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An experienced nurse attorney has surely helped a lot of RNs and LVNs when it comes to cases that may lead to disciplinary action. Unfortunately, not all nurses were able to hire a nurse attorney as they underwent such cases. This incident that an LVN committed on December 16, 2016, was one of those examples.

One of the RN’s many responsibilities is to record and properly monitor the patient as well as to accurately and precisely document the patient’s condition such as vitals, medication, dosage, reactions, etc. When done improperly, the patient can suffer severe consequences with the most extreme being death.

However, an LVN from Houston failed to do so which resulted in disciplinary action from the Texas Board of Nursing.

According to the complaint, the LVN failed to call the physician herself, and/or call Emergency Medical Services (EMS) when a patient experienced a change in condition to include: swelling in her neck and complaints of difficulty swallowing and breathing. Instead, the LVN contacted the LVN ADON, who then contacted the physician and obtained an order for an antibiotic. Six (6) hours later, the resident was transferred to the hospital for a higher level of care at the family’s request and treated for cellulitis in her neck/face. Her conduct was likely to injure the resident from a delay in medical intervention, and independent medical decisions made by a Licensed Vocational Nurse.

The Texas Board of Nursing has full jurisdiction over all cases regarding errors committed by an RN or LVN. Thus, she was called by the Board to defend against the case. In response to the incident, the LVN states that she came on duty at 0600 in the morning on December 18, 2016, and nothing was given in the report on the patient. She states that at approximately 0700, she assessed the resident and noted that the resident had slight swelling to the left side of her face that was red and warm to touch.

The LVN states that she notified the weekend on-call Licensed Vocational Nurse (LVN), who then notified the Director of Nursing (DON). She states that the DON followed up with her, she informed her of the findings, and no new orders were received at that time. The LVN states that the resident remained in bed, which was unusual, did not eat breakfast and refused pain medication as she was in too much pain. She states that at 1130, she assessed the resident again and per facility protocol, she notified the LVN of the condition change, who then notified the doctor and obtained an order for Rocephin.

The LVN states that the resident’s pain did not subside and the swelling continued to the left side of her face and began to spread to her left ear, across the front of her neck and right side of her face. She states that the LVN was again notified of the condition change, and instructed Respondent to follow her nursing judgment. The LVN states that the resident’s Power of Attorney was notified of the condition change and informed that the resident would be sent to a medical center for further evaluation. She states that she was in the process of determining how the resident would be shipped when the resident’s niece said she wanted the resident to go via ambulance. The LVN further states that the resident’s niece called 911 herself and the resident was out of the facility at 1335.

The following incident and defense against the case caused the Texas Board of Nursing to place the RN and her license into disciplinary proceedings. She would have sought assistance from a good nurse attorney to provide clarifications towards the case.

If you’ve ever done any errors during your shift as an RN or LVN, and you wish to preserve your career and your license, an experienced nurse attorney is what you need. Nurse Attorney Yong J. An, an experienced nurse lawyer for various licensing cases for 14 years, can assist you by contacting him at (832) 428-5679.