STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

FLORIDA STATE BOARD OF NURSING, )

)

Petitioner, )

)

vs. ) CASE NO. 76-1192

) MARJORIE SUE FANCHER, L.P.N., )

)

Respondent. )

)

RECOMMENDED ORDER

A hearing was held in the above styled cause pursuant to notice in the Conference Room of Community General Hospital, 1550 Fort King Road, Dade City, Florida on September 30, 1976 before Stephen F. Dean, assigned Hearing Officer of the Division of Administrative Hearings. This matter came on to be heard upon the Administrative Complaint filed by the Florida State Board of Nursing against Marjorie Sue Fancher which alleged that while on duty as a licensed practical nurse at Community General Hospital in Dade City, Florida on or about February 23, 1976 that Marjorie Sue Fancher did in several instances fail to administer, chart or account for narcotic drugs as required and that said conduct is unprofessional and violates Sections 464.21(1)(b) and 464.21(1)(f), Florida Statutes.

APPEARANCES

For Petitioner: Julius Finegold, Esquire

Attorney for Florida State Board of Nursing 1130 American Heritage Building Jacksonville, Florida 32202

For Respondent: Marjorie Sue Fancher was unrepresented

by Counsel and did not appear.

FINDINGS OF FACT

1. Because the Respondent Marjorie Sue Fancher, L.P.N., was not present at the Hearing, although commencement of the Hearing was delayed for thirty minutes, careful inquiry into the correct address of Marjorie Sue Fancher was made. From the personnel records of Community General Hospital, it was determined that Marjorie Sue Fancher had resided at 551 Emerald Avenue, Lake Wales, Florida, 33856, with her mother. Notice in this cause was sent to Marjorie Sue Fancher at 551 Emerald Avenue, Lake Wales, Florida, 33856, by

   first-class mail. Notice of the Hearing sent Marjorie Sue Fancher was not returned to the Division of Administrative Hearings by the United States Postal Service.

   
   

2. Marjorie Sue Fancher is a licensed practical nurse holding license number, LPN 37287-1. Marjorie Sue Fancher was employed by Community General Hospital in Dade City, Florida on approximately February 9, 1976. After

   undergoing an orientation at the hospital, she was moved from the day shift to the night shift. On February 22, 1976 Marjorie Sue Fancher was medication nurse on the eleven to seven shift at Community General Hospital. As medication nurse, Marjorie Sue Fancher was responsible for the administration and charting of the administration of medications to patients in Rooms 101 through 114 in the East Wing of Community General Hospital. As medication nurse, Marjorie Sue Fancher was responsible for the medication cart which contained the narcotics safe which had only one key.

   
   

3. The procedure of the hospital called for the oncoming medication nurse to inventory the narcotics with the medication nurse being relieved. When the oncoming medication nurse was satisfied with the inventory, the oncoming nurse would relieve the nurse going off duty and the key would be turned over to the nurse coming on duty. This key was on a long ribbon and worn around the neck of the medication nurse.

   
   

4. The hospital medical records for patients of the hospital in Rooms 101 to 114 on the East Wing were identified by Marian Newell, a registered records administrator and Records Administrator for Community General Hospital. The narcotic control records were identified by William Connors, Registered Pharmacist and Pharmacist for Community General Hospital.

   
   

5. Elizabeth Kutsch, L.P.N., was the medication nurse who relieved Marjorie Sue Fancher on the morning of February 23, 1976. Kutsch found that the narcotic control sheets had not been filled out, chartings for the patients not been done, and nurse's notes on the patients had not been made by Fancher when Kutsch relieved her on the morning of February 23, 1976. Because the narcotics on hand did not agree with the narcotics control records, Kutsch refused to relieve Fancher and assume responsibility for the narcotics safe and its contents. Kutsch called Dawn Bell, Registered Nurse, Acting Director of Nurses at Community General Hospital, who initiated an investigation.

   
   

6. Bell immediately interviewed Marjorie Sue Fancher. Fancher at that time appeared to Bell, a nurse with twenty-one (21) years of experience, to be under the influence of drugs. Fancher was unable to respond coherently to questions, could not remember what she had done during her shift, was somnolent and staggered when she walked.

