Findings Of Fact At all times material hereto, Respondent has been a licensed registered nurse in the State of Florida, with license number 78035-2. He has been licensed in Florida for a total of approximately seven years. Additionally, he has been a licensed registered nurse in New York, California and Texas for fifteen, seven and seven years, respectively. With the exception of this case, Respondent has not been the subject of license disciplinary proceedings in Florida, or any other state of licensure. On August 16, 1984 Respondent was employed as a licensed registered nurse at Harborside Hospital in St. Petersburg, Florida on the medical-surgical floor. He reported for duty at 7:00 a.m. on that day and was responsible for the medication cart, and dispensing medication to patients on the floor. A patient, known as W. H., was on the medical-surgical floor on August 16, 1984. W. H. had previously been a psychiatric patient at Harborside Hospital and while on the medical-surgical floor during this admission, W. H. had been assigned a psychiatric counsellor, Cecil North, who provided counselling and group therapy. Respondent knew that Cecil North had been assigned to W. H., and also that W. H. had attempted suicide sometime prior to this admission. While W. H. was walking back to his room on the medical-surgical floor on August 16, 1984, accompanied by Cecil North, Respondent heard W. H. tapping on the hallway wall. At the time W. H. was approximately twelve feet from Respondent, who was standing by the medication cart in the hallway. Respondent admits he looked up from the medication cart, saw W. H. and North, and said, "Here come the crazies." North, who was walking next to W. H., heard the comment. There is no evidence that W. H. heard the comment. Respondent testified that this comment was not a derogatory remark directed to W. H., but was said to himself as a reaction to W. H.'s tapping on the wall. Respondent had earlier been discussing movies with W. H., and specifically the movie "Escape From New York" in which the phrase, "Here come the crazies," was used in response to tapping sounds made by certain characters in that movie. Respondent stated that since the movie was on his mind, he just spontaneously made this comment to himself when he heard the tapping sounds. After considering Respondent's explanation as well as the expert testimony of Dr. Frank, it is specifically found that his comment, "Here come the crazies," was inappropriate and unprofessional, regardless whether W. H. heard it or not. It was said in a manner which allowed this comment to be overheard by North and other nursing staff, and can reasonably be interpreted as a derogatory comment about the patient, W. H. As such, Respondent disregarded his duty to W. H., a patient on his floor, by jeopardizing the patient's self esteem and possibly supporting his suicidal tendency. Later on August 16, 1984, Respondent was overheard talking with W. H. about filming a person committing suicide by fire. Respondent testified he was only talking about movie stunt techniques. However, in view of W. H.'s prior suicide attempt, of which Respondent was aware, this was an inappropriate and unprofessional, as well as potentially dangerous, discussion with W. H.
Recommendation Based upon the foregoing, it is recommended that the Board of Nursing enter a Final Order finding that Michael James Hanly has violated Section 464.018(1)(f), Florida Statutes, and therefore imposing a reprimand based upon this violation. DONE AND ENTERED this 17th day of August, 1987, in Tallahassee, Florida. DONALD D. CONN 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 17th day of August, 1987. APPENDIX DOAH Case No. 86-5025 Rulings on Petitioner's Proposed Findings of Fact: 1. Adopted in Finding of Fact 1. 2,3 Adopted in Finding of Fact 3. 4 Adopted in Finding of Fact 4. Adopted in Findings of Fact 4, 5. Adopted in Finding of Fact 4. Adopted in Finding of Fact 5. 8,9 Adopted in Findings of Fact 4, 6. Adopted in Findings of Fact 6, 8. Adopted in Finding of Fact 8. Adopted in Finding of Fact 9. 13,14 Adopted in Finding of Fact 8. 15 Adopted in Finding of Fact 9. 16-18 Adopted in Findings of Fact 8, 9. COPIES FURNISHED: Michael A. Mone', Esquire Department of Professional Regulation 130 North Monroe Street Tallahassee, Florida 32399-0750 Michael James Hanly P. O. Box 1472 Boynton Beach, Florida 33425 Judie Ritter Executive Director Board of Nursing Department of Professional Regulation 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 Having reviewed the entire record before it, the Board finds that the Findings of Fact as contained in the Hearing Officer's Recommended Order are adequately supported by competent, substantial evidence and hereby adopts those Findings of Fact as its own.
