STATE OF FLORIDA BOARD OF NURSING

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IN RE: THE PETITION FOR DECLARATORY STATEMENT OF

SANDW SCHELLHORN, RN.

FINAL ORDER

THIS MArtER came bfcm the Ewrd of Nvnlng mrd*) pursuant to Section 120.565, Florida

m m . at a duly-n0tlced publlc meetlng held in Orlando, Florida, on February 13,2003. for the purpose

of conaWerlng tha P d h n for Dedaretwy Statement filed by Sandra Schellhom, R.H.. Dlrectw of

Mursmg. Baptisl Medical Ceder. JacksonvAle. Florida rPetmmf). Notice of the petition was published

in Um FloMa Adrnlnbtrdw Weakly on F- 7.2003, a4 Volume 29, Number 8. The nc?ke Wlted

fiat the ptitim was filed by 'Baptist Mdlcal Center.' Having considered the won, the Board makes

the following Mdlngs end wnduslons.

I. Petitioner la a Registered M u m l i n s e d to pracHoe nmlng In the state of Florida.

2. W i 464.OW(3)(a), FMda St-. defines the practke of pmfessbnal nursing as W

performance of those acts requlrlng substantla1 mlal lzed knowledge. judgment, and nursing sklB based

upon apptled principles d psyehologbl, bblogkal, physlml, and sochl selenm whlch shall Indude, but

not be- l k n i to:

'1. The dmwatbn, assessment. nvtaing dtagnnmis, plmnlng, !nbmmtim, and evaluatbn of care; heam teaching snd counseling of the Ill, hjursd, or Infirm: and me promotion of wellness, maintenance of health, and prevention of Illness of ohm. -2. The admlnisbation of rnedkations and lreaimenh as pnrsulbed w authwized by a duly l'licensed practitioner authorized by the lews d thLs state to prescrtbe such rnedlcatlons and treatments.

'3. ~ ~ i o n m d t m c h i n g o f m p e r s o n n e l h Z h e t h e w y a n d prfonnance of any of the abwe acts."

3. S d h 464.012(4)(a). FIwlda Statutes, pmvWea hat 8 CerWied RegM6md Nurse AResthetlst (CRNA) may, to the extent swthorlzed by eslabllshed protom! appmved by the medlcal staW of the facili!y In w r h i me armthetlc serv6cg Is pwfmed. peffom any or all d h e following:

"I. Determhe the health mius of me patlent as a Mates to the nsk fsctors and to the amshetic msnegmsnt of Ihe patient ntmugh the perform- of the general functions.

"2. b e d on blstory, phyaleel sssessment, and supplemental labomtor)r mmlts. determine, wlth the m w n t d ths mponslble phyaiclan, the appropriate type of anesthesia wlthin the frernework of the protaco].

Y. Fwhm under the pmtwml pmmckm commonly u d to render the petlent ktsenslble to pain during the performance OF sumlcel, d$gbtrbl. therapeutic. or diagmstic clinial pmeedures, Thm pr-dures include ordering and adrninlslenng regional, spinal, and general anesthes~a; inhalation agents and bchniques; Intramnous wants and techniques; and techniques of hypnos~s.

3. Ordw w perform mnltwlng p*ocedum M M d as pwl$mit !a the snasthetlc heaRh cere management of the pa2tent.

V. S u m IR functions during anesthesia heab care, hcludlng inducton and Intubatlcn procedures, the use of approprlale mechanical supportive devices, and the management of Ruld, etectmlyte, and b l d mponen t balances.

7. Re~~gnlze and take appropriate Ewredtve actlon lor abnormal p M i i responses to anesthesia, Bdjunctlw medication, w other fms of therapy.

"8. Reqnlza and a cerdlac anhymrnla while the patient is under anesthetic care.

8, PerWpte In management of Iha patient whlk In Zhe postandhesla recowry area, lncludlng ordering the adrninlatratian of RuWs and drugs.

'10. P b speclal peripheral and canid m u s and arterial llnes for

Mod samphg md monhting as appropriate.'

4. Dlprl- Is an intravenous aedatlvdhypnotlc agent and is lndimted for InduEtlrxl and

rnalntenmm d gemml snesthmla In d u b ; d u l l M o n h monkxed anesthesle cam Intmshre cam

IlrnMom): mmamslhesb: and Eerdlsc anesthesia.

5. pewloner asks Iha fdlowfng quesuons:

a. l a M w l t h l n I h e ~ ~ ~ ~ ( ~ o f p r e c l i O B f o r s ~ U & n ~ w h o I s R o t a CRNA to admhlster Dlpriwn (propofol) foa the purpose of sedation to a rnonbred, Inhrbated and machanlcal!y ventilatd patient who is l-ed h an Inlenslve care sehng, pursuant to e verbal or mitten order given by a ficensed independent praetit~oner?

b. Is R wHhln the smpe of prectlce for a feglstered nurse who is not a CRNA to monitor mn lntvbated and mecttanlcally ventlleteu patlent mhring Qlprlvm (pmpofol) for the purpose of sedation, pursuant to a verbal w wrttten order given by licensed independent praetitiiner?

FONGLUsloruS OF LAW

8. The B o d has juriedMlon over thls m a w pwsuant to M o n 120.S5, norlda Statutes, and

Chapter 284, F l M a AdminlsWhre Code.

7. The Board an- both of tJw Petikada questions In Wt flnnath, pswided Ih9t the

registered nurse is Wried and c&lRed In Advancad Cardim Life S u m and Is tdlowlng Ihe

mbbllshed pollcles and pmaedureg of the Wity where the nurse parfwms Ihe ads Indited.

8. This Order constbtw Rnal agency adbn and may bs a p p d d by any party pursmnt to

Section 120.88. Florida StaMes, 6nd Rules 9.1 10 and g.lD0, Florlda R u k of AppdAppeltele P r d u n r . by

Wlng a ndca of appeel conforming to the requlrsments of Rulm 9.1 IO(d). FlorWa Rules of Appallate

-a, both with the appropriate Dktrkt Court of A p p l , a m p a n l e d by tlx~ qqmprlate Rllng fee.

and wilh the depment's clerk d agency proesedings. wsthln thlrty (SO) days of mndltim of Lhls Ordw.

WNE AND ORDERED this a d a y of a 2003.

BOARD OF NURSING

Dan Coble. EmCU%-e Dlrectur

CERTIFICATE OF SERVICE

I HEREBY CERTIFY mat a lnm and Gwrect copy of the f o e was fumlshed by U.S, Mall to

Barbara Maalrour-SmHh, R.N., 800 Prudential Orhe, Jacksonville, Florida 32207; and to Sunan B. Bodell,

Assistant Attorney G m t , office d the Attorney General, PL-OI The Capltol, Tellahasrpee, Florida

32394-1050, Ihla - day d ,2003,

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BAPTIST MEDICAL CENTER -I 1 1 . : ~ .

100 Prudentiri Dtivc 1.etronvilla. FL 32207

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