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Marlowe v. Keene State College

United States District Court, D. Massachusetts

May 26, 2016




         Jillian Marlowe (Plaintiff) seeks immediate reinstatement in the clinical nursing program at Keene State College. She was removed from the program on March 1, 2016, on the basis of alleged unsatisfactory performance at her clinical placement. Keene State College has offered her to return to the program to finish her studies in the fall of 2016, after completion of a paid summer internship. Plaintiff moves for injunctive relief, seeking an order that she be placed in a clinical program in the summer of 2016, without having to complete an internship. Because Plaintiff has presently failed to show a potential for irreparable harm, her motion (Docket No. 2) is denied. However, Defendants are ordered to produce additional information to clarify Plaintiff’s rights and obligations regarding the completion of her degree program.


         Jillian Marlowe (Plaintiff) began her undergraduate studies in the registered nursing program at Keene State College (Keene State) in the fall of 2012, as a member of the class of 2016. Keene State is a subsidiary member of the University System of New Hampshire (USNH). The first two years of Keene State’s nursing program involve classroom instruction; the last two years involve both classroom and clinical studies. At the time of Marlowe’s matriculation in 2012, nursing students were required to maintain a 3.0 GPA in “allied health courses” in order to continue with the major and begin clinical studies. Marlowe was accepted into the clinical portion of the program in the spring of 2015. During clinical studies, nursing students are placed in “preceptorships, ” during which they work alongside an expert nurse in a particular practice area for a required number of clinical hours. Preceptors are assigned as part of “NURS-406, ” which is typically taken in the final semester of undergraduate study. Preceptors are typically not faculty members.

         Marlowe’s participation in the nursing program is governed by the 2014-2016 Nursing Program Student Handbook (Handbook). Before beginning her clinical studies, she was required to execute a written acknowledgment of her review and understanding of the Handbook, and to agree to the policies and procedures set forth therein.

         Under the heading “Academic and Clinical Performance Counseling, ” the Handbook provides: “When a student is not successfully meeting performance criteria in the clinical or laboratory settings, a clinical learning contract is initiated. . . . Any student receiving a written clinical contract is required to meet with the Director of Nursing within one (1) week of receiving the clinical contract.” (Docket No. 1-3 at 17.) Under a heading titled “Clinical Skills Remediation, ” the Handbook provides:

Students who are unable to perform clinical skills satisfactorily in the clinical area will return to the clinical skills laboratory with a Clinical Learning Contract from the clinical instructor for additional practice. The nursing clinical laboratory instructor will sign and return a copy of the Clinical Learning Contract to the instructor and the Director of Nursing. Remediation must occur within two weeks. The nursing laboratory instructor will provide a written report to the instructor and the Director of Nursing at the end of the two weeks.

(Docket No. 1-4 at 8.) The Handbook also contains a sample “Clinical Learning Contract, ” which includes blank spaces for descriptions of the clinical objectives that the student has failed to meet, as well as the applicable remediation plan, to be signed by a member of the faculty and the student. (Docket No. 1-5 at 19.)

         On December 21, 2015, at the end of what Marlowe thought would be her penultimate semester at Keene State, she received an email from Keene State’s then-Director of Nursing, stating that she had “met the requirements for progression to Courses NURS 404, 405 and 406 as a senior in spring semester 2016 and earned a 3.0 in nursing courses this semester.” (Docket No. 1-8 at 1.) The school had previously determined that her GPA prior to the fall of 2015 was also satisfactory for continuation in the clinical program.

         Marlowe began her clinical nursing preceptorship in January of 2016 at Home Healthcare Hospice and Community Services (HCS) and performed approximately 120 preceptor hours in January and February. On February 25, 2016, Marlowe’s faculty advisor, Patricia Osimo, had a telephone conversation with her preceptor, Charlotte Pufki, to discuss Marlowe’s performance. The preceptor indicated that Marlowe was struggling in certain areas, such as understanding medical terms, taking vital signs, conducting assessments, applying her knowledge situationally, and managing her time. Osimo contacted Marlowe and requested to meet with her on March 1, 2016.

         At this meeting, Marlowe and Osimo were present, as well as the current Director of Nursing, Thomas W. Connelly, Jr. (Defendant), and the Assistant Dean of Graduate and Professional Studies, Karrie Kalich. Marlowe was informed that she was being removed from the Keene State clinical nursing program, effective immediately. The reasons given, verbally, included specific concerns allegedly mentioned to Osimo by Pufki with respect to Marlowe’s ability to conduct a head-to-toe assessment, as well as general concerns regarding her medical knowledge and overall performance compared to other students in the program. She was told that she could potentially graduate in May of 2016 with an Allied Health Science major and was instructed to speak with Kalich about arranging for this proposed degree change.

         Before the March 1, 2016 meeting, Marlowe had had weekly advisory meetings with Osimo, and Osimo had provided her written feedback in response to weekly reflection reports about her preceptorship. Osimo had not raised any concerns regarding Marlowe’s ability to successfully complete the preceptorship. Marlowe’s preceptor did not utilize the “Preceptor/Student Evaluation Form” or any other written medium for providing feedback about Marlowe’s clinical performance listed under “clinical preceptor responsibilities” on the NURS 406 syllabus. (Docket No. 1-6 at 7.) Marlowe was never offered a clinical learning contract to rehabilitate any alleged deficiencies in her clinical performance, as set forth in the Handbook.

         At a second meeting, on or about March 2, 2016, which included Marlowe, Marlowe’s mother, Osimo, Connelly, and Kalich, Marlowe and her mother requested a written explanation for her removal from the program. On March 16, 2016, Connelly wrote a letter summarizing the rationale for the decision:

• Your preceptor verbalized concerns over your physical assessment skills (specifically vital signs and a head-to-toe assessment) and your inability to take on the lead nursing role during home visits (under the direct supervision of the preceptor).
• Your preceptor also identified that you were not able to accurately assess the patient in relation to oxygenation status and smoking history.
• It was also noted that you experienced difficulty in the ability to multi-task and follow directions from the preceptor.
• Concerns were expressed over your limited knowledge and application of medical terminology and lacking a systematized plan for medication classifications and indications.

(Docket No. 1-9 at 1.) Connelly again suggested that if Marlowe wished to graduate in May of 2016 she should arrange a meeting with Kalich, and he told her that she ...

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