The Issue Whether one or more of the following penalties should be imposed on Elizabeth Worden: revocation or suspension of the Ms. Worden's practice, imposition of an administrative fine, and/or any other relief that the Board of Nursing deems appropriate?
Findings Of Fact Elizabeth Worden is, and has been at all times material hereto, a licensed practical nurse in the State of Florida. Ms. Worden holds State of Florida license number 0739611. Her license lapsed on April 1, 1987, and remained lapsed at least through September 20, 1988. On September 11, 1985, Ms. Worden was arrested and charged with one count of driving under the influence (hereinafter referred to as "DUI") and five counts of possession of controlled substance. On February 24, 1986, Ms. Worden was found guilty of DUI. Additionally, an Order Withholding Adjudication of Guilt and Placing Defendant on Probation was entered based upon a plea of nolo contendere by Ms. Worden to the five counts of possession of controlled substance. Ms. Worden was placed on three years probation for the charge of possession of controlled substance and was placed on a year of probation (to run concurrently with the sentence for possession of controlled substance), ordered to pay a fine, perform community service and had her drivers license suspended for six months for the charge of DUI. During at least part of 1986 and 1987, Ms. Worden was employed as a licensed practical nurse at the Ocala Geriatrics Center (hereinafter referred to as the "Center"). Ms. Worden was one of three licensed practical nurses at the facility during the 11:00 p.m. to 7:00 a.m. shift and was in charge of the patients on one floor of the facility. While on duty at the Center Ms. Worden retired to room 5 in the east wing of the Center almost every night to sleep. She generally went to the room at about 2:00 a.m. and remained in the room until approximately 6:00 a.m. While Ms. Worden slept, she left the certified nurses aides in charge of patient care and assigned duties to the aides which should have been conducted by a licensed nurse. Ms. Worden told the aides to wake her only if a patient needed medication, if another nurse appeared on her floor, and at 6:00 a.m. On three occasions Ms. Worden left the Center while she should have been on duty, leaving certified nurses aides in charge of patient care. On these occasions Ms. Worden was gone from fifteen to thirty minutes carrying out personal errands. Ms. Worden admitted on one occasion to a certified nurses aide that she had consumed a couple of beers before coming to work. Ms. Worden's breath often smelled of alcohol and the room in which she slept also smelled of beer on occasion. During 1987, Ms. Worden entered the Intervention Project for Nurses. She was dismissed from the program in August, 1987, for noncompliance with the program's requirements. On May 18, 1987, Ms. Worden was arrested and charged with DUI and resisting arrest without violence. She was adjudicated guilty of both offenses on July 13, 1987.
Recommendation Based upon the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that Elizabeth Worden be found guilty of having violated Sections 464.018(1)(c) and (g), Florida Statutes, as alleged in Count One and Count Three of the Administrative Complaint. It is further RECOMMENDED that the portion of the Administrative Complaint alleging that Ms. Worden is guilty of having violated Sections 464.018(1)(f) and (h), Florida Statutes, as alleged in the second Count One and Count Three of the Administrative Complaint be dismissed. It is further RECOMMENDED that Ms. Worden's license as a practical nurse be suspended until the later of the end of a five (5) year period from the date of the final order issued