STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

BOARD OF NURSING, )

)

Petitioner, )

)

vs. ) CASE NO. 79-1025

)

VIRGINIA DOWNEY WHITE, )

)

Respondent. )

)

RECOMMENDED ORDER

Pursuant to notice an administrative hearing was held before Delphene C. Strickland, Hearing Officer of the Division of Administrative Hearings, in Room

510 Richard P. Daniel State Regional Office Building at 111 Coastline Drive East, Jacksonville, Florida, beginning at 9:00 o'clock a.m. August 23, 1979.

APPEARANCES

For Petitioner: Julius Finegold, Esquire

1107 Blackstone Building 215

233 East Bay Street Jacksonville, Florida 32202

For Respondent: William J. Sheppard, Esquire

215 Washington Street Jacksonville, Florida 32202

ISSUE

Whether the license of the Respondent, Virginia Downey White, License No.

24571-1, should be revoked or suspended, or whether the Respondent should be placed on probation.

FINDINGS OF FACT

1. The Respondent, Virginia Downey White, holds Licensed Practical Nurse License No. 24571-1. During the time pertinent to this hearing the Respondent was employed as a licensed practical nurse at St. Catherine Laboure Manor a nursing home in Jacksonville, Florida.

   
   

2. An Administrative Complaint was issued against the Respondent on April 20, 1979, alleging unprofessional conduct. The Respondent requested an administrative hearing.

   
   

3. Prior to an investigation by the personnel at St. Catherine Laboure Manor, and prior to the issuance of the Administrative Complaint against Respondent White, a call had been received at the nursing home stating that medications were not being properly given by the Respondent to her patients.

4. On her own initiative, Priscilla Garske, a co-worker and licensed practical nurse who knew Respondent White, made a random selection of ten (10) patients from approximately twenty-five (25) assigned to the Respondent, listing the names of those ten (10) selected and listing their medications by their names in her nursing notes on March 25, 1979. Ms. Garske did not work on March 26, but on March 27, 1979, she returned to work on the 7:00 a.m. to 3:00 p.m. shift. On that date, after Ms. Garske had again counted medications for the same patients listed in her nursing notes, she reported to Florence Thibault, R. N., Director of Nurses at St. Catherine Laboure Manor, that the count was identical. Ms. Garske had checked the patients' medication sheets on which medications which had been given were to be charted and found that the medications had in fact been charted for these particular patients on March 25,

   26 and 27, 1979, by the Respondent. Ms. Garske gave her nursing notes to Ms. Thibault when she reported her findings.

   
   

5. Ms. Thibault examined the list of patients in Ms. Garske's nursing notes and their list of medications and immediately directed two (2) other nurses to check the medication cards against the list. Alberta Neeley and Eva Itameri, both licensed practical nurses, went to the units and checked Ms. Garske's list against the medication cards for the numbers of medications that were left. They returned with their findings, which indicated that six (6) of the ten (10) patients on the list had the same numbers of pills on their cards on that date, March 27, as they had had on March 25, 1979. Ms. Thibault then made a list of the same patients with their medications by their names, called Respondent White and discharged her from her employment, indicating to the Respondent that she had failed to give patients their medications while improperly charting on their records that they had received such medication.

   
   

6. Of the ten (10) patients listed in Ms. Garske's nursing notes and by Ms. Thibault, it was alleged that Respondent White had failed to give medications to six (6) of them, whose records were introduced into evidence. It was stipulated at the hearing that the remaining four (4) patients on the list had in fact received their medications from the Respondent.

   
   

7. Respondent White was responsible for giving medications to half of some fifty-eight (58) patients on her floor, who were mainly aged and infirm people. The patients on the list had not been questioned as to whether they had in fact received medication during the time in question.

   
   

8. Each patient on the floor had a medication card with twenty-five (25) to thirty (30) pills on it, each pill being encircled by a plastic bubble. Some patients had more than one card. Some patients had one card opened and one not opened, and some patients had two (2) cards opened, although it was the policy of the nursing home to give all the pills from one card before a new card was opened. On the medication cart there were additional stock medications, such as vitamins, which were given the patients from time to time. The counts made on the medication cards of the patients on the list who were the responsibility of the Respondent were made from one medication card only according to the testimony of Ms. Garske.

