Findings Of Fact Upon consideration of the oral and documentary evidence adduced at the hearing, the following facts are found: By an administrative complaint dated December 15, 1978, respondent was charged with unprofessional conduct in violation of Florida Statutes, Section 464.21(1)(b). The respondent timely requested an administrative hearing which was granted. The envelope which contained the request for hearing was mailed from Buffalo, New York, but the return address was 717 Breakers Avenue #3, Ft. Lauderdale, Florida, with the notation "Note: Address Change." All future correspondence was sent to this address, including the notice of hearing dated May 16, 1979. The hearing was scheduled to commence at 9:30 a.m. At approximately 9:50 a.m., the hearing proceeded without the appearance of the respondent. On July 20 and 21, 1978, the respondent Miller was employed as a registered nurse on the 11:00 p.m. to 7:00 a.m. shift at Cypress Community Hospital in Pompano Beach, Florida. At 3:55 a.m. on July 21, 1978, respondent signed out for 75 milligrams of injectable Meperidine (Demerol), a Class II controlled substance, for patient Frank Mantovi, and then walked into the patient's room with the substance. Another registered nurse on duty, Oletta Jones, observed that the patient was sleeping at the time. Nurse Jones called her supervisor, Anita Johnston, and they awakened the patient and inquired whether he had requested or received any medication for pain. He replied in the negative. The patient appeared oriented and alert, and his vital signs were stable and not indicative of receiving 75 milligrams of Demerol. The administration of Demerol was not charted on the patient's medication record, as it should have been had it been administered. Nurses Jones and Johnston then confronted respondent Miller in the nurses' lounge. At first respondent told them that she had administered the Demerol intermuscularly, but then said she had given it by I.V. push. The doctor's order sheet for patient Mantovi contained a notation for 75 milligrams of Demerol administered intermuscularly as needed for pain every three hours. There is nothing to authorize an I.V. introduction of this medication. It is not acceptable or prevailing nursing practice for a nurse to alter the mode of administration prescribed by the physician. After talking with respondent, patient Mantovi's vital signs were again checked. There was no indication that he had received Demerol. Respondent was then asked to leave the hospital. The pupils of her eyes were observed by Nurse Johnston to be of pinpoint size.
Recommendation Based upon the findings of fact and conclusions of law recited above, it is RECOMMENDED that the Board of Nursing find respondent guilty of unprofessional conduct within the meaning of Florida Statutes, 464.21(1)(b), and suspend her registered nursing license for a period of three (3) months. Respectfully submitted and entered this 14th day of August, 1979, in Tallahassee, Florida. DIANE D. TREMOR, Hearing Officer Division of Administrative Hearings Room 101, Collins Building Tallahassee, Florida 32301 (904) 488-9675 COPIES FURNISHED: Jane M. Miller 717 Breakers Avenue #3 Ft. Lauderdale, Florida 33304 Julius Finegold Esquire 1107 Blackstone Building Jacksonville, Florida 32202 Geraldine Johnson, R.N. Coordinator of Investigation and Licensing 111 East Coastline Drive Suite 504 Jacksonville, Florida 32304 ================================================================= AGENCY FINAL ORDER ================================================================= BEFORE THE FLORIDA BOARD OF NURSING IN THE MATTER OF: Jane Marie Miller 717 Breakers Avenue No. 3 Ft. Lauderdale, Florida 33304 CASE NO. 79-212 As Registered Nurse License Number 66021-2 /
The Issue The issue for consideration in this case is whether Respondent's license as a registered nurse in Florida should be disciplined because of the matters alleged in the Administrative Complaint filed herein.
