ALJDEC

98A-9606123-NUR · State Board of Nursing · 2000-07-19

IN THE OFFICE OF ADMINISTRATIVE HEARINGS

HEARING: July 12, 2000. APPEARANCES: The Arizona State Board of Nursing was represented by Assistant Attorneys General Mona Peugh-Baskin and Marc Harris. Respondent Greta Louise Eveland appeared personally.[1] ADMINISTRATIVE LAW JUDGE: Brian Brendan Tully _____________________________________________________________________ Evidence and testimony were presented and, based upon the entire record, the following Findings of Fact, Conclusions of Law and Recommended Order are made:

FINDINGS OF FACT

1. The Respondent, Greta Louise Eveland, was issued professional nurse license number RN042493 by the Arizona State Board of Nursing (“Arizona Board”). 2. Respondent was issued License No. 22220 to practice as a registered nurse in the State of Nevada by the Nevada State Board of Nursing (“Nevada Board”) on March 28, 1992. 3. On or about April 22, 1992, Respondent, acting in her capacity as a registered nurse working at Carson-Tahoe Hospital in Nevada, ordered blood gases on an infant patient without consulting or obtaining an order from the infant’s attending physician. 4. Subsequent to April 22, 1992, Respondent admitted that she was an alcoholic and had been diagnosed with probable alcohol abuse disorder. 5. On or about April 30, 1992, Linda Hoover, the assistant administrator of Carson-Tahoe Hospital, notified the Nevada Board in writing expressing concerns about Respondent’s clinical judgment and mental ability based upon her conduct. In addition to reporting that Respondent had ordered blood gasses on an infant without contacting the attending physician, Hoover also reported that at or about 8:30 a.m. on April 22, 1992, the hospital manager on duty contacted Respondent at her home to discuss the complaint. The manager was later contacted by another staff nurse who reported that she had spoken to Respondent for approximately two hours that day and who expressed concerns about Respondent’s safety. At approximately 4:00 p.m. on that date, the manager again contacted Respondent by telephone and noted that Respondent’s speech was slurred, that she had difficulty discussing the situation, that she was very angry and that she discussed many unrelated incidents. During that same day, Respondent had called several staff nurses and expressed suicidal ideations. Because the manager was very concerned about Respondent’s safety and her own, she contacted the Carson City Sheriff’s Department so that Respondent could be evaluated. 6. On or about June 9, 1994, the Nevada Board issued a complaint and notice of hearing alleging that Respondent had committed an act of unprofessional conduct when she ordered a laboratory blood gas test on an infant without contacting or obtaining an order from the infant’s physician. The complaint and notice of hearing informed Respondent that a disciplinary hearing before the Nevada Board would commence on July 13, 1994, at 8:30 a.m. 7. On or about June 29, 1994, Respondent, who was represented by legal counsel, voluntarily surrendered her Nevada nursing license in lieu of proceeding to formal disciplinary hearing. There is credible evidence that both the Respondent and her attorney were informed that the voluntary surrender of Respondent’s Nevada nursing license in lieu of formal disciplinary hearing was treated as a disciplinary action by the Nevada Board and that it was reportable as such to the National Council of State Boards of Nursing disciplinary data bank. 8. On or about February 16, 1995, Respondent submitted a biennial renewal application to the Arizona Board. Respondent answered “no” to the following application question:

“Since your last renewal has any disciplinary action, consent order or settlement been imposed or is any action pending on your license in any state (including Arizona) or jurisdiction? If yes, explain on a separate sheet of paper and enclose relevant documents.”