   
   

9. Eva Itameri, a nursing supervisor at St. Catherine Laboure Manor during the time pertinent to this hearing, and who had been instructed by Ms. Thibault to accompany Alberta Neeley to the floor on which Respondent White worked and to make an examination of the medication cards of the ten (10) patients on the list, pulled the cards from the patients' files, and Ms. Neeley wrote down their names and the numbers of medications on their cards. Ms. Itameri did not question the patients at the time she was making her investigation, stating that

   the patients on the floor whore the Respondent worked were very confused and disoriented. Ms. Itameri stated that it normally took about an hour to pass out medications each morning, and that sometimes the stock medications from the medication cart were also dispensed to the patients.

   
   

10. Alberta Neeley, the licensed practical nurse who accompanied Ms. Itameri as instructed by Ms. Thibault at the time pertinent to this hearing, stated she talked in general with the patients at that time, but that she did not make a list of those to whom she had talked and did not specifically ask whether they had received their medications. Ms. Neeley also stated that the situation at St. Catherine Laboure' Manor was subject to "a turn- over in staff."

    
    

11. At the hearing, Ms. Garske stated that all ten (10) patients listed in her nursing notes had had the same numbers of medications on their cards when counted by her on March 27, 1979, as they had had on March 25, but that each of those patients had been charted by Respondent White as having been given their medications each day as required.

    
    

12. It can not be reliably ascertained from the testimony and evidence presented at the hearing whether the medications for the six (6) patients, whose records were introduced into evidence, had in fact been given to them as indicated on their charts. Whether Respondent White gave them medications from a different card than previously used, whether some medications were given from the stock medications, or whether some of the six (6) patients were not medicated is unknown. The patients were not questioned, and if they had been questioned would not have remembered. Respondent White stated she gave the medications as required.

    
    

13. There was ill feeling between Respondent White and Ms. Garske, her co- worker, who made the initial count of the medications and reported that the Respondent had not given medications to the patients. Alberta Neeley, one of the witnesses for the Petitioner Board, was in doubt as to whether the count she and Ms. Itameri made as instructed by Ms. Thibault would conclusively indicate that medications had not been given patients.

    
    

14. From time to time during her employment at St. Catherine Laboure Manor, Respondent White misplaced medications for patients and required assistance from other nurses to locate such medications. She finished giving her patients medications in less time than did the two (2) other nurses, although each nurse had approximately the same number of patients to medicate.

    
    

15. Both Eva Itameri and Alberta Neeley, as witnesses for the Petitioner Board, stated they felt Respondent White to be a good nurse, but they had some reservations as to her general nursing performance.

    
    

16. No proposed findings of fact or memoranda of law were submitted to the Hearing Officer by the parties.

    
    

    CONCLUSIONS OF LAW

    
    

17. Section 464.21 Disciplinary proceedings.-- provides:

    
    

    1. GROUNDS FOR DISCIPLINE.--The board shall have the authority to deny a license to any applicant or discipline the holder of a license or any other person temporarily

       authorized by the board to practice nursing in the state who has been found guilty by the board of: . . .

       (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.

       
       

18. The Petitioner, Board of Nursing, has not shown that the Respondent, Virginia Downey White, has violated the foregoing statute by failure to conform to the minimal standards of accepted and prevailing nursing practice.

RECOMMENDATION

Based upon the foregoing Findings of Fact and Conclusions of Law, the Hearing Officer recommends that the Petition in this matter be dismissed.

DONE and ORDERED this 22nd day of October, 1979, in Tallahassee, Leon County, Florida.

DELPHENE C. STRICKLAND

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

William J. Sheppard, Esquire

215 Washington Street Jacksonville, Florida 32202

Geraldine B. Johnson, R. N. Board of Nursing

Ill Coastline Drive East, Suite 504 Jacksonville, Florida 32202

Docket for Case No: 79-001025

Orders for Case No: 79-001025