Nurse Charged With Homicide

[Nurse Beth]

Radonda Vaught, a 35 year old nurse who worked at the University of Vanderbilt University Medical Center, has been indicted on charges of reckless homicide. Read Nurse Gives Lethal Dose of Vecuronium

Radonda is the nurse who mistakenly gave Vecuronium (a paralytic) to a patient instead of Versed. The patient died.

[Tenebrae, BSN, RN]

3 minutes ago, JKL33 said:

Please....I'm asking nicely....please try to keep up with the convo.

She did a very wrong thing and therefore did not know that she had vecuronium in her hands. She should have known what she had in her hands. But she didn't.

And I'm saying as an ICU nurse and a nurse in general, she had no excuse not to know what she had in her hands.

You can ask as nicely as you like. I'm not going to sit by and justify gross negligence that cost a patient their life. Remember, the patient didnt just die, they spent their last minutes fully conscious suffocating

[JKL33]

That's true.

But that isn't what you said in the portion I quoted.

[Ruby Vee, BSN]

2 hours ago, mtnNurse. said:

Can you not imagine the possibility that this nurse was in fact a prudent nurse but inexperienced in the helper-nurse and orientation role she had, possibly in way over her head, and that a series of distracting pressures may have preceded her mindless moments to not think about what she was doing in that one medication administration task? Can you then not imagine how her working environment could make a difference in preventing future mistakes of this magnitude?

How about if inexperienced nurses (two years is not a heck of a lot of experience IMHO) aren't put in helper-nurse role or orienting new nurses to helper-nurse role? How about if ICU nurse could have dealt with her own patient in an environment that ensures every nurse gets an uninterrupted lunch break without causing someone else to double-up on patients? I'm sure we could all make long lists of ways to make a difference to prevent the type of mistake this nurse made. As much as everyone wants to think that no amount of safe working environment would have prevented this nurse from having her mindless moments leading up to the death, I believe the environment could have made all the difference. I believe if she'd had the ideal work environment (which of course is not likely to ever happen in this country), she perhaps would not have had her severe lapse of good judgement -- and if still she had become mindless, she would never have been in the situation that would have allowed her lapse of mind to cause a death. I'm not arguing she's not to blame. I'm not arguing it is solely the system's fault. But I do think if we all just brush it off with "that was a bad nurse who in every way failed to be a good nurse by bypassing med rights, and no change in the system can prevent that", we are ignoring all the failings in the environment that also led to that death. We are then saying that nothing can be done, we can't prevent a "bad nurse" from killing someone.

I think a lot of us want to brush it off with "that was a bad nurse who in every way failed to be a good nurse" so they can tell themselves it will never happen to ME because I'm a GOOD nurse.

Even good nurses make mistakes. EVERYONE makes mistakes. I've done it, and I've had colleagues whom I respect make mistakes.

A lot of folks on this forum seem to believe they never have made a mistake and never will because they follow the rules. Sadly, they're wrong. Hopefully none of us make mistakes so egregious or with consequences so serious, but we will ALL make mistakes.

[Wuzzie]

9 minutes ago, Ruby Vee said:

It wouldn't be unusual for a nurse with two years of experience to not have encountered Vecuronium before, although she should have known to monitor a patient to whom she had just given Versed.

I have been saying this exact same thing repeatedly. I know that she may not have been familiar with Vec but she most certainly had come across Versed in an ICU. The issue isn't the Vec it's the lack of monitoring for the med she THOUGHT she gave.

[Horseshoe, BSN, RN]

I think anyone with a decade or two of practice who says they've never made a med error, or has only made one is fooling themselves-as in they've made more than the one memorable one and just didn't realize it. Maybe not wrong drug or wrong person, but wrong dose or wrong route or wrong time. And the more you've been abused re: nurse to patient ratio/acuity, the more likely this is that you've done it without realizing it.

I'd like to think I'd never make this many mistakes in one series, but never say never (crosses self even though not Catholic).

[Workitinurfava, BSN, RN]

The nurse lost her mind (her head was in the clouds). Why she did, it is hard to say. She may not even know if you ask her. How she worked for 2 years up until now and hadn't killed anyone is what I am wondering. Apparently she must have been doing things right most of the time, to have been employed that long or the hospital was sweeping many things under the rug. Two years in the nursing field is like 50 years in doggy years lolz, just kidding.

[Daisy4RN]

40 minutes ago, Wuzzie said:

I have been saying this exact same thing repeatedly. I know that she may not have been familiar with Vec but she most certainly had come across Versed in an ICU. The issue isn't the Vec it's the lack of monitoring for the med she THOUGHT she gave.

