STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

DEPARTMENT OF PROFESSIONAL ) REGULATION, BOARD OF NURSING )

)

Petitioner, )

)

vs. ) CASE NO. 81-3265

) PATRICIA ANN CARTY POLAN MORRIS, )

)

Respondent. )

)

RECOMMENDED ORDER

Pursuant to notice, a formal administrative hearing was conducted in this matter on July 14, 1982, in Daytona Beach, Florida. The following appearances were entered: W. Douglas Moody, Jr., Tallahassee, Florida, appeared on behalf of the Petitioner, Department of Professional Regulation, Board of Nursing; and Charles T. Moore, South Daytona, Florida, appeared on behalf of the Respondent, Patricia Ann Carty Polan Morris.

The Petitioner filed an administrative complaint against the Respondent seeking to revoke or suspend the Respondent's license to practice nursing, or to take otherwise appropriate disciplinary action against the Respondent. The Respondent requested a formal administrative hearing, and Petitioner forwarded the matter to the office of the Division of Administrative Hearings for the assignment of a Hearing Officer and the scheduling of a hearing. The final hearing was originally scheduled to be conducted in February, 1982. Prior to that hearing, the parties entered into negotiations which appeared to have a favorable prospect of resolving the issues. The hearing was continued.

Negotiations were ultimately unsuccessful, and the final hearing was rescheduled to be conducted as set out above by notice dated June 3, 1982.

On July 12, 1982, a prehearing conference was conducted by telephone communication. Counsel for the parties and the undersigned Hearing Officer participated in the conference. Petitioner moved to amend its administrative complaint so as to change references to certain dates set out in the original complaint. The Motion to Amend was granted. Respondent moved to continue the hearing, and the motion was denied. An Amended Administrative Complaint was filed at the final hearing, and the Motion for Continuance was reargued by Respondent and denied.

Petitioner called the following witnesses: Barbara W. Kennedy, a licensed practical nurse who serves as the administrator of Huntington Square Convalarium, Inc., in Daytona Beach, Florida; Ellen Marie Gridley, a registered nurse who formerly worked at Huntington Square Convalarium as Director of Nurses; Dixie J. Arthur, a licensed practical nurse who works at Huntington Square Convalarium as a charge nurse; Patricia Collins, a registered staff nurse employed at Huntington Square Convalarium; Mary Ward, a nurse's aid employed at Huntington Square Convalarium; Jenny Wilson Smith, a registered nurse who formerly worked in the psychiatric department at Halifax Hospital; and Frederick

George Moore, Jr., an employee of Pick Shoe Store in Daytona Beach. Respondent called the following witnesses: Wilma Murphy, a registered nurse who serves as Director of Nursing at Bowman Nursing Center; and William P. Friedenberg, a licensed clinical psychologist who works with the Human Resources Center of Volusia County, Inc. Petitioner's Exhibit 1 and Respondent's Exhibits 1, 2 and 3 were offered into evidence and received. The parties have submitted post- hearing legal memoranda. Petitioner's post-hearing submittal includes Proposed Findings of Fact and Conclusions of Law. The proposed findings and conclusions have been adopted only to the extent that they are expressly set out in the Findings of Fact and Conclusions of Law which follow. They have been otherwise rejected as not supported by the evidence, contrary to the evidence, irrelevant to the issues, or legally erroneous.

ISSUES

The issues in this proceeding are whether the Respondent has committed violations of statutes pertaining to the practice of nursing as alleged in the Amended Administrative Complaint, and, if so, what disciplinary action is appropriate.

FINDINGS OF FACT

1. At all times material to this proceeding, the Respondent has been licensed by the Petitioner as a licensed practical nurse.

   
   

2. From approximately May 21, 1980 until May 29, 1981, the Respondent was employed as an "LPN charge nurse" at Huntington Square Convalarium, Inc., in Daytona Beach, Florida. She had previously been employed at Huntington Square in the same capacity for approximately two months. She then went on maternity leave before she was reemployed. Persons in this capacity at Huntington Square supervised several nurses' aides, and performed usual nursing duties which included assessment of patients, preparation, administering and charting of medications, public relations duties with members of patients' families, telephone duties, being aware of safety conditions in the building, and the like. During the time that she served as a charge nurse at Huntington Square, the Respondent, on a recurring and frequent basis, engaged in unprofessional conduct which departed from the minimal standards of acceptable and prevailing nursing practice. Respondent was experiencing extreme personal difficulties during that period, and she was subject to extreme mood swings while on the job. While in depressed moods, the Respondent would occasionally become inattentive to patients' needs and, on a few occasions, she failed to respond to obvious needs such as a catheter misplacement or edema. Respondent was subject to frequent crying fits. Other than occasional inattentiveness, the Respondent would, during her depressed episodes, inadequately chart and document procedures, use loud and profane language, and engage in extended conversations with staff members, visitors, and even patients regarding her personal problems. Respondent's conduct was disruptive and upsetting to the staff at Huntington Square, especially to those persons whom the Respondent supervised.

