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Nurse Charged With Homicide

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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
      358
    • She deserved to be charged
      104

462 members have participated

1 minute ago, hyllisR said:

CMS came in and did an audit and found that Vanderbilt had many deficiencies and they came them a chance to correct them. The nurse never got that second chance. 

I'm not saying they treated the nurse fairly.  I certainly don't have a high opinion of Vanderbilt after reading the 57 page report.  I'm just saying that for the foreseeable, the word "override" will likely get their knickers in a knot.

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You said knickers. 😂

 

Sorry, for some reason I’m getting slap-happy and that made me giggle. 

Edited by Wuzzie

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Something also to be said here.  I’ve read that the whole reason this patient went to the PET scan without monitoring was the fact that she had floor orders.  Which is correct.  We often will send a patient to MRI or CT with just transport, off monitors, if they have floor orders and then transport takes them to their new room.  

Im guessing once the patient was down there, they started experiencing some anxiety over the testing.  The original nurse probably called and got an order.  The physician probably had no idea this patient wasn’t being monitored.  Versed is not just a procedural drug as many are saying.  We often use it in the icu for anxiety and agitation.  1mg is appropriate dosing for that.  But they should have been monitored.  Why is the nurse who obtained the order and then sent the resource nurse to push it not also being held accountable?  If we are going this far to charge this nurse, why not the other?  How far does this go?  Nobody should be held criminally liable.

When you type versed in the Pyxis, midazolam comes up.  You can search brand names, but it will pull the generic even in an override.  I’m a little stumped on how vec got pulled.  There are times I myself can’t remember the generics so I type in the brand name.  It then pulls up the generic.  I’m like oh, yeah.  When your mind is in 15 different places, it’s easy to have a brain freeze. The Pyxis should have said that there was already an order in place if there truly was one.  I’m guessing it wasn’t verified yet.  

Versed never needs diluting so I’m stumped on that as well.  I just truly feel like she was not familiar at all with the drug.  Maybe her icu experience was at a small outlier where their icu population is more of a step down population.

The fact of the matter is, this sets a very dangerous precedent.  Think about this.  For all of you that state all nurses make med errors, realize they will now bring charges against you.  It could be considered assault if it doesn’t result in patient death.  Truly think about that.  

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21 minutes ago, TriciaJ said:

I don't think anyone is letting Vanderbilt off the hook.

I think you're talking about whether we here are letting them off the hook, and I agree I don't necessarily think so.

Clarification/question, though:

Are they, or are they not pretty much done jumping through CMS' hoops? Didn't it take them a matter of days to get over that whole "immediate jeopardy" thing? Or is that an ongoing matter?

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9 minutes ago, LovingLife123 said:

Something also to be said here.  I’ve read that the whole reason this patient went to the PET scan without monitoring was the fact that she had floor orders.  Which is correct.  We often will send a patient to MRI or CT with just transport, off monitors, if they have floor orders and then transport takes them to their new room.  

Im guessing once the patient was down there, they started experiencing some anxiety over the testing.  The original nurse probably called and got an order.  The physician probably had no idea this patient wasn’t being monitored.  Versed is not just a procedural drug as many are saying.  We often use it in the icu for anxiety and agitation.  1mg is appropriate dosing for that.  But they should have been monitored.  Why is the nurse who obtained the order and then sent the resource nurse to push it not also being held accountable?  If we are going this far to charge this nurse, why not the other?  How far does this go?  Nobody should be held criminally liable.

When you type versed in the Pyxis, midazolam comes up.  You can search brand names, but it will pull the generic even in an override.  I’m a little stumped on how vec got pulled.  There are times I myself can’t remember the generics so I type in the brand name.  It then pulls up the generic.  I’m like oh, yeah.  When your mind is in 15 different places, it’s easy to have a brain freeze. The Pyxis should have said that there was already an order in place if there truly was one.  I’m guessing it wasn’t verified yet.  

Versed never needs diluting so I’m stumped on that as well.  I just truly feel like she was not familiar at all with the drug.  Maybe her icu experience was at a small outlier where their icu population is more of a step down population.

The fact of the matter is, this sets a very dangerous precedent.  Think about this.  For all of you that state all nurses make med errors, realize they will now bring charges against you.  It could be considered assault if it doesn’t result in patient death.  Truly think about that.  

Because one would think that a certified ICU nurse would understand the basic principle of giving IV push medications which is to monitor the patient after for response. Observation for a period of time after would have been sufficient. Full monitoring was not necessary. Had she waited even one minute  she would have seen that the patient was not breathing. It appears she slammed the med and left. Vecuronium’s onset is almost immediate. 

The med had been verified and was available in the patient’s profile 10 minutes before she tried to pull it. 

At the time it happened she had two years of experience in the Vandie ICU and was certified as a CV-ICU nurse. 

I don’t at all agree with the alarmist idea that every nurse is now going to be indicted for simple med errors. This was not just a med error. It was an egregious violation of all the standards which bind us as nurses. 