Recommendation Based on the foregoing findings of fact and conclusions of law, it is RECOMMENDED that Petitioner's application for licensure by examination be GRANTED and that Ann Mary McKay be authorized to take the licensed practical nurse examination. DONE and ENTERED this 9th day of March, 1982, in Tallahassee, Florida. DONALD R. ALEXANDER 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 9th day of March, 1982.
The Issue Whether Mr. Ross' license as a practical nurse in the State of Florida should be issued conditioned on a 1 year period of probation?
Findings Of Fact Mr. Ross applied for licensure by examination as a licensed practical nurse in 1986. By Order dated January 13, 1987, the Board denied Mr. Ross' application. The Board denied the application based upon its conclusion that Mr. Ross was guilty of violating Section 464.018(1)(c) and (h), Florida Statutes. In its Order of January 13, 1987, the Board indicated that it would reconsider Mr. Ross' application in 6 months, upon the request of Mr. Ross. Mr. Ross requested an informal hearing pursuant to Section 120.57(2), Florida Statutes, to contest the Board's Order of January 13, 1987. The informal hearing was held on February 5, 1987. At the request of the Board, Mr. Ross submitted a psychological evaluation conducted by Philip R. Yates, Ph.D. Mr. Ross also submitted an additional psychological evaluation conducted by A. de la Torre, M.D. Based upon the Board's review of the evaluations performed by Dr. Yates and Dr. de la Torre, the Board again concluded that Mr. Ross was guilty of violating Section 464.018(c) and (h), Florida Statutes. The Board, therefore, denied Mr. Ross' application. The Board agreed, however, that it would reconsider Mr. Ross' application upon submission of a satisfactory third evaluation by a Board-certified psychiatrist specializing in psychosexual counseling. The person selected to perform the third evaluation was to review the previous evaluations of Dr. Yates and Dr. de la Torre. In order for the Board to reconsider its denial of Mr. Ross' application, the Board indicated that the third evaluation would have to resolve the conflicts between the first two evaluations and include a recommendation that Mr. Ross is able to engage in the safe practice of nursing. Mr. Ross submitted a third evaluation. The evaluation was conducted by William M. Hunt, III, M.D. Following the submission of the third evaluation, the Board issued an Order dated May 18, 1987. Paragraph 3 of the May 18, 1987, Order provides the following: 3. Applicant has submitted a satisfactory third psychological evaluation which reflects that the evaluating psychiatrist had reviewed the previous reports, which resolves the conflicts between the two previous evaluations, and which includes a recommendation that the Applicant is able to engage in the safe practice of nursing. Based in part on the evaluation of Dr. Hunt, the Board concluded that Mr. Ross' application should be approved. Because of the Board's conclusion that Mr. Ross was guilty of violating Section 464.018(1)(c), Florida Statutes, the Board concluded that "a period of probation is necessary to protect the public..." The terms of Mr. Ross' probation included requirements that Mr. Ross not violate any law, or rule or order of the Board, that he submit written reports to the Board quarterly, that he report any change in residence address, name, employer or place of employment or arrest and that he cause reports to be furnished to the Board by his employer. The period of probation was 1 year. The Board's conclusion that Mr. Ross is guilty of violating Section 464.018(c), Florida Statutes, is based upon Mr. Ross' conviction of exhibition of sexual organs in 1978 and his conviction of an unnatural and lascivious act in 1979. On December 7, 1978, Mr. Ross plead guilty to exhibition of sexual organs in violation of Section 800.03, Florida Statutes. He was found guilty of the offense and fined approximately $117.00. On December 31, 1979, Mr. Ross plead nolo contendere to an unnatural and lascivious act in violation of Section 800.02, Florida Statutes. He was found guilty of the offense and sentenced to thirty days in the Duval County Jail. His sentence was suspended and he was ordered to pay court costs. Mr. Ross was 18 or 19 years of age at the time of his offenses in 1978 and 1979. Mr. Ross was 27 years