Nurse Charged With Homicide

Nurses General Nursing

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  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?

    • 395
      She should not have been charged
    • 128
      She deserved to be charged

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Radonda Vaught, a 35 year old nurse who worked at the University of 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.

52 minutes ago, HomeBound said:

We already do have all the safeguards in place to "make sure this never happens again" and it fell to her, as a professional, to make use of those safeguards. She chose to ignore them.

If you had the power to put even more safeguards in place to help prevent future mistakes, could you think of any?

Here's some I thought of and I'd love to hear more from others:

* Hire enough qualified staff and train them well. No nurse should be pressured to care for more patients than she feels she can safely handle.

* Figure out a system for giving nurses uninterrupted breaks (what worker doesn't deserve at least one lunch break during a 12-hr shift?) that does not entail a fellow nurse doubling up on patients.

* Ensure that only a well-trained nurse of a given specialty can cover for other nurses of that specialty during their breaks.

* Ensure resource and float nurses are well-trained to provide support in areas they are going to help in. Enable resource nurses to block incoming messages for next-up orders using a message like "with a patient, do not interrupt".

* Administration should actively encourage staff every day to slow down, follow all safety measures, and call for help if they are being pressured to go faster than what is safe. Have a number to call for help if everyone in the nurse's area is too busy to help and a situation is feeling unsafe.

11 Votes
Specializes in LTC, assisted living, med-surg, psych.

I wouldn't charge her. I do think she deserves to lose her license, however. This wasn't just a "mistake", it was negligence all the way. We've all been in situations where we could have given the wrong drug to the wrong person (and I'm sure we all have at one time or another), but why on earth didn't it occur to her that something was wrong when she reconstituted a drug that wasn't supposed to come in a form that needed to be reconstituted? What was she thinking?? Or was she thinking at all? Was she running on autopilot or just ignorant of the medication she was about to administer?

There's no excuse for either. But again, I don't think she should be thrown into the criminal justice system. She will undoubtedly suffer from this for the rest of her life, and she will probably never work as a nurse again. That's enough punishment IMHO.

2 Votes
Specializes in ED, ICU, Prehospital.
1 minute ago, mtnNurse. said:

If you had the power to put even more safeguards in place to help prevent future mistakes, could you think of any?

Here's some I thought of and I'd love to hear more from others:

* Hire enough qualified staff and train them well. No nurse should be pressured to care for more patients than she feels she can safely handle.

* Figure out a system for giving nurses uninterrupted breaks (what worker doesn't deserve at least one lunch break during a 12-hr shift?) that does not entail a fellow nurse doubling up on patients.

* Ensure that only a well-trained nurse of a given specialty can cover for other nurses of that specialty during their breaks.

* Ensure resource and float nurses are well-trained to provide support in areas they are going to help in. Enable resource nurses to block incoming messages for next-up orders using a message like "with a patient, do not interrupt".

* Administration should actively encourage staff every day to slow down, follow all safety measures, and call for help if they are being pressured to go faster than what is safe. Have a number to call for help if everyone in the nurse's area is too busy to help and a situation is feeling unsafe.

yes.

it's called.....unionizing.

4 Votes
Specializes in Palliative.

Extenuating circumstances are a thing when it comes to real justice. And the purpose of law is ostensibly meant to be justice (though it rarely is). This is why most law systems have moved to a focus on rehabilitation rather than retribution. Retribution might feel right, but it rarely serves anyone. For those who said it, it means nothing to justice that you personally wouldn't "forgive". That's simply an emotional reaction.

Justice is also rarely cut-and-dried. Nor is the justice system always concerned with justice. Many missteps from the war on drugs to life sentences for felony murder to notorious plea bargains show this. Much of it is politics used by the powerful against the powerless, as it's quite clear this case is.

Because we know how the health system really works, I think most of us are capable of seeing through the smokescreen the hospital is using to deflect any blame from its own practices. If several people in administration were also charged for the decision-making structure that led to the nurse being unable to perform certain parts of her duties (specifically the monitoring), that might change things. But they aren't.

Additionally the charges do not appear to fit the crime. Claiming "reckless" homicide clearly is making a judgement about the thought process of the nurse that I'm not sure can be supported. This requires that she knew she was putting the patient at risk and proceeded knowing this. I think that would be very difficult to prove, especially if they're using pyxis override to do it. They *should* be fully aware that everyone needs to do this all the time simply because pharmacy hasn't processed stat orders. Pushing in this direction anyway suggests strongly that this is an intentional deflection and that she is their scapegoat, just as every poor person with a crack rock was to the "tough on crime" advocates of the 90s. Sure they did something wrong, but they were punished in proxy so that the real problems that put them there would not have to be addressed.

Iirc, this same hospital was forcing nurses to do housekeeping duties. This would be at least one systemic contributing factor, and I'd guess there is likely no real union in this hospital either. How many tasks was this nurse expected to do in 12 hours that she felt she needed to hurry the process on in this way?

I think this shows there is a discussion that needs to happen and that is how we as nurses are shouldering the Sisyphan burden of jobs that multiple people couldn't get done, plus everyone else's jobs, plus dealing with assaults and harassment and then blamed for all of them when we simply couldn't do the impossible. And now charged.

It's very much a reality of nursing that we were taught "best practices" and then quickly learn we will never be allowed to practice that way by hospital administrations. I am personally convinced best practice guidelines exist solely to provide a framework for blaming a single nurse when things go bad due to systemic failures, as I suspect had happened here. They don't want you to actually follow them. As I've said previously, I think this can be proven by the fact that "work to rule" is an effective labour resistance technique.

