Findings Of Fact Respondent, Jean L. Hammer, was at all times material hereto a licensed practical nurse in the State of Florida, having been issued license number 0588011. In October 1986, respondent was employed by Pinewood Lodge, a treatment center for alcohol and drug rehabilitation, as a staff nurse on the midnight to 8:00 a.m. shift. Respondent was the only employee on duty during her shift, and was responsible for monitoring the patients for signs of distress, noting their progress on the medical records, and administering prescribed medications. For such services, respondent was paid $27,000 per annum; a salary consistent with that paid a registered nurse (R.N.) at the facility. In January 1987, respondent was offered and accepted the position of Supervisor of Nurses at Pinewood Lodge. The staffing of this position required the services of and provided an annual salary of $25,000 and other benefits. Respondent occupied this position until July 1987 when it was discovered that she was not a registered nurse and was discharged. The respondent's personnel file at Pinewood Lodge demonstrates that in seeking and gaining employment at the facility respondent represented herself to be a licensed registered nurse, the recipient of a Bachelor of Science degree from the University of Pittsburgh, and the recipient of an Associate in Science Nursing degree from Broward Community College. Such representations were false, and the documents submitted to support such representations were forgeries. The proof further demonstrates that respondent assumed the title of R.N., routinely signed documents in a manner that identified her as an R.N., and otherwise led the public and associates to believe that she was licensed as a registered nurse; all for pecuniary gain. While there was no showing that anything untoward occurred during the course of her tenure at Pinewood Lodge, respondent knew her actions were improper.
Recommendation Based on the foregoing findings of fact and conclusions of law, it is RECOMMENDED that a final order be entered suspending respondent's license for one year, that following such suspension respondent be placed on probation for two years subject to such terms and conditions as the board may specify, and imposing an administrative fine against respondent in the sum of $1,000. DONE AND ENTERED in Tallahassee, Leon County, Florida, this 15th day of August, 1988. WILLIAM J. KENDRICK Hearing Officer Division of Administrative Hearings The Oakland Building 2009 Apalachee Parkway Tallahassee, Florida 32399-1050 Filed with the Clerk of the Division of Administrative Hearings this 15th day of August, 1988. APPENDIX Petitioner's proposed findings of fact have been addressed as follows: Addressed in paragraph 1. Addressed in paragraph 4. 3-4. Addressed in paragraph 3. 5-6. Addressed in paragraph 4. 7-8. Addressed in paragraphs 3 and 5. 9. Addressed in paragraph 5. COPIES FURNISHED: E. Raymond Shope, Esquire John S. Cobb Department of Professional Regulation 130 North Monroe Street Tallahassee, Florida 32399-0750 Richard Smith, Esquire 1258 South State Road 7 Fort Lauderdale, Florida 33317-5989 Judie Ritter, Executive Director Board of Professional Nursing 111 East Coastline Drive Room 504 Jacksonville, Florida 32201 William O'Neil, Esquire General Counsel Department of Professional Regulation 130 North Monroe Street Tallahassee, Florida 32399-0750
Findings Of Fact At all times pertinent to this proceeding, Respondent was a licensed practical nurse licensed in the State of Florida and holding license number 0504051. The Petitioner is an agency of the State of Florida and is charged with enforcing the provisions of Chapter 464, Florida Statutes (1981), related to regulating and enforcing the licensure and professional practice standards for nurses of various categories enumerated therein in the State of Florida. During times pertinent to the allegations of the amended administrative complaint, the Respondent was employed as a licensed practical nurse at Ocala Geriatric Center, Inc. On September 16, 1982, the Respondent was the "float nurse" at Ocala Geriatric Center, meaning that she was a nurse assigned to various portions of the Geriatrics Center on an impromptu basis, which assignments to the various wings of the facility would be communicated to her by notations on her timecard which she would receive when she reported to duty for a particular shift. On September 16, 1982, she was previously scheduled by her supervisor to work on the north wing of the Ocala Geriatric Center. When Respondent reported to work for the 11:00 p.m. to 7:00 a.m. shift for September 16 - September 17, 1982, she was told by her supervisor, Deloris Jamison, to work instead on the east wing of the facility. Respondent, upon learning this, became engaged in a dispute with Mrs. Jamison regarding this assignment, refused to fulfill the assignment and indicated that she preferred to report herself as sick and return home rather than work at her assigned location on the east wing that evening. The Respondent was told to shift her duties from her customary station on the north wing to the east wing that evening due to a shortage of nurses on duty on that shift. The director of nurses of the Ocala Geriatric Center, Ellen Cain, had already arranged for nurse Phyllis Shepard to work half of the 11:00 to 7:00 shift on the north wing of the facility. When nurse Shepard duly reported for duty at the north wing she found the Respondent