STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

DEPARTMENT OF PROFESSIONAL REGULATION, ) BOARD OF NURSING, )

)

Petitioner, )

)

v. ) CASE NO. 91-0266

)

CONNIE SUE WARD REEVES, )

)

Respondent. )

)

RECOMMENDED ORDER

Pursuant to notice, a formal hearing was held in this case on April 22, 1991, in Crestview, Florida, before the Division of Administrative Hearings, by its designated Hearing Officer, Diane K. Kiesling.

APPEARANCES

For Petitioner: Tracey S. Hartman, Senior Attorney

Department of Professional Regulation 1940 North Monroe Street

Tallahassee, Florida 32399-0792 For Respondent: No Appearance

STATEMENT OF ISSUES

The issue is whether the nursing license of Connie Sue Ward Reeves should be revoked or otherwise penalized based on the acts alleged in the Administrative Complaint.

PRELIMINARY STATEMENT

The Respondent, Ms. Reeves, failed to appear at the formal hearing. By an undated letter filed on May 8, 1991, Ms. Reeves acknowledged the date and time for the hearing. In that letter she advised that she had inadvertently slept through the hearing.

The hearing proceeded in Ms. Reeves' absence. The Department of Professional Regulation (DPR), Board of Nursing (Board), presented the testimony of Helene L. Metts and had Exhibits 1-7 admitted in evidence.

The transcript of the hearing was filed on May 1, 1991. Proposed findings of fact and conclusions of law were to be filed on May 11, 1991. Ms. Reeves filed no proposed findings of fact and conclusions of law. DPR filed a Motion for Extension of Time together with its proposed order on May 15, 1991. The Motion for Extension of Time is hereby GRANTED and the proposed order is deemed to be timely filed. All proposed findings of fact and conclusions of law have

been considered. A specific ruling on each proposed finding of fact is made in the Appendix attached hereto and made a part of this Recommended Order.

FINDINGS OF FACT

1. At all times relevant to the charges, Connie Sue Ward Reeves has been licensed in Florida as a practical nurse, holding license number 0739211.

   
   

2. In April 1990 Ms. Reeves was employed as a practical nurse at the Silvercrest Manor Nursing Home in Crestview, Florida.

   
   

3. On April 18, 1990, Ms. Reeves worked the 7:00 a.m. to 7:00 p.m. shift. Her duties included administering and charting medication.

   
   

4. Ms. Reeves punched out on the time clock at 7:30 p.m.

   
   

5. The Director of Nurses, Helene Metts, came on the floor when Ms. Reeves left because there was a staffing shortage. In determining what needed to be done, Ms. Metts examined the charts for the patients for whom Ms. Reeves had been responsible.

   
   

6. Ms. Metts found that some 8:00 p.m. medications and one 10:00 p.m. medication were already charted as having been administered by Ms. Reeves.

   
   

7. It is not the accepted practice at Silvercrest for the nurse on the prior shift to give the next shift's medications. In fact, the policy and procedure manual of Silvercrest requires that medications be given at the right time and that the medication be charted immediately after it is given. It is permissible according to policy to give medications up to one hour on either side of the prescribed time unless the prescribed time falls in the next shift. These practices also are required by principles of good nursing practice.

   
   

8. Ms. Reeves was given the policy and procedure manual as part of an orientation which she attended prior to beginning at Silvercrest.

   
   

9. Because Ms. Reeves had already left the premises, Ms. Metts never was able to determine the night of April 18, 1990, whether the medications had actually been given or whether they had just been pre-charted.

   
   

10. If Ms. Reeves did administer the medications which she had charted, then she gave them in contravention of the policies and procedures. The way these medications were charted was negligent in that the medications either were administered at the wrong time, by the wrong shift, or were pre-charted before the medications were actually administered. Further, by signing the medication charts of the patients involved, Ms. Reeves was making a record that she administered the medications at the time stated on the charts. This cannot be so since Ms. Reeves left work up to two and one-half hours before the medications were to be given.

    
    

11. Additionally, if Ms. Reeves pre-charted the medications, but did not administer them, the act of charting something that was not actually done would constitute negligence and the creation of a false record.

    
    

12. Ms. Reeves' negligence resulted in a situation where patients could either receive no medication or double medication. In either case, the patients were put at risk.

    CONCLUSIONS OF LAW

    
    

13. The Division of Administrative Hearings has jurisdiction of the parties to and subject matter of these proceedings. Section 120.57(1), Florida Statutes.

