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Nursing documentation must provide an accurate, complete, and honest account of the events that occurred, and medications administered to the patient. Any false or tampered information can lead to a disciplinary action from the board, suspension or worst revocation of RN/LVN license. If this happens, you need to seek the right nurse attorney to defend your case.

At the time of the incident, she was employed as an RN at a health care facility in Irving, Texas, and had been in that position for four (4) years.

On or about January 20, 2020, while employed as an RN at a health care facility in Irving, Texas, RN exceeded the scope of her Practice when she administered a bolus of fentanyl to a patient without a physician order. In addition, RN failed to document the administration of the fentanyl bolus. Subsequently, the aforementioned patient’s blood pressure dropped necessitating additional interventions, including the administration of vasopressor medications, fluid boluses, and albumin. RN’s conduct could have contributed to injury to the patient in that the administration of medication without a physician’s order resulted in non-efficacious treatment. RN’s conduct resulted in an inaccurate medical record and could have contributed to injury to the patient in that subsequent caregivers would not have accurate and complete information on which to base their decisions for further care.

In response, RN states that she started her shift receiving a report on the patient from the off-going nurse at the nurse’s station, however, they moved to the patient’s bedside as the patient became agitated. RN states that the patient did not seem to respond to the upward titration of fentanyl that the nurse had previously administered, so RN titrated and increased   the dose of versed. RN states that the patient’s blood pressure was within normal limits. RN states that she and the other nurse discussed increasing the dose of fentanyl, so she went to retrieve the key from the charge nurse desk where she explained the situation to both charge nurses present. RN states that the other nurse called from the patient’s room to let her know that the key was still at the bedside. RN states she used the charge phone to call the hospitalist to obtain restraint orders and proceeded back to the patient’s room. RN states that the other nurse proceeded to administer a versed bolus, however, the patient remained agitated. RN states that she verbalized to the other nurse that she intended to administer a bolus of fentanyl, rather than titrate the fentanyl drip any further at that time. RN states that she opened the syringe chamber, held it up to eye level, and pressed the plunger down until she had administered I ml or 50 mcg of fentanyl. RN states that the patient calmed down, but her blood pressure began to rapidly drop. RN states that since the patient was still hooked up to levophed, which the other nurse had turned off, she restarted the levophed and decreased the doses of fentanyl and versed. The Charge Nurse immediately assisted RN in notifying medical providers and receiving additional orders to increase the patient’s blood pressure with IV fluid boluses and albumin.

The above actions constitute 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)(C),(1)(D)&(1)(P) and 22 TEX. ADMIN. CODE §217.12(4).

However, without enough evidence to prove she’s not guilty, the RN lost the case. This is the reason why the Texas Board of Nursing placed her RN license under disciplinary action. 

Do not be stressed or anxious if you find yourself in a similar situation as that of the RN mentioned above. All you need to do is to find the right RN/LVN license attorney who can help you in the case. Equip yourself with the knowledge and expertise you need for a successful outcome by consulting a knowledgeable and experienced Texas RN/LVN license attorney. Texas Nurse Attorney Yong J. An is an experienced nurse attorney for various licensing cases for the past 16 years and represented over 300 nurses before the Texas BON. Contact the Law Office of Yong J. An 24/7 through text or call at (832) 428-5679.