Findings Of Fact The Respondent, Joann Jensen, graduated from the University of Nebraska with the degree of Bachelor of Science in Nursing in 1972. She became licensed as a Registered Nurse in Florida, but upon moving back to the North she let the license lapse. When she returned to Florida in 1976 she was reinstated as a Registered Nurse, and she now holds license number 70429-2 issued by the Board of Nursing. Thereafter the Respondent became employed at Holy Cross Hospital in Fort Lauderdale on the 3:00 p.m. to 11:00 p.m. shift, and was assigned to the nursery where she became charge nurse in August of 1977. She held this position during the March-October, 1979, period which is involved in this proceeding. In October of 1979 the Respondent was transferred out of the nursery into a medical/surgical adult unit at Holy Cross Hospital, where she remained for about six months, when she left the hospital to work for a private nursing agency. Between March and October of 1979 the Respondent was observed by six nurses on several occasions when she continued to feed infants after they had begun to choke, gag and struggle for air. Specific occurrences were described with reference to infant's named Baby Mandell, Baby Saul, Baby Riccobono, Baby McDaniel, Baby Fast, Baby Davis, Baby Pierce, and Baby Fletch, although precise time frames were not uniformly established. Other instances were described generally without reference to any particular infant. The Respondent was further observed to have tube-fed an infant to the point where its abdomen became distended, to have forced liquid into an infant after it had been breast fed by the mother, and to have manipulated the nipple of a bottle in the mouth of an infant in a rough manner so as to increase the flow of fluid into the mouth. On at least one occasion an infant turned blue and required suction to clear its passages. This form of handling of infants by the Respondent continued from March of 1979 until October when she was transferred to an adult-care unit. The testimony of the six nurses presented by the Petitioner also establishes that the Respondent used what is known as the Crede Maneuver to induce newly circumcised infants to urinate. This is a procedure used by some nurses in which the bladder is massaged gently until urination occurs. However, the manner in which the Respondent performed this procedure was forceful and rough, resulting in painful screams from infants. On one occasion there was no stated medical reason for use of the Crede Maneuver on the infant except that the Respondent wanted to have the chart show that urination had occurred during her shift. The evidence further establishes that the Respondent cursed and used foul language in the nursery, and that in one instance this was directed at an infant when the mask used to protect its eyes under the bilirubin lights kept slipping off its face. Placing an infant under bilirubin lights with its eyes masked for protection is a procedure designed to break-down excessive bilirubin in the blood when this is a problem. Although the Complaint did not specifically allege that the Respondent's language in the nursery would be an issue, this evidence was received without objection, but has been accorded no weight by the Hearing Officer. The evidence presented by the Petitioner's expert witness establishes the fact that conduct such as described above, if true, is not acceptable nursing practice, and deviates from the minimum standards established for and prevailing in the nursing profession. Based upon the observed candor and demeanor of all the witnesses, the evidence presented by the Petitioner has been accorded sufficient weight to support the findings of fact set forth herein. No evidence was presented to show that these facts were in accordance with good nursing practice; thus, the evidence warrants a finding that the Respondent's conduct failed to conform to and departed from the standards of acceptable nursing practice. The testimony of the Respondent and her witnesses, and other evidence, amounted to a denial that the occurrences took place, that the Respondent was not working on at least one date when the conduct described was observed, that the charts and records do not corroborate the facts charged, and that the Petitioner's witnesses were engaged in a conspiracy against the Respondent. However, the testimony of the three nurses on behalf of the Respondent establishes no more than that they have not observed the conduct described by the other nurses. There was no corroborative testimony relative to a conspiracy among the Petitioner's witnesses. Further, the occurrences described took place over a prolonged time period, and involved numerous infants. There is no particular significance to the failure of the charts to contain notations confirming the observations of the nurses, or that the Respondent was not shown by the records to have been on duty the particular date of only one incident. The Respondent's former supervisor related one instance when a mother complained that the Respondent had been rough with her infant. An investigation resulted, from which she concluded that the Respondent might have been rough with the baby. This witness also thought there was some merit to the complaints that nurses made of the Respondent's treatment of infants, although she continued to give the Respondent good performance evaluations. In summary, there was not sufficient evidence presented by the Respondent to support her own self-serving denial and assertion of a conspiracy against her, or to effectively rebut the clear and convincing testimony presented in support of the allegations set forth in the Administrative Complaint.