present at the north wing even though the Respondent had previously been informed that she was to work on the east wing. At this time the Respondent announced her intentions to nurse Shepard to remain on duty at the north wing and not to report to duty on the east wing, contrary to her supervisor's direction. At this point nurse Shepard went to the south wing of the facility and conferred with nurse Jamison regarding the Respondent's assignment and her own assignment, and had the instructions confirmed by supervisor Jamison. Upon nurse Shepard's return to the north wing, the Respondent indicated to her also that she intended to report herself sick and go home rather than work on the east wing. Only upon calling the Director of Nurses, Ellen Cain, at her home and again receiving instructions to work on the east wing that evening, did the Respondent ultimately elect to proceed to her assigned duty station. Patients Whitehurst and Rubright were classified on September 16, 1952 and September 17, 1982, "as critical geriatric patients" inasmuch as they were nasal-gastric or "tube-fed" patients and both had "indwelling" catheters for elimination of urine. On or about September 16, 1982, the Respondent charted a "dash" on the fluid intake and output record of patient Whitehurst, rather than specifying actual fluid, if any, taken in by the patient. This is an improper method of notation of fluid intake and output for such a patient, since this does not accurately reflect any information one way or the other regarding fluid intake or output for that patient for that shift. At best it might lead to a presumption that that patient had received no fluid, which is a potentially serious problem with such a patient since if a catheterized patient does not receive adequate fluid from time to time during the day, then the catheter is at risk of being blocked, with potentially serious health consequences to the patient. On that same date Respondent also failed to chart any information in her nurses' notes for patient Whitehurst. Both nurses Shepard and the Director of Nursing at Ocala Geriatric Center, Ellen Cain, were accepted as expert witnesses in the field of nursing and specifically with regard to minimal standards of professional nursing practice in Florida. It was thus established that the failure to chart in her nurses' notes any information for patient Whitehurst was conduct not comporting with minimal standards of nursing practice, especially in view of the fact that the patient Whitehurst was a naso-gastric tube patient who was also catheterized. It is imperative to note any reason why such a patient does not receive fluid during a single shift or alternatively, when a patient does receive fluid, to note on the chart the amount and type of fluids received. Further, the use of a dash on the nursing chart makes it even more imperative that the nursing notes explain what occurred on that shift regarding the patient's fluid intake, so that the nurse charged with the responsibility of that patient on the ensuing shift would be aware of the patient's fluid status and aware of any abnormality that may have occurred on the previous shift. Although the Respondent may have, in fact, administered the proper fluids to patient Whitehurst on that shift, she failed to record whether or not that duty was performed. On September 16, 1952, the Respondent also charted a for fluid intake on patient Rubright, but again failed to make any notation on the nurses' notes as to why this patient actually received no fluids. This failure to properly chart and make notes regarding the patient's fluid intake and failure to administer fluids without explanation does not comport with minimal standards of nursing practice, especially inasmuch as patient Rubright was also a naso- gastric tube-fed and catheterized patient. The Respondent also failed to chart or record any nurses' notes with regard to patient Lesimby on September 16, 1982. Failure to chart was established to be a violation of federal medicare regulations and a violation of this particular facility's policies with regard to such medicare patients. Although daily charting and notes from each shift for such critical care patients as patients Whitehurst and Rubright is required by minimal standards of professional nursing practice, failure to chart nurses notes for other patients, simply because they are medicare patients, does not necessarily depart from proper standards of nursing practice, although federal regulations require that medicare patients be the subject of daily charting, including recording of vital signs. Compliance with such federal standards is of course, not the subject of the administrative complaint in this proceeding, however. Respondent's failure to properly record fluid intake and output for patients Whitehurst and Rubright, and her failure to properly chart nursing notes for those patients on the above dates, as well as her failure to order medications for patients as required by her position at Ocala Geriatric Center, Inc., could have resulted in serious harm to the oat' ants. It was not established that the Respondent has committed acts or omissions that could have jeopardized safety in the past, however, and it was not shown that any other violations of the nursing practice act or failures to comport with minimal standards of nursing practice have ever been charged or proven with regard to the Respondent's licensure status and nursing practice in the past.