Respondent failed to disclose that she had voluntarily surrendered her Nevada nursing license in lieu of formal disciplinary hearing, which constituted a reportable disciplinary action. 9. On or about April 9, 1996, the State of Washington Department of Health Nursing Care Quality Assurance Commission (“Washington Commission”) issued an Interim Order requiring that Respondent, whose Washington nursing license had expired on February 15, 1996, obtain a psychiatric/psychological evaluation within 60 days. The Washington Commission found that it had reasonable grounds to believe that Respondent suffered from a mental condition rendering her incapable of practicing nursing with reasonable skill or safety. The Washington Commission further found that Respondent experienced unwarranted fears of past and future persecution by professional disciplinary boards, law enforcement and co-workers. Respondent failed to comply with the Washington Commission’s Interim Order. 10. Between October of 1995 and June of 1996, Respondent telephoned Deputy Attorney General for the State of Nevada, Keith Marcher[2], and left multiple voice mail messages. On four occasions, Respondent left approximately 25 messages during the night. In her voice mail messages, Respondent called Marcher a “nurse killer” and stated that he had “ruined her life”. Respondent’s speech was rambling, incoherent and repetitive. Respondent’s speech became more incoherent as she spoke and her words became slurred. The Board introduced into evidence as Exhibit 8 audio tapes of voice mail messages left by Respondent for Marcher. The portions of those tapes played during the hearing containing Respondent’s voice were chilling. 11. In a July 1, 1996, letter, Respondent was informed by the Arizona Board that a complaint was received against her Arizona professional nursing license. 12. Between July 3, 1996, and February of 1998, Respondent called the Arizona Board Office approximately 60 times. On approximately 25 occasions, Respondent left lengthy voice mail messages for Arizona Board staff. Respondent’s statements were rambling, disjointed, incoherent and inaudible at times. In some of her messages, Respondent was crying. The messages included statements by Respondent that she had attempted suicide on two occasions, that she suffered from depression and post-traumatic stress syndrome, that she wanted to die, that she was being slandered by state boards of nursing, that she was a victim and that she was being persecuted by boards of nursing because she was a victim. 13. On or about July 3, 1996, Respondent, in response to the Arizona Board’s July 1, 1996 letter, called the Arizona Board and left six lengthy voice mail messages at 10:59 a.m., 11:28 a.m., 1:29 p.m., 4:32 p.m., 4:44 p.m., and 5:00 p.m. In those voice mail messages, Respondent’s statements were disjointed, rambling, incoherent and inaudible at times. 14. Respondent’s 10:59 a.m. voice mail message stated in part:

“I have a suicide attempt from two years ago because I just couldn’t get on with my therapy, knowing that I was beaten and raped and I’m suppose to say that there is another patient involved here. There was no other patient, its me…So, I will be glad to meet with you, show you my documents from the FBI, Equal - United States Equal Opportunity Employment, the White House, I mean this has gone, the Nursing Commission, I have voluntarily surrendered expired nursing licenses to the State of Nevada and the State of Washington, just to say, listen you fools, I am tired of this.”

15. In the July 3, 1996, 11:28 a.m., voice mail message left by Respondent for the Arizona Board’s staff, she stated in part:

“In the past 4 ½ years five people in my life have died and its such a coincidence that every time somebody dies or something bad happens then I get notified by the Nursing Boards and I’m really tired of thinking that there are other people more important in life than my friends and family…”

16. In the July 3, 1996, 1:29 p.m., voice message Respondent stated in part:

“ Judy, its Greta again, I forgot to tell you that one of the reasons why [in audible] was pissed at me is because I am friends with the President of the State Bar, Mr. Steve DeForrest [inaudible]. I went river rafting with him, I was the nanny for one of the most famous attorneys in Washington, Mr. [inaudible] and I have another friend who works for the licensing division, Mr. Michael Stevenson and I called my troops in and I guess everything at the State Nursing Board that they are stronger then they it would be, so I just want you to know that this is not just, you start fucking with me, excuse my French but, you know my mom is heavily involved in politics…So, I have a history of having had a radio show of my own, I’ve have TV shows of my own and can walk away from this stuff but I can’t. I [inaudible]. I will smear your name, I will smear nursing [inaudible]…You violate me further and I will violate you guys and I am in a real damn good position to do it…You’re taking over my mother and I will fight tooth and nail to make sure you guys look like stupid [inaudible]…You can be a party of this or you can wash your hand of this. [Inaudible] more important than one another. I have the affidavits, I have the letters from the White House [inaudible]. I’ll cream you, not you Judy, but I want to cream your damn Board if you do one more thing to hurt me. You hurt other people when you hurt me. When will boards get that in their minds. You hurt our families you hurt our friends. You think its all down (sic) in the name of justice [inaudible] that’s about it in the end. The one thing that’s [inaudible] judgment day or one day after, one tin soldier rides away. From my generation, it’s a song [inaudible] treatment [inaudible] and that’s what is happening here. So, let’s do it kid. You do it to me. I’m going to annihilate you guys. One way or the other, you have to face the pearly gates. One way or the other and you had better be full of information. When you desecrate me, when you crucify me you better b [inaudible] died on the cross for the sake of others. It ain’t me. Get it. Can’t love you yet Judy, because I have only been through hate at the State Nursing Board. [Inaudible] because I have been hurt repeatedly in this case [inaudible]. [Inaudible] my nursing license [inaudible] is a [inaudible] profession. [Inaudible] and gossip against on another [inaudible]. Oh for heaven’s sake, don’t take the time to listen to what somebody has to say. Oh my gosh, they got this [inaudible] nurse. Nurses have no rights [inaudible] to blame [inaudible].”