of age at the time of the formal hearing of this case. Mr. Ross is currently employed as a licensed practical nurse by Kimberly Nurses. Mr. Ross was employed by Kimberly Nurses as a nursing assistant prior to his licensure. Mr. Ross has not experienced any difficulty in his employment as a result of the conditions of probation imposed by the Board. Although Mr. Ross has not sought employment elsewhere, he has not done so because of his concern with the conditions of his licensure. He would like to seek a more permanent position but will not do so until this proceeding is concluded. Mr. Ross' convictions arose as a result of his sexual preference. Mr. Ross is "gay" and at the time of his convictions he frequented public places as a way of meeting others of his sexual persuasion. Although Mr. Ross realizes that he violated the law and accepts the fact that he will always be gay, he has abandoned the "gay life style" of his younger years. The evaluation of Mr. Ross performed by Dr. Hunt resolved the conflicts between the report of Dr. Yates and Dr. de la Torre. Dr. Hunt made the following observations, among others, about Mr. Ross: The evaluation provided no evidence that would indicate that Mr. Ross suffers from any diagnosable mental disorder, according to DSM III criteria. The activities in 1978 and 1979 can best be seen as involving an identity disturbance of late adolescence, a very common condition. Since that time Mr. Ross's history, corroborated with clinical interview, provides evidence of significant personality maturing since that time, and no indications of a pattern of aberrant behavior overtime [sic] that would warrant a diagnosis of a passive-aggressive personality disorder or any other personality disorder. Mr. Ross's approach to the entire licensure process, including his approach and manner during my interview all suggested a fairly high level of personality organization and integration, in spite of his sexual preferences. There is no history, at least in the past seven years, that would indicate any increased probability that Mr. Ross's performance as a nurse would not be in the best interests of the nursing profession nor the patients he serves. Although Dr. Yates's report makes reference to some concerns about his ability to modulate his anger and avoid acting out in problematic, passive- aggressive way [sic], as well as some statements regarding unresolved psychosexual issues, it should be noted that the statements were in the context of the understanding by Dr. Yates at that point of what was meant by having abandoning [sic] life style. In the context of my current evaluation this information was finally judged by me to be similar to a false positive laboratory test. In summary, after what I determined to be an adequate evaluation, I recommend that the applicant, Mr. Ross, is able to engage in the safe practice of nursing and that the board favorably consider his application for licensure in nursing.
Recommendation Based upon the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that a license as a licensed practical nurse in the State of Florida be issued to Samuel D. Ross without restriction. DONE and ENTERED this 5th day of February, 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 5th day of February, 1988. APPENDIX TO RECOMMENDED ORDER, CASE NO. 87-3123 The Board 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 Board's Proposed Findings of Fact Proposed Finding Paragraph Number in Recommended Order of Fact of Acceptance or Reason for Rejection 1 1-3. 2 4-6 and 12-13. 3 7. 4 9-10. 5 12. 6 13. 7 5-9. 8 10 and 15. 9 16. COPIES Samuel FURNISHED: D. Ross 2583 Minosa Circle North Jacksonville, Florida 32209 Susan Tully Proctor Assistant Attorney General Board of Nursing Suite 1602 - The Capitol Tallahassee, Florida 32399-1050 Judie Ritter Executive Director Department of Professional Regulation 111 East Coastline Drive Room 504 Jacksonville, Florida 32201 William O'Neil General Counsel Department of Professional Regulation 130 North Monroe Street Tallahassee, Florida 32399-0750 =================================================================
The Issue Whether Respondent violated Section 464.018(1)(h), Florida Statutes (2000), covering unprofessional performance of nursing duties and failure to conform to minimal standards of nursing practice, and if so, what penalty should be imposed.
