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Nurse Charged With Homicide

Nurses   (39,159 Views 676 Comments)
by Nurse Beth Nurse Beth, MSN (Advice Column) Writer Innovator Expert

Nurse Beth has 30 years experience as a MSN and works as a Nursing Professional Development Specialist.

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Nurse Charged With Homicide

  1. 1. Should Radonda Vaught, the nurse who gave a lethal dose of Vecuronium to patient at Vanderbilt University Medical Center, be charged with reckless homicide?

    • She should not have been charged
      367
    • She deserved to be charged
      106

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8 hours ago, juan de la cruz said:

OK last point which I think is very important and could have saved this poor patient. Why doesn't Vanderbilt have bar code scanning for med administration in Radiology? All that is needed is a workstation on wheels with a scanner in all departments. I work for a similar-sized institution and nurses are not allowed to administer medications without bar code scanning in non-emergent situations, no exceptions!

I don't disagree and they had plans to roll it out in radiology. They were within several weeks of a their new (huge) EMR rollout when this happened.

However, although it would have been another precaution, I don't encourage anyone to use BCMS as a primary tool. It's a second or third check, aka "confirmation" at best. I see plenty of people who grab stuff out of machine and don't look carefully at it - because they plan to scan. Although they are a great tool, the ways in which they have been promoted is unfortunate. There just is no substitute for the 5Rs and I think we should spend some energy on promoting that, low-tech and uncool as it may be.

 

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Before a nurse pulls a certain med ( medication like the one the nurse gave ) there should be some verbal oversight by the pharmacy. You should need a special code that you get from the pharmacist. The pharmacist should question the heck out of you as to why you need this override code. A machine is a machine all day long and despite the nurse not checking things on her part it still doesn't negate that a woman was killed. How will this change in the future if ths hospital doesn't have a better way of handling this?  

Edited by Workitinurfava

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18 minutes ago, juan de la cruz said:

Would she override that too? that is certainly possible but we also have to reassure the public that systems such as bar code scanning exist for their protection. I spoke to a layman friend about this case and his reaction was "now I'm afraid to be a patient in a hospital".

Ha - I just erased a diatribe about how often we are instructed to override inappropriate error messages (depending upon how carefully or shoddily everything is programmed and how the ordering system is used overall)...I said I've had more than one professional-but-somewhat-terse conversations with important people trying to inform them how it is not appropriate to instruct nurses to override error messages because you don't yet have the system working the way you want it to....

Guess what happens when there are just too many inappropriate errors or hard stops that you have to override? Override becomes "NBD" almost instantly.

Re: Reassuring the public...

Do you feel things are generally safe in hospitals? Sincere question, of course. 🙂

Edited by JKL33

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juan de la cruz has 27 years experience as a MSN, RN, NP and works as a Adult Critical Care Nurse Practitioner.

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19 minutes ago, JKL33 said:

Do you feel things are generally safe in hospitals? Sincere question, of course. 🙂

I feel I work in an ICU that strives for safety at all times.

Our nurses are not allowed to override meds in non-emergent situations and actually get written up by Pharmacy for doing so. Pharmacy is just a phone call away so if they want a med order approved quicker, all they need to do is call the ICU Pharmacist and the nurses carry phones so calling is easy.

Our Pyxis has a blue line in a rectangular area where nurses would stand to get meds. That's a reminder for anyone, provider or any other hospital staff that the area is a no interruption zone because nurses need to focus on the act of pulling the right medication alone.

Like I mentioned already, we have bar code scanning in all the departments and we have been using Epic since 2013. 

We have break nurses as well. We use a similar Resource Nurse system but these are seasoned ICU nurses who won't take BS from anybody (physician or otherwise) and won't be cajoled into doing menial work because another nurse is too lazy to do it.

Have errors happened? I'm sure but hopefully not this magnitude.

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4 hours ago, Dsmcrn said:

This is a horrible direction for our profession.

Medical errors have been shown to harm or kill large numbers of patients annually.  Many medical errors go unreported.  Medical errors are not currently reported on patients' death certificates.  I read someone contrast this to the aviation industry, where near misses/accidents whether or not they result in passenger deaths/injuries are closely investigated and action taken.  

I don't believe this is a horrible direction for our profession; I hope it is a wake up call that will lead to changes that will result in improved patient safety.  Yes, criminal charges can be brought against licensed health care professionals.  Some nurses seem shocked at this.  Our licensure means that we are held legally and professionally responsible and accountable for meeting professional standards of care.  The purpose of our license is to protect the public.  Maybe more people who are either considering or are in the process of becoming licensed health care professionals will give serious consideration to the implications of professional licensure.  

My hope is that the general public will get more involved politically in advocating for patient safety.  Health care as an industry relies on the confidence of the public.  I believe that the general public has lost much trust in the health care industry.  