17. On or about July 3, 1996, at approximately 3:45 p.m., Respondent telephoned Arizona Board staff. Respondent spoke with Board staff for approximately 40 minutes. Respondent’s speech was rambling, she moved very quickly from subject to subject, and the content of her statements was unclear and incoherent to the Arizona Board staff. Respondent stated that she was mentally ill, that she had attempted suicide and that her last suicide attempt was in October of 1995. Respondent also stated that nursing boards lie, that she does not want to work in nursing, that she wanted to sell cosmetics and made references to a scalpel cutting her face. Arizona Board staff set up an interview with Respondent for July 8, 1996, at 2:00 p.m. 18. Later on July 3, 1996, at 4:32 p.m., Respondent left another voice mail message for Arizona Board staff wherein she stated that her doctor had prescribed her antidepressant medications. Respondent also state in part:

“All of the [inaudible] responsibility [inaudible] the co- dependent karma, you guys are killing people, so much for your [inaudible]…I hate this shit so much. I see death, death of best friends, death of, there is no way of changing it. It sucks…I don’t want anything to do with nursing, its Satan, its not God. [Inaudible] you guys are really sick…The Nursing Board’s [inaudible] turning into Satan. Sorry [inaudible], to kill one another and destroy one another, I don’t want any party of you. So Judy, I’d like to meet with you but don’t want any part of you guys…I don’t care to go on living in this life but I will meet with you and then you can take a good look at me and think about the people who care about me and who I might be important in their life and then you think about [inaudible] I’m sick of this shit. [Inaudible]. Fuck you all, fuck [inaudible] fuck everybody. You’re not going to hurt me anymore. Bye-bye.”

19. Again on July 3, 1996, at 4:44 p.m. Respondent left another voice mail message in which she indicated that she wanted to be dead. Respondent stated in part:

“ I met with two nursing boards, they lie, they cheat, the [inaudible] because they are government…Put it in your mind of all the dead people. [Inaudible] I don’t want to be a part of any kind of life anymore [inaudible]. Ideas that we kill each other, and we complain about each other and we destroy each other with rumors. I don’t want any part of this [inaudible]. I don’t want any part of it. [Inaudible] it was a part of my life, a big part of my life. [Inaudible] going forward. [Inaudible] gunshots, hanging, whatever. There were instructions [inaudible]. I have met so many nurses cross time that have committed suicide and I’ll do it right [inaudible]. There is never going to be any justice here. Never. It’s just too fucking bad. Forget your nice, cut me, take out your hatchet slay me. 20. On or about July 4, 1996, at 5:38 a.m., Respondent left a lengthy voice mail message for Arizona Board staff in which she stated in part that she had been hysterical yesterday, that she suffers from post-traumatic stress syndrome, that she had been slandered by nursing boards, that criminals had gone free but that she was being persecuted, and discussed that nurses historically had been either nuns or prostitutes. Respondent ended the conversation by stating:

“ You have to be sitting in a hot seat. I hope you mourn today because I will be mourning today about July 4th and what it is suppose to mean and how it [inaudible]. Thank you.”

21. Later on July 4, 1996, at 6:13 a.m., Respondent left another lengthy voice mail message for Arizona Board staff in which she stated, among other things, that she was writing a book called “Sinners and Saints” that will describe how nursing boards mistreat nurses. Respondent also questioned why “ am I now being crucified again.” Respondent also made reference to suicide, the suicide of another nurse, and made repeated references to her crucifixion and suffering. Respondent’s statements were rambling, incoherent and inaudible at times. 22. On July 8, 1996, Respondent failed to meet with Arizona Board staff as previously agreed upon. 23. On or about August 22, 1996, Respondent was interviewed at the Arizona Board’s office by Board staff. In that interview Respondent stated that she suffered from post-traumatic stress disorder, that she had been assaulted multiple times, that she had sought treatment at a behavioral health hospital in Seattle because she wanted help and wanted to be in a safe place, and that she was not an alcoholic but used alcohol to fall asleep. Respondent also stated that she had been prescribed the following medications:

a) Librium (anti-anxiety agent); b) Paxil (antidepressant); c) Prozac (antidepressant); d) Depakote (anticonvulsant); and e) Zoloft (antidepressant).