   Respondent's preoccupation with her own problems caused her to give too little attention to the needs of her patients, both directly and through persons she supervised.

   
   

3. There was no testimony from which it could be concluded that any serious repercussions were imposed upon the Respondent's patients by her conduct. The conduct did, however, fall below minimal and acceptable standards of nursing practice in the State of Florida.

4. Respondent's depression appears to have reached a peak in May, 1981. At that time, she was involved in an incident at Pick Shoe Store in Daytona Beach. The Respondent was dating an employee of the store. Respondent showed up at the store in an extremely agitated condition with a hand gun. Respondent was ultimately forced out of the store, the door was locked behind her, and she was handled by the police. What the Respondent's specific intent was at that incident is not known. She did admit to various persons, however, that on at least one occasion she attempted suicide at approximately that time.

   
   

5. The Respondent suffers from a condition, recurrent depression, which is properly classified as a mental illness. The condition has in the past affected her ability to perform nursing functions. The condition is, however, controllable. Respondent was hospitalized in connection with a suicide attempt. Since October, 1951, she has engaged in regular counselling services at the Human Resources Center in Daytona Beach. Her condition has stabilized, and she has taken positive steps to improve her personal relationships. If the Respondent's condition remains stable, she is fully able to practice nursing effectively. If the Respondent continues to engage in a regular counselling program, it is likely that her condition will remain stable.

   
   

6. Since November, 1981, the Respondent has worked at Bowman Nursing Center as a supervisor nurse. She is charged with responsibilities for examining reports; taking controlled drug counts; setting up, administering and charting medications; assisting with feeding; reporting on patients' progress; and making written evaluations. The Respondent has performed her job functions in an acceptable manner, and her job performance has steadily improved during her employment.

   
   

   CONCLUSIONS OF LAW

   
   

7. The Division of Administrative Hearings has jurisdiction over the parties and the subject matter of this proceeding. Sections 120.57(1), 120.60, Florida Statutes.

   
   

8. The Nurse Practice Act at Section 464.018, Florida Statutes, provides in pertinent part 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.

      * * *

      (h) Being unable to practice nursing with reasonable skill and safety to patients by reason of illness . . . or as a result of any mental or physical condition. A nurse af- fected under this paragraph shall at reasonable intervals be afforded an opportunity to demon- strate that she can resume the competent practice of nursing with reasonable skill and safety.

9. Respondent's job performance while employed at Huntington Square Convalarium, Inc., did not conform to the minimal standards of acceptable and prevailing nursing practice. The Respondent was unable to practice effectively as a nurse by reason of a mental condition. The Respondent's conduct while employed at Huntington Square Convalarium thus constitutes violations of the statutes.

   
   

10. It is apparent that the Respondent is able to practice effectively as a nurse so long as her mental condition is stabilized. It is also apparent that her mental condition can be stabilized if she continues to engage in a regular counselling program. Section 464.018(2)(e), Florida Statutes, provides as follows:

When the board finds any person guilty of any of the grounds set forth in subsection it may enter an order imposing one or

more of the following penalties:

* * *

(e) Placement of the nurse on probation for a period of time and subject to such

conditions as the board may specify, including requiring the nurse to submit to treatment,

to attend continuing education courses, to take an examination, or to work under the supervision of another nurse.

In view of the fact that the Respondent did not willfully violate any provisions of the Nurse Practice Act, that she is competent to practice as a nurse so long as her mental condition is stabilized, and that her condition can be stabilized with a regular counselling program, it is appropriate that the Respondent be placed on probation for a period of time, with the condition that she submit to a regular counselling program, and that regular reports be submitted to the Petitioner by the treating personnel.

RECOMMENDED ORDER

Based upon the foregoing Findings of Fact and Conclusion of Law, it is, hereby,

RECOMMENDED:

That the Board of Nursing enter a final order finding the Respondent guilty of the allegations set forth in the Amended Administrative Complaint and placing the Respondent on probation for a period of three years with the condition of probation being that the Respondent engage in a regular mental health counselling program, and that quarterly reports be submitted by treating personnel to the Board of Nursing.

RECOMMENDED this 16th day of August, 1982, in Tallahassee, Florida.

G. STEVEN PFEIFFER Hearing Officer

Division of Administrative Hearings The Oakland Building

2009 Apalachee Parkway

Tallahassee, Florida 32301

(904) 488-9675

Filed with the Clerk of the Division of Administrative Hearings this 16th day of August, 1982.

COPIES FURNISHED:

W. Douglas Moody, Jr., Esquire

119 North Monroe Street Tallahassee, Florida 32301

Charles T. Moore, Esquire Kennedy & Hogeboom

Post Office Box 4319

South Daytona, Florida 32021

Helen P. Keefe Executive Director Board of Nursing

Room 504, 111 East Coastline Drive

Jacksonville, Florida 32202

Samuel R. Shorstein Secretary

Department of Professional Regulation

130 North Monroe Street Tallahassee, Florida 32301

Docket for Case No: 81-003265

Orders for Case No: 81-003265