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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
      356
    • She deserved to be charged
      103

459 members have participated

4 hours ago, Horseshoe said:

Juan, what do you mean by "the dosing instruction convinced me of that plan"? Which "plan" do you mean?

Also, can you clarify what you mean by a "true sedation" procedure, because many states specifically state that it is within the scope of an RN to provide "moderate" sedation. This is specifically distinguished between "deep sedation" and "general anesthesia."

In my state, it would be entirely within an RN's scope of practice to give Versed/fentanyl for a procdure like a colonsocopy, where the patient maintains his airway and can follow simple commands. 1mg Versed with another 1 mg Versed to follow in the event of continued anxiety would have been well within an RN's scope and would not have necessitated the presence of an anesthesia "provider."

I *think* we are saying the same thing; just wanted to clarify.

We are saying the same thing, I think.

Yes, I know RN's can administer moderate sedation during procedures in the ED, endoscopy suites, etc. Those are done with a physician present and ultimately that sedation protocol is the responsibility of the physician or the proceduralist. Like you said, Versed and fentanyl are used. There are more and more places that actually have a CRNA or provider trained in anesthesia in the procedure room because they could use propofol and monitor the patient without having to intubate.

In this case, like you stated, the physician wrote the order for Versed 1 mg x 1 to be followed by another exact same dose if the first one was not enough for anxiety. I think this certainly is within RN scope in a high acuity or monitored unit (ED, ICU, PACU). There usually is some sort of institutional policy and training module that allows RN's in certain units to do this. Typically Versed is restricted for use by RN's outside of those high acuity units.

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2 minutes ago, Wuzzie said:

I’ve been there too. When we had down time we were often expected to float to busy units to help. They wanted us to give meds. We didn’t want to because we were unfamiliar with most of them but instead of saying no we just looked up each and every one in painstaking detail before we gave it. It took us so long that the floor staff finally asked us to just do vitals and nebs. As licensed nurses we need to know our limitations. 

"As licensed nurses we need to know our limitations."

Absolutely, I also had an experience similar to this case. Working on the floor and my pt was going down for testing and MD ordered 2mg Ativan IV (small lady with no hx of taking drugs), I told Charge I would not give it without a resource nurse to monitor (since I could not go) and received a lot of flack from both Charge and MD, the situation went up to the NM who "assured" me it would be fine but I still refused and told NM and/or MD if it would be fine then they could give it. Imagine that, they then "found" a resource nurse.

 

 

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On 2/6/2019 at 6:59 PM, Crow31 said:

Goodness, I can't get over this nurse is going to jail. You all really think about that. May be your next shift you could be in her shoes. 😔

 

 

She has been charged not tried in court.  She may not even go to jail.  Innocent until proven guilty in a court of law.  

I do not feel criminal charges are the way to go.  I do feel she should never work as a nurse again though.  She bypassed way too many safeguards.  

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Sad, and tragic mistake. I have been an RN for 14 years. I work in the ER and most of us are overwhelmed by the high patient load, lack of support, and the acuity of our people who seem to be sicker, and sicker as they walk through the doors of hospitals. Not a single one of us, is beyond making a medication error just like this one. I can definitively say, the nurses I work with.....we are all diligent; we check, and recheck, and verify and our biggest fear.....what we all lay down at night and have terrible dreams about.....making a mistake which will hurt any patient. This error, though awful, and resulted in the most dreaded outcome possible was not not done with malice, or intent to harm, and certainly not take life. Negligent homicide, really????? Then our society better go back and charge thousands of medical practitioners with the same negligent felonious accounts .....because there have been a multitude of medical decisions made which have resulted in very unfortunate outcomes throughout our hospitals, this country, every day! We, RN’s, doctors, Nurse Practitiner, PA’s and paramedics choose this career to care for people....with compassion, and to uphold, and preserve life. This women does not deserve such a charge, or a prison sentence for an error. I know, I hear the outcry of voices screaming, “What about the lady who died?” Those of us who practice medicine, are still yet human, and to be human, means we are faliable. There are millions of healthcare workers reading this story and desperately wanting to restore life to this women.....and trust me, so does the nurse who made the fatal mistake.  She will endure, and suffer  consequences which none of us can imagine....but a homicide felony charge.....outrageous.   

