STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

BOARD OF NURSING, )

)

Petitioner, )

)

vs. ) CASE NO. 78-2316

)

NANCY SEATON, )

)

Respondent. )

)

RECOMMENDED ORDER

This matter came on for hearing in Tampa, Florida, before the Division of Administrative Hearings by its duly designated Hearing Officer, Robert T. Benton, II, on March 8, 1979. The Division of Administrative Hearings received a transcript of the proceedings on April 9, 1979.

APPEARANCES

For Petitioner: Julius Finegold, Esquire

1107 Blackstone Building

Jacksonville, Florida 32202

For Respondent: Nancy Seaton, in propria persona

70 Davis Boulevard, Apartment 12 Tampa, Florida 33606

By administrative complaint dated September 15, 1978, petitioner alleged that respondent, while employed as a registered nurse at Tampa General Hospital, "reported for duty with the smell of alcohol on her breath and in a condition rendering her incapable of functioning as a nurse" on or about July 20, 1977; "accepted as correct an incorrect count of a controlled substance" while relieving a medication nurse on or about August 4, 1977; "was found to have an odor of alcohol on her breath while on duty" on or about September 23, 1977; "hysterically reported to her supervisor that [a] patient . . . had a blood pressure reading of 68/30 and was going into cardiac arrest . . . [but that one] Dr. Hampton was summoned and upon checking the patient found her blood pressure to be 188/80 and fundamentally . . . in no different condition that when last seen by the physician on or about October 27, 1977; answered the telephone and "reported to another nurse . . . that the caller was 'Dr. Hildehand' instead of Dr. Hampton" who was in fact the caller, also on or about October 27, 1977; "made a medication error with respect to Aminophyllin [sic] Injectable by administering same too rapidly" on or about September 28, 1977; "signed out on the Narcotic Control Record" for the wrong controlled drug, on or about October 2, 1977; "committed several errors in transcribing, copying or carrying out of doctor's orders;" "on a number of occasions appeared on duty with the smell of alcohol on her breath" while employed at Centro Espanol Memorial Hospital; and "was found to be in an intoxicated condition to the extent she could not carry out her normal functions as a registered nurse" at Centro Espanol on or about

February 13, 1978, all in violation of Section 464.21(1)(b), Florida Statutes (1977).

FINDINGS OF FACT

1. On July 20, 1978, Mary I. Gallagher, the seven to three supervisor at Tampa General Hospital "was called up to 3 South in regard to Mrs. Seaton's actions." (T.6) There she found respondent with a patient. Respondent was confused and smelt of alcohol; her speech was garbled. Mrs. Gallagher did not believe respondent capable of performing her normal duties and sent her home.

   
   

2. On August 4, 1977, respondent reported to work at Tampa General Hospital for the eleven to seven shift. As oncoming nurse, she took responsibility for the narcotics from the three to eleven nurse who had custody of the drugs. In doing this, she accepted a count of 25 ampules of morphine sulphate, even though the three to eleven nurse only had 24 ampules of this controlled substance.

   
   

3. On September 23, 1977, "Mrs. Johnson, one of the three to eleven supervisors, notified [Joyce Millis, Assistant Director of Nursing at Tampa General] in writing that she had been called to 4 South by one of the staff nurses, Mrs. Sellers, who [reportedly] noticed the odor of alcohol on Mrs. Seaton's breath." (T.14) See petitioner's exhibit No. 2.

   
   

4. On October 2, 1977, respondent administered Tuinal to a patient, but signed out for Nembutal rather than for Tuinal. This made the narcotic count incorrect.

   
   

5. On October 3, 1977, respondent administered 500 milligrams of Aminophyline intravenously to a patient. A 500 milligram dose of Aminophyline is supposed to be administered slowly; it should take an hour or more. Respondent said she spent only 45 minutes administering the drug on that occasion.

   
   

6. On October 27, 1977, according to a contemporaneous report of the incident, respondent told another nurse, Miss Findley, that a patient was "going to code," i.e., had suffered cardiac arrest, and that her blood pressure was 68/30. Miss Findley looked in on the patient, who did not appear to her to be in acute distress, and telephoned Dr. Hampton. When Dr. Hampton arrived, he found the patient's blood pressure to be 188/80. Later, Dr. Hampton telephoned; respondent answered the telephone and said to Miss Findley, "Dr. Hildehand is on the phone . . ." There was a patient named Hildehand on the floor at the time. See petitioner's exhibit No. 3.

   
   

7. Physicians order that drugs be administered or that diagnostic tests be done on patients at Tampa General Hospital by specifying the procedure prescribed in writing in a particular place on the patients' charts. A nurse has the duty of examining each patient's chart and transcribing the physician's orders, if any, to a central index. After examining a chart for this purpose, the nurse signs the doctor's orders sheet, even if no orders have been given.

   In dispensing medications and otherwise carrying out physicians' orders, the nursing staff works from the central index, ordinarily without consulting patients' charts.