Findings Of Fact At all times pertinent to the issues herein, the Department of Health, Board of Nursing, was the state agency in Florida responsible for the licensing of nurses and the regulation of the nursing profession in this state. Respondent was a registered nurse licensed in Florida with license number RN 2561322, which she obtained by endorsement in 1991. Respondent, using the name Michele Draper, applied for licensure as a registered nurse by endorsement by application filed on October 7, 1991. On that application, she listed 340-22-0150 as her social security number and June 22, 1954, as her date of birth. Attached to the licensure application was a copy of Respondent's Illinois driver's license which reflected her date of birth as June 22, 1951. The application form reflects that at some point, the name "Draper" was struck through and the name "Jackson" written in, but Respondent's signature on the application form reflects Michele Draper Jackson. This same application form reflects that Respondent answered "No" to the question, "Have you ever been convicted or have you a no-contest or guilty plea-regardless of adjudication-for any offense other than a minor traffic violation." Respondent had been arrested and, on June 8, 1988, convicted of a felony charge of "Deceptive Practices over $150" in McLean County, Illinois, and on July 1, 1988, was convicted of three misdemeanor charges of "Deceptive Practices under $150" in the same county. On the felony charge she was sentenced to serve 10 days in the McLean County Jail, to pay a fine of $300 plus court costs, and to serve 30 months' probation. On the misdemeanor charges, she was sentenced to 12 months' conditional discharge and to pay court costs. She was ordered to make restitution in both cases. No reference was made to this conviction by Respondent on her application for a Florida nurse's license. In 1993, Respondent was again arrested and indicted, tried, and convicted in Sarasota County on a third-degree felony charge of grand theft. She was sentenced to imprisonment for that offense, but the sentence was suspended and she was placed on probation for four years. The evidence reflects that as a part of the offense with which Respondent was charged was her use of three different social security numbers, to-wit: 344-33-4188; 360-22-0150; and 310-22-0150; and a date of birth of June 22, 1951. Respondent has a Florida driver's license number D616-540-57-722, bearing a Social Security Number 310-22-0150. She also has a Florida driver's license which bears the Social Security Number 360-40-8146. Both driver's licenses reflect Respondent's date of birth as June 22, 1957, yet the records of the Florida Division of Motor Vehicles reflect Respondent's date of birth as June 22, 1951. Respondent at one time also used an Illinois driver's license which bore the Social Security Number 360-42-4186, and a date of birth of June 24, 1954. In 1995, Respondent was charged in Sarasota County with a second-degree felony of scheme to defraud by using false pretenses, representations, or promises with a credit card to defraud a credit union, several banks, and an individual, of between $20,000 and $50,000 in July of that year. The court records relative to that incident indicate that Respondent stole the identity and social security number of her employer and used that number to secure a credit card and loans used to purchase two vehicles on which she failed to make the appropriate payments. Respondent was found guilty of this charge and of violation of her previously imposed probation and was, in March 1996, sentenced to five years in prison, which she served at the North Florida Reception Center beginning on March 8, 1996. Both felony convictions and the misdemeanor conviction were violations of Chapter 817, Florida Statutes, which deals with fraudulent practices. Before going to prison, between August 21, 1995, and February 28, 1996, Respondent was employed as a registered nurse at Hospice. When asked on her application for employment if she had ever been convicted of a felony, Respondent answered "No" when, in fact, she had been so convicted in 1988 and in 1993. On the application for employment, Respondent listed Social Security Number 306-44- 4186 and a driver's license bearing number D616-540-57-177. She also indicated on her résumé which she had submitted with the application that she held a bachelor of science degree from Northwestern University from which she had allegedly graduated with a 3.1 grade point average. Respondent did not hold a degree of any sort from Northwestern, having attended that institution's school of journalism for only a short period in 1972-1974. Respondent's résumé also reflected she had received a nursing diploma from Lewis University through the On Site Little Company of Mary Hospital in 1980, earning a grade point average of 3.0. In fact, Respondent did not earn a degree of any sort from that institution, having attended for only one year. Her grade point average when she left was 1.77. Her résumé also reflects she was employed in increasingly