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9 minutes ago, JKL33 said:

I think you're talking about whether we here are letting them off the hook, and I agree I don't necessarily think so.

Clarification/question, though:

Are they, or are they not pretty much done jumping through CMS' hoops? Didn't it take them a matter of days to get over that whole "immediate jeopardy" thing? Or is that an ongoing matter?

https://www.nashvillepost.com/business/health-care/hospital-management/article/21034476/cms-rescinds-vumc-termination-notice

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10 minutes ago, Wuzzie said:

Because one would think that a certified ICU nurse would understand the basic principle of giving IV push medications which is to monitor the patient after for response. Observation for a period of time after would have been sufficient. Full monitoring was not necessary. Had she waited even one minute  she would have seen that the patient was not breathing. It appears she slammed the med and left. Vecuronium’s onset is almost immediate. 

The med had been verified and was available in the patient’s profile 10 minutes before she tried to pull it. 

At the time it happened she had two years of experience in the Vandie ICU and was certified as a CV-ICU nurse. 

I don’t at all agree with the alarmist idea that every nurse is now going to be indicted for simple med errors. This was not just a med error. It was an egregious violation of all the standards which bind us as nurses. 

Who says it was available for 10 minutes? Vanderbilt?  And what about the Neuro ICU that called to get it ordered?  They knowingly sent a resource nurse to an unmonitored patient to push versed.

And I’m not off base saying we can all be charged.  This is a precedent being set.  Precedents are what shape future legal decisions.  

Im not saying this nurse was not wrong.  I think she should possibly lose her license as she was obviously not safe to practice in the position she was given.  And you are not “certified” to work in an ICU.  There are certifications you can get down the road, but it’s not some big test you pass to work in the icu.  I have no certifications but have been in the icu for over 5 years.  

I’d like to see that DA go in and prosecute all the asssults occurring in that hospital on a daily basis.  Then, we can talk.  

Where’s the outrage over the NP that was killed in the parking garage recently?

Edited by LovingLife123

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13 minutes ago, LovingLife123 said:

Who says it was available for 10 minutes? Vanderbilt?  And what about the Neuro ICU that called to get it ordered?  They knowingly sent a resource nurse to an unmonitored patient to push versed.

And I’m not off base saying we can all be charged.  This is a precedent being set.  Precedents are what shape future legal decisions.  

Im not saying this nurse was not wrong.  I think she should possibly lose her license as she was obviously not safe to practice in the position she was given.  And you are not “certified” to work in an ICU.  There are certifications you can get down the road, but it’s not some big test you pass to work in the icu.  I have no certifications but have been in the icu for over 5 years.  

I’d like to see that DA go in and prosecute all the asssults occurring in that hospital on a daily basis.  Then, we can talk.  

Where’s the outrage over the NP that was killed in the parking garage recently?

1. The Accudose and EPIC say so. Are you not aware that all that information can be tracked? CMS pulled the log from both systems and determined this. Nobody made it up. 

2. The resource nurse was an ICU nurse not just some random nurse pulled from anywhere and 1mg of Versed is an anxiolytic dose that does not require full monitoring. It DOES require observation like any IV push med does. Surely with your 5 years of experience you know this. 

3. Sorry this nurse was identified as a certified CV-ICU nurse but was actually CCRN certified although that must have been a fairly new certification given her experience. I’m well aware of the process. I have a few. 

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24 minutes ago, LovingLife123 said:

Where’s the outrage over the NP that was killed in the parking garage recently?

Ummmmm. Not related to this issue whatsoever. If you want to discuss it feel free to start a new thread, I’ll gladly chime in. One of my colleagues knew her well. 

Edited by Wuzzie

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51 minutes ago, Wuzzie said:

I don’t at all agree with the alarmist idea that every nurse is now going to be indicted for simple med errors. 

I agree with you completely.  

Edited by Susie2310

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9 hours ago, mtmkjr said:

Now move on to the actions of this nurse who did none of the checking and then proceeded to another area while in conversation with her orientee about who-knows-what (obviously not about correct processes and procedures...). She at this point believes that the Versed has not yet been verified, and in her rush to complete the task I I think it is more likely she would have also bypassed scanning. In her mind it would not scan if not in the patient's profile.

That's certainly possible given the gross lack of caution and common sense displayed in this nurse's actions. She seems like a lost cause at this point but it's hard to wrap one's mind around how a person can finish a BSN and work in an ICU for 2 years and not kill someone sooner if that is how she practiced nursing. 

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6 minutes ago, juan de la cruz said:

That's certainly possible given the gross lack of caution and common sense displayed in this nurse's actions. She seems like a lost cause at this point but it's hard to wrap one's mind around how a person can finish a BSN and work in an ICU for 2 years and not kill someone sooner if that is how she practiced nursing.

There’s no telling what may have occurred prior to this incident and I doubt we’ll ever know. The crazy thing is her license hasn’t even been suspended. 

Edited by Wuzzie

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