STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

POPIEL OGDEN HORAN a/k/a )

ANNETTE P. HORAN, R.N., )

)

Petitioner, )

)

vs. ) CASE NO. 76-1194

) FLORIDA STATE BOARD OF NURSING, )

)

Respondent. )

)

RECOMMENDED ORDER

A hearing was held in the above styled cause in the Conference Room of St. Francis Hospital, 250 West 63rd Street, Miami Beach, Florida, at 1:00 p.m., on August 26, 1976, before Stephen F. Dean, designated Hearing Officer of the Division of Administrative Hearings. This matter arose upon the Administrative Complaint filed by the Florida State Board of Nursing alleging that Annette Horan, while under suspension by the Florida State Board of Nursing, practiced private duty nursing contrary to Section 464.24(3) and (4), and Section 464.081, Florida Statutes 1973.

APPEARANCES

For Petitioner: Julius Finegold, Esquire

1130 American Heritage Building Jacksonville, Florida 32202

For Respondent: Annette P. Horan, pro se

465 Ocean Drive, RA1005 Miami Beach, Florida 33139

FINDINGS OF FACT

1. Annette P. Horan is a registered nurse holding License No. RN19396-2 issued by the Florida State Board of Nursing.

   
   

2. On September 10, 1973 the license of Annette P. Horan was suspended by the Florida State Board of Nursing for a period of two years.

   
   

3. The events which gave rise to the allegations contained in the Administrative Complaint occurred between March 3 and March 9, 1974, during the period the license of Annette P. Horan, as a registered nurse, was under suspension by the Florida State Board of Nursing.

   
   

4. Geraldine Johnson, a member of the staff of the Florida State Board of Nursing, identified Composite Exhibit 3 as documents received by her through the United States Mail from Annette P. Horan.

5. During the period March 2, 1974 until March 9, 1974, Annette P. Horan was hired by the family of Terry Bland or Bland Terry as a private nurses aide for his extra duty care when he was at St. Francis Hospital, Miami Beach, Florida.

   
   

6. The hospital records of Terry Bland or Bland Terry and the documents contained in Composite Exhibit 3 were identified by the documents custodian for St. Francis Hospital who presented these documents to Terrence Igoe, questioned documents examiner for Dade County. Terrence Igoe had examined Composite Exhibit 3 and had examined the Medical records of Terry Bland or Bland Terry introduced as Substitute Exhibit 4. Igoe determined that the handwriting appearing over the signature of Anne Horan, A. Horan, and Annette Horan and the signatures of Horan on the medical records were the same as the signature and handwriting contained in Composite Exhibit 3, which were samples of the Respondent's handwriting. Igoe could not state that the letters "R.N." following the Horan signatures in Substitute Exhibit 4 were written by the same hand.

   
   

7. The nurse's notes, medication record and record of fluid intake and output for the patient, Terry Bland or Bland Terry, bear the name Annette Horan or Anne Horan or A. Horan.

   
   

8. The nurse's notes and medication charts similar to Substitute Exhibit 4 are maintained at the nurses's station on the various wards at St. Francis Hospital. All members of the health care staff have access to these records, however, the charge nurse and medication nurse are responsible for all entries made therein.

   
   

9. Nurses aides working at St. Francis Hospital wear a different type of uniform from Licensed Practical Nurses and Registered Nurses working in the hospital. It is not the practice at St. Francis Hospital to permit nurses aides to make entries on either the medication record or nurse's notes. Anne Horan did not recall signing "R.N." after her name as it appeared in the various medical records.

   
   

10. Anne Horan could not have made the entries on the various medical records, for the patient without the consent of the medication nurse or charge nurse on the ward in question since the medical records were in their care at the nurse's station. As a private duty nurse's aide, Ms. Horan stayed in the room of the patient for whom she was caring.

    
    

11. While it would be a violation of the hospital's policy with regard to having a nurse's aide make entries on the nurse's notes, there is no indication that Ms. Horan had any knowledge of the hospital's policy. Although it is the general practice to have only licensed nurses make entries within the medical records, Mary Zagacki, director of nursing at St. Francis, indicated that other health services personnel do make entries in nurse's notes.

    
    

12. The entries were made by Anne Horan in the nurse's notes and on the medication records with the knowledge and consent of the charge nurse or medication nurse.

    
    

13. There was no direct evidence of Ms. Horan performing any task which would constitute the practice of nursing. The medical records for Terry Bland or Bland Terry do not indicate whether Anne Horan administered any medications to the patient. There is no direct testimony regarding who administered the medications. Ms. Horan denied having administered medications to the patient.

    CONCLUSIONS OF LAW

    
    

14. The Administrative Complaint charges that Annette P. Horan violated Subsections 464.24(3) and (4), Florida Statutes 1973, and Section 464.081, Florida Statutes 1973.

