STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

BOARD OF NURSING, )

)

Petitioner, )

)

vs. ) CASE NO. 79-1371

)

NANCY DRENNEN, )

)

Respondent. )

)

RECOMMENDED ORDER

This case was heard pursuant to notice on March 20, 1980, by Stephen F. Dean, assigned Hearing Officer of the Division of Administrative Hearings. This case arose on an Administrative Complaint filed by the Florida State Board of Nursing against Nancy Drennen alleging that she was guilty of unprofessional conduct contrary to Section 464.21(1)(b) , Florida Statutes (Section 464.18(1)(f) , Florida Statutes 1979).

APPEARANCES

For Petitioner: Julius Finegold, Esquire

1107 Blackstone Building

233 East Bay Street Jacksonville, Florida 32202

For Respondent: Hugo H. de Beaubein, Esquire

Suite 690, CNA Tower Post Office Box 87 Orlando, Florida 32802

FINDING OF FACT

1. The Respondent, Nancy Drennen, is a registered nurse licensed in the State of Florida.

   
   

2. During October, 1978, as indicated in the Administrative Complaint, the Respondent was employed as a registered nurse on the obstetrics floor of the Seminole Memorial Hospital.

   
   

3. There were only two O]3/GYN physicians practicing at Seminole Memorial Hospital in October of 1978, Drs. Roberts and Phillips. All of the patients involved were Dr. Phillips' patients; however, Dr. Roberts appealed as a witness and testified concerning the routine orders used by him and Dr. Roberts in October of 1978. Dr. Roberts indicated that their routine orders were kept on file at the hospital and were included in their patients' files when they directed that routine orders be followed.

   
   

4. The records reflect that on October 1, 1978, the Respondent signed out Dalmane 30 mg for Patricia Weller, Cindy Boatner and Regina Oliver. The

   patients' records reflect routine orders for this medication for Weller and Boatner for October 1, 1978. The Respondent made appropriate entries for Boatner and Weller in their Medication Administration Records (MAR) and nursing notes, both of which are contained in the same chart at Seminole Memorial Hospital. Oliver's records do not reflect a routine order by Dr. Phillips.

   
   

5. Oliver was nearly full-term and was admitted to the hospital on September 30, 1978, for treatment of a urinary tract infection. She had a pre- admission arranged and had been a patient of Drs. Roberts and Phillips. The Respondent had no specific recollection of this patient.

   
   

6. On October 2, 1978, the records reflect the Respondent signed out for Dalmane 30 mg for Carson, Boatner and Weller. The records again reflect that routine orders were in effect for Boatner and Weller. The records for Carson do not reflect a routine order for this medication.

   
   

7. The Respondent testified that it was Dr. Phillips' practice to give oral orders and sign them off afterward. The patients' records reflect every order given by Dr. Phillips to have been given orally and then signed off by him. Dr. Phillips' oral orders included Dalmane 30 mg for sleep for his patients. The Respondent indicated that Dr. Phillips did not appreciate calls to verify his oral orders, but signed them afterward if the patient requested medication. While the issuance of oral orders does not conform strictly to accepted practice, Drs. Roberts and Phillips were the only two OB/GYN's regularly practicing in Sanford and in the hospital. The Respondent had worked OB/GYN at the hospital for four years with Drs. Roberts and Phillips and had become used to their preferences. It is apparent that the Respondent failed to record an oral order as opposed to administering medication without a physician's order.

   
   

8. The patients' records reflect that appropriate entries were not made to indicate administration of Dalmane 30 mg on the MAR of Oliver on October 2, 1978, but an appropriate nursing note was made by Respondent. The records reflect that the Respondent signed out for Dalmane 30 mg for Carson on October 2, 1978, but no entries were made in the nursing notes or the MAR; however, all of the charting on Carson was done by Kendrick on the night in question. The records reflect that Dalmane 30 mg was signed out for Weller on October 2, 1978, but no entry was made by Respondent in the nursing notes or the MAR. On October 2, 1978, the same thing occurred with Boatner.