responsible nursing positions at Cook County Hospital in Illinois from 1980 to 1987. In fact, she did not receive her nursing license until 1984 and was never employed by Cook County Hospital. Respondent was sentenced to prison on March 1, 1996. That day she was scheduled to work at Hospice, but she did not appear for work as scheduled. Later that day she called in to advise she had been called away on a family emergency. Thereafter, she resigned her position with Hospice with no advance notice, and gave false reasons for leaving. Once Respondent was released from prison, on June 1, 1998, she filed an application for employment with Hospice on which she again denied ever having been convicted of a felony, and reiterated her false educational claims. In addition, she gave a false driver's license number and date of birth. There are several other inconsistencies running throughout Respondent's employment history. On her Florida nursing license application she was asked to list the names she has used during her lifetime and the name under which she received her nursing education. Respondent did not list the name Shepard in either response. The records of the Little Company of Mary Hospital Nursing School reflect that at no time was there a student at that school with the name Michele Nash, Michele Jackson or Michele Draper. At one point there was a student with the name Michele Shepard, but no social security number is on file for her. The former registrar of the nursing school testified that she received a telephone call from someone purporting to be Ms. Michele Shepard who requested a certification of graduation be issued in the name of Michele Jackson, which was supposed to be her new name. The registrar at no time saw any documentation to indicate Ms. Draper and Ms. Jackson were one and the same person, and she cannot say with any certainty that Respondent is a graduate of Little Company of Mary Hospital Nursing School. Nonetheless, she issued the letter of certification in June 1984, and that letter was forward to the Florida Board of Nursing in support of Respondent's application for licensure. Respondent submitted an Illinois nursing license as support for her application for licensure by endorsement in Florida. The application for the Illinois license is in the name of Michele Nash, and bears the Social Security Number 366-42-4116 as well as a birth date of June 22, 1954. The application also shows a date of graduation from the Little Company of Mary Nursing School of June 16, 1984. In her application for licensure by endorsement to Florida, Respondent used the Social Security Number 340-22- 0152, a birth date of June 22, 1954, a high school graduation date of 1965, a nursing school graduation date of May 1984, and a date of May 1982 as the date she took the nursing licensure examination in Illinois. She also used the names Draper, Jackson, and Nash, and she provided a copy of her Illinois driver's license showing a birth date of June 22, 1951. Because of the myriad contradictions in her application history, it is impossible to tell whether Respondent is the individual who graduated from Little Company of Mary Nursing School in June 1984. Respondent filed an application for employment with LifePath Hospice in Tampa on June 25, 1998, using the name Michele R. Draper, a Social Security Number of 261-40-6814, and a Florida Driver's license number D616-5154-671772. Neither that social security number nor a driver's license bearing that number was issued to Respondent. She also indicated she had not been convicted of a crime within the past seven years. That answer was false. Respondent also indicated in her employment application that she held a bachelor of science degree in education from Northwestern University with an earned grade point average of 3.5, and a degree in nursing from Lewis University/Little Company of Mary Hospital with an earned grade point average of 3.0. Both representations are false. Ms. Draper also outlined an employment history in this application which was false in many respects. She did not work for Nurse, Inc. from May 1993 to January 1996, as claimed; she did not work for Cook County Hospital from February 1980 to August 1983, as claimed; and she did not even hold a nursing license until 1984. When LifePath attempted to verify the information submitted by Respondent, it determined that the social security number she had given was incorrect; a second social security card presented in place thereof was false; and she provided a Florida driver's license which, though the number is correct, bears an incorrect and altered date of birth. Nonetheless, Respondent was hired by LifePath. Sometime after being hired by LifePath, Respondent presented them with a new social security card bearing the name Michele Ann Draper, and the number 570-83-2297. She said that she had married and the Social Security Administration had given her a new number. This is untrue. Respondent has been married to Al Draper since before 1978, and the Social Security Administration ordinarily does not issue a new social security number