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.

[TriciaJ, RN]

4 hours ago, Dsmcrn said:

You are way to quick to bash her. You know well I meant out in the every day world like the grocery store. The mall. The park. These are the places among many others criminal are a threat to society.

She has not been bashed. Hospital patients are part of society. Their safety is important, too. Any practicing nurse who is not fit to practice is a threat to that part of society. I'm not saying she is unfit to practice. But the information available so far needs to be addressed and society needs to be assured that she is fit to practice before she goes back.

The BON should have done this. They didn't and now it is a matter for the courts.

[hppygr8ful, ASN, RN, EMT-I]

10 hours ago, Pixie.RN said:

I understand that; where did I say she wasn't responsible for every single action? I am thinking about intent in the context of a murder charge. I am not a lawyer (obviously), but I always thought that murder required intent. This sounds more like... what, involuntary manslaughter? Murder lite? I dunno. She screwed up, no doubt, and she admits it. I am just musing over coffee. ☕

Legally she is not being charged with murder. She is being charged with criminally negligent homicide which are two different things. The first has implied intent the second requires no intent as the person killed is usually by some accident or mistake as a result of negligent actions.

Hppy

[hppygr8ful, ASN, RN, EMT-I]

10 hours ago, Dsmcrn said:

Extremely polite? Now that’s funny.

i didn’t say anyone said she did with intent. I said that is the key word. She didn’t. I was responding to Pixies comment. I didn’t say “these people say she intended” reread my comment I would cut and paste but it won’t allow me.

Actually Wuzzie is being extremely polite to you and I have watched the exchange with interest. Wuzzie has never been one who doesn't say her/his piece but almost always has facts to back up whatever is being said.

Hppy

[hppygr8ful, ASN, RN, EMT-I]

As a guide on this forum I feel I have to remind all here of a few rules. What started as a civil discourse on the merits of the case has turned into pages and pages of unnecessary name calling. There are some strong opinions here and all have merit and deserve to be said, but when one reacts with defensive name calling their argument immediately loses credibility.

I have been a nurse for nearly 20 years in one of the most competitive job markets in the country. I have worked LTC, LDRP, Med Surge and currently psych. To my great pleasure I have never been in a situation described here where administrations set nurses up to fail by purposely creating dangerous working conditions. However I am not a person who is easily rattled by the actions of others. I left the bedside because I didn't like the drama of my peers there. We have a great comradery where I work in that we take care of each other to ensure that the strengths of each team member from the Admins to RNs to housekeeping feel valued and supported. Still there are days I do wish I could have stayed home and baked cookies.

Let's try to keep this discourse civil and keep to "I" statements rather than "You" statements. There is no call for that

Hppy

[falconersys]

On 4/6/2019 at 6:59 PM, student24 said:

Hello Wuzzie,

Do not never say it can't happened to you, yes we are taught how to do things correctly but in the REAL world sometime we do not do it because the amount of pressure hospital administration put on US, ie, nurse managers, charge nurse, clinical coordinators, etc... The only way this can never happen is if ratio are doable, nurses are not burnt out and have time to care and know the patient we manage instead of completing task. It is so sad to see nurses like you think the nursing world is perfect, you probably never put time in and actually worked,REAL work. Smh... Nursing is a cut throat world, majority of our fellow sisters eat and chew us out. No support. I pray this never happens to you or anyone else.

According to the released reports, RV admitted that there was safe staffing ratios that night and that her unit had never had a problem with being short staffed. It's possible, but unlikely, that she was burnt out after only nursing for a couple years. I see the point you're making here, but it doesn't apply to this particular scenario. This nurse cut lots of corners. Even if she had only taken an extra 10 seconds to review the 5 rights, it's likely that the patient would still be alive. Nobody is too busy to do that.

[Wuzzie]

13 hours ago, Dsmcrn said:

Extremely polite? Now that’s funny.

I have not called you names, I have not judged your practice, I have not judged you personally, I have not yelled at you, I have not ridiculed your opinion. I have only asked for clarification and supporting evidence of the “facts” you keep referring to and my opinion differs from yours. The fact is you don’t like it my opinion but frankly that is too bad and it doesn’t make me rude.