Recommendation Having considered the foregoing Findings of Fact and Conclusions of Law, the evidence of record, the candor and demeanor of the witnesses and the pleadings and arguments of the parties, it is, therefore RECOMMENDED that a Final Order be entered by the Board of Nursing finding the Respondent guilty of the violations charged with respect to Section 464.018(1)(f), Florida Statutes (1981), with the exception of the violation charged with regard to patient Lesimby, and that the penalty of a reprimand and 90-day suspension of her licensure be imposed. DONE and ENTERED this 19th May of July, 1984 in Tallahassee, Florida. P. MICHAEL RUFF 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 20th day of July, 1984. COPIES FURNISHED: Julia P. Forrester, Esquire Department of Professional Regulation 130 North Monroe Street Tallahassee, Florida 32301 Linda Sears Gibson 2003 Southwest Seventh Street Ocala, Florida Helen P. Keefe, Executive Director Board of Nursing 111 East Coastline Drive, Room 504 Jacksonville, Florida 32202 Fred M. Roche, Secretary Department of Professional Regulation 130 North Monroe Street Tallahassee, Florida 32301
Findings Of Fact The Respondent, Bonnie Jean Hutcheson, is a licensed practical nurse, who holds License No. 19002-1. In June and July of 1978, the Respondent was employed at The Abbey Nursing Home in St. Petersburg, Florida. On July 4, 1978, the Respondent was terminated from her employment at The Abbey Nursing Home by the Director of Nursing. Respondent Hutcheson was employed as a licensed practical nurse at North Horizon Convalorium in St. Petersburg, Florida in April, 1979. On February 16, 1979, an Administrative Complaint was filed alleging that Respondent Hutcheson was guilty of unprofessional conduct. The Respondent requested an administrative hearing in May of 1979, and a hearing was scheduled for July 25, 1979, but was continued by Motion of the Petitioner. Thereafter, the Administrative Complaint was amended on August 12, 1979, to add additional charges. On June 17, 23 and 24, 1978, while employed at The Abbey, Respondent Hutcheson signed out for Dalmane, a controlled substance, for a patient, Josephine Miracky, and failed to chart the administration of same on the patient's medication record. On July 2, 1978, Respondent reported to work at The Abbey for the 3:00 p.m. to 11:00 p.m. shift. Alice Henderson, a registered nurse who was going off duty at 3:00 p.m., noticed the Respondent and reported to the nursing office that Respondent's speech seemed slurred, that she seemed unsteady on her feet and slow to respond, and that she had counted medications very slowly. On July 4, 1978, the Director of Nursing terminated the employment of Respondent Hutcheson for the reason that she felt the Respondent's performance was unsafe as a practitioner. In April of 1979, while employed at North Horizon Convalarium, Respondent Hutcheson signed out for Tylenol No. 3, a narcotic and controlled substance, at an interval of one hour for a patient, Emma Jackson, when the physician's order for this medication was that it be administered no more frequently than every four (4) hours. On three (3) or four (4) occasions during the month of April, 1979, the Respondent took from the patients' medication stock three (3) or four (4) Tylenol No. 3 tablets and left the facility with them to give to her son at home. Respondent Hutcheson did not deny the allegations in the Administrative Complaint. In defense of her actions she testified that she knew Alice Anderson, the witness for Petitioner, but that she had not worked with her and did not work with her on the same shift. (Ms. Anderson's report is contained in Paragraph 2) Respondent Hutcheson acknowledged that she knew Eris J. Frye, the Director