STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

MARGIE LEVERSON, )

)

Petitioner, )

)

vs. ) CASE NO. 80-956

)

DEPARTMENT OF PROFESSIONAL ) REGULATION, BOARD OF NURSING, )

)

Respondent. )

)

RECOMMENDED ORDER

Pursuant to notice, the Division of Administrative Hearings, by its duly designated Hearing Officer, DONALD R. ALEXANDER, held a public hearing in the above styled case on August 19, 1980, in Miami, Florida.

APPEARANCES

For Petitioner: Margie Leverson, Pro Se

4030 Northwest 190th Street Opa Locka, Florida 33055

For Respondent: Frank Vickory, Esquire

Assistant Attorney General The Capitol

Tallahassee, Florida 32301

Margie Leverson appeared on her own behalf and chose to represent herself although she was advised of her right to be represented by counsel.

By Administrative Complaint dated March 12, 1980, the Board of Nursing denied an application of Margie Leverson to re-register her terminated license as licensed practical nurse. As grounds therefore, it is alleged that on or about March 10, 1978, while on duty as a licensed practical nurse at Palm Springs General Hospital, Homestead, Florida, in the cardiac wing on the 11 p.m. to 7 a.m. shift, petitioner failed to conform to the minimal standards of acceptable and prevailing nursing practice in that she (a) failed to chart medications administered to patients on the patients' medication administration profile sheets; (b) failed to adequately and properly chart the nurses' notes of patients in her care and, in the case of some patients, failed completely to chart any information on the narrative section of the nurses' notes during the entire shift; and (c) failed to place her signature on medication administrative profile sheets and nurses' notes.

The issue presented is whether the petitioner's application for re- registration as a licensed practical nurse should be granted.

FINDINGS OF FACT

1. Margie Leverson, petitioner, was registered with the Florida State Board of Nursing in 1978 as a licensed practical nurse holding license number 13107-1.

   
   

2. On the evening of March 9, 1978, petitioner was assigned to work the 11

   p.m. through 7 a.m. shift in the critical care unit of Palm Springs General Hospital, Homestead, Florida. An audit of administration records at the Hospital disclosed that petitioner failed to properly chart medications administered to a number of patients, that she failed to complete the nurses' notes of patients under her care, and that she did not sign the medication administration profile sheets or nurses' notes for any of the patients under her care during the time at issue.

   
   

3. The importance of conforming to these requirements is to assure that all medications have been given when scheduled and to assure continuity in evaluating a patient's illness. With critically ill patients, it is necessary to be able to ascertain when a condition or problem was noted and how it was treated. Otherwise, continuity is lost, and it is possible that decisions as to treatment may not be accurately made, and the nurse in charge cannot in every case be identified unless her signature appears on the documents.

   
   

4. Failure to chart medications administered to patients.

   
   

5. On two occasions, petitioner failed to chart medications administered to patients. Specifically, Juan Pinera was to receive 2 million units of penicillin intravenously every four hours, including twice during the time he was in petitioner's care. However, the prescribed medication was not charted as having been given to the patient during this time. Another patient, Peter L. Garcia, was scheduled to receive ampycillin 500 mg. at midnight and 6 a.m., and garamycin 40 mg. at midnight. Such administrations, if given, were not charted by petitioner.

   
   

6. Failure to adequately and properly chart the nurses' notes of patients in the nurse's care.

   
   

7. In the case of four patients under the care of petitioner, no nurses' notes were kept. (Exhibit Nos. 1, 2, 5, & 6). For the other three patients, the notes were of minimal, if any, value because they did not provide any evaluation or explanation of the problems noted. (Exhibit Nos. 3, 4 & 7). Petitioner herself acknowledged that the words were written in her hand writing and were of no value to anyone attempting to determine the patient's condition.

   
   

8. Failure to sign medication administration profile sheets and nurses' notes.

   
   

9. The petitioner failed to sign the medication administration profile sheets and nurses' notes for any of the patients under her care during the time at Issue.

   
   

10. In mitigation, petitioner had earlier completed a 3 p.m. through 11

    p.m. shift at another hospital on the same date. She arrived on duty at the Hospital around 11:30 p.m. Because of an argument with a co-worker, she was transferred by her supervisor to another unit around 1:00 a.m. and claims she cannot be held accountable for the failures as to the seven patients who were

    under her care. Petitioner stated she ultimately left the hospital on leave around 3:00 a.m. due to a pinched nerve in her back.

    
    

    CONCLUSIONS OF LAW

    
    

11. The Division of Administrative Hearings has jurisdiction over the parties and subject matter of this proceeding.

    
    

12. Section 464.018(1)(f), Florida Statutes, provides as follows:

    
    

    1. The following acts shall be grounds for disciplinary action set forth in this section.

       (f) Unprofessional conduct, which shall include, but not be limited to, any departure from, or the failure to conform to, the minimal standards of acceptable and prevailing nursing practice, in which case actual injury need not be established. Whenever the Board finds any person guilty of any of the grounds set forth in subsection (1), it may refuse to certify to the Department an application for licensure.

       
       

13. The facts above constitute a violation of this provision and the petitioner is guilty of departure from the minimal standards of acceptable and prevailing nursing practice and is, therefore, subject to disciplinary action, pursuant to Section 464.018(2), Florida Statutes.

    
    

14. While the petitioner has clearly violated the provisions of the aforesaid statute, the Board's action appears too severe in light of her actions. A more fair and just penalty under such circumstances is approval of petitioner's application but placing her on probation for one year during which time she should be required to submit to the Board the name and address of her employer if she is employed as a nurse and any change in her own name and address. Further, while on such probation, petitioner must strictly comply with all statutes and rules of the Board in her nursing practice.

RECOMMENDATION

Based upon the foregoing findings of fact and conclusions of law, it is RECOMMENDED the application of Margie Leverson for reinstatement of her

license as a licensed practical nurse be granted subject to the conditions set

forth in conclusion 14 above.

DONALD R. ALEXANDER

Hearing Officer

Division of Administrative Hearings Room 101, Collins Building Tallahassee, Florida 32301

(904) 488-9675

COPIES FURNISHED:

Ms. Margie Leverson

4030 Northwest 190th Street Opa Locka, Florida 33055

Frank A. Vickory, Esquire Assistant Attorney General The Capitol

Tallahassee, Florida 32301

Docket for Case No: 80-000956

Orders for Case No: 80-000956