STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

DEPARTMENT OF PROFESSIONAL ) REGULATION, BOARD OF NURSING, )

)

Petitioner, )

)

vs. ) CASE NO. 82-2506

)

GREGORY BURGESS STONE, )

)

Respondent. )

)

RECOMMENDED ORDER

This matter came on for hearing in Orlando, Florida, on January 19, 1983, before the Division of Administrative Hearings and its duly appointed Hearing Officer, R. T. Carpenter. The parties were represented by:

For Petitioner: W. Douglas Moody, Esquire

119 North Monroe Street Tallahassee, Florida 32301

For Respondent: James M. Nicholas, Esquire

170 East Washington Street Orlando, Florida 32801

This matter arose on Petitioner's Administrative Complaint which charges Respondent with professional misconduct under Section 464.018, Florida Statutes (1981)(F.S.). Petitioner alleges that Respondent failed to administer medications which he recorded as having been administered.

Petitioner charged Respondent with medication discrepancies involving 13 patients at the Orlando Lutheran Towers Health Care Center, but withdrew charges as to 10 of these patients during the course of the final hearing. The parties submitted proposed findings of fact which have been incorporated herein to the extent they are relevant and consistent with the evidence.

FINDINGS OF FACT

1. Respondent, Gregory Burgess Stone, is a licensed practical nurse holding license number 0463451. Respondent was so licensed at all times relevant to this proceeding.

   
   

2. Respondent was employed at Orlando Lutheran Towers Health Care Center,

   300 East Church Street, Orlando, Florida, as a practical nurse at all times material hereto.

   
   

3. During April, 1982, Respondent acted as the full-time medicine nurse on the 7:00 a.m. through 3:00 p.m. nursing shift at Orlando Lutheran Towers.

4. Orlando Lutheran Towers utilizes the Unidose system of medication administration. The individual who administers the medication is required only to remove the appropriate dosage from the Unidose card which may contain from thirty to sixty doses of medication and thereafter record the administration of the medication on a medication administration record by inserting his initials under the appropriate date on the medication administration record format.

   
   

5. Each patient at Orlando Lutheran Towers is assigned a Unidose card for each medication he may require. The patient's name and other pertinent information appear on a label placed on the front of the Unidose card.

   
   

6. Respondent was intermittently relieved from duty in April by Gloria Underhill, another nurse-employee of Orlando Lutheran Towers.

   
   

7. Underhill worked in place of Respondent on April 8, and the Respondent thereafter worked the intervening period from April 9 through April 12.

   
   

8. Underhill returned to work in place of Respondent again on April 13, and in the course of administering medications, she observed that certain prescribed medications had not been administered between April 9 and April 13.

   
   

9. Underhill ascertained this information because of the procedure she had previously followed. It was Underhill's general practice to place her initials not only on the medication administration record but also on the Unidose card next to the particular unit of medication she intended to administer.

   
   

10. By comparing her initials with the physical presence of the succeeding units of medication in the Unidose card, she determined that the Respondent had apparently failed to administer medication to the following patients:

    
    

    PATIENT	MEDICATION	UNITS NOT RECEIVED
    1. Lowe	DDS 100 milligrams	4
    2. Doze	Corgard 40 milligrams	4
    3. Miller	TAM/LL	3

    
    

11. The medication administration record, however, indicated by the placement of the Respondent's initials that the foregoing medications had been received.

    
    

12. Respondent speculated that he may have administered the medication by utilizing doses not taken by other patients. This possibility was not supported by the evidence and is rejected.

    
    

13. Underhill's findings were given to the Director of Nursing and the Administrator of Orlando Lutheran Towers, who thereafter confronted Respondent with the Unidose card discrepancies. Respondent did not offer any explanation for the discrepancies and was therefore discharged from employment at Orlando Lutheran Towers.

    
    

    CONCLUSIONS OF LAW

    
    

14. Section 464.018, F.S., provides in part:

    
    

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

       (d) Making or filing a false report or record, which the licensee knows to be false, intentionally

       or negligently failing to file a report or record required by state or federal law, willfully im- peding or obstructing such filing or inducing another person to do so. Such reports or records shall include only those which are signed in the nurse's capacity as a licensed nurse.

       (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.

    2. When the board finds any person guilty of any of the grounds set forth in subsection (1), it may enter an order imposing one or more of the following penalties:

       1. Refusal to certify to the department an application for licensure.

       2. Revocation or suspension of a license.

       3. Imposition of an administrative fine not

          to exceed $1,000 for each count or separate offense.

       4. Issuance of a reprimand.

       5. 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.

          
          

15. Respondent failed to administer medication to three patients or, at best, was uncertain whether or not he administered the required medications during the period of April 9 through April 13, 1982. He did, however, certify that he had in fact administered these medications.

    
    

16. By certifying to matters which he knew to be false, or was uncertain as to their truth, Respondent is guilty of filing false reports and with unprofessional conduct within the meaning of Subsections 464.018(1)(d) and (f), F.S., quoted above. Be is therefore subject to disciplinary action under Subsection 464.018(2), F.S., also quoted.

RECOMMENDATION

Based on the foregoing, it is RECOMMENDED:

That Petitioner enter a final order finding Respondent guilty of the violations of law charged in the Administrative Complaint and placing his license in a probationary status for two years.

DONE and ORDERED this 18th day of March, 1983, in Tallahassee, Florida.

R. T. CARPENTER, 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 18th day of March, 1983.

COPIES FURNISHED:

W. Douglas Moody, Esquire

119 North Monroe Street Tallahassee, Florida 32301

James M. Nicholas, Esquire

170 East Washington Street Orlando, Florida 32801

Helen P. Keefe, Executive Director Board of Nursing

Department of Professional Regulation Room 504, 111 East Coastline Drive

Jacksonville, Florida 32202

Fred Roche, Secretary

Department of Professional Regulation

130 North Monroe Street Tallahassee, Florida 32301

Docket for Case No: 82-002506

Orders for Case No: 82-002506