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The practice of the nursing profession can become challenging and demanding all at the same time. An RN in Texas needs to follow several rules and regulations to prevent suspension or revocation of her RN license. In the past, several cases were filed against different nurses for misconduct and gross negligence which may have put their RN license in danger. Therefore, nurses need a nurse attorney to defend their case.

On or about September 20, 2019, while employed as the Director of Nursing (DON) at a skilled nursing and rehabilitation facility in Corpus Christi, Texas, RN was accused of the following:

  1. RN failed to conduct a complete investigation after it was reported that six (6) mL of Morphine was missing from the medication bottle of a resident. Specifically, the charge nurse informed RN of the missing Morphine and  that she had witnessed another nurse administering one half of a medicine cup full of Morphine to the resident on the previous day. RN then commenced an investigation and concluded that the missing Morphine was due to leakage, before speaking to the administering nurse and other staff. There was no evidence of leakage. Additionally, RN failed to properly document the incident and did not notify leadership until one (1) month after it occurred. Subsequently, the patient had a change in condition and expired three (3) days after the medication error. RN’s conduct was likely to injure the resident from adverse reactions to possible overdose of medication going unaddressed.
  2. RN failed to discipline or re-educate a nurse after RN was informed that the nurse administered one half of a medicine cup full of Morphine to a resident. The nurse admitted that she “eye-balled” the dosage before administering it to the patient. RN’s conduct placed patients at risk of harm from inappropriate nursing care due to lack of knowledge and education.

In response, RN states that she received a call from the dayshift charge nurse that her shift-to-shift narcotic count was not correct regarding morphine for the resident, missing approximately six (6) to seven (7) mL. RN states that the charge nurse reported that the previous day she had watched another nurse administer to the resident a full cup, approximately thirty (30) mL full of morphine. RN states that the change nurse stated that she did not report the alleged overmedication to anyone. RN states that at that time RN informed the administrator about the situation. RN states that the resident in question was placed on an actively dying status prior to the alleged medication error and was receiving daily hospice RN visits and was being monitored by facility staff. RN states that she notified the Hospice Director of Nursing (DON) the following day and discussed the allegation with her. RN states that she provided a timely update of the investigation to the administrator and consultant pharmacist, and it was determined that the missing medication was due to leakage from around the bottle stopper. RN states that she spoke on the phone with the nurse who administered the medication to the resident. RN states that the nurse reported that she gave the appropriate dose of morphine and documented it on the controlled count sheet and medication administration record, which RN states she verified. RN states that she spoke with the DON from Hospice, who let her know that her team had met with the medical director, and they agreed that it was not physiologically possible for the resident to receive six (6) mL of morphine and be awake in the therapy gym approximately one (1) hour later. RN states that she notified the administrator and the consultant pharmacist of her conversation with the Hospice DON. RN states that no disciplinary action was taken against the nurse who administered the medication for her part in the investigation because at no time did RN verify that there was a medication error. RN states that the count sheet was documented as correct before and after the nurse’s shift.

The above action constitutes grounds for disciplinary action in accordance with Section 301.452(b)(10)&(13), Texas Occupations Code, and is a violation of 22 TEX. ADMIN. CODE §217.11(1)(A),(1)(B),(1)(D),(1)(P)&(1)(U) and 22 TEX. ADMIN. CODE §217.12 (1)(A),(1)(B),(1)(C),(2),(4)&(6)(H).

Unfortunately, the Texas Board of Nursing found her guilty of her deeds. Her RN license was subjected to disciplinary action. She did not hire a skilled Texas BON attorney to fully defend her case which led to this decision by the Texas Board of Nursing.

Do you have questions about the Texas Board of Nursing disciplinary process? Contact The Law Office of Texas Nurse Attorney Yong J. An for a confidential consultation by calling or texting 24/7 at (832) 428-5679. Texas Nurse Attorney Yong J. An is an experienced nurse attorney who represented more than 300 nurse cases for RNs and LVNs for the past 16 years.