Findings Of Fact Respondent Jane Wickham is a Licensed Practical Nurse in the State of Florida, having been issued license number PM1227531. Petitioner is the State Agency charged with regulation of the practice of nursing, pursuant to Chapters 20, 456, and 464, Florida Statutes (2000). On June 6, 2001, Respondent was a nurse employed by and/or working at Daytona Health and Rehabilitation Center (DHRC), Daytona Beach, Florida. On June 6, 2001, Respondent was assigned to provide patient care to patient M. M., an 81-year-old female patient, who suffers from Alzheimer's Dementia and/or Alzheimer's Disease and dementia. M. M. had been recently admitted to DHRC on May 23, 2001. Her records indicate she was very combative. Respondent had worked with M. M. between May 23, 2001, and June 6, 2001. On June 6, 2001, Respondent attempted to administer oral medication to M. M.. M. M. said the medicine upset her stomach and refused it. She was heard repeatedly saying, "I don’t want it!" Respondent enlisted assistance from a Certified Nursing Assistant (CNA), who helped Respondent give M. M. a portion of the medicine, which M. M. then spat into Respondent's face. Some medicine struck Respondent. Respondent wiped herself off with a towel. She then grabbed M. M. forcibly by the arm, and briskly walked her into the dayroom and sat her on the couch. Lynn Peabody, Physical Therapy Assistant, observed M. M. and Respondent in the dayroom. M. M. attempted to get up from the couch and away from Respondent. M. M. and Respondent were swinging at each other, but Ms. Peabody was unable to see any "striking" by Respondent. M. M. swung the towel and knocked off Respondent's glasses. At that point, Respondent one again grabbed M. M. forcibly by her arm, wrenched her up from the couch, and briskly walked her to her room. Respondent used such force that M. M.'s slipper was pulled off as she tried to resist being pulled down the hall by Respondent. Respondent put patient M. M. in her room, shut the door, and held the door shut, trapping patient M. M. inside. While trapped in the room, M. M. was yelling, screaming, and trying to get out of the room. M. M. was upset and crying. Judy Kiziukiewicz, Marketing Director, was in the restroom across the hall from M. M.'s room. She heard screaming and banging from the altercation. She heard M. M. calling, "Help! help! help!" She also heard Respondent saying, "I'll kill you! I'll kill you!" Ms. Kiziukiewicz exited the restroom and went to M. M.'s aid. M. M. was shaky, tearful, frightened, and holding her arm, which was very red. M. M. said to Ms. Kiziukiewicz, "She won't let me out." Ms. Peabody testified without refutation that she observed Respondent shut M. M. in her room and hold the door closed, while M. M. shouted "Let me out!" Ms. Peabody also heard Respondent say, "I've had enough of this shit." About 3:00 p.m. on June 7, 2001, Janice Ullery, Licensed Practical Nurse, documented in patient M. M.'s records that M. M.'s right thumb was swollen and noted bruising. On June 8, 2001, Thomas Mistrata, an Investigator for the Department of Children and Families, interviewed patient M. M. He did not testify, but his report was admitted, pursuant to Section 120.57(1)(c), as explaining or supplementing direct evidence. His report indicates bruising to M. M.'s right hand, along the thumb extending to the wrist, and small circular bruising to M. M.'s arm, which appeared to him to be a hand print. His report also indicates observation of bruising to the top of M. M.'s left hand that was circular and approximately four centimeters wide. He took photographs of the bruises. Ms. Kiziukiewicz, who did testify, observed that these photographs did not fully show the redness of M. M.'s arm on June 6, 2001, when she observed M. M.'s injuries immediately after M. M.'s altercation with Respondent. On June 9, 2001, M. M. was examined by James R. Shoemaker, D.O. Dr. Shoemaker observed and documented in M. M.'s DHRC medical records a bruise on M. M.'s right hand. Upon the expert testimony of Meiko Miles, Licensed Nurse Practioner and Registered Nurse, it is found that Respondent's conduct with regard to Alzheimer's Patient, M. M., was below prevailing standards of nursing, constituted negligence, and further constituted a failure to conform to the minimal standards of acceptable and prevailing nursing practice for elderly, fragile patients or for patients refusing medications. Even though Ms. Miles was not present for all of the witnesses' testimony concerning the actual altercation between Respondent and M. M., I accept Ms. Miles' testimony based upon her review of medical records, nursing notes, and medical administration reports, and given her answers in response to questions which conformed to the facts as related by the witnesses who had observed the actual event. I also accept the testimony of Ms. Miles and other witnesses to the effect that Respondent's training and experience had or should have provided her with less extreme methods upon which to rely in dealing with M. M.'s resistance and combativeness.
Recommendation Based on the foregoing Findings of Facts and Conclusions of Law, it is RECOMMENDED that the Department of Health, Board of Nursing enter a final order which finds Respondent, Jane Wickham, guilty of violating Section 464.018(1)(h), Florida Statutes, and of violating Rule 64B9-8.005 (12) and (13), Florida Administrative Code; and imposing a penalty as follows: Issues a reprimand; Assigns a fine of $300.00, plus the cost of investigation; Requires that Respondent complete a specified number of hours of continuing education course work in the subject areas of anger management and patient rights; Places Respondent on probation until such fine is paid and such course work is completed, the probation to be upon such conditions as the Board deems appropriate to protect the public health, safety and welfare; and Requires, after the fine is paid and the course work is completed, that Respondent appear before the Board to determine if she is safe to practice and to determine if any further probation is warranted, and if so, to determine the terms of that probation. DONE AND ENTERED this 9th day of July, 2003, in Tallahassee, Leon County, Florida. S ELLA JANE P. DAVIS Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (850) 488-9675 SUNCOM 278-9675 Fax Filing (850) 921-6847 www.doah.state.fl.us Filed with the Clerk of the Division of Administrative Hearings this 9th day of July 2003.