[LilPeanut, MSN, RN, NP]

On 4/6/2019 at 11:48 AM, student24 said:

Listen, you can put up as many examples as you want, it is not the same when you are a bedside nurse and have critical patients to manage. I see you are a N.P (me too) but remember when you were at the bedside doing the best you can to manage these patients, praying none of them coded because you are barely making it for the shift. Please stop throwing nurses under the bus because it can happen to you too in different ways. As nurses, you know hospital administration treat us like garbage, never listen when we say we have too many patient, cannot admit another so you are forced to transfer another to get another (don't forget) with your silly sad examples. I can't stand nurses like you, acting high and mighty. This has touch my heart because I know as a SICU nurse now NP how things can get crazy.

I was never negligent as an RN. I am not negligent as an NNP. I make mistakes, but I am not negligent. There's a difference between making a mistake and negligence. And honestly, I've never been in these situations that some people refer to. I've been on a unit when we've been short staffed, but not to the level people here talk about. More like it's just annoying because my night is crazy, but I'm not scared for my patients.

I floated once as an RN and had a pt. with an assessment that I felt wasn't good and needed more care and so I kept escalating up the chain of command until the infant was properly cared for. As nurses, we can't expect to be absolved of responsibility when we know something is wrong and do it anyway.

On 4/6/2019 at 8:02 PM, Young_Torso said:

This post is riddled with poor comparisons.

1. Comparing this situation to a drunk driver: not close because while both involve licensure, the accessibility to the means to cause harm is MUCH, MUCH, MUCH higher for the drunk driver. You can suspend a drunk driver's license and they can still potentially cause harm as long as they have access to car keys. A nurse can't just randomly show up at any given healthcare facility and potentially cause harm. You're also not dealing with any issues of underlying addictions that create such behavior.

2. Comparing this to the high mother: again not a good comparison because there's no licensure involved in having a child, and that's not even factoring in that baby doesn't just starve and die in the same duration that pushing a paralytic would do the job. That's days upon days of complete and utter neglect rather than a few moments. Infinitely greater potential to right that wrong.

3. Comparing this to drug dealers: this one isn't even close. I'll also give my unpopular opinion that the drug dealers should definitely be charged with possession with intent to sell, but not homicide (unless they sold a drug mixed with a substance that the buyer wasn't looking to purchase). I don't think we should charge store clerks at the liquor store with homicide if someone went in and bought a handle of vodka and subsequently died of alcohol poisoning.

4. Comparing to someone accidentally shot: this is more of a consequence of a lack of gun regulations in this country. This country was built on the backs of guns and we've had over 2 centuries to establish gun legislation had some semblance of reasonability. It's negligence, but I've taken a look at Utah's gun laws and it seems like laws on recreational shooting are...vague at best.

5. Comparing this to an irresponsible landlord: Again...no licensure issues that would stop an individual from doing the same thing again.

6. Comparing to an airshow pilot that accidentally crashed: No mention of mechanical failures. Just sounds like an airshow gone wrong without any explanation of the actual "negligence". Call me crazy...but I've been to an airshow and they're inherently dangerous.

No matter the differences, I think the big difference lies in how we feel jail time benefits the perpetrator and the community as a whole. I'm of the opinion that jail should be reserved for violent criminals and individuals that prey on others for their own gain--individuals that truly have no value to society and pose a definite threat to others. If there's a chance to remove the individual from the environment to which they've caused harm and help rehabilitate that should be the first option.

You are comparing specific actions, which misses the point.

They are all criminally negligent homicide, same as RV. They are all people who didn't intend to kill anyone. Many of them likely feel horrific that someone died. But they were still charged.

On 4/6/2019 at 8:35 PM, Young_Torso said:

Did you happen to see the poll where over 1/5th of those that voted think she should be charged? What do you think will happen if she's charged and convicted?

Other than that we agree on every point other than the buck stopping at the level of the justice system.

As other people pointed out, charging does not mean jail time. If I had been in her shoes, I would have plead guilty and thrown myself on the mercy of the court.

