Nurses Call the Governor of Tennessee

Horseshoe, BSN, RN · Feb 13, 2019

5 minutes ago, HomeBound said:
Which is why the law has sub-categories for things like this---we can, yet again, circle back to the distracted driver who swerves to miss a kitty cat and plows into a group of kids waiting for the schoolbus. Where was the malice and intent?

I personally don't think putting the driver swerving to miss the kitty who accidentally plows into the children in jail serves society one bit. Maybe instead of asking why the nurse should be treated any differently, we should be asking whether or not criminal penalties are always the go to default for bad things that happen. Our society is getting entirely too focused on throwing people into jail rather than trying to find other ways to get their pound of flesh. We have the highest levels of physical incarceration of most democratic societies. Is that something to be proud of and to advocate?

Horseshoe, BSN, RN · Feb 13, 2019

1 minute ago, Wuzzie said:
But the lack of intent is why she isn't being charged with murder.

I understand that. Doesn't change my opinion.

Advanced Practice Columnist / Guide · Feb 13, 2019

29 minutes ago, Jory said:
...but consider this...and this is heartfelt question.
If this case doesn't meet the standard of criminal negligence, then there is NO LIMIT other than intentional homicide, we are willing to tolerate in our profession. Is there any limit for you?
If you think that doesn't damage the profession, it absolutely does.

I draw the line at intent at this point not knowing exactly what factors made the error happen. Listen, Nurse RV did an unspeakably horrific, umm really "stupid with a capital S" act of negligence, I 100% agree with that. Our profession by nature of what we do on a daily basis puts all of us always in a degree of risk. As a community of healthcare professionals, we need to get together to address this important issue and make attempts to minimize this risk. Nurse RV deserves sanctions no doubt, extreme and urgent ones in my opinion, and the BON is a good start...I know, her case is probably on their table already and it is just taking a while. We are also talking about hypothetical situations here since Nurse RV is already facing criminal trial. I sure am not here to get in the way of something that's already been decided.

Jory, MSN, APRN, CNM · Feb 13, 2019

23 minutes ago, Horseshoe said:
Where *I* would draw the line would be in intent and malice. Just because you are not put in prison does not mean you cannot be penalized very severely. But Tennessee clearly doesn't make that distinction; it's not up to me.

...and this is sad. But you are wrong on intent which is WHY she is being charged.

She didn't intend to kill the patient, but she did INTEND to bypass MULTIPLE safety checks designed to protect the patient as well as herself which caused the death of the patient.

You seem to keep forgetting that. Her actions, were 100% willful.

Jory, MSN, APRN, CNM · Feb 13, 2019

1 minute ago, juan de la cruz said:
I draw the line at intent at this point not knowing exactly what factors made the error happen. Listen, Nurse RV did an unspeakably horrific, umm really "stupid with a capital S" act of negligence, I 100% agree with that. Our profession by nature of what we do on a daily basis puts all of us always in a degree of risk. As a community of healthcare professionals, we need to get together to address this important issue and make attempts to minimize this risk. Nurse RV deserves sanctions no doubt, extreme and urgent ones in my opinion, and the BON is a good start...I know, her case is probably on their table already and it is just taking a while. We are also talking about hypothetical situations here since Nurse RV is already facing trial. I sure am not here to get in the way of something that's already been decided.

The factors that made this error happen rests on her. She decided to do the override, pulled a medication what wasn't what she was looking for, didn't wait for the pharmacy verification, didn't scan it, didn't read the vial that showed it was a paralytic, ignored a warning on the Pyxis that the med was only to be given for a stat order...which she did not have.

HomeBound · Feb 13, 2019

Horseshoe,

I appreciate the Libertarian in you, I really do. I, however, like the idea that if someone violates my rights---as in...comes walking around my property looking in my windows, squats on my property and tries to take possession, steals my car---they go to jail.

These are not malicious acts. Even the car theft isn't directed AT ME. They stole property. THEY GO TO JAIL. It's not "stupid" to keep people who cannot follow the rules of civil society contained. If someone just cannot live without my car, then they had better be prepared to go to jail for it. Some people are just dumb enough to believe that my car is just so special and they have to have it. They get to go to jail.

The laws are made not just because of the crime, but because there has to be some semblance of order. You have to have EXPECTATIONS of behavior.

This goes right back to nursing. There are expectations of basic nursing behaviors that are acceptable, and they are agreed upon, and they are now rules. They are there for a reason. The public has a reasonable expectation that they can hand themselves over to healthcare workers and they will be treated with respect for their rights and their lives.

This girl is an unknown. You don't know her, nor do I. You have no idea what her background is---and what my angle and that of others is---until we know, by way of a legal proceeding to demand discovery, I am not comfortable with allowing someone who may very well be a very dangerous person to continue on, in any capacity, in society.

