Ress v. Abbott Northwestern Hosp., Inc.
| Decision Date | 25 April 1989 |
| Docket Number | No. C8-88-2208,C8-88-2208 |
| Citation | 438 N.W.2d 727 |
| Parties | Randy W. RESS, Relator, v. ABBOTT NORTHWESTERN HOSPITAL, INC., Commissioner of Jobs and Training, Respondents. |
| Court | Minnesota Court of Appeals |
Syllabus by the Court
1. In deciding a misconduct issue, the Commissioner of Jobs and Training was not bound by a disciplinary decision rendered by the Board of Nursing.
2. Relator's good faith refusal to follow a superior's suggestions and order did not constitute misconduct for unemployment compensation purposes.
Daniel J. Sheran, Lindquist & Vennum, Minneapolis, for Randy W. Ress, relator.
Robert S. Halagan, Falhaber, Larson, Fenlon and Vogt, Minneapolis, for Abbott Northwestern Hospital, Inc., respondent.
Hubert H. Humphrey, III, Atty. Gen. and Donald E. Notvik, Asst. Atty. Gen., St. Paul, for Commissioner of Jobs and Training, respondent.
Considered and decided by CRIPPEN, P.J., and HUSPENI and IRVINE, JJ., without oral argument.
Relator, a registered nurse, seeks review of a decision by the Department of Jobs and Training denying him unemployment compensation benefits. Relator argues that his actions constituted a good faith response to a situation involving the best interests of a hospital patient, and should not be characterized as misconduct. We agree and reverse.
Relator Randy Ress worked for the respondent Abbott Northwestern Hospital as a registered nurse for approximately eight years. Ress was discharged from his position on the hospital's cardiac care unit following an incident on January 21, 1988 when he allegedly initiated a course of treatment that was potentially dangerous to a patient and outside the scope of his license.
Upon his discharge, Ress applied for unemployment compensation benefits, claiming he had responded to an emergency situation in an appropriate manner. A claims adjudicator with the Department of Jobs and Training disallowed Ress' claim, and Ress appealed to a Department referee, who conducted a hearing.
The evidence revealed that on the evening of January 21, Ress was the primary care nurse for a patient who was attached to a ventilator by means of an endotracheal tube. A pulmonary artery catheter was monitoring the patient's heart.
At approximately 10:40 p.m., the patient began bleeding profusely from the endotracheal tube. Ress called for help, disconnected the endotracheal tube, and began suctioning the bloody fluid from the tube. Shortly thereafter, a first-year resident arrived on the scene.
The resident did not testify at the hearing before the referee, but his written statement was submitted into evidence. According to the resident, when he entered the patient's room he "suggested" to the nurses present that an attempt be made to pull back the endotracheal tube slightly. In response, Ress stated that the patient was very difficult to intubate, and that the endotracheal tube should not be touched. The resident indicated that at a later point, he again suggested adjusting the endotracheal tube, but Ress again disagreed with the suggestion.
Ress suggested administering epinephrine 1 to the patient, but the resident suggested using vasopressin 2 instead. Ress stated that he was not sure vasopressin was available on the unit. Ress ordered another nurse to get the epinephrine, and the resident did not object.
Under Ress' direction, another nurse poured sterile saline solution over ice, rendering the solution unsterile, and then administered small doses of the iced saline solution into the endotracheal tube while Ress continued suctioning.
The evidence indicated that there are no nursing, medical or hospital procedures for lavaging an endotracheal tube with iced nonsterile saline solution; however, lavage with normal saline solution may be appropriate under some circumstances.
The resident did not object to the lavaging procedure, but left the room to consult with a second-year resident. By 11:00 p.m. when the resident returned, the bleeding had stopped, and Ress had discontinued the lavaging procedure. At that point, the resident told Ress to order a chest x-ray, but Ress replied that the patient's family wanted to visit, and he would order the x-ray after they had visited. Ress testified that he ordered the x-ray shortly thereafter, and the x-ray was completed around midnight. Ress began paging the resident immediately, but received no response from the resident. The x-ray was apparently not interpreted until noon the next day.
The referee determined that while Ress may have exercised poor judgment or acted negligently, his actions did not constitute misconduct. In a memorandum, the referee found that the resident offered Ress no direction and, by his silence, acquiesced in Ress' actions. The referee noted that Ress did not refuse to comply with the x-ray order; he simply wanted to wait until the patient's family had visited.