    
    

15. Subsections 464.24(3) and (4), Florida Statutes 1973, are penal statutes which make the commission of the acts enumerated therein a misdemeanor.

    
    

16. Section 464.081, Florida Statutes 1973, prohibit the use of the designation "Registered Nurse" or "R.N." by a person not licensed as a Registered Nurse by the Florida State Board of Nursing. Section 464.081, Florida Statutes 1973, supra, does not provide any penalty for violation of this section.

    
    

17. The Administrative Complaint filed against Annette P. Horan makes no reference to Section 464.21, Florida Statutes 1973, which states the grounds for discipline of licensees.

    
    

18. Assuming that the Board seeks to take action under the provisions of Section 464.21, supra, the only provision thereunder which would be applicable to the specifically enumerated statutory violations would be Subparagraph f of Subsection (1) of said Section, which provides for disciplinary action if a licensee is found guilty of:

    
    

    "Willfully or repeatedly violating any of the provisions of this chapter or laws of this state involving moral turpitude;"

    
    

19. There is no evidence that Annette Horan repeatedly violated any of the provisions of the chapter or laws of the State of Florida, and further, none of the violations alleged involve moral turpitude.

    
    

20. There is insufficient evidence to conclude that Anne Horan placed the designation "R.N." after her name as it appears in the medical records in light of the expert testimony and the fact that all medical staff had access to the records.

RECOMMENDATION

Based on the foregoing Findings of Fact and Conclusions of Law, the Hearing Officer finds both as a matter of fact and as a matter of law that the Complaint against Annette Horan is not proven, the Hearing Officer RECOMMENDS that the Board take no action.

DONE and ORDERED this 16th day of September, 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

Annette P. Horan, R.N.

465 Ocean Drive, RA1005 Miami Beach, Florida 33139

Ms. Geraldine Johnson State Board of Nursing

6501 Arlington Expressway, Bldg B. Jacksonville, Florida 32211

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

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

BEFORE THE FLORIDA STATE BOARD OF NURSING

/

ORDER

The above entitled cause came on to be heard by the Florida State Board of Nursing on the 25th day of October, 1976, at the office of the Board located at 6501 Arlington Expressway, Building B, Jacksonville, Florida 32211.

The Board reviewed the Administrative Complaint filed against the Respondent, Annette Popiel Ogden Horan, reviewed the complete transcript of the record and the recommended order of the Hearing Officer; and the Board makes the following Findings of Fact:

1. That the Board has jurisdiction over the Respondent and subject matter thereof.

   
   

2. Respondent, at the time of the hearing, is licensed as a registered nurse holding license no. 19396-2.

   
   

3. The Hearing Officer found that the Respondent was employed by the family of Terry Bland, as a private nurses aide while a patient at St. Francis Hospital, Miami Beach, Florida. Further testimony at the hearing was presented by Document Examiner, Terrance Igoe, who questioned documents submitted to him from St. Francis Hospital for review. Mr. Igoe determined the handwriting appeared to be that of Annette Horan, however, the designation following the

name of R.N. could not be conclusively testified to have been signed by Annette Horan. Respondent testified that she does not recall signing R.N. after her name, but (Page 91) the Respondent states "I was not paid R.N. fee, so I don't know why I would be putting R.N. I was not paid as an R.N." Further on Page 91, she testified that she did not sign it deliberately. "I may have signed it unconsciously, but I don't recall." On Page 94 of the transcript the Respondent testified that she was permitted to write in the nurses' notes because the hospital remembers me as an R.N. These nurses probably remember me as an R.N., so they knew I was qualified to do it. They knew my observations would be properly recorded and the patient was critical and the patients condition was getting more critical and he was sinking every day." She further states that she does not recall writing R.N., however, in reviewing the exhibits presented on the nurses' notes, a large gap would have been in the documentation if the

1. had been eliminated and entered by someone else.

   
   

   CONCLUSIONS OF LAW

   
   

   From the facts, the Board finds the Respondent did violate the Florida Statutes 464.081(1)(3) in that the Respondent did use the abbreviation R.N. in caring for a patient Terry Bland.

   
   

   ORDERED AND ADJUDGED that the Respondent, licensed to practice nursing as a registered nurse, be placed on probation for one (1) year with the following stipulations:

   
   

   1. Respondent contact the Board of Nursing office every three months in writing to inform the Board of her resident address and place of employment.

      
      

   2. Respondent refrain from violation of any law; Federal State of Local.

DONE AND ORDERED this 4th day of November, 1976, in Jacksonville, Florida.

Dorothy C. Stratton, R.N., President Florida State Board of Nursing

BOARD SEAL

cc: Julius Finegold, Esquire

Docket for Case No: 76-001194

Orders for Case No: 76-001194