in this case or the date that Ms. Worden provides proof acceptable to the Petitioner of her successful completion of a rehabilitation program acceptable to the Petitioner. DONE and ENTERED this 18th day of November, 1988, in Tallahassee, Florida. LARRY J. SARTIN Hearing Officer Division of Administrative Hearings The Oakland Building 2009 Apalachee Parkway Tallahassee, Florida 32399-1550 (904) 488-9675 Filed with the Clerk of the Division of Administrative Hearings this 18th day of November, 1988. APPENDIX TO RECOMMENDED ORDER, CASE NO. 88-2548 The Petitioner has submitted proposed findings of fact. It has been noted below which proposed findings of fact have been generally accepted and the paragraph number(s) in the Recommended Order where they have been accepted, if any. Those proposed findings of fact which have been rejected and the reason for their rejection have also been noted. The Petitioner's Proposed Findings of Fact Proposed Finding Paragraph Number in Recommended Order of Fact Number of Acceptance or Reason for Rejection 1 1. 2 3. 3-4 2. 5 3-4. 6 5. 7 7. 8 9. 9 10. 10 10-11. COPIES FURNISHED: Michael A. Mone' Staff Attorney Department of Professional Regulation 130 North Monroe Street Tallahassee, Florida 32399-0750 Elizabeth Worden 412-A Clark Street St. Charles, Missouri 63301 Bruce D. Lamb General Counsel Department of Professional Regulation 130 North Monroe Street Tallahassee, Florida 32399-0750 Lawrence A. Gonzalez Secretary Department of Professional Regulation 130 North Monroe Street Tallahassee, Florida 32399-0750 Judie Ritter Executive Director Department of Professional Regulation Room 504, 111 East Coastline Drive Jacksonville, Florida 32201
Findings Of Fact Pamela Kay Johnson is a licensed practical nurse licensed by the Florida State Board of Nursing. The records of Sanford Nursing and Convalescent Center showed that Pamela Kay Johnson either administered Atarax to Herbert Speir without a doctor's order or administered the Atarax to another patient and erroneously charted its administration on Speir's medication chart while she was on duty at the center on November 6, 1977. On the morning of November 8, 1977, after having worked the evening shift and then gone partying with her husband, Pamela Kay Johnson exhibited faintness and physical distress at the staff meeting at the convalescent center. She was examined by the director of nursing at the center, who sent her home and subsequently terminated her when it was discovered that she had mismedicated Speir. Mr. Lewis Johnson stated that his wife had been treated for convulsive seizures and had been prescribed Phenobarbital and Dilantin by her treating physician, Dr. Merritt. Mr. Johnson stated that his wife had been on this medication since July, 1977, and subsequent to her initial adjustment to the medication had suffered no ill effects from it. When Mr. Johnson arrived home on November 8, Mrs., Johnson was in bed and asleep. He spoke that day with the director at nursing who advised him that she felt Mrs. Johnson needed to see a physician because of her condition. Mr. Johnson took his wife the following day to Watson Clinic in Ocala, Florida, where she was seen by her treating physician, Dr. Merritt. Dr. Merritt conducted tests on Mrs. Johnson and subsequently advised Mr. and Mrs. Johnson that the level of Phenobarbital and Dilantin in her system was consistent with the dosage he had prescribed. After testing, Dr. Merritt reduced the dosage of Phenobarbital. Dr. Merritt could offer no explanation of Mrs. Johnson's reaction to Phenobarbital. Mrs. Johnson is currently employed with Homemakers Upjohn as a licensed practical nurse. She has not had any other drug reaction since the reduction of the medication.
