Accusations are stressful issues for an RN or LVN, except when a Texas BON attorney assists you against the case. The Texas Board of Nursing is responsible for all hearings against RNs and LVNs undergoing a case that may revoke, suspend, or only discipline their license. Take note that a nurse attorney can also defend a nurse’s license against accusations.
At the time of the initial incident, she was employed as an RN at a hospital in McAllen, Texas, and had been in that position for four (4) years and eleven (11) months.
On or about July 4, 2018, while employed as an RN at a hospital in McAllen, Texas, RN failed to intervene and transfer a patient to the local Emergency Department (ED) in a timely manner. RN was notified the patient had not eaten for several days, had inappropriately received 20 Units of Isophane Insulin that morning, and had a Blood Glucose of 51mg/dL at 11:30 AM, with new-onset lethargy. RN assessed the patient with the physician at that time, witnessed the patient receive Sublingual Glucagon, discontinued all insulin orders, and ordered a family care plan meeting for possible Percutaneous Endoscopic Gastrostomy (PEG) placement and/or hospice. RN was notified the patient had Blood Glucose of 41mg/dL at 12:12 PM and was still unresponsive to repeated Glucagon administration. Nursing staff requested the patient be sent to the local ED; instead, RN ordered another dose of Glucagon be given, an Intravenous (IV) line be placed, and Dextrose 10% Injection (D10) be administered intravenously. The nursing staff informed RN that neither Intramuscular (IM) Glucagon or D10 was available at the facility, and RN ordered Dextrose 5% Intravenously (D5) instead. After three failed attempts by nursing staff to start the IV, RN was notified, and the patient was sent to the ED at 2:10 PM. Subsequently, the patient died on July 10, 2018, at the hospital. RN’s conduct was likely to injure the resident from a potential delay in necessary medical treatment and may have contributed to the patient’s prolonged suffering, unrelieved hypoglycemia, and subsequent death.
In response, RN reports the nurse informed her that the patient was not eating, however, the nurse had administered 20 units of Isophane Insulin. RN reports she gave orders to stop all insulin and administer Glucagon and promptly made her way to the long-term unit to assess the patient with the physician. RN reports they assessed the patient to be at her neurological baseline; she personally wrote the order to discontinue all insulin orders, administer Glucagon, and a family care plan meeting for possible PEG tube placement and/or hospice discussion. RN reports she personally saw the nurse administer Sublingual Glucagon to the patient; she asked the nurse to recheck Blood Glucose levels and call her with the results. RN reports the patient was stable and at baseline when she and the physician left the facility. RN reports when the nurse called again with concerns of low Blood Glucose level, she ordered STAT Intramuscular Glucagon again and a peripheral Intravenous Line to be started for Dextrose 10% administration. RN reports the nurse informed her that neither Intramuscular Glucagon nor Dextrose 10% was available; therefore, she asked the nurse to give Dextrose 5% instead. RN reports the nurse informed her that they had been unable to place an intravenous line after multiple attempts; and at this point, she ordered the patient to be sent out to the nearest Emergency Department for evaluation and treatment.
The above actions constitute grounds for disciplinary action in accordance with Section 301.452(b)(10)&(13), Texas Occupations Code, and a violation of 22 TEX. ADMIN. CODE §217.11(1)(A),(1)(B),(1)(M),(1)(Q)&(4)(A) and 22 TEX. ADMIN. CODE §217.12(1)(A),(1)(B)&(4).
The Texas Board of Nursing gave the RN sufficient time to defend the complaints filed against her. However, there was a failure on the RN’s part to find the right Texas BON attorney to handle her case. The negligence of the nurse attorney led to the decision of the Texas BON to place the RN’s license under disciplinary action.
Equip yourself with the knowledge and expertise you need for a successful outcome by consulting a knowledgeable and experienced Texas BON attorney. Texas Nurse Attorney Yong J. An is one of those dedicated nurse attorneys who helped represent more than 200 nurse cases for the past 16 years. Contact the Law Office of Yong J. An 24/7 through text or call at (832) 428-4579 for a confidential consultation regarding any accusations from the Texas BON.