MIAMI _ A Daytona Beach nurse has had her license restricted after she appeared to be impaired by morphine during her shift at a patient's home, the Florida Department of Health said.
An addiction physician said the incident unveiled substance abuse and mental health issues that put both the nurse and her patients at risk until they're addressed.
That's in the emergency restriction order (ERO) that the Department of Health dropped on the license of Christy Shumate, a licensed practical nurse in Florida since November 2009. Shumate is restricted from practicing nursing until the Intervention Project for Nurses, which monitors impaired nurses, or an IPN-approved evaluator says she's no longer a danger as a nurse.
According to the ERO, Shumate worked as a home health care nurse for Vitas Healthcare (the ERO lists this company as both "Vista Health Care" and "Vitas." State records show no "Vista Health Care" registered to do business in Florida and "Vitas Healthcare" is registered and does hospice care).
Shumate was assigned home hospice care to 51-year-old man, identified as "D.S." She showed up for her May 16 shift at 7 p.m.
"Shortly after Ms. Shumate arrived, another nurse observed Ms. Shumate empty a vial of morphine into her drink," the ERO reads. "Ms. Shumate then went into the bathroom and remained there for approximately 20 minutes. When Ms. Shumate emerged from the bathroom, the morphine vial was full again with a clear liquid."
"M.S.," the patient's wife, noticed that Shumate "behaved erratically and had difficulty staying awake."
Just 30 minutes after midnight May 17, D.S. died. Two hours later, M.S. called Shumate's Vitas Healthcare supervisor to say Shumate "appeared impaired and hadn't called the funeral home yet."
Shumate's supervisor arrived and saw Shumate, "asleep in the kitchen, standing up with her head resting on the stove," the ERO says. "When awakened, Shumate slurred her words and didn't recognize her supervisor.
"The supervisor reviewed Ms. Shumate's written notes from the evening and found them illegible and incomplete."
Also, the supervisor noticed, whatever was in the morphine vial didn't look like morphine nor did it smell like morphine.
The ERO says Shumate "abruptly" left Vitas Healthcare before taking part in any investigation of the incident. She couldn't avoid, however, the Department of Health's order she be evaluated by addiction physician Jeremy Mirabile.
Shumate, 45, admitted problems with alcohol abuse and depression, the former from age 17 to 31 and the latter for which she had received medication treatment in the past. For her anxiety, she was taking lorezepam (brand name: Ativan). She said she had been prescribed morphine for chronic back problems.
When Mirabile contacted Shumate's pain management doctor, however, he found she hadn't seen that doctor since December 2015. Shumate admitted she'd been taking opioids left from a previous prescription. The ERO says she also admitted taking morphine and Ativan simultaneously.
Mirabile diagnosed Shumate with mild opioid, sedative/hypnotic and alcohol use disorders and major depression disorder.
"Dr. Mirabile noted that Shumate's admitted concurrent use of morphine and lorezepam placed her at risk for respiratory depression, impaired coordination with driving and cognitive impairment," the ERO reads. "Dr. Mirabile also opined that her episodic alcohol use was hazardous in combination with these two drugs."
He recommended an "intensive outpatient treatment" for Shumate's drug, alcohol and mental health problems concurrent with a monitoring agrement with IPN.
As Shumate has done neither, the Department of Health put an ERO on her license Saturday.
