrams of Demerol administered intermuscularly as needed for pain every three hours. There is nothing to authorize an I.V. introduction of this medication. It is not acceptable or prevailing nursing practice for a nurse to alter the mode of administration prescribed by the physician.

   
   

6. After talking with respondent, patient Mantovi's vital signs were again checked. There was no indication that he had received Demerol. Respondent was then asked to leave the hospital. The pupils of her eyes were observed by Nurse Johnston to be of pinpoint size.

   
   

   CONCLUSIONS OF LAW

   
   

7. The respondent Miller is charged with unprofessional conduct in violation of Chapter 464, Florida Statutes. The petitioner presented sufficient evidence at the hearing to sustain this charge.

   
   

8. The vital signs and alert nature of the patient after the alleged administration of the medication were contradictory to an administration of 75 milligrams of Demerol. And, even if the patient had received the medication signed out for by respondent, it is not acceptable nursing practice for a nurse to change the form of administration prescribed by the physician on the patient's chart or to fail to chart the administration on the patient's medical record, a document vital to the proper care of patients.

   
   

9. The Board has sufficiently sustained the charges against respondent and is authorized to impose disciplinary measures against such unprofessional conduct.

RECOMMENDATION

Based upon the findings of fact and conclusions of law recited above, it is RECOMMENDED that the Board of Nursing find respondent guilty of unprofessional conduct within the meaning of Florida Statutes, 464.21(1)(b), and suspend her registered nursing license for a period of three (3) months.

Respectfully submitted and entered this 14th day of August, 1979, in Tallahassee, Florida.

DIANE D. TREMOR, Hearing Officer Division of Administrative Hearings Room 101, Collins Building Tallahassee, Florida 32301

(904) 488-9675

COPIES FURNISHED:

Jane M. Miller

717 Breakers Avenue #3

Ft. Lauderdale, Florida 33304

Julius Finegold Esquire 1107 Blackstone Building

Jacksonville, Florida 32202

Geraldine Johnson, R.N.

Coordinator of Investigation and Licensing

111 East Coastline Drive Suite 504

Jacksonville, Florida 32304

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

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

BEFORE THE FLORIDA BOARD OF NURSING

IN THE MATTER OF:

Jane Marie Miller

717 Breakers Avenue No. 3

Ft. Lauderdale, Florida 33304 CASE NO. 79-212

As Registered Nurse License Number 66021-2

/

RECOMMENDED ORDER

This matter came on for final action by the Florida Board of Nursing on the 8th day of October, 1979, at 111 Coast Line Drive East, Suit 508, Jacksonville, Florida.

The Board, having reviewed the entire record, including all pleadings, exhibits admitted into evidence, the transcript of the 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. However, the Board rejects the Recommended Order of the Hearing Officer due to the Respondent improperly administering a controlled drug, Demerol, to a patient by a mode of administration not ordered by the physician. Such actions pose a serious danger to the patient in her charge, which is not reflected in the recommended penalty of the Hearing Officer, THEREFORE IT IS:

ORDERED AND ADJUDGED that the registered nurse license number 66021-2 of the Respondent, Jane Marie Miller, be suspended for a period of two (2) years. However, it is ordered that said suspension be stayed after a period of six (6) months and the licensee by placed on probation for the remaining period of eighteen (18) months upon the following terms and conditions:

1. That the Respondent shall forthwith return license number 66021-2 and current renewal receipt to practice nursing as a registered nurse to the Florida Board of Nursing.

   
   

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

   
   

3. That the Respondent attend a drug rehabilitation program and at the outset of the suspension the licensee shall secure from her psychiatrist or counsellor in the drug rehabilitation program a letter describing her current health status, and a prognosis. There shall also be random urine screen analysis performed by the program or clinic and a report of such analysis be provided to the Board of Nursing. Prior to allowing the licensee to begin her probationary status, at the end of the six months period of suspension, the licensee shall instruct the psychiatrist or counsellor to send a letter to the Board that will describe her health status at that time.

   
   

4. 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.

   
   

5. That the Respondent inform the Board, in writing, of any change of address or place of employment during the time of this Order.

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

DONE AND ORDERED this 22nd day of October, 1979, at Jacksonville, Florida.

FLORIDA BOARD OF NURSING

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

BOARD SEAL

COPIES FURNISHED:

Jane Marie Miller

717 Breakers Avenue #3

Ft. Lauderdale, Florida 33304 Julius Finegold, Esquire

Docket for Case No: 79-000212

Orders for Case No: 79-000212