RECORD OF PROCEEDINGS
AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS


IN THE MATTER OF: 			DOCKET NUMBER: BC-2014-02996

   						COUNSEL:  NONE

						HEARING DESIRED:  NO 



APPLICANT REQUESTS THAT:

Her Separation Program Designator (SPD) Code of GHK (substandard performance) on her DD Form 214, Certificate of Release or Discharge from Active Duty, be changed to GHF (Other).


APPLICANT CONTENDS THAT:

The SPD code of GHK was the incorrect code.  She was initially put through administrative proceedings due to alleged “clinical deficiencies” which were determined to be unsubstantiated by a Board of Inquiry (BOI), credential Board, mental evaluation report, and the Georgia Board of Nursing.  However, based upon the unsubstantiated allegations, she was given the GHK code.

The applicant’s complete submission, with attachments, is at Exhibit A.


STATEMENT OF FACTS:

The applicant initially entered the Regular Air Force on 3 Mar 10.

On 24 Aug 11, the applicant was removed from her clinical nursing practice as a result of clinical deficiencies.  The reasons for taking this action were:

	a.  On or about 16 Mar 10, the applicant negligently performed a catheterization on a pre-op patient that was under anesthesia. 

	b.  On or about 18 Aug 10, the applicant provided an inaccurate needle count during a surgical procedure.  

	c.  On or about 21 Jan 11, while on call, the applicant failed to respond within 30 minutes of notification of an emergency case after normal duty hours. 

	d.  On or about 24 Jun 11, the applicant negligently failed to document all aspects of patient care in four individual instances.  

	e.  On or about Jun 11, the applicant displayed basic clinical deficiencies when performing surgical skin prep for a patient, resulting in potential surgical site infection. 

	f.  On or about Aug 11, the applicant displayed basic clinical deficiencies when performing surgical skin prep for a patient, resulting in potential surgical site infection.  

	g.  On or about 17 Aug 11, the applicant displayed basic clinical deficiencies when she failed to provide the required equipment for surgery being performed by the physician.

On 7 Dec 12, the applicant’s commander notified her he was going to recommend her discharge due to substandard performance.  The applicant disagreed with the proposed action, and requested a Board of Inquiry (BOI) review her case. 

On 4-5 Apr 13, a BoI reviewed the applicant’s case and substantiated all of the findings except for one and recommended the applicant be separated with an Honorable service characterization.  

On 17 Sep 13, the applicant’s commander concurred with the recommendation of the BoI that the applicant be discharged with an Honorable discharge.  The discharge action was determined to be legally sufficient.  

On 28 Jan 14, the Director of the Air Force Review Boards Agency, on behalf of the Secretary of the Air Force, directed that the applicant be discharged under the provisions of        AFI 36-3207, Separating Commissioned Officers, with an Honorable service characterization.

On 10 Feb 14, the applicant was furnished an Honorable discharge, with an SPD code of GHK, a narrative reason for separation of “substandard performance,” and was credited with 15 years, 5 months, and 22 days of total active service.   

The remaining relevant facts pertaining to this application are contained in the memoranda prepared by the Air Force offices of primary responsibility (OPR), which are attached at Exhibits C, D, and E.    


AIR FORCE EVALUATION:

AFPC/DPANF recommends denial indicating there is no evidence of an error or an injustice.  The applicant was not separated due to a medical condition.  She was separated because of substandard performance following the recommendation of the BOI.  

A complete copy of the AFPC/DPANF evaluation is at Exhibit C.

AFMOA/SGHQ recommends denial indicating there is no evidence of an error or an injustice.  On 24 Aug 11, the applicant was removed from patient care duties within the operating room in response to evidence of clinical deficiencies in communications, documentation, and patient care.  On 19 Sep 11, an Individual Practice Review (IPR) reviewed multiple Memoranda for the Record (MFR), Letters of Counseling (LOC), peer/provider Reviews, and many medical charts.  The reviewer recommended permanent removal from all patient care duties in the preoperative setting, a Mental Health Evaluation to evaluate cognitive functioning, and an evaluation of her position to support the Air Force mission.  On 14-17 Nov 11, a Peer Review Panel (PRP) convened and determined the applicant could not safely function independently in a perioperative or other nursing role, and recommended revocation of clinical practice and removal from all patient care duties.  On 22 Nov 11, the Credentials Function convened to review the recommendations from the PRP, and concluded the evidence provided supported that the applicant does not function safely in a perioperative setting and, thus, should no longer perform duties in a nursing environment.  On 27 Feb 12, the applicant’s commander recommended revocation of clinical nursing practice.  The applicant waived her right to a hearing.  On 29 May 12, the applicant’s commander revoked her clinic nursing practice.  The multiple MFRs, LOCs, an LOR, peer/provider testimony, as well as a chart review of 89 chats, all support that the applicant was deficient in her ability to communicate, document, and provide effective and safe patient care in a perioperative setting.  Despite multiple opportunities to correct clinical deficiencies the applicant repeatedly demonstrated inadequate clinical skills that have directly impacted patient safety.  

A complete copy of the AFMOA/SGHQ evaluation is at Exhibit D.

AFPC/DPSOR recommends denial indicating there is no evidence of an error or an injustice.  A legal advisor certified the BoI proceedings were accurately reflected in the record and that a majority of the voting members concurred with the findings and recommendation.  The applicant’s SPD code, narrative reason for separation, and character of service are consistent with the procedural and substantive requirements of the discharge instruction and within the authority of the discharge authority.  Therefore, her DD Form 214 is correct.  

A complete copy of the AFPC/DPSOR evaluation is at Exhibit E.



APPLICANT'S REVIEW OF AIR FORCE EVALUATION:

Copies of the Air Force evaluations were forwarded to the applicant on 11 Feb 15 for review and comment within 30 days (Exhibit F).  As of this date, no response has been received by this office.


THE BOARD CONCLUDES THAT:

1.  The applicant has exhausted all remedies provided by existing law or regulations.

2.  The application was timely filed.

3.  Insufficient relevant evidence has been presented to demonstrate the existence of an error or injustice.  We took notice of the applicant’s complete submission in judging the merits of the case; however, we agree with the opinions and recommendations of the Air Force offices of primary responsibility (OPR) and adopt their rationale as the basis for our conclusion the applicant has not been the victim of an error of injustice.  While the Board notes the applicant’s contention the BoI did not substantiate the allegations of her “clinic deficiencies,” we note the BoI not only substantiated the allegations, but recommended she be separated for substandard performance.  Therefore, in the absence of evidence to the contrary, we find no basis to recommend granting the requested relief.


THE BOARD DETERMINES THAT:

The applicant be notified the evidence presented did not demonstrate the existence of material error or injustice; the application was denied without a personal appearance; and the application will only be reconsidered upon the submission of newly discovered relevant evidence not considered with this application.


The following members of the Board considered AFBCMR Docket Number BC-2014-02996 in Executive Session on 16 Apr 15 under the provisions of AFI 36-2603:

	Panel Chair
	Member
	Member


The following documentary evidence pertaining AFBCMR Docket Number BC-2014-02996 was considered:

	Exhibit A.  DD Form 149, dated 22 Jul 14, w/atchs.
	Exhibit B.  Applicant's Master Personnel Records.
	Exhibit C.  Memorandum, AFPC/DPANF, dated 28 Aug 14.
	Exhibit D.  Memorandum, AFMOA/SGHQ, dated 24 Oct 14.
	Exhibit E.  Memorandum, AFPC/DPSOR, dated 17 Nov 14.
      	Exhibit F.  Letter, SAF/MRBR, dated 11 Feb 15.