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The Texas Board of Nursing (BON) is known to be very strict when it comes to all actions of nurses, which is why a nurse attorney is needed when attending hearings before the Board. The Texas Board of Nursing does not allow those who wish to exceed the scope of their practice as an RN or LVN. A certain LVN in Texas could’ve done this but failed to hire a good nurse attorney.

At the time of the incident, an LVN was employed as a Licensed Vocational Nurse at a medical facility in McAllen, Texas, and had been in that position for three (3) years.

On or about January 7, 2019, while employed as a Licensed Vocational Nurse, the LVN failed to timely intervene and report a change of condition to the Physician or Nursing Supervisor, for a patient, during a home nursing visit. The parent of the patient reported to the LVN that the patient had been lethargic and vomiting excessively over the weekend and the parent held the patient’s chemotherapy medication due to the vomiting. The LVN then documented that the patient’s abdomen appeared concave, she had coarse lung sounds, increased mucus secretions, and an increased temperature, and had abnormal vital signs including respirations of sixty-six (66), a heart rate of fifty-eight (58), a blood sugar of forty-eight (48) milligrams per deciliter. Approximately an hour later, the patient had a seizure at which time Emergency Medical Services (EMS) were activated and the patient became unresponsive; EMS arrived and at that time the patient had a glucose level of seventeen (17). Resuscitation efforts were unsuccessful and the patient expired. The LVN contacted another nurse outside the facility rather than a nurse at the facility for documentation advice, only. The LVN’s conduct may have deprived the patient of timely intervention.

In response to the incident, the LVN states that the patient’s parent informed her that the patient had excessive vomiting throughout the weekend, and that the parent had held chemotherapy. The LVN states that it was not uncommon for the patient to have frequent vomiting, due to the chemotherapy. The LVN reports that she noticed the patient was also lethargic, which was also not uncommon for the patient since she had started her chemotherapy, and she frequently slept most of the day. She also states that the parent informed her that lorazepam had been given to the patient and that there had been no vomiting the previous night or prior to her arrival. The LVN states that given the patient’s normal behavior and with the parent stating he had given her lorazepam; she states that she was not alarmed at this time. The LVN states that she advised the parent that they should go to the emergency room. She reports that the parent stated that the patient was not having any new symptoms, but if anything changed, he would take her to the emergency room. She states that she decided to take the patient’s blood sugar, which was not the normal routine.

And also states that the parent administered apple juice for the patient’s low blood sugar. In addition, she reports that this was the last testing strip available, so she was unable to recheck the blood sugar. And that she again suggested to the parent that they should take the patient to the hospital. She noticed the patient had a moderate amount of secretions, which was not uncommon. She suctioned the patient and at that time the patient began biting on the suction. The LVN states that after the removal of the suction, the patient continued to clench her teeth and turned to her left side. She states that it appeared the patient was having a seizure. And that she reassessed the patient, and she was no longer breathing, at this time she immediately called 911 as she moved the patient from the couch to the floor and began cardiopulmonary resuscitation (CPR). She continued CPR with 911 on speakerphone listening to her counts. She reports that upon Emergency Medical Services (EMS) arrival, EMS took over. And lastly, she states that she called the on-call service at Special Kids Care to report the incident.

As a result, the Texas Board of Nursing decided to sentence her LVN license to disciplinary action to ensure that she will never commit such negligence again. She failed to defend herself as she did not hire a nurse attorney to help and assist her with the case.

The case would have yielded a different result if the LVN was able to hire a nurse attorney. So if you also have the same cases or concerns, it’s best to contact Nurse Attorney Yong J. An, for further details. You may contact him at (832) 428-5679 to get a schedule for a confidential consultation.