I read the TBI and it's even more damning, IMO. I was somewhat relieved to see that she did look at a MAR eventually, even though she would have seen the versed listed as midaz there, so that should have keyed her into the generic name that was on the patient profile. But the number of warnings on the pyxis is damning.

I'm surprised that no one else in the legal part is commenting that versed is a double pull and vec isn't and the fact that it wasn't a double pull should have also been a red flag. If you are trying to pull morphine and it isn't asking for a witness, wouldn't you do a double take and wonder what went wrong?

[JKL33]

5 hours ago, LilPeanut said:

I'm surprised that no one else in the legal part is commenting that versed is a double pull and vec isn't and the fact that it wasn't a double pull should have also been a red flag. If you are trying to pull morphine and it isn't asking for a witness, wouldn't you do a double take and wonder what went wrong?

If the white powder doesn't invoke a full stop, I don't know what would. But I'm commenting because details like what you are calling a double pull are specific to the institution and its configuration of the particular machine in the unit where it is located. I've never had to have a witness to remove any CS.

But none of the investigation seems very thorough to me so it also wouldn't surprise me to find out there's more...

[Truth66]

I know that I have been periodically ridiculed by various supervisors when I intervened in different situations in order to safe guard the patients under my care. One case in particular was during an influenza outbreak. The house physician had ordered every one of the elderly residents to be placed on an anti-viral medication. The medication didn’t arrive to the facility until shortly after 10:00 pm. By the time I had all of those prepackaged meds sorted for the 30 plus residents it was around 10:15 pm.

I spoke with the charge nurse and we agreed that the medication should not be given that late because nearly all of the residents were asleep. In addition, many of these residents had already been given their HS sedation a couple of hours prior. One of the principal side effects with this antiviral medication was nausea and vomiting. Therefore, it was also a safety issue of not giving the antiviral medication at that time. There would be no way to safely monitor that many residents. I put on my report (my shift ended at 11:00 pm) what we had done and for the staff on days to get the time for this medication checked by the physician.

The Assistant Director of Nursing had me in a disciplinary meeting several weeks later for not giving that medication that evening. I made it clear that it was discussed with the charge nurse and we had agreed that the administration time of that medication being so late was not appropriate. I was warned by both the Assistant Director of Nursing and someone from Human Resources that if that situation arose again, I was to give the medication.

How many nurses have been bullied into doing a nursing task that they know full well could jeopardize the safety of their patients?

I’ve been in situations where a call bell is ringing and when I went to answer it, I was told to stay where I was by a senior staff and told that one of the Personal Support Workers can answer it. If that call bell was a medical emergency and I didn’t answer it, what kind of trouble would I be in if that resident died and it could have been prevented?

These two examples are only a small glimpse of what I’ve experienced in my 15 plus years of nursing. The point is that many Nurses are routinely placed in situations where they could potentially injure/kill someone. One of the key aspects of Nursing is Critical Thinking. Yet, if the Nurse is not allowed to use their Critical Thinking because of their particular work environment, how many of those patients are at risk?

How many Nurses out there have been “ordered” to do various things that could potentially harm their patients? Many of those Nurses have done those things due to the high probability of being disciplined under insubordination, even though their Critical Thinking told them that it was wrong.

[LilPeanut, MSN, RN, NP]

30 minutes ago, JKL33 said:

If the white powder doesn't invoke a full stop, I don't know what would. But I'm commenting because details like what you are calling a double pull are specific to the institution and its configuration of the particular machine in the unit where it is located. I've never had to have a witness to remove any CS.

But none of the investigation seems very thorough to me so it also wouldn't surprise me to find out there's more...

Are you in the US? I'd be shocked if there was anywhere in the US where controlled substances are readily available without a second person.

[Dsmcrn]

Was Versed the appropriate drug of choice for claustrophobia during PET scan?

[KJoRN81, RN]

Do others have to have a witness simply to pull meds (controlled obviously) from the Pyxis, etc? We don’t, never have anywhere I’ve worked...only if we’re going to waste some of it of course.