True, I have refused to send a pt down with (only) Ativan on board bc no nurse to monitor. The question is how did she not know that the pt needed to be monitored, esp. if she worked in ICU, this must have come up prior to this somehow.

[JKL33]

Well now I'm curious.

All patients in a hospital are strictly monitored if they've received or have been receiving singular small doses of any IV benzo? IOW, every patient who has received an IV anxiolytic is monitored with sedation protocols?

Is this monitoring formal or informal?

Would like to hear the common practices around the country. Please don't comment on conscious/moderate sedation but rather anxiolysis with a single small dose of IV benzo.

[HomeBound]

6 hours ago, Horseshoe said:

Hey, she's just stating her opinion, just as you have numerous times in this thread, just as I have in this thread.

No, she's not. She's stating, again and again, ad nauseum that the nurse IS NOT ELIGIBLE TO BE CHARGED UNDER ....whatever wikipedia definition suits her argument.

The continuous examples of other cases, completely outside of nursing is what is called a Straw Man Fallacy. She also uses argumentum ad populum---the more she says it, the more it's true, because she believes it.

There is a whole boatload of legal PROFESSIONALS in the offices in TN who disagree, and know the law far, far better than any of us do. The idea that someone is going to continually sit here and say....

SHE CANNOT BE CHARGED UNDER THIS LAW BECAUSE.....I SAID SHE CAN'T.

Show me evidence based argument. Show me what the prosecutors and legal eagles in TN saw that they believe she IS eligible to be charged under this law, and I will listen with an open mind.

This thread was started with the question...

DO YOU BELIEVE SHE SHOULD HAVE BEEN CHARGED. Not in a legal sense. Beth was not asking....hey you nurse lawyers out there---what's the legal basis she's being charged under?

This is an opinion that is being asked. MtnNurse is stating that definitively----SHE CANNOT BE CHARGED.

Well, a bunch of much smarter lawyers and judges will decide that. And they did. A whole lot of procedure has to happen prior to a charge and arrest. This isn't some DV accusation some woman made against her husband and they go pick him up. This charge was leveled after MONTHS of investigation.

If an opinion is offered, evidence should be there to support it. Not examples of completely unrelated stories that are not connected in any way....and then peppering the discussion with argumentum ad ignorantiam fallacies.

[Wuzzie]

3 minutes ago, JKL33 said:

Well now I'm curious.

All patients in a hospital are strictly monitored if they've received or have been receiving singular small doses of any IV benzo? IOW, every patient who has received an IV anxiolytic is monitored with sedation protocols?

Is this monitoring formal or informal?

Would like to hear the common practices around the country. Please don't comment on conscious/moderate sedation but rather anxiolysis with a single small dose of IV benzo.

We are expected to visually monitor the patient for at least 5 minutes and recheck vitals in 15. If the patient is iffy (I think everyone knows what that means) then a portable pulse ox is used. My experience is any respiratory suppression manifests pretty quickly. It should be noted that the onset of Vec is almost immediate. Full monitoring would be overkill. However, this patient had a known bleed. I might put her in the “iffy” category.

[HomeBound]

7 minutes ago, JKL33 said:

Well now I'm curious.

All patients in a hospital are strictly monitored if they've received or have been receiving singular small doses of any IV benzo? IOW, every patient who has received an IV anxiolytic is monitored with sedation protocols?

Is this monitoring formal or informal?

Would like to hear the common practices around the country. Please don't comment on conscious/moderate sedation but rather anxiolysis with a single small dose of IV benzo.

No. She was in a different department, in a scanner, separated from help. When someone is given versed or any other IV medication that can alter consciousness or physiologic response, they are in nursing care. Even when I worked in ED, and I'd give someone morphine---on goes the monitor, even some Os if they're older, obese or otherwise compromised. Monitoring is a given.

In radiology, the techs do talk to the patients. Most of the time, when someone is non responsive, (NOT UNRESPONSIVE), the assumption is made that the person is asleep (it happens quite often) and the tech hits "autoscan". If there is some kind of concern, such as a pt that has been injured in some way---response is required. If the patient is given even .5 of ativan....monitoring is required because of the length of the scans, the distance from the control room, and the fact that if the tech had to elicit a response from the patient each time, the scan would never get done. The sedation is usually given for agitation, or claustrophobia. The whole POINT is to keep the patient calm and hopefully asleep.

Ergo, monitoring.

[Horseshoe, BSN, RN]

7 minutes ago, HomeBound said:

If an opinion is offered, evidence should be there to support it.

Why? Just because you say so?

In my opinion, Whitney's voice was prettier than Mariah's. Where shall I go to find evidence for my opinion?