to a woman when she marries. When LifePath learned of Respondent's concealed criminal record, the numerous misrepresentations as to her education, experiences, and references, and of the numerous different social security numbers, they terminated her employment on July 2, 1999. This was approximately one year after she had been hired and placed in patient's homes by the company. Commencing in the Fall of 1980, while a student at Lewis University, until 1998, Respondent used fourteen different social security numbers and six different birth dates in her dealings with educational institutions, licensing officials, and employers. Records of the Social Security Administration indicate that only two Social Security Numbers, 360-42-4186, used at Lewis University in 1980, and 590-83- 2297, used in the last LifePath application in 1998, were issued to Respondent. None of the other numbers she used was ever issued to her under any of the names she used. By the same token, Respondent has used various dates of birth in her educational career, on driver's licenses, and on applications for licensure and employment. Birth records of the state of Illinois indicate that Michele Ann Jackson, Respondent herein, was born in Illinois on June 22, 1951. Until just recently, Respondent appears to have continued to show evidence of dishonesty and misrepresentation in her dealing with authorities. Significant among these are, for example, in her response to a complaint against her license filed in Illinois, she falsely asserted she had been cleared of any wrongdoing in Florida, and that the allegations of criminal convictions are incorrect. Further, during the Florida investigation into the instant allegations, Respondent advised the investigator she had resigned from Hospice in 1996 with proper notice and that she had not had any legal problems prior to her employment by Hospice in 1995. No evidence was presented that Respondent has ever physically harmed or neglected a patient in her care or stolen from a patient.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is recommended that the Board of Nursing enter a final order finding Respondent guilty of the matters alleged in the Administrative Complaint and revoking her license to practice nursing in Florida. DONE AND ENTERED this 25th day of January, 2001, in Tallahassee, Leon County, Florida. ___________________________________ ARNOLD H. POLLOCK 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) 921-6947 www.doah.state.fl.us Filed with the Clerk of the Division of Administrative Hearings this 25th day of January, 2001. COPIES FURNISHED: Diane K. Kiesling, Esquire Agency for health Care Administration 2727 Mahan Drive Fort Knox Building Three Room 3231A Tallahassee, Florida 32308 Michele Jackson Draper 4645 Flatbush Avenue Sarasota, Florida 34233 Ometrias Deon Long, Esquire Long & Perkins, P.A. 390 North Orange Avenue Suite 2180 Orlando, Florida 32801 Ruth R. Stiehl, Ph.D. R.N. Executive director Board of Nursing Department of Health 4080 Woodcock Drive, Suite 202 Jacksonville, Florida 32207-2714 Theodore M. Henderson, Agency Clerk Department of Health 4052 Bald Cypress Way Bin A02 Tallahassee, Florida 32399-1701
The Issue The issue is whether respondent's license as a practical nurse should be disciplined for the reasons cited in the administrative complaint.
Findings Of Fact Based upon the entire record, the following findings of fact are determined: At all times relevant hereto, respondent, Ruthie Mae Owens Brooks (Brooks or respondent), was licensed as a practical nurse having been issued license number PN 0877941 by petitioner, Department of Professional Regulation, Board of Nursing (Board). She has been licensed as a practical nurse since 1987. There is no evidence that respondent has been the subject of disciplinary action prior to this occasion. When the events herein occurred, respondent was an agency nurse for Underhill Personnel Services, Inc., an agency that furnished nurses to various health care facilities, including Methodist Medical Center in Jacksonville, Florida. She was employed at all times as a licensed practical nurse. On November 17, 1990, respondent was scheduled to work the 11 p.m. - 7 a.m. shift at Methodist Medical Center. Although her duty shift began at 11:00 p.m., respondent arrived a few minutes late and reported directly to the medical-surgical- orthopedic wing instead of signing in at the nursing office as required by hospital rules. After reporting to her work area, respondent went to the assignment board to review her assignment for that evening. Her specific duties that evening were to care for five patients in the medical-surgical-orthopedic wing. While respondent was at the assignment board, a registered nurse, Lynn Ivie, came to the board to ascertain her assignment. At that time, Ivie reported that she smelled a "strong odor of alcohol" on respondent's breath. However, Ivie said nothing at that time since she wanted to give respondent the benefit of the doubt. Around midnight, one of respondent's patients awoke in his room with severe chest