    
    

14. Ms. Reeves is charged with violating Section 464.018(1)(f) and/or Section 464.018(1)(h), Florida Statutes. Those sections make the following acts grounds for disciplinary action:

    
    

    (f) Making or filing a false report or re- cord, which the licensee knows to be

    false. . . . Such reports or records shall include only those which are signed in the nurse's capacity as a licensed nurse.

    * * *

    (h) Unprofessional conduct, which shall in- clude, but not be limited to, any departure from, or the failure to conform to, the min- imal standard of acceptable and prevailing nursing practice, in which case actual injury need not be established.

    
    

15. "Unprofessional conduct" is defined in Rule 21O-10.005(1)(e)2, Florida Administrative Code, to include "Administering medications or treatments in negligent manner." [sic]

    
    

16. The burden of proof is on DPR to prove its allegations by the clear and convincing evidence. That burden of proof has been satisfied.

    
    

17. The evidence shows that Ms. Reeves administered medications in a negligent manner. That act constitutes unprofessional conduct in violation of Section 464.018(1)(h). Additionally, by signing the patients' charts that she administered medications at 8:00 p.m. and 10:00 p.m., when in fact Ms. Reeves left work by 7:30 p.m., Ms. Reeves is guilty of making a false report or record in violation of Section 464.018(1)(f).

    
    

18. The disciplinary guidelines of the Board found in Rule 21O-10.011(2), Florida Administrative Code, establish a recommended penalty range of a reprimand and fine of $250 to revocation and $1000 fine for a single offense of knowingly making a false report. It also recommends a penalty range of 6 months probation and CE courses to two years probation and CE courses for a single offense of unprofessional conduct. The licensure file of DPR admitted as Petitioner's Exhibit 1 shows no record of any prior disciplinary action against Ms. Reeves. Because there is no evidence of aggravating factors, the recommended penalty is within the low range of the disciplinary guidelines.

RECOMMENDATION

Based upon the foregoing Findings of Fact and Conclusions of Law, it is recommended that the Department of Professional Regulation, Board of Nursing, enter a Final Order and therein:

1. Find Connie Sue Ward Reeves guilty of violating Sections 464.018(1)(f) and (h), Florida Statutes.

   
   

2. Place Ms. Reeves on probation for a period of one (1) year.

3. Require Ms. Reeves to attend continuing education classes in an amount and subject area to be established by the Board.

   
   

4. Impose a fine of $250.00.

RECOMMENDED this 31st day of May, 1991, in Tallahassee, Florida.

DIANE K. KIESLING

Hearing Officer

Division of Administrative Hearings The DeSoto Building

1230 Apalachee Parkway

Tallahassee, FL 32399-1550

(904) 488-9675

Filed with the Clerk of the Division of Administrative Hearings this

31st day of May, 1991.

APPENDIX TO THE RECOMMENDED ORDER, CASE NO. 91-0266

The following constitutes my specific rulings pursuant to Section 120.59(2), Florida Statutes, on the proposed findings of fact submitted by the parties in this case.

Specific Rulings on Proposed Findings of Fact Submitted by Petitioner, Department of Professional Regulation

1. Each of the following proposed findings of fact is adopted in substance as modified in the Recommended Order. The number in parentheses is the Finding of Fact which so adopts the proposed finding of fact: 1-8(1-12).

COPIES FURNISHED:

Tracey S. Hartman, Senior Attorney Department of Professional Regulation 1940 North Monroe Street

Tallahassee, FL 32399-0792

Connie Sue Ward Reeves Rt. 1 , Box 390

Laurel Hill, FL 32567

Jack McRay, General Counsel Department of Professional Regulation 1940 North Monroe Street

Tallahassee, FL 32399-0792

Judie Ritter Executive Director

504 Daniel Building

111 East Coastline Drive Jacksonville, FL 32202

NOTICE OF RIGHT TO SUBMIT EXCEPTIONS:

All parties have the right to submit written exceptions to this Recommended Order. All agencies allow each party at least 10 days in which to submit written exceptions. Some agencies allow a larger period within which to submit written exceptions. You should contact the agency that will issue the final order in this case concerning agency rules on the deadline for filing exceptions to this Recommended Order. Any exceptions to this Recommended Order should be filed with the agency that will issue the final order in this case.

Docket for Case No: 91-000266

Orders for Case No: 91-000266