The Issue Whether Respondent engaged in unprofessional conduct and, if so, what penalty should be imposed on his nursing license.
Findings Of Fact The Department of Health is the state agency charged with regulating the practice of nursing pursuant to Chapter 464, Florida Statutes. Respondent, Cecil Harold Floyd, was at all times material hereto a licensed practical nurse in the State of Florida, having been issued a license numbered PN 0960631. At all times material hereto, Respondent was employed as a licensed practical nurse by the North Shore Senior Adult Community in St. Petersburg, Florida. At all times material hereto, Respondent was assigned to care for Patient M.F., a patient in the skilled nursing section of the North Shore Senior Adult Community. On February 26-27, 1996, Respondent worked as the charge nurse on the 11:00 p.m. to 7:00 a.m. shift. On February 27, 1996, at approximately 6:00 a.m., Respondent wrote in the nurse's notes that Patient M.F. was lethargic and having difficulty swallowing; that the patient's bottom dentures were out; and that the patient's tongue was over to the right side. In this entry, Respondent also noted "will continue to monitor." After Respondent completed his shift on February 27, 1996, Conchita McClory, LPN, was the charge nurse in the skilled nursing facility at North Shore Senior Adult Community. At about 8:10 a.m., Nurse McClory was called by the CNA who was attempting to wake up Patient M.F. Upon Nurse McClory's entering Patient M.F.'s room, she observed that the patient was sleeping, incontinent, and restless and that the right side of the patient's face was dropping. Based on these observations, Nurse McClory believed that Patient M.F. may have suffered a stroke and she immediately called 911. Following the 911 call, Patent M.F. was taken to Saint Anthony's Hospital in Saint Petersburg, Florida. Prior to coming to this country, Conchita McClory had been trained and worked as a registered nurse in the Philippines. However, Ms. McClory is not licensed as a registered nurse in the State of Florida. Saint Anthony's Hospital's records regarding Patient M.F. indicate that the patient had a history of multiple strokes beginning in 1986. The Department’s Administrative Complaint against Respondent included the following factual allegations, all of which were alleged to have occurred on February 27, 1996: At approximately 6:00 a.m., Respondent recorded in the nurse’s notes that Patient M.F. was lethargic and having difficulty swallowing; the patient's bottom dentures were out; and the patient's tongue was over to the right side. Respondent also noted in the nurses' notes that Patient M.F. should continue to be monitored. Patient M.F.'s roommate told Respondent that she believed that M.F. had suffered a stroke because she could not swallow and her speech was slurred. At about 8:00 a.m., Patient M.F.'s roommate went to the nurses' station and requested that a certified nurse's assistant check on M.F. Patient M.F. was found paralyzed on her left side, soaked in urine and unable to speak. There was no evidence presented to support the factual allegations referenced in paragraph 9b and 9c above and included in the Administrative Complaint.
Recommendation Based upon the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that the Department of Health, Board of Nursing, enter a final order dismissing the Administrative Complaint against Respondent. DONE AND ENTERED this 6th day of October, 1999, in Tallahassee, Leon County, Florida. CAROLYN S. HOLIFIELD Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (850) 488-9675 SUNCOM 278-9675 Fax Filing (850) 921-6847 www.doah.state.fl.us Filed with the Clerk of the Division of Administrative Hearings this 6th day of October, 1999. COPIES FURNISHED: Howard M. Bernstein, Esquire Agency for Health Care Administration Allied Health - Medical Quality Assistance 2727 Mahan Drive, Building 3 Tallahassee, Florida 32308-5403 Cecil Harold Floyd 1680 25th Avenue, North St. Petersburg, Florida 33713-4444 Ruth Stiehl, Executive Director Board of Nursing Department of Health 4080 Woodcock Drive, Suite 202 Jacksonville, Florida 32207 Angela T. Hall, Agency Clerk Department of Health 2020 Capital Circle, Southeast, Bin A02 Tallahassee, Florida 32399-1701 Pete Peterson, General Counsel Department of Health 2020 Capital Circle, Southeast, Bin A02 Tallahassee, Florida 32399-1701
The Issue The issues in this case are as established through an administrative complaint alleging misconduct by the Respondent when he was employed in his capacity as a licensed practical nurse at the Arlington Manor Care Center, Jacksonville, Florida. The charges are brought under the authority of Chapters 20, 455, and 464, Florida statutes. The details of the administrative complaint are more completely described in the conclusions of law.
