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July 18, 1997


Appeal from the Circuit Court of Du Page County. No. 95--CM--636. Honorable George J. Bakalis, Judge, Presiding.

Rehearing Denied September 3, 1997. Released for Publication September 3, 1997.

The Honorable Justice Colwell delivered the opinion of the court. Thomas and Rathje, JJ., concur.

The opinion of the court was delivered by: Colwell

The Honorable Justice COLWELL delivered the opinion of the court:

Defendant, Nanette M. Stults, appeals her conviction of practicing nursing without a license in violation of the Illinois Nursing Act of 1987 (Nursing Act) (225 ILCS 65/1 et seq. (West 1996)). On appeal, Stults contends that she should be awarded a new trial because the trial court erroneously sustained an objection at trial. In the alternative, Stults argues that her conviction should be reversed because (1) she was not proved guilty beyond a reasonable doubt; (2) the provisions of the Nursing Act prohibiting the unlicensed practice of nursing are unconstitutional; and (3) newly discovered evidence demonstrates that the trial court's finding of guilt was erroneous. We affirm.

The record shows that Stults is an unlicensed medical assistant. After graduating from high school in Illinois, Stults enrolled in a medical assistant's program at Catholic Medical Academy in Wisconsin. Upon completing the one-year program, Stults entered an internship in pediatrics. During her internship, Stults studied anatomy, physiology, X-ray procedures, physical assessment procedures, blood-drawing procedures, and immunization procedures, among other tasks.

After completing her internship, Stults worked in a pediatric clinic located in a medical-surgical clinic in Milwaukee as a "pediatric nurse." While working at the clinic, Stults enrolled in Marquette University, taking child psychology and infant and toddler nutrition courses. Upon completing the classes at Marquette, Stults enrolled in a registered nurse (RN) program at Milwaukee Technical College. Stults completed approximately 20 months of courses before dropping the program "in academic good standing." At trial, Stults testified that she had to leave the program because her husband worked for the air force and was transferred to California.

Stults returned to Illinois from California in 1973. In 1980, she started to work for a pediatrician in Downers Grove. Stults testified that her responsibilities at the Downers Grove office consisted of what she had been doing "years before in pediatric nursing." The pediatrician Stults worked for in the Downers Grove office left shortly after Stults arrived. Stults, however, remained working at the office for the new pediatrician, Dr. Koteswara Batchu.

Stults testified that her duties remained the same while working for Dr. Batchu. Mainly, she assessed physical measurements of children and placed the measurements on medical charts. Stults also administered immunizations to children.

Stults next went to work for Dr. Lynn. She worked for Dr. Lynn for over 11 years, performing essentially the same duties as she had with Dr. Batchu. Stults left Dr. Lynn to work for General Pediatrics in June 1991. Stults stated that she learned about the position at General Pediatrics because General Pediatrics was located one floor below Dr. Lynn's office in the medical center. Stults said that a nurse in General Pediatrics, Patricia Reidy, talked to her during her lunch hour and asked her to consider working for General Pediatrics. Stults stated that she never told Reidy that she was a registered nurse and that she never asked Reidy about her credentials.

Stults testified that Dr. Michael Steinken, a doctor at General Pediatrics, called her in May 1991. Stults stated that he said he "was in desperate need" to fill Reidy's position and asked whether she would take the position. Stults declined. Dr. Steinken called Stults again on June 9, 1991. Dr. Steinken asked whether Stults had reconsidered her position and the two scheduled an interview for the following day.

Stults testified that she met with Dr. Steinken during her lunch hour on June 10. She said that she brought him her resume, even though he had not requested one. Stults stated that during the course of the 30 to 40 minute interview Dr. Steinken never reviewed her resume, inquired about her qualifications, or asked if she was a RN or a licensed practical nurse (LPN). Stults then explained that Dr. Steinken and Dr. Lynn communicated with each other regarding her in July 1991. Shortly after the conversation, Stults went to work for Dr. Steinken at General Pediatrics.

Stults testified that Dr. Steinken's office was not run like any other pediatric office where she had worked. Stults stated that she performed phone triage and administered immunizations but that she did not have much contact with the children. Instead, Stults explained that she would accompany Dr. Steinken into a room and Dr. Steinken would then hand her the child's chart and tell her to do an immunization, a respiratory treatment, or take off an umbilical cord that had been left on at the hospital.

Stults testified that she also performed diet counseling over the phone. She stated that mothers called the clinic and asked questions about formula problems or about switching from formula to solid food. Stults explained also that she performed blood drawing, which is a "finger stick" where the blood is drawn up from a small capillary tube in the finger. Stults said that aside from the immunizations and her finger-prick duties, the receptionists performed the same duties as she did in the clinic.

Stults testified that Karen Raak became the business manager of General Pediatrics in August 1994. Stults testified that her relationship with Raak was, at best, "stormy."

Stults explained that Raak requested a nurse's license from her around November 8, 1994. Stults stated that Raak's request for a license was the first request that she had from anyone in General Pediatrics for anything, including malpractice insurance or a CPR card. Stults testified that when Raak asked her for her license she was shocked and she wondered whether everyone at the clinic had thought that she was a nurse. Stults said that at that point she was considering resigning because she did not like her job due to its not being hands-on with children, so she told Raak that she was going to resign and that the license did not make any difference. Stults stated that she did not tell Raak that she had a license or that she would give her the license.

We note that, at trial, Raak's version of events contradicted Stults' testimony. Raak testified that she requested Stults' nursing license from Stults in September 1994. Raak said that Stults told her that she would get the license for her. Raak stated that after two weeks she called Stults again and requested the license and Stults told her that she kept forgetting to bring it and that she would get it for Raak. Raak repeated this procedure with the same results in the following weeks. Finally, early in November Raak called Stults and told her that she needed the license because the accountant was going to visit the office. Raak said that Stults told her that she was quitting but that she would get the license to her.

Stults then explained that she had been interviewing in the two-week period prior to Raak's asking for her license. Stults identified an application she filed with the Visiting Nurses Association. The application is not in the record on appeal. Stults, however, explained that the application does not state that she is an RN or LPN. Instead, her resume indicates that she is a pediatric nurse.

Stults next identified several bills from the clinic's records. Stults pointed out which handwriting on each of the bills was her own, which handwriting was done by the receptionist, and which handwriting was done by a third person. Stults acknowledged that on a couple of bills the initials "R.N." appeared after her name. Stults explained, however, that she never put "R.N." after her name and that, from looking at the bills, all the "R.N." 's were not in her handwriting. These bills are not in the record on appeal.

On cross-examination, Stults explained that a pediatric nurse and a registered nurse were two different things. Further, Stults said that Raak's testimony that Stults told her that she would bring her license to her on six occasions is ludicrous because a RN license is the size of a business card and carried alongside a person's CPR card. Accordingly, it would be ridiculous for her to tell Raak that she would have to go home to get the license.

Laura Angela testified that she worked as a medical receptionist at General Pediatrics between 1989 and 1992. Angela testified that Stults was hired as a "pediatric assistant" and that it was her understanding that Stults was not a registered nurse. Angela added that, during her time working with Stults, Stults never held herself out to be a registered nurse or a pediatric nurse. Angela testified that she had never seen Stults put the initials "R.N." after her name on a bill or any other document. On cross-examination, ...

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