Ethridge v. Arizona State Board of Nursing

796 P.2d 899, 165 Ariz. 97, 50 Ariz. Adv. Rep. 73, 1989 Ariz. App. LEXIS 361
CourtCourt of Appeals of Arizona
DecidedDecember 21, 1989
Docket2 CA-CV 89-0132
StatusPublished
Cited by20 cases

This text of 796 P.2d 899 (Ethridge v. Arizona State Board of Nursing) is published on Counsel Stack Legal Research, covering Court of Appeals of Arizona primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Ethridge v. Arizona State Board of Nursing, 796 P.2d 899, 165 Ariz. 97, 50 Ariz. Adv. Rep. 73, 1989 Ariz. App. LEXIS 361 (Ark. Ct. App. 1989).

Opinion

OPINION

ROLL, Presiding Judge.

Appellants Phyllis Ethridge, Bettie Mazel, and Mildred Eaves appeal from the superior court’s review of the Arizona Board of Nursing’s disciplinary action. For the reasons set forth below, we affirm in part and vacate in part.

FACTS

Phyllis Ethridge, Bettie Mazel, Mildred Eaves, and three other individuals are nurses licensed by the State of Arizona and employed at Carondelet St. Mary’s Hospital and Health Center (St. Mary’s). Ethridge is the nursing director, Mazel is the unit director of the burn unit, and Eaves is a staff nurse on the burn unit. The three other individuals are a staff nurse on the burn unit, the infection control nurse, and the supervisor of all critical care units.

The burn unit at St. Mary’s is an intensive care unit with inpatient and outpatient services for burn victims. The unit has no full-time director and is staffed by attending physicians who are private doctors in the community. During 1985, several staff nurses on the burn unit complained to Ethridge and Ethridge’s supervisor about problems related to scheduling, morale, and nursing practice. Regular staff meetings were held but no hospital policies or procedures were altered.

On August 8, 1986, several staff nurses swore out complaints to the Arizona Board of Nursing (the Board). The numerous allegations were within three categories: (1) issues concerning nursing practices, (2) possible drug diversion and falsification of records, and (3) failure of supervisors and administrators to take corrective action once aware of problems. In 1986 and 1987, the Board conducted an investigation. Board staff interviewed the complainants, reviewed 8,000 pages of hospital records and policies, and interviewed the appellants. The Board filed formal charges in October 1987. In all, 20 charges were brought against six nurses.

In December 1987, four days of hearings were conducted before a hearing officer for the Board. The hearing officer sent findings of fact, conclusions of law, and recommendations to the Board. At a public meeting, on February 18 and 19, 1988, the Board heard from the nurses and considered the hearing officer’s recommendations.

On April 18, 1988, the Board issued findings of fact, conclusions of law, and an order. The Board found insufficient evidence to support the charges against one burn unit staff nurse and one infection control nurse, and sufficient evidence to support the charges against the supervisor of the critical care units. As to Ethridge, the Board found:

1. Ethridge permitted the use of “Admission Orders for the Burn Unit” in their blank form as “standing orders” when such forms had not been ordered or completed by a physician, which constituted a failure to maintain minimum standards of acceptable and prevailing *99 nursing practice. A.C.R.R. R4-19-403(1). 1
2. Ethridge failed to report Mazel’s unauthorized removal of Valium as required by A.R.S. § 32-1664(A).

As to Mazel, the Board found:

1. Mazel used “Admission Orders for the Burn Unit” in their blank form as “standing orders” when the forms had not been completed by a physician, which constituted a failure to maintain minimum standards of acceptable and prevailing nursing practice. A.C.R.R. R419-403(1).
2. Mazel permitted the use of “Admission Orders for the Bum Unit” in their blank form as “standing orders” when such forms had not been ordered or completed by a physician, which constituted a failure to maintain minimum standards of acceptable and prevailing nursing practice. A.C.R.R. R4-19403(1).
3. Mazel applied Travase, an enzymatic debriding medication, without prior physician ordérs, which constituted a failure to maintain minimum standards of acceptable and prevailing nursing practice. A.C.R.R. R4-19-403(l).
4. Mazel removed drugs from the work place without authorization and falsified an entry when she removed a vial of injectable Valium from the burn unit in order to treat a member of her family, which constituted a failure to maintain minimum standards of acceptable and prevailing nursing practice. A.C.R.R. R4-19-403(l), (10), and (13).
5. Mazel failed to properly supervise tank room attendants who were performing debriding of burn wounds, applying enzymatic debriding agents such as Travase, and using anti-bacterial creams on patients, which violated A.R.S. § 32-1663(D)(4) and A.C.R.R. R4-19402(C)(1)(b).

As to Eaves, the Board found:

1. Eaves used “Admission Orders for the Bum Unit” in their blank form as “standing orders” when the forms had not been completed by a physician, which constituted a failure to maintain minimum standards of acceptable and prevailing nursing practice. A.C.R.R. R419-403(1).
2. Eaves made an inadequate chart entry on April 23, 1985, which did not provide sufficient detail to show what activity had been performed or what actions were taken, and constituted a failure to maintain minimum standards of acceptable and prevailing nursing practice. A.C.R.R. R4-19-403(l) and (5).
3. Eaves administered Percocet-Demi to a patient without first obtaining physician orders, which constituted a failure to maintain minimum standards of acceptable and prevailing nursing practice. A.C.R.R. R4-19-403(l).

The Board found that these violations of A.C.R.R. R4-19-403 constituted unprofessional conduct pursuant to A.R.S. § 32-1663 and were cause for discipline. The Board ordered that (1) Ethridge be censured and placed on 12 months’ probation (as terms of her probation, Ethridge must obtain a passing grade in a course in medical-legal ethics and implement procedures at St. Mary’s to ensure that nursing staff do not administer medication without a prior order from a physician); (2) Mazel be censured and placed on 12 months’ probation (as terms of her probation, she must obtain passing grades in a medical-legal ethics course and submit quarterly reports from her supervisor to the Board, pertaining to her work performance); and (3) Eaves be censured.

Ethridge, Mazel, and Eaves appealed the Board’s decision to the Pima County Superior Court. The trial court found that substantial evidence existed to support all violations. The court, however, ruled that conclusions of law numbers 2 and 3 were invalid because Ethridge, Mazel, and Eaves had not been charged in the complaint with a violation of A.C.R.R. R4-19-403(l) through using or permitting the use of blank “Admission Orders for the Burn *100 Unit” as “standing orders.” 2

The trial court also found that A.R.S. § 32-1663(D)(4) and A.C.R.R.

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Cite This Page — Counsel Stack

Bluebook (online)
796 P.2d 899, 165 Ariz. 97, 50 Ariz. Adv. Rep. 73, 1989 Ariz. App. LEXIS 361, Counsel Stack Legal Research, https://law.counselstack.com/opinion/ethridge-v-arizona-state-board-of-nursing-arizctapp-1989.