on January 27, 1976, before Stephen F. Dean, assigned Hearing Officer of the Division of Administrative Hearings.
Whether the Respondent was in violation of Subsection 464.21(1)(b), Florida Statutes.
This matter arose upon the Administrative Complaint and Notice of the Board of Nursing to the Respondent charging in paragraph 1 that she signed out Demerol, failed to chart administration and failed to show wastage of the drug; charging in paragraph 2 that she signed out Demerol, failed to administer the drug per chart entry and failed to account for the drug; charging in paragraph 3 that she withdrew Demerol when there was no doctor's order for said drug and did not administer same; charging in paragraph 4 that she withdrew Demerol when there was no doctor's order for the drug and failed to chart the drug; and finally charging in paragraph 5 that she admitted to a member of the Board staff that she intended to use said drugs on herself.
Prior to hearing the Board struck paragraphs 1 and 2 of the Administrative Complaint, and the Respondent admitted the allegations in paragraphs 3 and 4 but denied any intent to use said drugs. After the hearing was over, the foregoing stipulation was read into the record whereupon the Board rested its case without putting on any evidence with regard to paragraph 5.
The effect of the stipulation was to reduce the charges against Miss Calhoun to the withdrawal of Demerol without a doctor's order, and failing to chart same. The Board presented no evidence regarding any intent to use said drugs, resting its case. There was no evidence that Miss Calhoun intended to use said drugs or whether the drugs were administered to the patients. Therefore, the Respondent admitted withdrawing drugs without a doctor's order and two counts of failing to properly chart. There was no evidence that this resulted in any harm-to the patients.
The Petitioner is a white female, 26 years of age, who received her education in nursing at Abraham Baldwin Junior College, Tifton, Georgia; passed her Georgia boards in June 1969; worked for Putnam Memorial Hospital from 1969 until November 1971; passed her Florida nursing examination in October 1971; and worked at University Hospital of Jacksonville, Florida, from November 19/1 until October 1975 when the incident, upon which these charge are based, occurred.
The Petitioner then took the stand and Exhibit 1 to 5 were introduced into the record in mitigation of the offenses. These were letters of various nurses and doctors who knew the Petitioner professionally. These letters generally indicate that Miss Calhoun was a very well trained, very competent emergency room nurse who got along well with staff, patients, and their families.
In explanation of her behavior the Petitioner testified that she had had a "close personal relationship" with a member of the staff who prior to the incident had transferred from the hospital at which both were employed to another state. Their separation caused Miss Calhoun to go into a deep depression which required her hospitalization for psychiatric treatment for eight (8) days ending the third week of August 1975.
Shortly thereafter Miss Calhoun visited the former friend during which time their relationship was permanently severed. She again went into a depression which continued from the period of this final meeting until the date of, the incident.
The Petitioner stated that she had not received any further medical assistance for her personal problems after her hospitalization but that she was longer depressed although she was anxious over the outcome of these proceedings.
It would appear from the evidence that Miss Calhoun is technically killed and has the ability to relate well with staff, patients, and their families. However, the failure to chart medications is a serious breach of professional conduct. There is uncontroverted testimony that Miss Calhoun suffered a severe emotional depression as the result of the termination of a close personal relationship., Her condition was so bad that she required treatment by a psychiatrist while hospitalized for eight (8) days for severe depression with suicidal tendencies.
Those who know her have indicated that her behavior was not in keeping with her normal professional conduct, and that she has a deep respect and love of her chosen profession.
Miss Calhoun indicated her willingness to seek professional help and guidance to assist her with her emotional problems, and to have periodic reports
on her progress submitted to the Board as a condition of her continued practice. She also was willing to have her job performance monitored by periodic reports from her employer to the Board.
Considering particularly Dr. Farquhar's letter, he places some degree of responsibility for her condition upon the supervision which she received from the physicians and nurses at her hospital. Dr. Farquhar states that Miss Calhoun's performance prior to the occurrence of her personal problem was outstanding. He further indicates that he would be willing to re-employ Miss Calhoun if she were rehabilitated and if she could meet the expectations of her profession. Dr. Farquhar concludes by expressing his belief that she can again represent the best of nursing as she had in the period before her problems.
There are few of us who have not tasted the bittnerness of a broken personal relationship. Each person is effected to a greater or lesser deree, and reacts differently . The majority are able to re-establish their personal relationships and pursue their social and professional interest. However, during that period when all seems lost and when just coping is a struggle there are few of us who have not succumbed to some form of abnormal behavior.
The duty of the Board of Nursing is first to protect the people of Florida by insuring the high quality of nursing care. The Board has the further duty to insure its members adhere to the high standards and ideals of the nursing profession. It also has a duty to its members individually to nurture and protect their talents so that the Boards two other purposes are served. In this case the Board has an opportunity to fulfill all of its purposes.
The record in this case would indicate that Miss Calhoun's behavior was the result of an isolated, though undoubtedly personally tragic situation. The record reveals that her case was not effectively followed up after her release from the hospital, and that at the time of the incident charged she was not responding normally.
CONCLUSIONS OF LAW
The Hearing Officer would also refer the Board to the case of Brod v. Jernigan, 188 So 2d 575 (2DCA-1966). In Brod vs. Jernigan the court reviewed the suspension of a real estate broker's license for nine months assessed in part for his failure to deposit funds in a trust account as required by Section 475.25(1)(i), F.S. The Court stated concerning the violation as follows:
"Chapter 475 vests in the Florida Real
Estate Commission a broad discretionary power and authority to supervise the privileged business of real estate broker and to deal firmly with those engaged in it, even to the point of taking away their means of livelihood by revocation or suspension of license. But such potent administrative weapons must always
be reasonably and cautiously, and even sparingly, utilized. The administrative processes of the Commission should be aimed at the dishonest and unscrupulous operator, one who cheats, swindles, or defrauds the general public in handling real estate transactions. Here the $100 Young deposit was not misappropriated, or dissipated, or lost; and no one was hurt or prejudiced thereby. In
discussing the Commission's disciplinary proceedings that reach the Courts, the First District Court, in Horne v. Florida Real
Estate Commission, Fla. App. 1964, 153 so 2d 515, text 517, commented as follows:
'In general these cases have held that the frequency of past unscrupulous practices in Florida real estate dealings are of such public interest
as to make the subject amenable to regulation by properly enacted legislation. The fiduciary relationship between customer and broker, inviting and usually receiving a high degree of trust and confidence, is a proper subject for reasonable regulation. The purpose of the statute and
these regulations is to protect the public by permitting only those who possess special qualifications of aptitutde, ability and integrity to engage in the business. The duty to determine the continued eligibility and qualification of registrants has been vested in the Real Estate Commission in accordance with the procedures provided by Chapter 475.
Disciplinary proceedings under this chapter are for the primary purpose of protecting the general public from unscrupulous or dishonest real estate operators.' (Emphasis supplied.) [by Court]
What we have said is not, in the slightest, to be construed as a criticism of the Commission. It is merely to reiterate the guide lines governing its administrative procedures."
The Court stated that a suspension for nine months was harshly inappropriate for a technical violation of the law under extenuating circumstances, and reduced the suspension to a $100 fine.
The Respondent's conduct as admitted, while serious, is not conduct of a nature to require her revocation especially when one considers the personal pressures existing on Miss Calhous. It was apparent from his letter that Dr. Farquhar has an interest in those persons who are in his department and seeks to improve them personally and professionally. It also appears that he has high standards of personal and professional performance and demands that they be met. His letter indicated that he would like to re-employ Miss Calhoun.
