STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

FLORIDA STATE BOARD OF NURSING, )

)

Petitioner, )

)

vs. ) CASE NO. 79-415

)

JOAN TETTER, )

)

Respondent. )

)

RECOMMENDED ORDER

Pursuant to notice a hearing was held in this case on April 25, 1979, by Stephen F. Dean, assigned Hearing Officer of the Division of Administrative Hearings upon an administrative complaint alleging that Respondent, Joan Tetter, violated Section 464.(1)(b) and (f), Florida Statutes.

APPEARANCES

For Petitioner: Julius Finegold, Esquire

1107 Blackstone Building

233 East Bay Street Jacksonville, Florida 32202

For Respondent: Jeff Weiner, Esquire

Suite 700, Rivergate Plaza

444 Brickell Avenue Miami, Florida 33131

FINDINGS OF FACT

1. Joan Tetter is a registered nurse licensed by the Florida State Board of Nursing.

   
   

2. On September 5, 1978, Respondent Tetter reported to work at the Baptist Hospital in Miami, Florida. She had been in an accident earlier in which she had bruised her back. Her boy friend had also been injured in this same accident and had been treated with Percodan, a controlled substance, for his injuries. Subsequent to reporting to work, Ms. Tetter experienced severe pain and took the Percodan prescribed for her boy friend. Ms. Tetter then experienced a temporary and incapacitating reaction to the drug, which was observed and reported by others on her shift. After a supervisor arrived, Ms. Tetter was relieved and sent to the hospital's emergency room for evaluation. The emergency room's findings were inconclusive.

   
   

3. Testimony was received from several witnesses regarding alleged discrepancies in charting. The testimony of Katherine Young, a licensed practical nurse, regarding an alleged error in the narcotics count was not coherent although, in fairness to Ms. Young, the incident had been some months before, and she was severely fatigued, having worked the night shift. The

   records involved were not submitted as a late filed exhibit and are not a part of the record in this case.

   
   

4. Regarding Ms. Tetter's sign-out for Demerol for Kent Kelly, the allegations were that Ms. Tetter had not administered Demerol "prn" for pain because the nurse's notes made by Price indicated he was in no pain. Kelly and his mother testified he had been in intense pain and had never received Demerol except as required for the control of pain from Ms. Tetter.

   
   

5. Regarding the other charting violations, there was no evidence of any substantial departure from the use of these records. In some instances the times were not in chronological order on the narcotic sign-out sheets; however, entries were made on all forms required. It appears Ms. Tetter entered the time of administration, not of sign-out, on the narcotic sign-out sheets. In some instances the medication administration record did not bear Ms. Tetter's initials to indicate which of two or more nurses administered the medication. However, this appears to be a common error, as only a cursory examination of the records reveals. There was also an occasional failure to chart administration of medication in the nurse's notes' however, this again appears to be the general practice in South Florida, where the medication nurse does not chart nurse's notes.

   
   

6. There was no evidence that Ms. Tetter had ever self-administered a prescription drug, Tigan, taken from hospital stock without a physician's prescription.

   
   

7. No evidence was introduced regarding administration of Demerol 75 mg to Kent Kelly on September 12, 1978, and failure to correctly chart its administration.

   
   

8. No evidence was presented of any condition which was of a nature to preclude Ms. Tetter from practicing nursing.

   
   

   CONCLUSIONS OF LAW

   
   

9. The Board of Nursing alleges that Joan Tetter has violated Sections 464.21(1)(b) and 464.21(1)(f), Florida Statutes. As stated above, there is no evidence of any violation of Section 464.21(1)(f), Florida Statutes. The sum total of the evidence in support of a violation of Section 464.21(1)(b) is as follows:

   
   

10. Joan Tetter took a drug, Percodan, which had been prescribed for her boy friend for the relief of pain to relieve pain she was having resulting from a severely bruised back.

    
    

11. Joan Tetter failed in some instances to initial the medication administration record to indicate it was she who had administered the medication when two or more nurses names appeared at the bottom of the form as being responsible for administration. In the limited number of records received, this appears to be a fairly common error among the staff.

    
    

12. Joan Tetter in several instances did not chart the sign-out of controlled substances in chronological order. While this is contrary to the requirements, it occurred in other instances at the hospital. See narcotic sign-out sheet No. 15102, lines 4 and 5, and sheet No. 15101, lines 6 and 7.

13. The first and third incidents above are violations of Section 464.21(1)(b), Florida Statutes. The Hearing Officer notes the testimony of Dr. Haas, who stated that it is not an uncommon practice for persons to take medications prescribed for another, although it is a violation of law to do so. The fact that she would have a reaction to Percodan, thus impairing her ability to perform her duties, was beyond Tetter's knowledge. From the narcotic sign- out sheets, it appears that Ms. Tetter was recording thereon the time of administration and not of sign-out. If so, this was the result of her inexperience in her duties, having practiced nursing for less than one year and having been in her position for only a few weeks.

RECOMMENDATION

Based upon the foregoing Findings of Fact and Conclusions of Law, the Hearing Officer recommends that the Florida State Board of Nursing suspend Joan Tetter for two months and place her on probation for ten months.

DONE and ORDERED this 19th day of June, 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

Jeff Weiner, Esquire

Suite 700, Rivergate Plaza

444 Brickell Avenue Miami, Florida 33131

Geraldine B. Johnson, R. N.

111 East Coastline Drive Jacksonville, Florida 32202

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

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

IN THE MATTER OF:

Joan Marie Tetter

BEFORE THE FLORIDA STATE BOARD OF NURSING

As a Registered Nurse Case No. 78-764

10932 N. Kendall Drive, Apt. U-4 License Number 0981152 Miami, Florida 33176

/

ORDER

This matter came on for final action by the Florida State Board of Nursing on the 26th day of June, 1979, at 111 Coastline Drive East, 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 0981152 of the Respondent, Joan Marie Tetter, be suspended for a period of one (1) year. However, it is ordered that said suspension be stayed after a period of two (2) months and the licensee be placed on probation for the remaining period of ten

1. months upon the following terms and conditions:

   
   

   1. That the Respondent shall forthwith return license number 0981152 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 continue to attend the Spectrum Program and provide this Board with a written report from the counsellor or therapist every three

1. months of her progress in the program or treatment.

   
   

2. That the Respondent inform the Florida State Board of Nursing every three (3) months of her current address and place of employment.

   
   

3. If employed as a nurse during the period of probation, that the Respondent have her employer provide the Board with an evaluation of her nursing performance every three (3) months during the period of this probation.

   
   

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

DONE AND ORDERED this 6th day of July, 1979, at Jacksonville, Florida.

FLORIDA STATE BOARD OF NURSING

BY:

Dorothy C. Stratton, R.N. President

BOARD SEAL

ccs: Joan Marie Tetter

10932 N. Kendall Drive, Apt. U-4 Miami, Florida 33176

Jeff Weiner, Esquire Suite 700, Rivergate Plaza

444 Brickell Avenue Miami, Florida 33131

Julius Finegold, Esquire

Docket for Case No: 79-000415

Orders for Case No: 79-000415