Recommendation The facts presented in this case indicate that the Board should not take any disciplinary action, but that the Board should take action to insure that the public interest is protected. Based upon the foregoing findings of fact and conclusions of law, the Hearing Officer recommends that the Florida State Board of Nursing suspend the license of Mrs. Pamela Kay Johnson as a licensed practical nurse until July, 1978, the date Dr. Merritt indicated that she could cease taking the medications and not be subject to further seizures. In addition, the Hearing Officer would recommend that Board suspend the recommended suspension upon being satisfied that Mrs. Johnson's health does not constitute an undue risk to the public. DONE and ORDERED this 4th day of May, 1978, in Tallahassee, Florida. STEPHEN F. DEAN Hearing Officer Division of Administrative Hearings 530 Carlton Building Tallahassee, Florida 32304 COPIES FURNISHED: Julius Finegold, Esquire 1007 Blackstone Building Jacksonville, Florida 32202 Pamela Kay Johnson 1670 Morrell Drive Lakeland, Florida 33801 Geraldine B. Johnson, R.N. State Board of Nursing 6501 Arlington Expressway - Bldg B. Jacksonville, Florida 32211 =================================================================
Findings Of Fact The Respondent is a licensed registered nurse in the State of Florida holding license number 1091372. The Petitioner is an agency of the State of Florida charged with enforcing the provisions of Chapter 464 related to the licensure standards for nursing in the State of Florida and the regulation and enforcement of standards of nursing practice. Pursuant to a previous disciplinary proceeding against this Respondent, a Final Order was entered by the Petitioner whereby the Respondent's nursing license number 1091372, which is the subject of this proceeding, was placed on probationary status for a period of one year from August 19, 1985. As a condition of that probation, the Respondent was required to submit to random blood and/or urine tests. Pursuant to the authority of this Order, Charles E. Wheelahan, an investigator with the Investigation Section of the Department of Professional Regulation, attempted to obtain a urine sample from the Respondent, pursuant to the previously entered Final Order, during the period June 13-27, 1986. Mr. Wheelahan first phoned the Respondent on June 13 to set up an appointment and told the Respondent the reason for the appointment. The Respondent appeared to be somewhat incoherent in her conversation by phone that day and so the investigator set up an appointment for another day. He went to her residence on June 25 and asked that she supply a urine sample. She informed him she was unable to do so at that time. He waited approximately one and one-half hours, during which time she made no attempt to furnish him with the requested sample. The following day he requested by phone that she meet him at "University Hospital" on the following day, which would be June 27, 1986. Later that day she called him and cancelled that appointment. He then offered to meet her at any other time on that day and got no cooperation from the Respondent. Thus, after giving the Respondent three opportunities to comply with the requirements of the Order by which her license was placed on probation, Mr. Wheelahan recommended and the Petitioner ultimately instituted the instant prosecution. Witness Elaine Brantley testified and established that she had transcribed the telephone conversation Mr. Wheelahan had with the Respondent on June 27, 1986. That transcript was admitted as Petitioner's Exhibit C, being a transcript of the witness' shorthand notes regarding the telephone conversation. This exhibit, as well as the testimony of Mr. Wheelahan, and the other uncontroverted evidence, establishes that the Respondent evaded and obstructed Mr. Wheelahan's attempts to obtain a urine sample as required by the Final Order which had imposed probation with that random sampling as a condition. Mr. Wheelahan advised the Respondent that her failure to cooperate in arranging to provide the sample would be reported as a refusal to comply with the terms of the probation and he so reported it. She continued her evasiveness and refusal to cooperate in arranging the provision of a urine sample to the Petitioner with this knowledge.
