At 7 AM, when RN Michelle Flacco took over the care of 66-year-old Lester Scanlon, who had dementia and type 1 diabetes, she was notified that his blood glucose level was significantly elevated, at greater than 550 mg/dL. Ms. Flacco performed blood glucose tests three times during her shift, each time after Mr. Scanlon had eaten a meal, and each time his blood glucose level was elevated. However, Ms. Flacco didn’t notify Mr. Scanlon’s physician, nor did she administer insulin to the patient. The next shift, Mr. Scanlon was found unresponsive, with a very elevated blood glucose level. He was diagnosed with diabetic coma. The incident was reported to Ms. Flacco’s state board of nursing, and she was accused of professional incompetence. The board is seeking revocation of her RN license.

That’s the opening of “You’re Being Investigated by Your State Nursing Board” in the June issue of AJN. The case described is a composite, but it illustrates a situation that a nurse can find herself or himself in. The article, currently open access, is by Margaret E. Mangin, who practiced nursing for 12 years before becoming an attorney. For the past 26 years, she has practiced law in San Diego, primarily defending hospitals, nurses, and other health care providers. This is the latest installment of our Legal Clinic column. You might want to check it out. The table below gives the most frequent licensing violations, 1996 to 2006.