pains. Both Ivie and respondent immediately went to the room. Although Ivie instructed Brooks to get a vital signs machine (also known as the Dynamap), Brooks ignored the instruction and "wiped the patient's face with a wet cloth". Ivie then brought the machine into the room and respondent was instructed by Ivie to take the patient's vital signs (blood pressure, temperature and pulse). This merely required her to place an attachment around the patient's arm and push a button to start the machine. The operation of the machine is considered a basic nursing skill. According to Ivie, respondent could not focus on the machine and did not seem to remember how to operate it. After waiting a few moments with no response from Brooks, Ivie finally took the patient's vital signs herself. During this encounter, Ivie again smelled alcohol on respondent's breath and concluded that her inability to assist in the care of the patient and to operate the machine was due to alcohol. Within a few moments, the patient was transferred to the intensive care unit (ICU) on another floor. Before accompanying the patient to the ICU, Ivie instructed respondent to chart the incident and action taken in the nurse's notes and then meet her in the ICU with the completed notes. These notes should be completed in an expedited manner so that the nurses in the ICU wing can utilize them in providing follow-up care to the patient. However, respondent did not chart the incident nor bring the notes to the ICU. Indeed, she failed to chart the notes on any of the patients assigned to her that night. By failing to chart any notes that evening, respondent contravened the requirement that a nurse file a report or record (nursing notes). Around 1:30 a.m. on November 18, Ivie and Joyce Biddix, the nursing supervisor, went to the room of one of the patients assigned to respondent and found the patient, a confused elderly male, sitting nude in a chair with the bed stripped of all linens. He had previously been tied to the bed to prevent him from falling. The linens were soiled with urine and were lying in a heap on the floor. Although respondent had taken the patient out of the bed, disrobed him, and removed the linens, she had left him unattended in the room and had not returned. Biddix called down the hall for someone to bring fresh linens and observed respondent "floating" down the hall saying "I can't find the linens" in a "singsong" voice. When she got closer to respondent, Biddix smelled alcohol on respondent's breath. It may reasonably be inferred from the evidence that respondent's conduct with this patient was unprofessional and constituted a departure from acceptable and prevailing nursing practice. After being confronted by Biddix regarding the alcohol, respondent told her she had drunk one beer with her meal around 10:30 p.m., or just before reporting to duty that evening. However, she denied she was intoxicated or unable to perform her duties. Respondent was then told to leave work immediately. The incident was later reported to Underhill Personnel Services, Inc. and that agency contacted the Board. After an investigation was conducted by the Board, an administrative complaint was filed. At hearing, respondent did not contest or deny the assertion that by reporting to work with alcohol on her breath, she was acting in an unprofessional manner and deviated from the standards of acceptable and prevailing nursing practice. In this regard, she acknowledged that she had drunk alcohol (which she claimed was only one tall beer) with her meal around 10:30 p.m., or just before reporting to duty. However, she contended that all of her previously scheduled shifts at the hospital had been cancel led and she assumed her shift that evening might also be cancelled. In response to the allegation that she could not operate the vital signs machine, respondent offered a different version of events and suggested that the machine in the patient's room was inoperative. Therefore, it was necessary for Ivie to bring a Dynamap into the room and Ivie took the vital signs without respondent's assistance. She justified leaving the elderly patient alone without clothes in his room on the grounds there was no clean gown, the patient was not combative, and she was only gone from the room for a few moments. Finally, she contended that she charted the notes for one of her patients but did not chart the others because the remaining patients were removed from her care by Ivie and Biddix when she was sent home at 1:30 a.m. However, these explanations are either deemed to be not credible or, if true, nonetheless do not justify her actions. Although there was no testimony concerning the specific issue of whether respondent is unable to practice nursing with reasonable skill and safety by reason of use of alcohol, taken as a whole respondent's conduct on the evening of November 17, 1990, supports a finding that her capacity was impaired that evening by virtue of alcohol. Accordingly, it is found that respondent was unable to practice nursing with reasonable skill and safety by reason of use of alcohol.