of Nursing at The Abbey Nursing Home, and admitted that she might have made a "common error" by failing in June of 1978, to chart medication on a patient's medication record. She did not know she had been terminated as "an unsafe practitioner." Respondent Hutcheson recalled the day of July 2, 1978, when she came to work, and she stated she had developed a back problem, having a chronic type of arthritis. She stated that she had taken a pain medication prescribed for her by her physician, Dr. Spatapora, which was a medication called Anexsia-D. Respondent stated that at that time she had just learned that her daughter, who was fifteen (15) years of age and unmarried, was pregnant, and that she in fact was exceedingly disturbed over her daughter's condition and could not sleep, and had taken the medication prescribed for her by her physician. She said she had not taken any of the medication at work, but that she was so over-whelmed by her problems she was ready to resign her position at The Abbey at the time she was terminated on July 4, 1978. Respondent Hutcheson stated that in April of 1979, while working at North Horizon Convalarium, she took several tablets of Tylenol No. 3 from the medication supplies to give to her son, who had recently come out of the hospital after having been seriously injured in an automobile accident. She testified that her son was in a great deal of pain, that she had to leave him alone in the house, and that she used the tablets to help him get to sleep for a few nights because she could not get in touch with his physician and could not afford to take him to another physician. She said her son used the nine (9) to eleven (11) tablets only, and was not and is not addicted to drugs. Respondent Hutcheson is not addicted to drugs. Witnesses for the Petitioner Board stated that it was contrary to acceptable and prevailing nursing practice for the Respondent to fail to accurately chart all medications signed out by her, and that it is contrary to acceptable and prevailing nursing practice to take Tylenol No. 3 tablets from the patients' medication supplies. Witnesses for the Respondent testified that she is a good neighbor and a hard-working, conscientious nurse, and that she is a devoted mother to her son and daughter. They stated Respondent is divorced and has the responsibility for her children. Petitioner and Respondent submitted proposed findings of fact and recommended orders. These instruments were considered in the writing of this Order. To the extent the proposed findings of fact have not been adopted in, or are inconsistent with, factual findings in this Order they have been specifically rejected as being irrelevant or not having been supported by the evidence.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, the Hearing Officer recommends that the Respondent, Bonnie Jean Hutcheson, be placed on probation for a period of two (2) years from the date hereof. DONE and ORDERED this 7th day of November, 1979, in Tallahassee, Leon County, Florida. DELPHENE C. STRICKLAND Hearing Officer Division of Administrative Hearings Room 101, Collins Building Tallahassee, Florida 32301 (904) 488-9675 COPIES FURNISHED: Julius Finegold, Esquire 1107 Blackstone Building 233 East Bay Street Jacksonville, Florida 32202 Jean M. Flanagan, Esquire Gulfcoast Legal Services, Inc. 641 First Street, South Post Office Box 358 St. Petersburg, Florida 33731 Geraldine B. Johnson, R. N. Board of Nursing 111 Coastline Drive East, Suite 504 Jacksonville, Florida 32202
The Issue The issue for determination is whether Ferman Barrett committed unprofessional conduct and departed from minimal standards of acceptable nursing practice, in violation of Section 464.018(1)(f), Florida Statutes by abandoning his shift.
