STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

STATE BOARD OF NURSING, )

)

Petitioner, )

)

vs. ) CASE NO. 79-623

)

EUNICE LYLES NICHOLSON, )

)

Respondent. )

)

RECOMMENDED ORDER

Pursuant to notice, an administrative hearing was held before Diane D. Tremor, Hearing Officer with the Division of Administrative Hearings, on July 19, 1879, in the conference room of the Social Service Center in Titusville, Florida. The issue for determination at the hearing was whether respondent should be disciplined for the grounds set forth in the Administrative Complaint dated February 19, 1979.

APPEARANCES

For Petitioner: Julius Finegold

1107 Blackstone Building

233 Fast Bay Street Jacksonville, Florida 32202

For Respondent: Carl Wasileski

Post Office Box 1256

150 Taylor Street Titusville, Florida 32750

FINDINGS OF FACT

Upon consideration of the oral and documentary evidence adduced at the hearing, the following relevant facts are found:

1. The respondent Eunice Lyles Nicholson is 53 years of age and has been a registered nurse since 1947. She moved to Florida in 1970 and went to work for Jess Parrish Memorial Hospital, where she remained until February of 1977.

   Since that time, she has been employed in private nursing jobs and at the Titusville Nursing and Convalescent Center. At all times relevant to the incidents which are the subject of the Administrative Complaint, respondent was the charge nurse for the second floor of Jess Parrish Memorial Hospital. Her employee evaluations at the Hospital between 1970 and 1976 were "very good" overall.

   
   

2. On or about December 2, 1979, respondent destroyed an ampule containing

   100 mg of Demerol, a controlled substance, in the presence of another nurse. She did not sign for the destruction at this time. Later, when the nurse who witnessed the event was out, respondent requested another nurse to sign the

   document stating that she had witnessed the destruction. It is not acceptable or prevailing nursing practice to request one who did not actually witness the event to sign a document stating that she had witnessed the destruction of a controlled substance.

   
   

3. Between February 4, 1977, and February 17, 1977, a period of time in which the Hospital was busier than normal, various discrepancies, inconsistencies and insufficiencies were -noted in the charts and records of approximately six patients under respondent's care. These included incomplete and insufficient nurses notes on the patients' charts; failure to chart the administration of controlled susbstances on the patients' medical record; discrepancies between the nurse's notes, the patient's medication record and the narcotic control record; and the administration of medication at more frequent intervals then called for by the physician's orders. It was respondent's testimony that the charting errors were not intentionally made. She could not explain the errors and could only recall that the Hospital was very busy during that period of time. There was no evidence that any patient was harmed by the charting errors or that there was any similarity in the errors found. There was no evidence that respondent converted any controlled substance to her own use.

   
   

4. On or about February 17, 1977, respondent was the head nurse on the 7:00 A.M. to 3:00 P.M. shift. After respondent left this shift, it was noticed that there were two extra ampules of Demerol 75 in the narcotic cart. Respondent was called at home and notified of the discrepancy. She returned to the Hospital. Rather than making an attempt to determine the reason for the narcotic count being incorrect, respondent simply destroyed the two extra ampules. Witnesses observed this event. It is the responsibility of the nurse in charge of each shift to account for, reconcile and verify the inventory of controlled substances with the narcotic records before she leaves her shift. The reason for the discrepancy was never determined.

   
   

   CONCLUSIONS OF LAW

   
   

5. Respondent has been charged with unprofessional conduct, for which the Board of Nursing is authorized to take disciplinary action pursuant to Florida Statutes, 464.21(1)(b). That section defines unprofessional conduct as including

   
   

   "any departure from, or the failure to conform to, the minimal standards of acceptable and prevailing nursing practice, in which

   proceeding actual injury need not be established."

   
   

6. The evidence in this proceeding clearly establishes that respondent departed from standards of acceptable and prevailing nursing practices when she committed a series of charting errors, failed to accurately account for controlled substances under her supervision and requested another nurse to falsely verify the destruction of a controlled substance. She is thus guilty of unprofessional conduct and the Board is authorized to take disciplinary action against her.

   
   

7. When imposing sanctions, the Board should consider the facts that, with the exception of the December 2, 1976, occurrence, all the events for which respondent is guilty occurred within a two-week period during which the Hospital was busier than normal. Aside from the proven charges contained in the Administrative Complaint, there was no evidence that respondent had otherwise

performed her duties as a registered nurse in an unprofessional manner in the past 32 years.

RECOMMENDATION

Based upon the findings of fact and conclusions of law recited above, it is recommended that the Board:

1. find the respondent guilty of unprofessional conduct in violation of Florida Statutes, 464.21(1)(b); and

   
   

2. impose a six-month suspension of respondent's registered nursing license; and

   
   

3. suspend the enforcement of the suspended license and place the respondent on probation for a period of one (1) year.

Respectfully submitted and entered this 5th day of September, 1979, in Tallahassee, Florida.

DIANE D. TREMOR, Hearing Officer Division of Administrative Hearings Room 101, Collins Building Tallahassee, Florida 32301

(904) 488-9675

COPIES FURNISHED:

Julius Finegold

1107 Blackstone Building

233 East Bay Street Jacksonville, Florida 32202

Carl Wasileski

Post Office Box 1286

150 Taylor Street Titusville, Florida 32780

Geraldine Johnson Board of Nursing

111 Coastline Drive East, Suite 504 Jacksonville, Florida 32202

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

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

BEFORE THE FLORIDA BOARD OF NURSING

IN THE MATTER OF:

Eunice Rae Lyles Nicholson 1813 Lilac Circle

Titusville, Florida 32780 CASE NO. 79-623

As a Registered Nurse License Number 53804-2

/

ORDER

This matter came on for final action by the Florida Board of Nursing on the 8th day of October, 1979, at 111 Coast Line Drive East, Suite 508, Jacksonville, Florida.

The Board, having reviewed the entire record, including all pleadings, exhibits admitted into evidence, the transcript of the 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. However, the Board rejects the Recommended Order of the Hearing Officer due to the discrepancies in properly accounting for narcotic drugs, and inconsistencies and insufficiencies noted in the charts of six patients pertaining to the failure to properly document the administration of narcotic medications as ordered by the physician. Such action poses a serious danger to the patients in her charge which is not reflected in the recommended penalty as found by the Hearing Officer. THEREFORE IT IS:

ORDERED AND ADJUDGED that the registered nurse license number 53804-2 of the Respondent, Eunice Rae Lyles Nicholson, be suspended for a period of two and one-half years. However, it is ordered that said suspension be stayed after a period of one year and that the licensee be placed on probation for the remaining period of eighteen months upon the following terms and conditions:

1. That the Respondent shall forthwith return license number 53804-2 and current renewal receipt issued to practice nursing as a registered nurse to the Florida 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 a refresher course in pharmacology and the administration of medication, and provide the Board of Nursing with a copy of the course outline or curricular of such a course of study prior to attending same, and upon completion of such a course approved by the Board provide the Board with satisfactory completion of this course of study.

4. That the Respondent inform, in writing, the Florid Board of Nursing immediately of any change of address or change of employment

   
   

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

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

DONE AND ORDERED this 22nd day of October, 1979, at Jacksonville, Florida.

FLORIDA BOARD OF NURSING

By: Dorothy C. Stratton, R.N. President

BOARD SEAL

COPIES FURNISHED:

Eunice Rae Lyles Nicholson 1813 Lilac Circle

Titusville, Florida 32780

Carl Wasileski, Esquire Post Office Box 1256 Titusville, Florida 32780

Julius Finegold, Esquire

Docket for Case No: 79-000623

Orders for Case No: 79-000623