STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

BOARD OF NURSING, )

)

Petitioner, )

)

vs. ) CASE NO. 78-1912

)

INEZ STRICKLAND, )

)

Respondent. )

)

RECOMMENDED ORDER

This case was heard pursuant to notice on October 19, 1979, by Stephen F. Dean, assigned Hearing Officer of the Division of Administrative Hearings. This case was presented on an Administrative Complaint filed by the Florida State Board of Nursing against the Respondent, Inez Strickland. This Administrative Complaint alleged that the Respondent had violated Section 464.21(1)(b) Florida Statutes, by failing to perform certain nursing duties herself and permitting non-professional staff to perform these duties without supervision. At the commencement of the hearing, the Board withdrew and struck Paragraph 4 of the Administrative Complaint. Formal hearing in this cause was originally noticed for 10:00 a.m. on October 19, 1979; however, after waiting 30 minutes for the Respondent to arrive, and after determining that notice had been given in accordance with the applicable provisions of the rules and statutes, the hearing began at 10:30 a.m.

APPEARANCES

For Petitioner: Julius Finegold, Esquire

1107 Blackstone Building

233 East Bay Street Jacksonville, Florida 32202

For Respondent: Did not appear and was not represented FINDINGS OF FACT

1. The Respondent, Inez Strickland, is a licensed practical nurse holding License No. 24846-1, issued by the Florida State Board of Nursing.

   
   

2. Notice, as required by the statutes and rules, was given to the Respondent.

   
   

3. The Respondent was employed by the Beaches Hospital in Jacksonville Beach, Florida, in her capacity as a licensed practical nurse. While employed at the Beaches Hospital, the Respondent directed a nursing aide to give a patient a non-controlled pain reliever (Tylenol) while the Respondent was involved in the performance of other duties after the aide had reported that the patient was complaining of minor pain. There is no allegation that this medication had not been ordered by the treating physician.

4. The Respondent also permitted a nursing aide to fill out nursing history forms and "flow sheets" utilized by the Beaches Hospital. Blank copies of these forms were submitted as a late-filed exhibit by the Board at the request of the Hearing Officer. The aide's activities were not supervised by the Respondent.

   
   

5. The nursing staff of Beaches Hospital had been advised by the nursing supervisor to personally take nursing histories. This finding is based upon the direct testimony of the supervisor of nursing at the Beaches Hospital. The minutes dated March 9, 1978, regarding a staff meeting discussing nursing histories, are specifically excluded from consideration because they were forwarded with the Board's late-filed exhibit and were beyond the scope of the exhibit requested by the Hearing Officer to be filed.

   
   

   CONCLUSIONS OF LAW

   
   

6. The Florida State Board of Nursing has authority to take disciplinary action against the Respondent as one of its licensees, and has acquired jurisdiction over the Respondent by serving upon the Respondent an Administrative Complaint and through the Respondent having been noticed of the formal hearing in this cause.

   
   

7. Section 468.21(1)(b), Florida Statutes, provides that a licensee may be disciplined for the departure from or failure to conform to minimal standards of acceptable and prevailing standards of nursing practice. The practice of nursing specifically includes the administration of medications as prescribed or authorized. See Section 464.021(2)(a)2, Florida Statutes. The Board argues that this provision prohibits the Respondent from permitting an unlicensed individual to administer an oral medication.

   
   

8. The nurse's function is greater than passing out medications to patients even when the medication is a common pain reliever available over the counter. The nurse should observe and assess the patient any time a medication is directed or requested to be administered. Only through such observation and assessments can the nurse determine whether the medication should be administered. Further, the effective and safe treatment of a patient requires that all medication administered to a patient be controlled. Only by restricting the function of administering medications to professional staff can such control be maintained. However, considering the factual circumstances under which the Respondent departed from this standard, the violation is de minimis.

   
   

9. Section 464.021(2)(a)1, Florida Statutes, defines "observation and assessment of patients" as the practice of nursing. Of course, the statute does not nor can it restrict the observation and assessment of patients by anyone on a hospital staff. Because of the variety of care required by a patient in the hospital setting, every staff member coming in contact with a patient, whether or not they are professional staff and within the limits of their abilities, should observe, assess and report to members of the professional staff. A special role in observation and assessment may be assigned to the professional staff by the administration of a hospital or physicians. When this occurs, there is a professional obligation to adhere to the direction of one's administrative superiors and co-professionals. The Respondent, together with all members of the nursing staff, had received instructions to complete nursing histories. By failing to follow these instructions, the Respondent violated Section 464.21(1)(b) Florida Statutes.

10. When the Respondent's violation of this provision of Chapter 464 is considered alongside drug thefts, addiction to drugs and gross departure from acceptable and prevailing standards of nursing practice, the Respondent's violation is de minimis. The Respondent's departure did not immediately endanger or imperil any patient or contribute to a patient's pain or suffering. When viewed in light of the overall enforcement of Chapter 464, the Respondent's violation is not a major problem, although it requires remedial action.

RECOMMENDATION

Based upon the foregoing Findings of Fact and Conclusions of Law, the Hearing Officer recommends that the Florida State Board of Nursing suspend the license of the Respondent, Inez Strickland, for a period of 30 days and place her on probation for a period of six (6) months.

DONE and ORDERED this 5th day of November, 1979, in Tallahassee, Leon County, Florida.

STEPHEN F. DEAN, 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

Ms. Inez Strickland 4427 Barnes Road

Jacksonville, Florida 32207

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

111 Coastline Drive East, Suite 504 Jacksonville, Florida 32202

Docket for Case No: 78-001912

Orders for Case No: 78-001912