Findings Of Fact Petitioner, State of Florida, Department of Professional Regulation, is charged with the regulation of the practice of nursing in Florida. This is in keeping with the authority expressed in Section 20.30, Florida Statutes; Chapter 455, Florida Statutes; and Chapter 464, Florida Statutes. At all times relevant to the inquiry, Respondent, Christopher Allen Fitchett, has been a licensed practical nurse in the state of Florida, having been issued license number 0608751. At times relevant to the underlying administrative complaint, Respondent was employed at Arlington Manor Care Center, Jacksonville, Florida. On the night of March 21, 1984, commencing at 11:00 p.m. and continuing through 7:00 a.m., March 22, 1984, Respondent was acting as a charge nurse in the Arlington Manor Care Center. In this capacity, it was his responsibility to see that the residents of the facility were well cared for; that nursing practices were maintained; that the patients in the facility got their medicines and treatments; that doctors' orders were carried out; and that these duties were performed on time. Around 5:30 on the morning of March 22, 1984, Marilyn R. Funk, registered nurse, who was the director of nursing at Arlington Manor Care Center, arrived at the facility. She came in the back door and approached the left-hand side of the nursing station. Respondent was sitting in a chair with his head resting on the desk in the nursing station area. When the door which she had entered through closed, Mr. Fitchett did not respond. Funk stood by Fitchett for a period of two or three minutes, and Fitchett did not respond. At that time, Della, one of the residents of the facility, started to leave the facility and a nursing assistant, seeing the resident exiting the facility, called out to the resident to not go out. Respondent did not react to the circumstance of the patient's leaving and the nursing assistant's calling the resident back. During this time frame, one of the employees at the nursing home who worked in the kitchen dropped a Vaseline jar with a metal lid onto the floor in the nursing station area, making a loud noise. Fitchett did not react to that activity. All told, Ms. Funk observed the Respondent with his head down on the desk for a period of approximately fifteen minutes, during which time Respondent did not stir and his eyes were closed. A fair inference can be drawn that Fitchett was asleep during this time. As described by Nurse Funk and another licensed Florida registered nurse, Carolyn Hoffman, both of whom were accepted as experts in the nursing field, Respondent, by being asleep on duty and failing to be alert to the needs of the residents and his surroundings, was involved in unprofessional conduct which departs from the minimum standards of acceptable and prevailing nursing practice. Ms. Funk identifies the fact that Respondent should have told the other charge nurse who was in the building at the time that he was tired and wished to be relieved from his duties for a period. He could then have gone into the lounge area to rest for a short while. Problems that can occur when the Respondent is not alert would include a circumstance as seen with the resident Della who was about to leave the facility and be without supervision. In addition, Respondent's inattentiveness placed all the residents within the nursing home at general risk related to their health care. In this connection, on the date of the incident Respondent had not signed in or out for narcotics located in the nursing home. Moreover, when the director of nurses took the keys from the Respondent that morning, she discovered that the medicine room was open and the medicine cart was unlocked.
The Issue Respondent is charged under Section 464.018(1)(c), Florida Statutes, of being convicted, regardless of adjudication, of a crime which directly relates to the practice of nursing or the ability to practice nursing, and under Section 464.018(1)(d) 5, of being found guilty, regardless of adjudication, of a violation of Chapter 784, Florida Statutes, relating to assault, battery, and culpable negligence.