Findings Of Fact At all times material Ferman Barrett was licensed as a practical nurse, with State of Florida license number PN0628671. He was originally licensed by examination on December 14, 1981, and has regularly renewed' his license since then. Mr. Barrett was employed as a practical nurse at Westlake Hospital, in Longwood, Florida, from July 1987 until January 1988. Westlake is a psychiatric hospital serving individuals of all ages with complex psychiatric problems. On January 2, 1988, Mr. Barrett was assigned to the children's unit, consisting of 12-13 children with conduct disorders. He was given charge of three patients whose medication he was to maintain and whose activities he was to supervise. The children could have been combative and [illegible]. Barrett was scheduled to work a double shift on January 2, 1988 from 7:00 A.M. until 3:00 P.M., and from 3:00 P.M. until 11:00 P.M. At approximately 8:05 A.M., Barrett told Denise McCall, the charge nurse for that shift, that he "couldn't take it anymore" and was leaving. She asked him to wait until she could contact a supervisor to properly relieve him, but he left without permission. He was subsequently discharged by the hospital for abandoning his job. Diana Eftoda was qualified as an expert in the practice of nursing. She has been licensed as a registered nurse in Florida since 1978. She has 20 years experience in nursing, including beginning her nursing career as a licensed practical nurse. She has administered nursing staff of an entire hospital and has served in a policy making position with the Board of Nursing. Mrs. Eftoda established that abandonment of a shift without notice or permission is a breach of professional responsibility and constitutes misconduct. Ferman Barrett's action jeopardized the safety and well being of his patients and his license should be disciplined.
Findings Of Fact At all times relevant hereto Respondent was licensed as a licensed practical nursing in Florida and was employed at the Lake Wales Convalescent Center. On the evening of December 29, 1983, Respondent was called into patient Allen's room by the nurses aide because Allen had refused to get into his pajamas as requested and was verbally abusing the aide. Respondent approached Allen, who began swearing at her, whereupon Respondent rolled up a towel and struck Allen several times on the left arm causing some bleeding and bruises which were visible to another witness two days later. Respondent does not deny striking Allen with the towel but contends Allen picked up a pitcher and called her a nigger before she picked up the towel. Respondent denies any intent to hurt the patient and testified she has worked as a licensed practical nurse for 15 years and has never before struck a patient. Allen is senile, often verbally abusive, but has never been violent while a patient at Lake Wales Convalescent Center. He does not bruise as easily as do many elderly patients. It is below the minimal standards of acceptable and prevailing nursing practice to strike a patient and, especially, a senile patient who is not violent.
Findings Of Fact Pauline J. Brown Larach, Respondent, is licensed by the Board of Nursing as a Registered Nurse, license No. 60268-2 and was so licensed at all times here relevant. Respondent was employed by Hollywood Memorial Hospital during the period July-October, 1981, in the Intensive Care Unit (ICU). At the time of her employment Respondent represented that she was qualified to work in the ICU. Hollywood Memorial Hospital sends all nurses employed through an orientation program of approximately one week before assigning them to a particular duty. Respondent went through this orientation program before she was assigned to ICU. Respondent was assigned the shift under the direct supervision of Shirley Scott, who was assistant head nurse of the ICU and was supervisor on the shift to which Respondent was assigned. Respondent's work was unsatisfactory and she was counselled several times by Scott. Specifically, Respondent was counselled about the manner in which she maintained her nurse's notes, her inability to schedule her time and duties, her inability to concentrate on a particular problem, her refusal to seek assistance when needed, and a penchant for ignoring serious problems. The following incidents gave rise to the concern about the type of care provided by Respondent to patients in the ICU: On about October 21, 1981, a neurological patient assigned to Respondent was on the drug Nipride to keep the blood pressure low. The patient had suffered intracranial hemorrhaging. The Nepride, which is considered a dangerous drug unless its administration is carefully monitored, was administered to this patient in much less than the time it should have taken for the Nipride to be infused and the patient's blood pressure dropped very low. The ICU