   
   

8. A Dr. Tyner ordered that an antibiotic, Keflin, be administered to a patient at Tampa General. Although respondent signed off on the patient's chart, she failed to transcribe this order to the central index; as a result,

   the drug was not administered to the patient on respondent's shift, contrary to Dr. Tyner's order. On another occasion, a doctor ordered K-Lor for a patient but respondent entered K-Lyte on the central index.

   
   

9. In anticipation of an operation, a physician prescribed Dalmane for a patient at Tampa General, and ordered that it be given at ten in the morning. Respondent administered this drug at ten the night before, spurning the patient's suggestion that she check the doctor's orders. On another occasion, respondent ordered a liver scan for a 96 year old patient in Tampa General with gastrointestinal bleeding. Curious, another nurse checked the patient's chart and found that no liver scan had been ordered. Still another time, respondent transcribed a physician's orders from a patient's chart to the central index and signed the patient's chart; but failed to transcribe an order for hemoglobin and hematocrit tests every twelve hours.

   
   

10. In January of 1978, Ronald C. Baker, R.N., patient care coordinator at Centro Espanol Memorial Hospital, smelt alcohol on respondent's breath while she was on duty as a nurse in the emergency room. On February 13, 1978, respondent's supervisor, a Mrs. Phillips, observed respondent moving carefully and stiltedly, having trouble with her equilibrium. Mrs. Phillips smelt alcohol on respondent's breath and sent her home from El Centro, because she felt respondent was unable to perform her duties.

    
    

    CONCLUSIONS OF LAW

    
    

11. Petitioner established that respondent was guilty of unprofessional conduct in violation of Section 464.21(1)(b), Florida Statutes (1977).

RECOMMENDATION

Upon consideration of the foregoing, it is RECOMMENDED:

That petitioner suspend respondent's license for two years.

DONE and ENTERED this 20th day of April, 1979, in Tallahassee, Florida.

ROBERT T. BENTON, II

Hearing Officer

Division of Administrative Hearings Room 530, Carlton Building Tallahassee, Florida 32304

(904) 488-9675

COPIES FURNISHED:

Julius Finegold Esquire 1107 Blackstone Building

Jacksonville, Florida 32202

Mrs. Nancy A. Seaton

70 Davis Boulevard Apartment 12

Tampa, Florida 33606

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

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

BEFORE THE FLORIDA STATE BOARD OF NURSING

IN THE MATTER OF:

Nancy Ann Middendorf Seaton As a Registered Nurse

70 Davis Boulevard CASE NO. 78-2316

Apt. No. 12 LICENSE NUMBER 91995-2

Tampa, Florida 33614

/

ORDER

This matter came on for final action by the Florida State Board of Nursing on the 26th day of June, 1978, at 111 Coastline Drive, Suite 508, Jacksonville, Florida.

The Board, having reviewed the entire record, including all pleadings, exhibits admitted into evidence, the transcript of hearing proceedings, the Findings of Fact, Conclusions of Law and Recommended Order of the Hearing Officer, adopts the Findings of Fact and Conclusions of Law of the Hearing Officer and IT IS THEREFORE:

ORDERED AND ADJUDGED that the registered nurse license number 91995-2 of the Respondent, Nancy Ann Middendorf Seaton, be suspended for a period of three

1. years. However, it is ordered that such suspension be stayed after a period of two (2) years and the licensee be placed on probation for the remaining period of one (1) year upon the following terms and conditions:

   
   

   1. That the Respondent shall forthwith return license number 91995-2 and current renewal receipt issued to practice nursing as a registered nurse to the Florida State Board of Nursing. The failure to comply shall be deemed a violation of this condition of the probation.

      
      

   2. That the Respondent refrain from violation of any law, Federal, State, or Local.

      
      

   3. That the Respondent attend an Adult Mental Health Clinic or undergo treatment by a qualified psychiatrist and provide this Board with a written report from the therapist, counsellor or physician every three (3) months of her progress in the program or treatment.

   4. That the respondent provide the Florida State Board of Nursing with a written report every three (3) months of her resident address and place of employment.

      
      

   5. If employed as a nurse during the period of probation, that the Respondent have her employer to provide this Board with an evaluation of her nursing performance every three (3) months during the period of this probation. Such evaluations must prove to be satisfactory to the Board.

      
      

   6. The failure to comply with the terms of said probation shall be deemed a violation of this Order.

DONE AND ORDERED this 3rd day of July, 1979, at Jacksonville, Florida.

FLORIDA STATE BOARD OF NURSING

BY:

Dorothy C. Stratton, R.N. President

BOARD SEAL

ccs: Nancy Ann Middendorf Seaton

70 Davis Boulevard Apt. No. 12

Tampa, Florida 33606 Julius Finegold, Esquire

Docket for Case No: 78-002316

Orders for Case No: 78-002316