Findings Of Fact The Respondent is, and at all times material hereto has been, a licensed registered nurse in the state of Florida, having been issued license number RN 1931082. She has been licensed in one or more states as a nurse for 25 years. She has been a critical care nurse and worked emergency rooms and ambulances. She has never before been the subject of Florida license discipline. On March 15, 1995, Respondent was charged with the crime of vehicular homicide, a second degree felony, pursuant to Section 782.071, Florida Statutes (1993). (See Exhibit R-5 showing the statutory year.) That statute provided in pertinent part, 782.071 Vehicular homicide. -- "Vehicular homicide" is the killing of a human being by the operation of a motor vehicle by another in a reckless manner likely to cause death of, or great bodily harm to, another. Vehicular homicide is a felony of the third degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084. Any person who commits vehicular homicide and willfully fails to stop or comply with the requirements of s. 316.027(1) is guilty of a felony of the second degree, punishable as provided in s. 774.082, s. 775.083, or s. 775.084 Respondent pled "not guilty" to the charge of vehicular homicide. On May 30, 1996, Respondent was tried and found guilty by a jury of vehicular homicide, in the Circuit Court in and for Manatee County, Florida under Case No. 94-3739F. A charge against Respondent of leaving the scene of the accident was dropped at trial. On June 27, 1996, Respondent was sentenced to six-and- one-half years of imprisonment followed by eight years of probation. The Second District Court of Appeal affirmed the Respondent's conviction, but her sentence was recalculated in connection with the applicable sentencing guidelines. There have been no other appellate decisions regarding Respondent's conviction. Respondent was due for work release shortly after formal hearing. The Respondent testified that she considered it her obligation as a nurse to stop and render assistance if she knew she hit someone with a motor vehicle; however, Respondent maintained that she did not know that she had hit anyone. The Agency presented no testimony, expert or otherwise, to relate Respondent's second degree felony conviction of vehicular homicide to the practice of nursing or the ability to practice nursing.
Recommendation Upon the foregoing findings of fact and conclusions of law, it is RECOMMENDED that the Department of Health, Board of Nursing enter a Final Order finding Respondent not guilty of both counts of the Administrative Complaint and dismissing the Administrative Complaint. DONE AND ENTERED this 8th day of May, 1998, in Tallahassee, Leon County, Florida. ELLA JANE P. DAVIS Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (850) 488-9675 SUNCOM 278-9675 Fax Filing (850) 921-6847 Filed with the Clerk of the Division of Administrative Hearings this 8th day of May, 1998.
Findings Of Fact At all times pertinent to the allegations contained herein, Respondent Lawrence J. Sleurs, was a registered nurse in Florida under License Number 1248372, which was issued on February 21, 1987, and which expires on March 31, 1989. Respondent was originally licensed by endorsement on June 1, 1981 and was licensed for the renewal bienniums from June, 1981 through March, 1989. The Board of Nursing is the agency responsible for licensing registered nurses in Florida. At all times pertinent to the allegations contained in the Administrative Complaint the Respondent was employed as Director of Nursing at the Hillsborough County Developmental Center in Tampa, Florida, having been hired to that position by Julia Pearsall, the Administrator of the facility. Starting in July, 1987, numerous employees at the facility reported to the Administrator that Respondent was not performing his duties in an appropriate fashion. A consultant, Addle Colgan, employed by Medical Services Corporation, was called to evaluate Respondent's performance and conducted a series of evaluations of the facility as it related to Respondent's performance as Director of Nursing in June, July, and August, 1987. During the course of these various interviews, she determined that Respondent had failed to record appropriate records or take appropriate steps regarding several grand mal seizures of a particular patient during the latter part of June and the early part of July, 1987; that he had failed to exercise appropriate managerial skills in providing appropriate nursing help; that his medical record-keeping was less than satisfactory; that his drug control operations were substandard; and, that numerous other areas of nursing practice as accomplished by Respondent were below standards. In her report dated July 16, 1987, Ms. Colgan recommended that Respondent be put on probation for a period of observation followed by reevaluation. This information and the failures in his performance were discussed with the Respondent by Ms. Colgan and he indicated his awareness of them and his belief that he could do better. It was obvious, however, that he could not do so. On July 25 and 26, 1987, Respondent again failed to orient a licensed practical nurse as required; he failed to relieve one nurse, requiring her to work approximately 20 hours straight; and his mismanagement caused the nurse in charge to commit multiple