Nursing is like spinning straw into gold. This situation shows it and raises the question, how do we say "enough"? How do we protect the lives of patients and ourselves against what the profession is being turned into? It's something we need to answer sooner rather than later.

11 Votes
5 hours ago, HomeBound said:

That is the definifition of negligent, and according TO THE LAW, "reckless homicide" is when you are AWARE (and being a nurse, if she was not aware that every single damned drug she ever gives to anyone is a potential to be lethal...and she doesn't get it that she needs to....oh.....ASSESS EFFICACY....she needs to not be a nurse) that your behavior may endanger another, and you do it anyway.

I think it's pretty unlikely she was aware that her behavior might kill that patient, because if she had been then she would not have behaved in the way she did. She was being mindless and made the horrible assumption that she grabbed the right medicine. When committing the fatal act of injecting it into the patient I bet she had no doubt in her mind that she was giving the right medicine and the patient would not be harmed. So I don't think "reckless homicide" applies to her situation. You argued that she should have been aware, and that's true, but that doesn't mean she was.

4 Votes
Specializes in ACNP-BC, Adult Critical Care, Cardiology.

Just as a hypothetical question...I learned of this case from an acquaintance at VUMC even prior to this case blowing up in the media. This happened over a year ago and I’m told that the nurse was fired following the sentinel event at VUMC but sought employment and did get a job at another ICU in the Nashville area fairly soon after the case. There was either no complaint made to the BON or the process for investigating BON complaints go at a snail’s pace, I’m not sure. If this is true, would that affect perceptions of the jury on how she dealt with the tragedy? I think it might get brought up as a point against her. I have no idea what her state of mind is before, during, and after it happened so I won’t pass judgement.

4 Votes
Specializes in LTC & Teaching.

This case has hit too close to home, but for the wrong reasons.

Several years ago I badly injured my back and was put on various medications which created impairement. These were Percocett, Flexeril and Naproxen. In spite of this impairement issue, the Worker's Compensation Board (WCB) insisted that I be at work and they put in writing that I was to do light medication passes. I insisted that I was a nurse and that I am accountable to my governing body. They still insisted that I be at work. Eventually my employer pulled me off work because I was impaired and indicated that I was in a safety sensitive possition.

Once the WCB got wind that I was off work, they went nuts and imediately deemed me as non compliant. They retaliated further by denying me more than two thirds of the treatments that I needed to recover. They deliberately sabotaged my recovery and my back continues to be messed up to this day with all of the treatment denials.

Had I been at work in the condition that I was in, there's a high probability that I could have done various medication errors, potentially killing one or more of the elderly seniors under my care.

About a year later when I was on even stronger medication, the employer's insurance provider started doing the same thing that the WCB did. During that period I was on numerous medications which included 1500mg of Valproic Acid per day. They were routinely dismissing my professional obligations as a nurse. They eventually deemed me as non compliant as well and stopped paying me.

It has been over 7.5 years and the battles with the WCB continue and last year, after sending them mounds of medical documents, they continue to insist that I'm being non compliant. I have insisted that I will not intentionally commit an act that can potentially kill somebody.

My heart definitely goes out to this nurse in the original post who has been charged, because that could easily have been me.

1 Votes
Specializes in ICU.

This entire scenario is just horrific. We all know the dangers of unsafe nursing assignments and we accept is because “that’s just the way it is”. So many corners are cut due to unsafe and dangerous staffing practices. Every time there’s a new requirement to be met it is dumped on the nurses. They’re giving us more and more responsibilities and less and less time and help to do it all. It is time we all (every last damn one of us) start advocating for patient ratios and an end to unsafe staffing practices. It could very easily be one of us being crucified for a mistake that should never have been possible to have been made in the first place.

8 Votes

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. ?

3 Votes
18 minutes ago, lemur00 said:

It's very much a reality of nursing that we were taught "best practices" and then quickly learn we will never be allowed to practice that way by hospital administrations. I am personally convinced best practice guidelines exist solely to provide a framework for blaming a single nurse when things go bad due to systemic failures, as I suspect had happened here. They don't want you to actually follow them. As I've said previously, I think this can be proven by the fact that "work to rule" is an effective labour resistance technique.

EXACTLY!!! I've been trying to figure out how to put these thoughts of my own into a concise paragraph and you did it for me!

There is a huge gap between what nursing school teaches us is the right, safe way to do things and what the reality is of what's expected in most nursing jobs out there. When I started as a new nurse, trying to go through all the medication steps which included explaining side effects of each medicine to my patient, my preceptor harshly reprimanded me "This ain't nursing school, we don't have time for that!" and showed me that we are to just hand over the meds and tell the patient "Here's your medicines, Yes you need them, Doctor ordered them, just take them".

6 Votes
Specializes in medical oncology, emergency.

For an error this significant to reach the patient this is failure of the system, thus a system error. She should not have even had access to this drug.

3 Votes

Well I don't even think that she should lose her license.. that is her livelihood - what's she gonna do now? flip burgers? I don't think so and I wouldn't wish that on anyone.. I'm SURE she already learned her lesson - maybe put practice restrictions on her but not lose her license. I'm sure jobs will be very limited but give her a chance to salvage herself. I mean, I feel like there are many doctors out there who also commit mistakes that ends people lives and they are still practicing.

2 Votes
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