   
   

9. The Respondent had no specific recollection of the events of October 1, and 2, 1978. The Respondent testified, and her testimony was supported by other witnesses, that shortly before the events of October 1 and 2, 1978, a new director of nursing was appointed. Administrative changes were made which dissatisfied many members of the staff. The Respondent was an outspoken critic of those changes. On October 3, 1978, she was advised that she was terminated. She was given no grounds for her discharge. She interviewed with another local hospital, and the director of nursing for Seminole Memorial Hospital advised the other hospital that the Respondent was still employed. She was, however, terminated. She was not advised of any grounds for her discharge, but she gradually became aware that there was an effort being made by Seminole Memorial Hospital to keep her from being re-employed. The Respondent kept attempting to obtain an explanation of her termination, which resulted in a letter dated December 27, 1979, in which the director of nursing alleged that the Respondent had medicated a patient without proper authority. The Board of Nursing became aware of the events as a result of the conflict between Seminole Memorial Hospital and the Respondent and lodged the instant Administrative Complaint.

   However, the Respondent was not fully aware of the specifics of the charges against her until June of 1975. 1/ By that date she was no longer employed by Seminole Memorial Hospital, the events in question had occurred nine months earlier, and she had no access to the records to refresh her memory.

   
   

10. Dr. Roberts and the nurses who worked with the the Respondent all had the highest respect for the Respondent and her professionalism. The Respondent is currently employed, doing a good job, and pleasing her employer as an OB nurse.

    
    

    CONCLUSIONS OF LAW

    
    

11. The Board of Nursing charges the Respondent with unprofessional conduct contrary to Section 464.21(1)(b) , Florida Statutes (Section 464.18(1)(f) , Florida Statutes 1979). Clear and uncontroverted testimony was received concerning the Respondent's experience, professionalism and competence from her coworkers and a physician for whom she worked directly for four years. The records show that on October 2, 1978, the Respondent filed to chart the administration of Dalmane 30 mg to patients and to record and obtain the physician's signature on his oral order for the Dalmane for Oliver and Carson. The records reflect that the Respondent made the appropriate entries on the MAR's on October 1, 1978, for all the patients involved. The records do not show what the events of October 2, 1978, were which caused the Respondent to depart from her normal professional conduct. The facts reflect that the duties assigned to the Respondent were diverse and required her to leave the postpartum floor periodically.

    
    

12. The record is crystal clear that thee Respondent was denied any information concerning the grounds for her termination until nearly three months after the fact, and then was only generally advised of the grounds for her discharge. When one considers that the Respondent had been employed by the hospital for four years, this action gas clearly precipitous and reflects that her discharge was most probably the result of a personality conflict with the director of nursing. Although the personality conflict between the Respondent and the director of nursing does not change the fact that entries in the patients' records were not made, it does affect directly the ability of the Respondent to reconstruct the events of October 2, 1978, which contributed to her actions.

    
    

13. Taken as a whole, the record indicates a single isolated occasion on which the Respondent technically violated the statute contrary to her normal practices and adherence to accepted nursing practice.

RECOMMENDATION

Based on the foregoing Findings of Fact and Conclusions of Law the Hearing Officer recommends that the Respondent, Nancy Drennen, receive a letter of reprimand. In making this recommendation, the Hearing Officer specifically considers the outstanding comments made about the Respondent by her Dr. Roberts and her coworkers, the fact that she has been employed as an OH nurse since January of 1979, performing her duties without complaint or incident, and the fact that the complaint was filed against her so long after the incident that it truly diminished the Respondent's ability to defend herself.

DONE and ORDERED this 29th day of May, 1980, In Tallahassee, Leon County, Florida.

STEPHEN F. DEAN, Hearing Officer Division of Administrative Hearings Room 101, Collins Building Tallahassee, Florida 32301

(904) 488-9675

ENDNOTE

1/ After being fully advised of her rights, the Respondent waived informal conference in this case.

COPIES FURNISHED:

Julius Finegold, Esquire

307 Blackstone Building

233 East Bay Street Jacksonville, Florida 32202

Hugo H. de Beaubein, Esquire Suite 690, CNA Tower

Post Office Box 87 Orlando, Florida 32802

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

111 Coastline Drive East, Suite 504 Jacksonville, Florida 32202

Docket for Case No: 79-001371

Orders for Case No: 79-001371