The Texas Board of Nursing (BON) has the jurisdiction to hear and decide cases involving the practice of professional nursing in Texas. Any RN or LVN found guilty for violating the state laws and regulations may be subjected to a disciplinary case if not properly defended by a nurse attorney.
At the time of the initial incident, an RN was employed as a Progressive Care Unit (PCU) Staff Nurse at a hospital facility in Houston, Texas, and had been in that position for eight (8) years and seven (7) months.
On or about January 10, 2018, while employed as a PCU Staff Nurse, the RN failed to document a complete assessment of the abdomen, including abdominal description and palpation, of a patient who was hospitalized in connection with surgery to repair a Colo vesicular fistula with sigmoid colectomy and ileostomy and was experiencing an ileus. The RN’s conduct was likely to injure the patient in that subsequent caregivers would not have accurate and complete information on which to base their decisions for further care.
On or about January 10, 2018, while employed as a PCU Staff Nurse, the RN failed to recognize the deteriorating condition of the aforementioned patient, and thus failed to collaborate with other members of the patient’s healthcare team to implement appropriate interventions to stabilize the patient, despite evidence of increased pain, increased heart rate, increased drain output with color change, and receipt of numerous STAT orders from the physician. Furthermore, the RN failed to report an elevated potassium level of 5.9 to the physician despite the receipt and acknowledgment of STAT laboratory orders and the aforementioned patient’s continued receipt of intravenous fluids that contained potassium. Subsequently, the patient died later in the day of septic shock. The RN’s conduct was likely to injure the patient in that caregivers would not have current and complete information on which to base their decisions for further care. Moreover, the RN’s conduct may have contributed to the patient’s demise.
On or about February 25, 2018, while employed as a PCU Staff Nurse, the RN failed to document contact with the physician regarding the decreasing blood pressure and heart rate of the patient and failed to clarify and/or document clarification of medication orders for the administration of Lasix and amiodarone with the physician in light of the aforementioned patient’s decreasing blood pressure and heart rate. Additionally, the RN failed to obtain and document the aforementioned patient’s blood pressure and heart rate prior to the administration of amiodarone and one hour after the administration of amiodarone and failed to notify the physician that she called for rapid response team assistance in response to the patient’s low blood pressure and heart rate. The RN’s conduct was likely to injure the patient in that subsequent caregivers would not have accurate and complete information on which to base their decisions for further care.
In response to the incidents, the RN disputes that there was a failure to recognize a declining condition as during her shift the patient was alert speaking coherently, and had an appropriate response to pain. The RN states that the patient’s oxygen saturation was within normal limits, at approximately 94%, throughout the time period that the RN cared for the patient. The RN states that the patient’s vital signs remained stable throughout her shift. The RN states that her notes indicate that at 09:00, the drainage in the JP drain was seriously clear, approximately 50 ml. At 10:00, the RN states she recompressed the JP drain and there was no drainage present. The RN states she noted the drainage in the patient’s drain was scant at 11:25. The RN states that the patient was connected to life systems monitors that were audible and viewable from the patient’s bedside and central nursing station. The RN states that at no time did she hear or see any alarms sounding that indicated a change in the patient’s condition- or vital signs, nor did she receive any notification from the monitor room. Furthermore, multiple staff members, including the charge nurse, certified nursing assistant, respiratory therapist, and the patient’s physician, had contact with the patient; however, none of the staff members that interacted with the patient brought any concerns about a decline in the patient’s condition to the RN with any sense of urgency. The RN states that there were multiple systemic failures made by the facility in the delay of treatment provided to the patient, failures of which were outside of her control.
As a result, the RN was sentenced to probation and ordered to pay an amount. She was disciplined warning to suspension of her RN license by violating Texas Board of Nursing regulation.
If you’ve ever done any errors during your shift as an RN or LVN, and you wish to preserve your career and your license, an experienced nurse attorney is what you need. Nurse Attorney Yong J. An, an experienced nurse lawyer for various licensing cases for many years. Consult with Texas nurse attorney Yong J. An, today if you have any questions about your disciplinary process by calling or texting him at (832) 428-5679 day, night or on weekends.