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MUNCIE, Ind. — A nurse who was accused of diverting morphine and other pain-killing opioids from IU Health Ball Memorial Hospital has been judged safe to practice after presenting exculpatory evidence.
“She was not terminated for diversion; the attorney general jumped to that conclusion,” attorney Lorie Brown, who represents registered nurse Christina Hall, told the Star Press. “ … not everything the state alleges is necessarily true.”
Brown also criticized the hospital for not intervening sooner after red flags were raised about Hall’s practice.
The attorney general’s office filed a complaint asking the state nursing board to take disciplinary action against the Muncie nurse’s license, citing eight pages of allegations, such as:
Hall withdrew six syringes of morphine for a patient over a three-day period when no other nurses withdrew morphine for the patient. During another three-day period, Hall withdrew eight tablets of the pain killer hydrocodone for a patient when no other nurses withdrew any hydrocodone for the patient.
Hall called a patient’s doctor and obtained and documented administering an order for morphine when the patient’s nurse left for lunch. The patient had told the nurse who left for lunch that on a scale of 1 to 10 his pain level was zero. The patient denied receiving morphine from Hall.
An audit showed Hall withdrew several tablets of morphine, oxycodone and hydrocodone, plus four vials of morphine, that were not documented as administered, wasted or returned.
Other nurses reported that Hall was impaired on duty; during a two-month period, she failed to clock back in after lunch break on half of her shifts; she volunteered to give narcotics to other nurses’ patients; she took bathroom breaks up to 45 minutes long and lunch breaks lasting more than two hours, after which she stared into space; on other occasions, she sweated profusely, slurred her words, sang, twirled another nurse’s hair and could barely keep her eyes open.
Hall’s name appeared on a “proactive diversion report” after she made a large number of withdrawals of morphine from an automated medication dispensing station.
While the hospital fired Hall on Dec. 10, 2015, it was not for diversion but for unsafe/reckless practice and falsification of patient records, attorney Brown noted.
IU Health BMH had an obligation when it fired her to perform a drug test, but failed to do so, according to Brown. “Had they performed such a test, the urine would have been negative … indicating that she had no substance use or abuse problems and no diversion,” the attorney told The Star Press.
What’s more, on Jan. 29, 2016, about six week after she was terminated, Hall was assessed for substance abuse, and, despite previous long-term opioid use, was found not to have a substance abuse disorder, the attorney general acknowledged. Additionally, Hall submitted to a hair drug screen, which detects drug use over approximately the previous 90 days, on March 11, 2016. The results were negative. (Hall had been fired 92 days before the hair drug test).
More recently, Hall again was assessed for substance abuse, by Parkdale Center for addicted professionals, this past March 27, and was found to be safe to practice and did not warrant a narcotics’ restriction.
Hall is not claiming to be a perfect nurse but wants it to be known that she denies the diversion allegations and they were never proven, Brown said. After being fired by IU Health BMH, Hall was employed by another hospital system and is “doing great,” her attorney said. Hall had worked for IU Health BMH since 2013. The hospital became suspicious of her practice eight months before firing her.
A licensed nurse herself, Brown, who specializes in representing nurses, said, “The hospital wasn’t properly supervising its employee for letting this go for so long. I see this all the time. They wait so long. So does the attorney general.” Had the hospital addressed the concerns right away, “they could have kept a good employee and helped her to meet standards,” Brown said, “instead of waiting until they gather all of this evidence and saying goodbye.”
If a nurse is impaired, the sooner she or he is caught the better, Brown says. It reduces turnover, gets nurses into recovery faster, lowers the risk of harm to patients, and lowers the liability of malpractice, Medicaid/Medicare billing fraud, etc., the attorney says.
IU Health BMH declined comment.
The attorney general and Hall reached a settlement that called for her to be placed on probation for two years, pay a $250 fine, enter into a recovery monitoring agreement with the Indiana State Nurses Assistance Program (ISNAP), complete 12 hours of continuing education in medication administration and 12 more hours in ethics, and submit various reports to the nursing board.
Hall stipulated in the agreement that she used unsafe judgment in obtaining an order for morphine for a patient who had zero pain scores, repeatedly failed to document the administration or waste of controlled substances, unsafely engaged in a pattern of giving patients oral an intravenous pain medications at the same time, and falsely documented that patients had a two-point pain-scale reduction within minutes of receiving oral narcotics.