It’s a sad reality that there are scenarios in which nurses are incorrectly and unnecessarily disciplined. An LVN or RN license can be disciplined over simple misunderstandings and even small mistakes or situations in which they made a bad decision. When this happens to you, you should know that you need legal representation in the presence of a Houston Nurse Lawyer.
At the time of the initial incident, the LVN was employed in a hospital in Dallas and had been in that position for four months.
On or about April 10, 2016, the LVN allegedly failed to unclamp the secondary intravenous tubing through which the patient’s scheduled vancomycin was to infuse, which delayed administration of the medication. Subsequently, the patient’s morning vancomycin trough level was not within therapeutic range. Her conduct could have contributed to the injury of the patient in that failure to correctly administer ordered medication resulted in non-efficacious treatment.
On or about July 29, 2016, the LVN allegedly failed to document hourly assessments of the patient’s peripheral intravenous site, per policy. She only documented three peripheral intravenous (IV) assessments during her shift. About July 29, 2016, the LVN allegedly failed to document a complete initial set of vital signs including heart rate or respiration rate. On or about August 18, 2016, the same RN allegedly failed to document a complete initial set of vital signs including heart rate or blood pressure.
On or about August 18, 2016, the LVN again failed to perform and document the patient’s respiratory rate and sedation level every two hours as required for a patient with a Patient Controlled Analgesia (PCA) pump. In addition, she failed to document PCA total milliliters, demands, and deliveries every four hours as required for a patient with a PCA pump.
This sequence of events of the LVN’s conduct resulted in an incomplete medical record and could have contributed to the injury of the patient in that subsequent caregivers did not have accurate and complete information on which to base their decisions for further care.
On or about March 12, 2017 through March 13, 2017, the same LVN failed to place the patient on continuous heart rate and respiratory rate monitoring , as ordered. Further, she failed to document progress notes and care plans for the aforementioned patient. Subsequently, the oncoming staff member charted alarm limits for continuous heart rate and respiratory rate monitoring at 07:15 and by 07:53 was in contact with the physician for abnormal vital signs. The patient was transferred to the Neonatal Intensive Care Unit after experiencing a Code Blue.
This conduct by the LVN could have contributed to the injury of the patient by depriving caregivers of pertinent information that may have given an earlier indication of the patient’s deteriorating condition and prompted earlier medical interventions.
Because of the incidents, the Texas Board of Nursing summoned the LVN. During the hearing, the LVN states that the IV pumps at the hospital were known for causing errors in administration, especially with piggybacked medications. She states that this incident is chiefly the result of a systems error.
In response to the other incident, the LVN states that in order for nursing staff for the night shift to meet the policies dictated by administrators, appropriate staffing needed to be maintained for the acuity of the patient census, and this was not done. She states that while the day shift staff did document approximately every hour, there were four nurses involved in this documentation. The LVN states that she did not have equal resources on the night shift.
The LVN further states that initial vital signs were performed and documented on 7/29/16 at 21: 15. She states that vital signs and assessment were recorded when she realized that the Patient Care Technician had not completed vital signs prior to documentation of her assessment.
The LVN also states that vital signs for temperature and respiratory rate were noted at 20:19; however, there is no blood pressure notation. She states that the blood pressure noted by the nurse on the prior shift was tagged as high, but the nurse noted that the baby was kicking and therefore the blood pressure was not reliable.
The LVN states that she was at the bedside with the patient obtaining a complete assessment, including temperature and respiratory rate. She states that the reason a blood pressure would not have been taken was due to the baby kicking and being upset/active, such that an accurate blood pressure reading could not have been obtained.
In response to the other allegation, the LVN states that a full assessment was documented on 8/18/16 at 21:32 including respiration and sedation level. Sedation level was again assessed and documented on 8/19/16 at 00:00 and 04:00. Respirations were documented with vital signs by the nurse aide at 23:30 and 03:36. With regard to documenting PCA totals, the policy at the hospital was to clear the PCA pump totals with the oncoming nurse. The patient did not have any changes to their PCA totals after the LVN’s initial documentation which was cleared with the previous nurse. This would lead the total count to read zero (0) as was documented by the nurse on the next shift.
In response to the other incident, the LVN states that she was assigned to three (3) patients with high acuity, plus an additional patient as an admission later in her shift. She states that throughout the shift it is documented that the patient had multiple temperatures greater than 100 degrees and needed multiple increases in oxygen. She states that there was a miscommunication of orders as the doctor changed the medication order from an as-needed medication to a scheduled medication.
The LVN states that because the patient had just been given Tylenol, it was not apparent that the Ibuprofen medication was to be given immediately. Further, she states that at about the same time, he took his break and requested the Charge Nurse to cover her patients. The ordered Ibuprofen was not mentioned again until vital signs were retaken and the RN spoke with the doctor again. Ibuprofen was administered shortly thereafter.
In response to the last incident, the LVN states that she had many demands on her time due to her patient assignment and states that her documentation was not as complete as she would have liked it to be. She states that the patient was placed on pulse oximeter. Though there were oxygen desaturations during the shift, she states that she checked on the patient every time and each time the desaturation was due to the probe failing to capture an accurate reading because the baby was kicking or being held by the mother.
However, without an expert nurse attorney to prove her innocence, the LVN was disciplined and suspended.
The LVN could have defended herself by hiring a Houston Nurse Lawyer on her side. However, she failed to do so, which led to her license being suspended.
If you have been summoned by the Texas Board of Nursing, you need legal representation in the person of a Houston Nurse Lawyer. Find the right nurse attorney in Houston to help you with your needs. Contact Houston Nurse Lawyer Yong J. An directly by calling or texting him at (832) 428-5679 for a discreet consultation.