Recommendation Based upon the foregoing findings of fact and conclusions of law, it is RECOMMENDED that license number 70429-2 authorizing the Respondent, Joann Jensen, to practice as a registered nurse, be revoked. THIS RECOMMENDED ORDER entered on this 25 day of September, 1981. WILLIAM B. THOMAS, 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 25 day of September, 1981. COPIES FURNISHED: William M. Furlow, Esquire 130 North Monroe Street Tallahassee, Florida 32301 Marie S. Hotaling, Esquire 1523 North East 4th Avenue Fort Lauderdale, Florida 33304
Findings Of Fact Based upon the testimony of the witnesses and the documentary evidence received at the hearing, I make the following findings of fact: At all times material to the allegations of the. administrative complaint, Respondent, Michael James Hanly, was a licensed registered nurse, license no. RN 78035-2. On or about November 18, 1987, the Board of Nursing entered a final order regarding disciplinary action against this Respondent. The final order found the Respondent guilty of improper conduct and specified the following penalties: The licensee shall pay an administrative fine of $500.00 within 6 months. The licensee is hereby placed on PROBATION for a period of two years, subject to the following terms and conditions: The licensee shall not violate any Federal or State law, nor any rule or order of the Board of Nursing. The licensee shall submit written reports to the Board, which contain the licensee's name, license number, current address, current employer's name, address and telephone number, and a statement by the licensee describing his nursing employment and performance These reports shall be submitted quarterly, as scheduled by the Board probation section. The licensee shall enroll in and successfully complete, in addition to normally required continuing education courses, courses in the following subject areas: medical ethical considerations and legal aspects of nursing within six (6) months from the filing of this Order. * * * While employed as a nurse, the licensee shall be responsible for causing reports to be furnished by his employer to the Board; these reports shall set out the licensee's current position, work assignment, level of performance, and any problems. The reports shall be submitted every three months as scheduled by-the Board probation section. If employed otherwise than as a nurse, the licensee shall report the position, employer and place of employment to the Board section on the scheduled quarterly dates. If not employed, the licensee shall so notify the Board probation section on the scheduled quarterly dates. Any deviation from the requirements of this probation without the prior written consent of the Board shall constitute a violation of this probation. Subsequent to the entry of the final order, the Respondent did not submit reports, did not complete the continuing education, and did not pay the administrative fine. On June 10, 1988, the Department wrote to the Respondent to notify him that the terms of the final order had not been met. This letter was received by the Respondent on June 14, 1988. On June 29, 1988, the Department again wrote to the Respondent to advise him that he was delinquent and in violation of the final order. This letter was received by the Respondent on July 12, 1988. Upon receipt of the correspondence described in paragraph 3, Respondent replied to the Department by stating that the matters addressed in the final order were on appeal to the district court of appeal. The Respondent did not pay the administrative fine nor seek additional time within which to comply with the remaining terms of the final order. Finally, the Department wrote to Respondent on July 22, 1988, acknowledged that the final order had been appealed, but informed Respondent that he was required to comply with the final order unless a stay were entered by the appellate court. Respondent did not obtain a stay from the appellate court and, as of the date of the hearing, had not complied with the terms of the final order entered November 18, 1987.
Recommendation Based on the foregoing, it is RECOMMENDED: That the Board of Nursing enter a final order which finds Respondent guilty of the violation alleged in the administrative complaint, imposes an administrative fine in the amount of $250, and lengthens the period of Respondent's probation to four years. DONE and ENTERED this 5th day of July, 1989, in Tallahassee, Leon County, Florida. Hearings Hearings JOYOUS D. PARRISH Hearing Officer Division of Administrative The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32301 (904)488-9675 Filed with the Clerk of the Division of Administrative this 5th day of July, 1989. APPENDIX TO THE RECOMMENDED ORDER RULINGS ON THE PROPOSED FINDINGS OF FACT SUBMITTED BY THE DEPARTMENT: Paragraphs 1 and 2 are accepted. With regard to paragraph 3, it is accepted that the Respondent filed an appeal which was assigned case no. 88- 1069; whether that appeal was timely or complied with the provisions of Section 120.68, Florida Statutes, is unknown and not a part of this record. It is accepted that the parties, for purposes of the hearing, believed the appeal to be proper. Paragraphs 4 through 11 are accepted. The Respondent did not submit proposed findings of fact. An ex parte communication was submitted on June 19, 1989, which is rejected as argument, irrelevant or contrary to the weight of the credible evidence. COPIES FURNISHED: Michael A. Mone' Senior Attorney Department of Professional Regulation 1940 North Monroe, Suite 60 Tallahassee, Florida 32399-0729 M. James Hanly, R.N. Post Office Box 1472 Boynton Beach, Florida 33425 Kenneth Easley General Counsel Department of Professional Regulation 1940 North Monroe, Suite 60 Tallahassee, Florida 32399-0729