supervising nurse discovered the patient in a severely hypertensive state and Respondent had placed the patient in a position with the head below the feet. This attitude would be correct for most patients whose blood pressure is low but was contraindicated for a neuro-patient or a patient with the history of intracranial bleeding. Although the head nurse's intervention possibly avoided further intracranial bleeding, no entry of blood pressure drop or of the emergency was placed in the nurse's notes kept by Respondent. On or about August, 1981, Respondent was observed by her shift supervisor (Scott) hiding her nurse's notes under a patient's mattress so Ms. Scott could not read them. During a "code" situation Respondent offered the doctor a cookie while he was resuscitating the patient. Respondent's nurse's notes are virtually illegible and replete with trivia and inappropriate items while failing to include pertinent information. Specifically, these nurse's notes were also found deficient in that Respondent did not chart complete systems before going to another system, but instead jumped around from items in one system to items in another and included trivia while omitting essential information about the patient. On one occasion when a patient was transferred from the emergency room to the ICU as a patient to be tended to by Respondent, who had accepted the patient by phone from the emergency room, upon arrival the patient was in dire distress and Respondent left the room. Another nurse declared a "code" emergency on this patient, but Respondent did not return to the room until after the "code" situation was ended. During a "code" situation involving one of Respondent's patients, it was discovered that she had incorrectly computed the infusion rate for the drug Dopamine, which drug is intended to raise blood pressure. Respondent's evaluations (Exhibit 1), which were prepared three months after Respondent commenced work at Hollywood Memorial Hospital, evaluated Respondent as unsatisfactory and far below the minimal standards required for acceptable nursing practices. This report followed numerous conferences with Respondent during this three-month period when the areas in which she was unsatisfactory were pointed out to her. All of the witnesses who worked with and observed Respondent in the ICU concurred that Respondent's professional competency, as observed by them, was far below minimal acceptable standards and that they would be unwilling to have Respondent assigned under them in an ICU. All expert witnesses opined that in the manner in which Respondent maintained nurse's notes, organized her work, provided care to patients, and, specifically, to react properly in an emergency situation, Respondent's performance as a nurse was far below minimal acceptable standards. At the expiration of Respondent's three-month period during which her evaluation was unsatisfactory, a conference was held between Respondent and hospital staff. At this meeting the evaluations were presented to Respondent and she was given the alternatives of voluntary resignation, transfer to a less critical area of the hospital, or termination. Respondent opted for voluntary resignation.
The Issue The issue is whether Respondent's license to practice nursing should be revoked, suspended, or otherwise disciplined under the facts and circumstances of this case.
Findings Of Fact Upon consideration of the oral and documentary evidence adduced at the hearing, the following relevant findings of fact are made: At all times material to this proceeding, Respondent Rita Flint (Flint) was a licensed practical nurse in the State of Florida, holding license number PN0655201. Flint's last known address is 6494 South West 8th Place, North Lauderdale, Florida 33068. At all times material to this proceeding Flint was employed by North Broward Medical Center (NBMC) located in Pompano Beach, Florida, as a practical nurse. On August 3, 1990, Flint was assigned to care for patients J. C. and J. K. including administering their medications and charting same on their Medication Administration Record (MAR). On August 3, 1990, J. C.'s physician prescribed one (1) nitroglycerine patch each day. Flint failed to administer the patch on this date. On August 3, 1990, J. C.'s physician prescribed 100 mg. of Norpace every six (6) hours. Flint failed to administer the 2:00 p.m. dosage of Norpace to J. C. On August 3, 1990, J. C.'s physician prescribed 120 mg. of Inderal each day. Flint failed to administer the 9:00 a.m. dosage of Inderal until 1:30 p.m. without noting any explanation on J. C.'s MAR. On August 3, 1990, Flint failed to document the administration of J. K's own medications on the MAR. On August 3, 1990, Flint failed to sign the MARs for J. C. and J. K. as required by hospital policy. On August 15, 1990, Flint left an intravenous bag with an exposed needle