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All LVN or RN is under the jurisdiction of the Texas Board of Nursing (BON). All complaints or cases concerning the practice of their license are lodged before the Texas Board of Nursing (BON). Thereafter, the members of the Board will hear the case and decide on the issues or matters submitted for resolution. The parties charged are given the opportunity to be heard with the help of a nurse attorney. This is part of their right to due process.

From the time of the incident on or about January 3, 2018, through January 25, 2018, while employed as a PACU nurse at a hospital in Frisco, Texas, RN withdrew Hydromorphone, Promethazine, and Fentanyl from the medication dispensing system but failed to follow the facility’s policy and procedure for the wastage of any of the unused portions of the medications. The RN’s conduct left medications unaccounted for was likely to deceive the hospital pharmacy and placed the pharmacy in violation of Chapter 481 (Controlled Substance Act) of the Texas Health and Safety Code.

And on or about January 26, 2018, while employed as a PACU nurse, the RN administered excessive Fentanyl, Meperidine, and Hydromorphone to a patient and failed to assess and intervene appropriately when the patient suffered respiratory depression. As a result, no interventions were provided until the
nurse who received the patient on the medical/surgical unit administered Narcan. The RN’s conduct was likely to injure the patient in that the administration of medications in excess frequency and/or dosage of the physician’s order could result in the patient suffering respiratory depression.

Then on September 26, 2018, the RN was evaluated by an expert doctor in which the doctor states that based on available evidence and testing, the RN does not have a substance use disorder and is not in need of recovery. Her history, which appears to include an otherwise stable nursing work history
suggests that the issues that arose were likely more situational than due to deficits on her part.

In regards to the incidents above, the RN states that the medication administration record and Pyxis did not accurately record when she scanned the medication. And the RN states that the patient was screaming in pain and that she kept administering narcotics in order to keep her comfortable and calm.
After administering multiple doses of narcotics without success in controlling the patient’s pain, the RN states that she notified the physician and obtained an order for patient-controlled analgesia (PCA) of Hydromorphone. The RN states that she pushed the button to administer the PCA narcotic twice. However, she failed to follow the physician order to turn off the PCA, apply oxygen, and administer Narcan for respirations less than 8.

As a result, the RN was disciplined by the Texas Board of Nursing and will be receiving further sanction. The discipline and the sanction were based on and are caused pursuant to Section 301.452(b)(10) & (13) wherein the evidence received by the Board were sufficient to prove the RN’s violation(s).

If you have questions about the Texas Board of Nursing disciplinary process? Contact The Law Office of nurse attorney Yong J. An for a confidential consultation by calling or texting 24/7 at (832) 428-5679 and ask for nurse attorney Yong.