Respondent stated that she was non-compliant with taking her medications because of nursing boards. Respondent also stated that she had attempted suicide by overdosing on Elavil (antidepressant) on August 3, 1996. There was credible testimony from Valerie Smith, who is the Arizona Board’s Impaired Practice Consultant with a master’s degree and extensive work experience in the field of psych/mental health, that it is uncommon to have someone prescribed three antidepressant medications. 24. On or about December 2, 1997, Arizona Board staff contacted Respondent to inform her that her case would be presented to the Arizona Board at its upcoming meeting. Respondent replied that there were rumors about her and stated that:

“You win. Go ahead and condemn me. Just remember Christmas is coming and a lot of nurses will be committing suicide and you helped.”

The telephone call lasted 29 minutes. 25. On or about December 18, 1997, the Arizona Board reviewed Respondent’s case and issued an Interim Order requiring that Respondent obtain a chemical dependency evaluation and a psychological evaluation by Phillip D. Lett, Ph.D., within 30 days, pursuant to A.R.S. § 32-1664(F). The Arizona Board also ordered that the results of the evaluations be returned to it. Respondent failed to obtain the evaluations as ordered by the Arizona Board. 26. On or about February 24, 1998, the Arizona Board considered Respondent’s case and voted the matter to formal hearing. 27. On or about June 7, 1999, the Arizona Board received a letter from Dr. Lett. In the letter, Dr. Lett wrote that he had seen the Respondent for a total of five visits. Dr. Lett opined that based upon his professional experience and clinical assessment, Respondent was experiencing significant emotional distress and that it appears that she has a depressive condition and post-traumatic stress disorder. Dr. Lett recommended that Respondent obtain a psychiatric evaluation, psychiatric care and psychotherapy. 28. There is credible evidence from Arizona Board staff to substantiate significant concerns about Respondent’s ability to safely practice nursing. The following are deemed legitimate concerns pertaining to Respondent:

a) That she likely has a major psychological disorder. b) It is unknown if treatment would be effective. c) Respondent has persecution ideation. d) Respondent’s persecution ideation could transfer to patient care. e) Respondent’s suicidal ideation. 6. Respondent’s professional nurse license expired in 1999. However, the expiration of that license does not deprive the Arizona Board from continuing to prosecute the Amended Complaint against Respondent in this matter. 7. Respondent has shown a consistent pattern of being unregulatable by state boards of nursing. 8. Respondent is unsafe to practice nursing.

CONCLUSIONS OF LAW

1. The conduct and circumstances described in the above Findings of Facts constitute violations by Respondent of A.R.S. § 32-1663(D) as defined in A.R.S. § 32-1663(D)(4) (amended 1993), A.R.S. § 32-1601 (11)(a) and (d) (amended 1995), A.R.S. 32-1601(10)(d) (amended 1997), and A.R.S. § 32- 1601(13)(d) and (I) (amended 1998) and A.R.S. § 32-1601(14)(d). 2. Pursuant to the provisions of A.R.S. §§ 32-1606, 32-1663 and 32-1664, the Arizona Board has the authority to impose disciplinary sanctions on a licensee, whether or not that license has expired, for proven violations of the Nurse Practice Act[3], including suspension, revocation, probation, censure and/or the imposition of an administrative penalty. The evidence of record supports the Arizona Board’s revocation of Respondent’s professional nurse license. Such a revocation would not ban Respondent from practicing nursing in Arizona forever, however it would require her to establish her qualifications for professional licensure if she should ever reapply.

RECOMMENDED ORDER

In view of the foregoing, it is recommended that Respondent’s Professional Nurse License Number RN042493 be revoked. Done this day, August 1, 2000

______________________________________ Brian Brendan Tully Administrative Law Judge

Original transmitted by mail this ____ day of ____________, 2000, to:

State Board of Nursing Joey Ridenour, R.N., M.N. Executive Director ATTN: Audrey Rath, R.N., M.N. 1651 West Morten, Suite 150 Phoenix, AZ 85020

By ___________________________

----------------------- [1] Ms. Eveland voluntary absented herself from the hearing after the completion of opening statements and prior to the presentation of any evidence and testimony. [2] Marcher prosecuted the Nevada Board disciplinary action against Respondent. [3] A.R.S. § 32-1601 et seq.

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Office of Administrative Hearings 1400 West Washington, Suite 101 Phoenix, Arizona 85007 (602) 542-9826