medication errors due to her fatigue, lack of orientation, and the receipt of improper directions from Respondent. As a result, on July 30, 1987, Respondent was interviewed by Ms. Colgan and Ms. Pearsall at which time he verified what he had advised the nurse in question; his failure to document medication errors or to notify a physician; his failure to read policy and procedures regarding medication errors; and his lack of awareness of immediate and future scheduling needs. Considering the seriousness of these offenses and the fact that Respondent had not improved over the period of probation, at 2:30 PM on July 30, 1987, he was relieved of his duties as Director of Nursing and discharged from employment with the facility. The personnel file pertaining to Respondent and the investigative file concerning his alleged misconduct were forwarded to Mary L. Willis, a registered nurse consultant and expert in the field of nursing competence for evaluation. Having reviewed the entire file, she is satisfied that Respondent's skills were poor and he interfered with the nurses under his supervision in the details of their duties. As a result of his activities, she questions his managerial skills, his preparation for the job of Director of Nursing, his knowledge of care of seizure patients, and his lack of understanding and experience with medications. Taken together, these defects convince her that the care rendered by Respondent during the period in question did not come up to minimal standards as it relates to seizure patients. She is also convinced that the level of skill demonstrated by Respondent in this case was less than that of a practical nurse. In addition, it is her opinion that his charting of medications failed to achieve minimal technical standards in that he ignored basic principles involved in the administration of medication. Ms. Willis has many serious doubts regarding Respondent's preparation to serve as a Director of Nursing. She cannot understand, in light of the fact that he initially complained of the hours required of a Director of Nursing and because of the fact that he lived in Lakeland and while working in Tampa, why he accepted the position in the first place. Taken together, it is her opinion and it is so found, that Respondent's performance of duty as Director of Nursing and as a registered nurse, during the period June - July, 1987, failed to conform to the minimal standards of acceptable and prevailing nursing practice in Florida.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is, therefore: RECOMMENDED that the Respondent Lawrence J. Sleurs, R. N., be reprimanded, that he be placed on probation for one year under such terms and conditions as the Board may specify, and that he pay an administrative fine of $500.00. RECOMMENDED this 16 day of February, 1989 at Tallahassee, Florida. ARNOLD H. POLLOCK, 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 Administrative Hearings this 16 day of February, 1989. COPIES FURNISHED: Judie Ritter, Executive Director Department of Professional Regulation Board of Nursing Room 504, 111 East Coastline Drive Jacksonville, FL 32201 Charles F. Tunnicliff, Esquire Department of Professional Regulation 130 North Monroe Street Tallahassee, Florida 32399-0750 Lawrence J. Sleurs, R.N. 2047 Somerville Drive Lakeland, Florida 32801
The Issue At issue in this proceeding is whether Respondent committed the offense set forth in the Amended Administrative Complaint and, if so, what penalty should be imposed.
Findings Of Fact Respondent, Cheryl A. Wasconis, is, and was at all times material hereto, a licensed practical nurse (LPN) in the State of Florida, having been issued license number PN 0797261.2 On or about September 19, 1995, in the Circuit/County Court, Broward County, Florida, Case No. 94017854MM10A, Respondent entered a plea of nolo contendere to one count of driving under the influence (DUI), an offense proscribed by Section 316.193(1), Florida Statutes. Respondent was adjudicated guilty of the offense, and sentenced to nine months probation, a six month driver's license suspension, a $500 fine, court costs, and mandatory attendance at two Alcoholics Anonymous meetings per week (presumably for the term of her probation).3 Respondent, although accorded the opportunity, elected not to testify at hearing or to offer any explanation of the circumstances surrounding her nolo contendere plea or the reasons for entering such plea. See Ayala v. Department of Professional Regulation, 478 So. 2d 1116 (Fla. 1st DCA 1985). Similarly, the Department offered no proof regarding the circumstances (particulars) of the offense, or that the occurrence was other than an isolated event in Respondent's personal history. Finally, it was agreed between the parties, that Respondent was not actively practicing nursing at the time of her arrest or at the time she entered her plea to the charge.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that a Final Order be rendered which dismisses the Amended Administrative Complaint. DONE AND ENTERED this 8th day of September, 1998, in Tallahassee, Leon County, Florida. WILLIAM J. KENDRICK Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (850) 488-9675 SUNCOM 278-9675 Fax Filing (850) 921-6847 Filed with the Clerk of the Division of Administrative Hearings this 8th day of September, 1998.
