Nurse Who Violated Hospital's Medication Policies Loses Bias Claim

A hospital did not discriminate against a registered nurse when it fired her after discovering that she had violated the hospital's policies on handling and documenting patient medications and had a history of chronic absenteeism, a California appeals court ruled. Although the nurse alleged disability bias, among other claims, she failed to produce any evidence that the hospital's asserted reasons for discharging her were untrue or a pretext for illegal discrimination, the court said.

The nurse began working at the hospital in 2005. From November 2016 until December 2017, she received several written disciplinary notices for poor attendance, each warning that her employment could be terminated if her attendance continued to be poor.

In addition, in November 2017, the nurse's supervisor was asked to investigate a concern that a patient had received medication without supporting documentation, as required by hospital policies. The investigation showed that the nurse had failed to properly document how she handled and administered Narcan (which is used for the emergency treatment of an opioid overdose). During the investigation, the nurse's supervisor learned of other occasions when the nurse had signed off on the administration of medication, including controlled substances, but failed to properly complete the paperwork.   

The nurse was discharged in January 2018. Her supervisor said she was fired for failing to properly document controlled substance administration and her chronic attendance issues, both of which jeopardized patient safety.

The nurse sued the hospital, alleging disability discrimination, among other claims. She asserted that she suffered from multiple disabilities including chronic back pain, Hashimoto's disease, torn wrist ligaments and excessive uterine bleeding and was terminated because of these disabilities.

The trial court dismissed the lawsuit before trial, and the nurse appealed. 

Proving Bias Claims

California uses the three-part test established by the U.S. Supreme Court, known as the McDonnell Douglas test, for trying claims of intentional discrimination.

To allege discriminatory termination, the plaintiff must first show that she was fired even though she was performing the job competently and that circumstances suggest a discriminatory motive. The employer must then produce evidence showing that it took its actions for a legitimate, nondiscriminatory reason.

If the employer shows a legitimate reason for the discharge, the employee must show that the employer's reasons are a pretext for discrimination or offer other evidence of a discriminatory motive. 

The nurse claimed that her termination was the result of disability bias, but the hospital produced evidence that she was discharged because she repeatedly failed to properly document the administration of patient medication and the discarding of unused medication in violation of the hospital's policy, and because of her chronic absenteeism over the course of the prior 14 months, the appeals court said.  

And the nurse failed to present any evidence that the hospital's stated reasons for terminating her employment were pretextual or evidence that the hospital acted with discriminatory intent, the court concluded.

The nurse argued that the hospital's time-keeping system was inaccurate, and although there were several errors made in counting her absences, those errors were all corrected. Nothing suggested intentional fabrication by the hospital, the court said, and the evidence of time-keeping errors did not by itself show discriminatory intent or pretext.

Similarly, the nurse's claim that she produced evidence of pretext by showing that her supervisor did not counsel her, as she had other employees, about medication documentation issues was not supported by the evidence, the court said. The nurse herself testified at her pretrial deposition that her supervisor discussed with her the issue of her improper documentation of medication.

Finally, the court rejected the nurse's claim that an inference of the hospital's discriminatory intent against her was supported simply because she had previously taken leave for her health issues. She cited no evidence that linked any of her attendance violations, which included missed timecard punches and the failure to report to work on time, to any disability or protected leave, the court said. 

Therefore, the trial court properly dismissed the nurse's bias claim before trial, the court ruled.

Wilkin v. Community Hospital of the Monterey Peninsula, Calif. Ct. App., No. G060420 (Nov. 18, 2021).

Professional Pointer: Although it may seem that an employee is required to present very little evidence of bias for a claim proceed to trial, this case shows that the employee must present at least some evidence. Here, the employer's well-documented reasons for the employee's discharge coupled with her inability to produce any evidence that those reasons were not the real reasons led to the dismissal of the case.

Joanne Deschenaux, J.D., is a freelance writer in Annapolis, Md.