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The bit that I just cannot get my head around is that the nurse didn't actually read the label on the vial. I simply cannot imagine ever sticking a needle into a vial and drawing up medication without actually looking at and reading the label. 

I can certainly see some aspects of the Swiss cheese effect, perhaps she was rushed and overworked,  perhaps she was in a role which was not appropriate for her experience, perhaps her orientee was a distraction, perhaps there was a lack of communication and some confusion and she believed somebody else would be monitoring the patient, maybe someone was having a hissy fit over the holdup getting the patient scanned, maybe she was having a spectacularly bad day. .........It takes seconds to read the label on the vial.......

I'm from the UK and I work in patients homes not in a hospital so completely different culture. I am curious how technology; automated medication machines, scanning etc has affected nurses thinking and behaviour. What are people's honest opinions, has this created a culture where it's the norm to not read labels on vials? Not judging, just curious.

 

 

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Maybe the nurse was chemically impaired or dealing with some mental issues, we will never know because apparently it isn't important to check when charging someone with homicide. We are assuming she wasn't. If she was high on something, things make more sense, if suffering from a  mental condition, then its another  story. The case has holes.

Edited by Workitinurfava

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2 hours ago, Workitinurfava said:

How do we know that the hospital didn't set some of these things up?, like planting the syringes, they definitely aren't on her side and probably want to hurry up and just be done with the whole case. The hospital didn't allow for any mental evaluations  to be done on the nurse, yet concluded all of these things. Maybe something was going on with her mental state at the time.

OMG! Now you’re really reaching. The hospital PLANTED the syringes? Did you read the CMS report? Wait, you couldn’t have read it and come up with this idea. If you do read it you’ll see that what happened is in the nurse’s very own words!!! And where do you get that the hospital refused a mental evaluation? The conclusions the CMS, not the hospital, came up with were based on direct deposition of each of the staff members involved. 

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35 minutes ago, Workitinurfava said:

Maybe the nurse was chemically impaired or dealing with some mental issues, we will never know because apparently it isn't important to check when charging someone with homicide. We are assuming she wasn't. If she was high on something, things make more sense, if suffering from a  mental condition, then its another  story. The case has holes.

The case has zero holes. 

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1 hour ago, JKL33 said:

However, although it would have been another precaution, I don't encourage anyone to use BCMS as a primary tool. It's a second or third check, aka "confirmation" at best. I see plenty of people who grab stuff out of machine and don't look carefully at it - because they plan to scan. Although they are a great tool, the ways in which they have been promoted is unfortunate. There just is no substitute for the 5Rs and I think we should spend some energy on promoting that, low-tech and uncool as it may be.

 

I am embarrassed for our profession that we have had to resort to this kind of technology to make up for the fact that we are not doing our jobs the way we were taught. The bar code scanning is in place because we take short cuts and don’t do the 5 rights like we are supposed to. We wouldn’t need it if we were. 

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TriciaJ has 35 years experience as a RN and works as a Retired.

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14 hours ago, johsonmichelle said:

Of course not. I don't think you understand my point. Apparently this nurse was serving as a resource nurse. For example, if you are a medical surgical nurse, and  you were pulled to the ICU as a resource nurse/helping hands and a physician ordered an ICU medication that was appropriate but you never received training for  it, would you administer the medication?

1.  Ask the charge nurse:  is there anything specific I need to know about Versed?  2.  Do a quickie look-up on whatever resource I have on hand  3.  LOOK at the med I've pulled and make damn sure it's what was ordered  4. Call the ED and say I'm running late on the swallow study;  I need to stay and monitor a patient.

This was not an error.  This was a nurse demonstrating no more care and attention than you could legally expect from a layperson.  Yes, the hospital bears culpability for a lot of things.  But as nurses we are held to a certain standard of practice and responsible for our own actions.

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4 minutes ago, TriciaJ said:

1.  Ask the charge nurse:  is there anything specific I need to know about Versed?  2.  Do a quickie look-up on whatever resource I have on hand  3.  LOOK at the med I've pulled and make damn sure it's what was ordered  4. Call the ED and say I'm running late on the swallow study;  I need to stay and monitor a patient.

This was not an error.  This was a nurse demonstrating no more care and attention than you could legally expect from a layperson.  Yes, the hospital bears culpability for a lot of things.  But as nurses we are held to a certain standard of practice and responsible for our own actions.

You did not answer my question, I'm not trying to deter from the original case, because the nurse in question is an ICU nurse. I'm not an ICU nurse, therefore I  would not administer ICU medications under normal circumstances especially in this case. It's also part of the unit policy not administer those type on my floor unless it was an emergent situation.

Edited by johsonmichelle

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