Recommendation Based upon the foregoing findings of facts and conclusions of law, it is, RECOMMENDED that respondent be found guilty of violating Subsections 464.018(1)(f), (h), and (j), Florida Statutes (1989), and that her nursing license be suspended for six months but that such suspension be stayed upon respondent's entry into and successful completion of the Intervention Program for Nurses. Respondent's failure to remain in or successfully complete the program will result in the immediate lifting of the stay and imposition of the six-month suspension. Thereafter, said license shall not be reinstated until such time as respondent appears before the Board and can demonstrate that she can engage in the safe practice of nursing. DONE and ENTERED this 16th day of December, 1991, in Tallahassee, Florida. DONALD R. ALEXANDER 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 16th day of December, 1991. APPENDIX TO RECOMMENDED ORDER CASE NO. 91-5033 Petitioner: Partially adopted in finding of fact 1. Partially adopted in finding of fact 3. Partially adopted in finding of fact 8. Partially adopted in finding of fact 3. 5-6. Partially adopted in finding of fact 4. 7-10. Partially adopted in finding of fact 5. 11-14. Partially adopted in finding of fact 6. 15-16. Partially adopted in finding of fact 7. 17-18. Partially adopted in finding of fact 8. COPIES FURNISHED: Roberta L. Fenner, Esquire 1940 North Monroe Street, Suite 60 Tallahassee, Florida 32399-0792 Ruthie Mae Owens Brooks 1604 S.W. 40th Terrace, #A Gainesville, Florida 32607 Jack L. McRay, Esquire 1940 North Monroe Street, Suite 60 Tallahassee, Florida 32399-0792 Judie Ritter, Executive Director 504 Daniel Building 111 East Coastline Drive Jacksonville, FL 32202
Findings Of Fact The Respondent, Jo Ann Murphy, is a licensed registered nurse in the State of Florida, holding license number 69367-2. The Respondent received her nursing education and training in Albany, Georgia, and became a registered nurse in Florida in 1973. In 1977 she became certified by the American College of Obstetrics and Gynecology as a nurse clinician. In 1981 she was certified as a clinical nurse practitioner in ambulatory gynecology and obstetric care. Until 1979, the Respondent was head nurse of OB/GYN Labor and Delivery, Postpartum Unit, at West Florida Hospital in Pensacola. From 1979 to 1983 she was office nurse and nurse practitioner in the office of Thomas H. Wyatt, M.D., in Pensacola. The Respondent became employed at University Hospital in Pensacola on April 25, 1983, primarily because of her knowledge in the field of Caesarian Sections. She was terminated less than one month later, on May 23, 1983, while still in her probationary period, for unsatisfactory nursing performance. On May 18, 1983, another registered nurse on the morning shift with the Respondent, testified that she smelled alcohol on the Respondent's breath at 7:30 A.M. Although this witness worked with the Respondent each day, this is the only time she contends that she smelled alcohol on her breath, and this witness did not see the Respondent stagger or exhibit any other symptom of alcohol use. This witness testified that the Respondent showed a lack of initiative, but that when the Respondent was told to do something she would do it well, and that she never had any concern regarding the Respondent's ability to function as a nurse. Two other hospital employees, a Licensed Practical Nurse (LPN) and a nurses aide, testified that they smelled alcohol on the Respondent's breath on a date unknown. The nurses aide, however, never saw the Respondent stagger, or exhibit any other sign of intoxication, and she says she only smelled alcohol on the Respondent's breath on one occasion. The LPN testified that she also saw the Respondent sitting at her desk in a daze or stupor, but this symptom was not observed or described by any other witness. Both of these witnesses worked with the Respondent each day, but only claimed to have smelled alcohol on her breath on one occasion. The Respondent denied having any alcohol to drink on or before any shift that she worked while employed at University Hospital. Her husband and her daughter confirmed that the Respondent had not consumed alcohol on the morning of May 18, 1983, before going to work. Another witness, a physician who was in the residency program at University Hospital while the Respondent worked there, had the opportunity to work in close contact with the Respondent on five or six occasions in the labor and delivery suite, and never smelled alcohol on her breath, or saw her stagger or exhibit any other sign of intoxication. This doctor found her to be alert, she performed her functions with no problems, and he had