Case Studies

The case studies listed below are actual cases that have come before the Board.  Although disciplinary action taken by KBN is a matter of public record, the identity of the nurses are not revealed.


Case Study #1

CASE:

Nurse M asked Nurse A if she had any medication for a headache. Nurse A tells nurse M “yes”, she has some Advil in a brown bottle in her purse in her locker. Nurse M gets two (2) white pills from Nurse A’s purse which looked very similar to the Advil she takes at home. She takes her colleague’s medication and starts having difficulty focusing on her work and cannot keep up with her patients’ treatments, care or charting.

Nurse M’s nursing supervisor questions her about her unusual behavior, and asks her to provide a “for cause” or “fitness for duty” urine drug screen (UDS). Nurse M denied using any mood altering medication or taking any medications from the facility. The nursing supervisor sent Nurse M home until an internal investigation had been completed.

Nurse M was terminated from her nursing position because she had a positive UDS for Hydrocodone. She did not have a prescription for this drug. Nurse M had mistakenly taken two Hydrocodone from Nurse A’s purse that she assumed were Advil. Nurse A had been prescribed Hydrocodone for a back injury.

Nurse M was reported to the Kentucky Board of Nursing for violating the Kentucky Revised Statutes KRS 314.031; 4 (h) (j) which are the Kentucky Nursing Laws.

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Case Study #2

CASE:

Nurse C had a bad cold, headache, and a productive cough for seven days with no improvement. She called a friend of hers who was an APRN and asked if the APRN would give her something for her head congestion and cough.

The APRN asked if she had a fever and about the color and consistency of her sputum and/or drainage. Nurse C stated she was not running a fever and her sputum was thick and green in color.

The APRN told her to take over the counter Mucinex D twice daily and she would call in a prescription for an antibiotic. The APRN called in Amoxicillin 500 mg twice a day for five days for a sinus infection and cough as well as Tussionex to take every twelve (12) hours for her productive cough.

An APRN cannot prescribe medication without examining a patient and without having an established patient /healthcare provider relationship as well as a medical record for the patient she /he is treating.

This is a violation of the Kentucky Administrative Regulations 201 KAR 20:057 the Scope and Standards of practice of the advanced practice registered nurse and 218 KAR.

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Case Study #3

CASE:

Nurse Z was experiencing multiple stressors at home including the fact that her husband was unemployed and her seventeen year daughter had started drinking alcohol and had been arrested for drinking while intoxicated (DUI). Nurse Z was having difficulty sleeping and her healthcare provider prescribed Ambien 10 mg to take every night for sleep.

Nurse Z had been taking the Ambien for approximately two months. One night after she had taken the Ambien she received a phone call from the police that her daughter had been arrested for another DUI and possession of drugs. Nurse Z decided to drive to the police station. On her way to the station she was pulled over by the police for swerving all over the road while driving. The police arrested Nurse Z and took her to jail.

Nurse Z awoke the next morning in jail and had no memory of any of the events that occurred the night before or why she was in jail.

This arrest was reported to her employer and she was terminated from her nursing position of twelve years and reported to the Kentucky Board of Nursing.

Nurse Z had heard stories about the side effects of memory loss and strange behaviors that occurred while taking Ambien but never thought it could happen to her. She did not follow the warning about driving while taking this medication.

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