The hospital appealed to a Commissioner's representative, who reversed the referee's decision. In a memorandum, the Commissioner's representative found that Ress had refused the resident's suggestion to adjust the endotracheal tube; had ordered epinephrine without the resident's authorization; had instituted an unestablished lavaging procedure; and had refused to follow the resident's directive to immediately order the chest x-ray. The Commissioner's representative concluded that Ress' conduct was insubordinate and went beyond the scope of conduct contemplated by his nursing license.
Ress submitted a Request for Reconsideration of the Commissioner's decision, indicating that the Minnesota Board of Nursing had considered and dismissed a complaint by the hospital regarding his actions on the evening of January 21. A Commissioner's representative denied Ress' request for reconsideration. Ress subsequently delivered a copy of the Board's findings to the Commissioner's representative.
Ress has sought review of the Commissioner's determination, arguing that he reacted in good faith to a situation involving the well being of a patient, and did not commit misconduct for unemployment compensation purposes.
1. Did the Commissioner's representative err by adopting a decision contrary to the Board of Nursing?
2. Did the Commissioner's representative err by concluding that Ress' actions constituted disqualifying misconduct for unemployment compensation purposes?
1. Ress challenges the determination of the Commissioner's representative that he acted outside the scope of his nursing license on the evening of January 21, 1988. Ress claims the Minnesota Board of Nursing declined to make such a determination, and the Commissioner's representative erred by failing to consider the Nursing Board's decision.
Ress' argument is not supported by principles of collateral estoppel, which require the following:
(1) the issue was identical to one in a prior adjudication; (2) there was a final judgment on the merits; (3) the estopped party was a party or in privity with a party to the prior adjudication; and (4) the estopped party was given a full and fair opportunity to be heard on the adjudicated issue.
Willems v. Commissioner of Public Safety, 333 N.W.2d 619, 621 (Minn.1983). We are unconvinced that the issues in the disciplinary action were identical to those in the present misconduct proceeding; nor does the record indicate that the hospital was allowed the opportunity during the disciplinary proceedings to present its evidence concerning Ress' conduct.
We particularly note that the Nursing Board's decision was not presented to the Commissioner's representative until after he had issued his decision denying Ress' request for reconsideration. While the Board's decision is appended to Ress' brief, it was never made a part of the record below. In Lumpkin v. North Central Airlines, Inc., 296 Minn. 456, 209 N.W.2d 397 (1973) the supreme court stated:
There being no proof in the record before us as to the adjustment board's findings or the issues litigated before that board, its decision is not res judicata in the Manpower Services hearing with which we are concerned.
Id. at 462-63, 209 N.W.2d at 402.
In Whorton v. Department of Health & Human Services, 368 N.W.2d 750 (Minn.Ct.App.1985), we upheld a decision where the Commissioner of Economic Security (now Jobs and Training) refused to be bound by an arbitrator's decision in a separate proceeding:
The arbitration award finding for relator was provided to the Commissioner after oral argument. The Commissioner * * * chose not to be bound by the decision of the arbitrator. He determined the arbitrator's decision was based upon the terms of the collective bargaining agreement and not Minnesota unemployment services law. The Commissioner noted that exhibits, documents and testimony submitted to the arbitrator were not part of the record in the employment claim. Finally, the Commissioner held the arbitrator's decision, even if accepted into evidence under stipulation, did not have a res judicata or collateral estoppel effect.
Id. at 751. Similarly, we conclude in the present case the Commissioner's representative was not bound by the decision issued by the Board of Nursing.
2. Minn.Stat. Sec. 268.09, subd. 1(b) (1988) provides that an individual who is discharged for misconduct is disqualified from receiving unemployment compensation benefits.
* * * [T]he intended meaning of the term "misconduct" * * * is limited to conduct evincing such wilful or wanton disregard of an employer's interests as is found in deliberate violations or disregard of standards of behavior which the employer has the right to expect of his employee, or in carelessness or negligence of such degree or recurrence as to manifest equal culpability, wrongful intent or evil design, or to show an intentional and substantial disregard of the employer's interests or of the employee's duties and obligations to his employer. On the other hand mere...
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Ress v. Abbott Northwestern Hosp., Inc., C8-88-2208
...denying benefits; the court of appeals reversed the commissioner and awarded benefits. We reverse the Minnesota Court of Appeals, 438 N.W.2d 727, and reinstate the commissioner's order denying The facts in this case are as follows. Randy Ress worked as a nurse at Abbott from May 5, 1980, un......
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