no complaints with her. The nursing director at University Hospital, who conducted the termination interview of the Respondent, observed what she characterized as red, blotchy skim on the Respondent, and the Respondent appeared to be nervous. However, this witness did not smell alcohol on the Respondent's breath, and she saw no other symptoms of alcohol use. Both the Respondent and the physician who employed her for four years confirmed the Respondent's skin blotches, but this is an inherited tendency having nothing to do with medical problems or alcohol use. The nursing director and the patient care coordinator both testified that the Respondent stated at her termination interview that she used to have an alcohol problem, but that she had been rehabilitated. The Respondent denies having made such a statement. Another physician, in addition to the one mentioned in paragraph 7 above, who was in labor and delivery with the Respondent more than ten times, and probably every day she worked at University Hospital, did not smell alcohol on her breath although they worked together closely. This witness found the Respondent's nursing abilities to be competent and very professional. Likewise, the physician who employed the Respondent for four years had no problems with her or her work, he found her prompt and attentive in her duties, and an excellent nurse. On another occasion, not specifically dated, but separate from the instances of the alleged alcohol breath, the Respondent is charged with having "defied an order to stay with a critically ill patient". The evidence is completely devoid of any explicit order given to the Respondent to stay with any patient during the time she worked at University Hospital. Instead, it is contended that the Respondent violated what are characterized as "standing orders" that a nurse should not leave a patient who has been assigned to her. These "standing orders" are supposed to have been set forth in policy manuals given to employees of the hospital, but no such manual was offered in evidence; nor was the nature of the "standing orders" explicitly described by the witnesses. On the one occasion when the Respondent is charged with defying orders to stay with a patient, the patient was being attended also by an LPN when the Respondent left to telephone the patient's physician. In the same general area, but behind the curtains of an adjoining cubicle, another registered nurse was attending a patient there. The patient whom the Respondent and the LPN attended went into deceleration after the Respondent had left to telephone her physician. The LPN needed help with the oxygen and to turn the patient. The other registered nurse in the adjoining cubicle came in and the patient was stabilized. The Respondent returned in a few minutes. It is below minimum standards of acceptable and prevailing nursing practice for a registered nurse to leave a patient, whose condition is considered critical, in the care of an LPN. Yet the patient was not in critical condition when the Respondent left to call the physician, and there was another registered nurse in close proximity who responded when the need for her arose. Thus, there is not sufficient competent evidence to support a finding of fact (1) that the Respondent either had alcohol on her breath or was in a drunken condition while on duty; (2) that the Respondent defied an order to stay with a critically ill patient; or (3) that the Respondent left a patient whose condition is considered critical in the care of an LPN. The competent evidence in the record supports a finding of fact (1) that the Respondent did not have alcohol on her breath at any time while employed at University Hospital; (2) that the Respondent did not defy an order to stay with a critically ill patient; and (3) that the Respondent did not leave a patient whose condition is considered critical in the care of an LPN.
Recommendation Based upon the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that the Administrative Complaint against the Respondent, Jo Ann Murphy, be dismissed. THIS RECOMMENDED ORDER entered this 10th day of January, 1985, in Tallahassee, Florida. 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 10th day of January, 1985. COPIES FURNISHED: Julia P. Forrester, Esquire 130 North Monroe Street Tallahassee, Florida 32301 Thomas C. Staples, Esquire P. O. Box 12786 Pensacola, Florida 32575 Ms. Helen P. Keefe Executive Director, Board of Nursing Department of Professional Regulation Room 504, 111 East Coastline Drive Jacksonville, Florida 32202 Mr. Fred Roche Secretary Department of Professional Regulation 130 North Monroe Street Tallahassee, Florida 32301
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.