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This is exactly why I carry personal liability insurance. Even when I'm not working. Too easy to get the blame thrown down on the nurse even though the issue MIGHT go all the way back to a possibly written order with terrible handwriting, filled then by the pharmacist, given then by a nurse who was too new and likely expected to do 75 things at once.

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15 minutes ago, Jax01 said:

Not a single one of us, is beyond making a medication error just like this one.

Just like this one? Nope. There are thousands of us who will never make a series of extraordinarily horrible decisions like this nurse made. That’s not to say I’m above making a mistake. I already have. But to this level uh uh, no way. 

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9 minutes ago, missaretha said:

Too easy to get the blame thrown down on the nurse even though the issue MIGHT go all the way back to a possibly written order with terrible handwriting, filled then by the pharmacist, given then by a nurse who was too new and likely expected to do 75 things at once.

Except that wasn’t the case. The CMS report is linked on page 14. 

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I know we all make mistakes. Or will, for some others. I just don’t see this as that, a mistake. Willfully bypassing some of these safeguards (not even knowing what med you’re administering for one example) in place in this scenario makes me cringe. Rights were practically beat into us in nursing school. Those are rights to protect the patient from harm. Those rights were, in part, were to hopefully better the outcome for the patient. It’s hard to look past some of these negligent behaviors. They’re egregious.  Not checking what medication you’re administering could be viewed as the nurse was purposely attempting to not provide care to the patient when that’s what her job was.  Surely that’s not the case but I could see this scenario as possibly setting precedence in the future.  I think playing roulette with someone’s health is an awful way to expect a good outcome.  The outcome in this case doesn’t help.

I really am sad for this nurse and the choices she made that ended in the loss of life for the patient. None of that sadness will bring back the patient, however. 

Fortunately or unfortunately we have a legal system in place. 

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7 minutes ago, JadedCPN said:

I can't completely agree with this logic. There are way too many facilities out there that are so focused on the money that you have brand new nurses with a year's experience getting placed in inappropriate roles like charge nurse, precepting, etc. Not saying she definitely wasn't a prudent nurse, simply saying that her being in the role of resource nurse does not automatically imply that she was.

Re read my post again, I said she was deemed prudent BY THE FACILITY. Every facility has different standards. 

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6 hours ago, mtnNurse. said:

You cannot conclude that this awful day in this nurse's life represents how she always practiced nursing. She may have been the most prudent nurse in the world up until that day for all we know. Two years is not necessarily enough experience to become a highly competent nurse who is capable of resource-nurse role. It's not hard for me to wrap my head around many possibilities, such as: she was highly competent and then this happened; she was highly incompetent but a well-meaning hard-worker, just not the brightest crayon in the box, and thus far lucked out. 

 

I didn't conclude that she practiced nursing in such a dangerous way so easily. I do feel that we all fall under a spectrum of being ultra detail oriented or lackadaisical. I don't know where she typically lingers on that spectrum but she is a nurse who was apparently on the Dean's List in her BSN (allegedly per media reports), has been working for 2 years in a high acuity setting at a renowned institution, etc. I wouldn't automatically assume that she isn't bright at all given what she has accomplished leading to this event.

I get that med errors happen some with catastrophic outcomes to good nurses but the egregious nature of her actions makes me want to think of a nurse who is "over-confident", "reckless", "non-chalant" despite knowing better. Luck may have been on her side as far as dodging events in her likely short nursing career if this was really how she was as a nurse. I am anxious to read or hear her answers to the cross examination in court but unfortunately, that will be all colored by the coaching she will receive from her legal team.

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This why nurses are suppose to scan medications before giving if computer says no administration order for this med look see if correct med. I don’t agree with charges! Yes she should loose her license but not go to prison! Drs wouldn’t go to jail they would just pay 💰 to family! 

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6 minutes ago, sherriehuntress said:

This why nurses are suppose to scan medications before giving if computer says no administration order for this med look see if correct med. I don’t agree with charges! Yes she should loose her license but not go to prison! Drs wouldn’t go to jail they would just pay 💰 to family! 

You don't think she would have just ignored the scan?  She was in the zone, so to speak. 

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