   
   

7. Bell's review of the patient records, their narcotics control records, and nurse's notes revealed many discrepancies.

   
   

8. These records conflicted on whether Fancher had administered preop medications to a patient, Elmer Wile. Although the narcotics control sheet indicated that Fancher had withdrawn 10 mgs of morphine sulphate at 7:30 a.m., the drug administration records and nurse's notes had not been filled out indicating administration of the drug to the patient.

   
   

9. Fancher had failed to administer insulin and pronestyl, a heart medication, as directed in the medication administration records for Hush Walker, a patient.

   
   

10. Fancher had failed to administer inderal to Rena Bell at 6:00 a.m. as prescribed and had indicated this by circling the time on the medication administration record but no explanation of why the drug was not administered was entered in the nurse's notes by Fancher.

11. Fancher had failed to administer kafsol to Florence Profe, as prescribed at 6:00 a.m. No entry was made on the medication administration records and no explanation was made in the nurse's notes by Fancher.

    
    

12. Fancher failed to administer ampicillin and phenobarbital to Tonya Harnage at 6:00 a.m. as prescribed. The medication administration record shows no entry and no explanation was made in nurse's notes.

    
    

13. Fancher administered talwin intramuscularily to Martha Jackson, a patient, instead of talwin compound prescribed to be administered per oz.

    
    

14. Fancher signed out for 15 mgs of morphine sulphate on the narcotics control record for administration to the patient, Catherine Dolan, but no indication of administration of the drug was made in the medication administration record or in the nurse's notes for the patient Dolan.

    
    

15. Fancher withdrew 10 mgs of morphine sulphate for administration to patient, Bessie Wolf, who had a preoperative order for the administration of 5 mgs of morphine sulphate and .2 mg of atrophine. The narcotics control record did not indicate the wastage of 5 mgs of morphine sulphate. The medication administration record indicated the administration of .2 mg of atrophine while the Nurse's notes indicated that .6 mgs of atrophine had been administered. The patient Wolf had been prescribed demerol PRN. The narcotics control record for demerol indicated that an entry showing 25 mgs had been withdrawn by Fancher for administration to the patient, Bessie Wolf, had been lined out. Inventory of demerol on hand in the narcotics safe for which Fancher was responsible, indicated an overage of one ampule of demerol. Fancher had failed to have the narcotics control record corrected by the pharmacist as required in accordance with hospital operating procedure when an erroneous entry was made.

    
    

16. Patients who were scheduled for laboratory workups on the morning of the twenty-third and who were to receive no medications after twelve, midnight, had had medications administered to them by Fancher contrary to direction. Patients who were to receive preoperation medication did not have these medications administered. The records of the shift which Marjorie Sue Fancher had worked were so confused and incomplete that it was impossible to determine what medications had been administered to what patients. Marjorie Sue Fancher's physical condition was such that she could not remember what she had done during the shift to include what medications she had administered to what patients.

    
    

    CONCLUSIONS OF LAW

    
    

17. Section 464.21, Florida Statutes, provides that a nurse licensed by the Florida State Board of Nursing who has been found guilty of unprofessional conduct may be disciplined. The conduct of Marjorie Sue Fancher failed to conform to minimal standards of acceptable and prevailing nursing practice, and was unprofessional contrary to Section 464.21, Florida Statutes.

RECOMMENDATIONS

The Hearing Officer having considered the Findings of Fact and Conclusions of Law recommends that the Florida State Board of Nursing revoke the license to practice nursing of Marjorie Sue Fancher.

DONE and ORDERED this 11th day of October, 1976 in Tallahassee, Florida.

STEPHEN F. DEAN, Hearing Officer Division of Administrative Hearings Room 530, Carlton Building Tallahassee, Florida 32304

(904) 488-9675

COPIES FURNISHED:

Julius Finegold, Esquire

1130 American Heritage Building Jacksonville, Florida 32202

Marjorie Sue Fancher

551 Emerald Avenue

Lake Wales, Florida 33856

Mrs. Geraldine Johnson State Board of Nursing Suite 201

6501 Arlington Expressway

Jacksonville, Florida 32211

Docket for Case No: 76-001192

Orders for Case No: 76-001192