Recommendation Having considered the foregoing Findings of Fact, Conclusions of Law, the evidence of record, the candor and demeanor of the witnesses, and the pleadings and arguments of counsel, it is, therefore RECOMMENDED that the Florida Board of Nursing enter a Final Order suspending the Respondent's license until such time as she appears before the Board and adequately demonstrates her ability to safely engage in the practice of nursing in the State of Florida. DONE and ORDERED this 2nd day of July 1987, in Tallahassee, Florida. P. MICHAEL RUFF Hearing Officer Division of Administrative Hearings The Oakland Building 2009 Apalachee Parkway Tallahassee, Florida 32399-1550 (904) 488-9675 Filed with the Clerk of the Division of Administrative Hearings this 2nd day of July, 1987. APPENDIX TO RECOMMENDED ORDER, CASE NO. 86-4770 The Petitioner's Proposed Findings of Fact have all been accepted. The Respondent did not file Proposed Findings of Fact. COPIES FURNISHED: Gary D. Beatty, Esquire Department of Professional Regulation 130 North Monroe Street Tallahassee, Florida 32399-0750 Delores Eckard 775 Berkley Drive Pensacola, Florida 32503 Judie Ritter, Executive Director Board of Nursing Room 504 111 East Coastline Drive Jacksonville, Florida 32201 Van Poole, Secretary Department of Professional Regulation 130 North Monroe Street Tallahassee, Florida 32399-0750 Joseph A. Sole, Esquire General Counsel Department of Professional Regulation 130 North Monroe Street Tallahassee, Florida 32399-0750
Findings Of Fact The Florida State Board of Nursing filed an Administrative Complaint against Respondent, William Scott Brewer, who holds licensed practical nurse license number 33305-1, seeking to place on probation, suspend or revoke Respondent's license for the following reasons: On or about January 11, 1978, Respondent uttered forged prescriptions at Maitland Rexall 145 South Orlando Avenue, Maitland, Florida, for controlled substances, to-wit: Quaalude (Methaqualone) and Demerol (Meperedime), and received said controlled substances from the pharmacist. On or about January 16, 1978, Respondent uttered a forged prescription at Walgreen Drug Store, Castleberry, Florida, for a controlled substance, to-wit: Percodan (Oxycodone Hydrochloride). On or about January 25, 1978, Respondent uttered a forged prescription at the Liggett Rexall Drug Store located at 4434 Curry Ford Road, Orlando, Florida, and received a controlled substance from the pharmacist to- wit: Quaalude. On the same date and place as alleged in paragraph C, Respondent uttered a forged prescription for a controlled substance, to-wit: Demerol. Respondent requested this administrative hearing, contending that the Administrative Complaint contained disputed issues of material fact. Based upon the evidence presented and the admissions made by Respondent, it is found that on or about January 11, 1978, the Respondent presented to James A. Robinson, a pharmacist, two prescriptions, one for Demerol and one for Quaalude purportedly signed by Lawrence a Bilotta, M.D. Dr. Bilotta denied signing the prescriptions and the Respondent admitted signing Dr. Bilotta's name thereto. Respondent admitted securing the drugs for himself and his friends. Based upon the evidence presented and the admissions made by Respondent, it is found that on or about January 25, 1978, Respondent presented to Fred Martini, a pharmacist, two prescriptions, one for Quaalude and one for Demerol. Said prescriptions were purportedly signed by Lawrence A. Bilotta M.D. Dr. Bilotta denied signing the prescriptions and the Respondent admitted signing Dr. Bilotta's name thereto. The pharmacist filled the prescription for the controlled drug Quaalude, but did not fill the prescription for controlled drug Demerol. The Respondent admitted securing the Quaalude for use for himself and his friends. After the Respondent left the store with the Quaalude the pharmacist notified the authorities. An information was filed against Respondent in the Circuit Court for Orange County, Florida, charging him with violation of Section 893.13(3)(a)(1) , F.S., charging him with the obtaining of a controlled substance by misrepresentation, fraud, forgery, deception or subterfuge. Respondent pleaded guilty to the crime and the court withheld adjudication of guilt and ordered a pre-sentence investigation by the Florida Parole and Probation Commission and a report to the Circuit Judge. Said report, if any, was not filed in evidence. The allegations contained in allegation B, regarding a forged prescription for a controlled substance, Percodan, was not proved. Respondent, William Scott Brewer, testified, that he has not used drugs since January of 1978, and does not intend to again use drugs. This testimony was not refuted by the Petitioner.
Recommendation Suspend the license of Respondent for a period of not more than three (3) years. DONE AND ENTERED this 10th day of August, 1978, in Tallahassee, Florida. DELPHENE C. STRICKLAND Hearing Officer Division of Administrative Hearings Room 530, Carlton Building Tallahassee, Florida 32304 (904) 488-9675 COPIES FURNISHED: Julius Finegold, Esquire 1005 Blackstone Building Jacksonville, Florida 32201 William Scott Brewer Post Office Box 176 Nacotee, Florida 33864 ================================================================= AGENCY FINAL ORDER ================================================================= BEFORE STATE OF FLORIDA BOARD OF NURSING IN THE MATTER OF: William Scott Brewer Box 176Street Nacotee, Florida 33864 CASE NO. 78-778 As a Licensed Practical Nurse License Number 33305-1 /