Do you know if she's dangerous? Do you know what her life is like outside of nursing? Do you know if she was impaired when she was at work?

She never had a drug test, as far as the public knows. Maybe she did...maybe this is EXACTLY why she was charged with negligent homicide.

I absolutely want to know and maybe, because I don't know the law in TN---maybe the only way to get to the bottom of the case, with the facts that they know now---is a criminal charge.

You do not know what the prosecutors have in hand in order to have believed that they can obtain a conviction, is my point.

mtmkjr, BSN · Feb 13, 2019

What is really the difference in this case from those where workers are injured/killed in industrial accidents where safety measures were disregarded? When those horrific things happen, people are quick to call for criminal charges. Is this really different?

TNnursejane, BSN, RN · Feb 13, 2019

Yes, Ms Vaught made a terrible error but the issue comes down to she missed all of the safety points that were put into place. My question is why did she override the med when if it was ordered should have been in the patient's profile. If she had given Versed in the past, she would have known if did not have to be reconstituted as was the Vercromium that she administered. My concern is that if she is convicted and sentenced then it will change the whole "just" culture that we have been working on since the early 2000s. Nurses will not report errors anymore because they are afraid of the repercussions. The bottom line is that it could have been any of us. It has to do with the processes that went wrong. I'm sure that Ms Vaught did not do this maliciously. She should suffer the consequences such as losing her license and/or paying a fine but to be put in jail is going over the top.

Horseshoe, BSN, RN · Feb 13, 2019

I've been a prisoner in my home for a couple of days due to work being done on my house. I've had the luxury of being on AN a lot during these days. I can't stay online all day. I think there have been a lot of nurses advocating for civil penalties who could be questioned over and over about their opinions. I'm a reasonable person who is an advocate for safe nursing practice. I just don't happen to agree that there is only one way to achieve it. Threat of criminal charges is a poor way of achieving compliance imo, and even if it gives some kind of satisfaction for a sense of "justice," is it effective at deterrence? I doubt it but await the data.

Have to head out, but if nothing else, we can all agree that this has been a very tragic occurrence that will hopefully result in meaningful change.

Advanced Practice Columnist / Guide · Feb 13, 2019

1 minute ago, Jory said:
The factors that made this error happen rests on her. She decided to do the override, pulled a medication what wasn't what she was looking for, didn't wait for the pharmacy verification, didn't scan it, didn't read the vial that showed it was a paralytic, ignored a warning on the Pyxis that the med was only to be given for a stat order...which she did not have.

What made her do that in that specific instant is unanswered. Does she override non-urgent drugs often and was just lucky that she never in her short career ever pulled the wrong drug to give a patient? What made her intentionally ignore the drug label yet follow the instructions of reconstituting the drug? Has she always been that careless by not watching a patient for the effects of medications she administered intravenously? What was going on in her mind when she was mixing the drug? I don't know how Nurse RV is like as a nurse and with that element of doubt I can't say to her one error and you're going to jail despite the egregious nature of her actions.

mtmkjr, BSN · Feb 13, 2019

3 minutes ago, TNnursejane said:
Yes, Ms Vaught made a terrible error but the issue comes down to she missed all of the safety points that were put into place. My question is why did she override the med when if it was ordered should have been in the patient's profile. If she had given Versed in the past, she would have known if did not have to be reconstituted as was the Vercromium that she administered. My concern is that if she is convicted and sentenced then it will change the whole "just" culture that we have been working on since the early 2000s. Nurses will not report errors anymore because they are afraid of the repercussions. The bottom line is that it could have been any of us. It has to do with the processes that went wrong. I'm sure that Ms Vaught did not do this maliciously. She should suffer the consequences such as losing her license and/or paying a fine but to be put in jail is going over the top.

It couldn't have been "any of us" because this was not a simple med error. It was error upon error upon error... and so on (x8) leading to death of the patient. If any one of those "errors" had been checked, the patient wouldn't have died that day.

I don't think it will change anything as so many seem to fear. There have been criminal charges against nurses in the past and no "precedent" has followed.

Horseshoe, BSN, RN · Feb 13, 2019

12 minutes ago, Jory said:
...and this is sad. But you are wrong on intent which is WHY she is being charged.
She didn't intend to kill the patient, but she did INTEND to bypass MULTIPLE safety checks designed to protect the patient as well as herself which caused the death of the patient.
You seem to keep forgetting that. Her actions, were 100% willful.

Hey, I was asked where *I* would draw the line. I would say don't ask the question (I know you didn't) if you can't handle any possible answer. This was an opinion question, and you don't get to change the answer. You've obviously got your own answer, so feel free to answer her post yourself.