Nurse Prescribed Patient 51 Pills Per Day, Kept License

By Kelly Burch 10/16/18

The nurse practitioner was the ninth most heavy-handed opioid prescriber in Tennessee.

nurse handing prescription to patient

Forty opioid pills, four muscle relaxers, six Xanax and an Ambien in a day would likely do more harm than good for even the sickest of patients—but that’s the amount that a Tennessee nurse prescribed a patient eight years ago, exceeding today’s opioid recommendations by more than 31 times.

And yet, the nurse is still licensed to prescribe today. 

Christina Collins, a nurse practitioner near Knoxville, was the ninth most heavy-handed opioid prescriber in Tennessee, and officials now say that she must have known that her patients were not taking the pills as she prescribed them. 

“In short, Mrs. Collins was a machine that dispensed prescriptions without regard for any professional responsibility,” Mary Katherine Bratton, a Tennessee Health Department attorney, wrote in state documents analyzed by The Tennessean. “Her own lawyers argued that Mrs. Collins engaged in patient-led prescribing, simply giving patients whatever dangerous drugs they requested.”

Last year, officials attempted to have Collins’ license revoked, but the state nursing board opted to instead put her on professional probation, which means she can still write prescriptions. She still works as a nurse in the Knoxville area.

However, the state’s health department and attorney general are now appealing that decision in a move that a spokesperson called “rare but not unprecedented.” 

Collins and her lawyer claim that despite doing things like telling one patient to wear three fentanyl patches at once in addition to taking other medications, Collins thought she was giving good medical advice at the time the prescriptions were written. 

“She became a victim of her environment and the medical community and the ideas that were floating around out there at that time period,” said Eric Vinsant, her lawyer. “This case stretches from 2011 and 2012, which was a time before Tennessee really began looking at the prescribing of opioids and other controlled substances for pain, and there was really a very limited amount of guidance for practitioners on what was expected and what were best practices.”

Vinsant added that there was "no real evidence" that Collins’ pills were resold on the black market. 

During a hearing with the nursing board last year, Collins said that she left the clinic she was with at the time when she became suspicious that Dr. Frank McNiel, who ran the clinic, was overprescribing. McNiel has since surrendered his medical license. 

“When I initially started there… obviously I did not think that there was anything below the standard of care or anything wrong with the patients or the prescriptions they were taking,” Collins said, according to a transcript of the hearing. “If I were looking at doses like that in today’s time after the guidelines and everything that I’ve learned, yeah, I would think that was very high amounts.”

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Kelly Burch writes about addiction and mental health issues, particularly as they affect families. Follow her on TwitterFacebook, and LinkedIn.