hanging at the bedside of a patient. On August 29, 1990, Flint was assigned to care for patient R. R. including administering his medications. Flint failed to administer the following medications leaving all of them at R. R.'s bedside: (a) Timolo (9:00 a.m. and 2:00 p.m. doses); (b) Mixide (9:00 a.m. dose); (c) Zantac (9:00 a.m. and 4:00 p.m. doses); (d) Lasix (9:00 a.m. dose); and, (e) Entozyme (8:00 a.m. and 12:00 noon doses). On August 30, 1990, NBMC terminated Flint's employment as a result of the aforementioned conduct. There is no evidence that any patient suffered any actual harm as a result of Flint's errors. In September of 1990, NBMC referred Flint to the Intervention Project for Nurses. At all times relevant to this proceeding, Flint's job performance was adversely affected by long work schedules necessitated by severe financial problems. During the week of August 3, 1990, Flint worked a ninety-two-hour week. The acute financial stress was due to domestic problems including the breakup of her twenty-two-year-old marriage. Flint had no problems involving substance abuse. Flint attended individual therapy sessions with a clinical psychologist, Priscilla Marotta, Ph.D., and participated in group therapy designed primarily for persons with substance abuse problems. Flint attended weekly therapy sessions for approximately one month after which she could no longer afford treatment. Even though Flint was financially unable to continue treatment with Dr. Marotta or any other counseling program recommended by the Intervention Program for Nurses, she diligently undertook a self-help program to educate herself on stress management techniques, to develop self-reliance, and to improve self-esteem. Flint's effort to participate in therapy, to the extent financially possible, and to rehabilitate herself shows a strong commitment to her profession. Flint has been licensed to practice nursing since May 31, 1982. There is no evidence of any disciplinary action against her license prior to or after the incidents herein described. Flint is currently employed as a nurse in a hospice. Her recent performance appraisal reports indicate that, on an average, she fully meets all job requirements.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is, therefore recommended that the Board of Nursing enter a Final Order finding Respondent guilty of violating Section 464.018(h), Florida Statutes (1989), as defined in Rule 210-10.005(1)(e)1 and Rule 210-10.005(1)(e)2, Florida Administrative Code, and not guilty of violating Section 464.018(1)(j), Florida Statutes. It is further recommended that the Board's final order: (1) place the Respondent on probation for one year subject to such requirements as the Board may require; and (2) require the Respondent to pay an administrative fine in the amount of two hundred fifty dollars ($250). DONE AND ENTERED in Tallahassee, Leon County, Florida, this 21st day of November 1994. SUZANNE F. HOOD, Hearing Officer Hearing Officer Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-1550 (904) 488-9675 Filed with the Clerk of the Division of Administrative Hearings this 21st day of November 1994. APPENDIX TO RECOMMENDED ORDER IN CASE NO. 93-2715 The following constitutes my specific rulings pursuant to Section 120.59(2), Florida Statutes, on all of the Proposed Findings of Fact submitted by the parties to this case. FOR THE PETITIONER: Incorporated into Findings of Fact 1. Incorporated into Findings of Fact 2 and 11. Incorporated into Findings of Fact 4. Incorporated into Findings of Fact 5. Incorporated into Findings of Fact 6. Incorporated into Findings of Fact 7. Incorporated into Findings of Fact 8. Incorporated into Findings of Fact 9. Incorporated into Findings of Fact 10. The first sentence is incorporated into Findings of Fact 13. The remaining portion of this proposed fact is not supported by competent substantial evidence. Furthermore, Respondent's Exhibit 3, as it relates to a diagnosis of a mental condition, is hearsay which does not supplement or explain any other psychological or medical evidence. Thus, any reference in Exhibit R3 to a generalized anxiety disorder is insufficient to support Petitioner's proposed finding. Unsupported by competent substantial evidence. Unsupported by competent substantial evidence. See number 10 above. FOR THE RESPONDENT: 1. Respondent did file proposed findings of fact or conclusions of law. COPIES FURNISHED: Laura Gaffney, Esquire Natalie Duguid, Esquire Agency for Health Care Administration 1940 North Monroe Street Tallahassee, Florida 32399-0792 Rita Flint 3313 South East Second Street Pompano, Florida 33063 Judie Ritter Executive Director Board of Nursing AHCA 504 Daniel Building 111 East Coastline Drive Jacksonville, Florida 32202 Harold D. Lewis General Counsel The Atrium, Suite 301 325 John Knox Road Tallahassee, Florida 32303
