Radonda Vaught Was A Guest On A Good Nurse / Bad Nurse Podcast

[Anonymous865]

For those of you who are following the Radonda Vaught case, she was a guest on the podcast Good Nurse Bad Nurse on January 18, 2022.  (For those not familiar with this case, search for Radonda Vaught and read the threads on the case.  It was discussed extensively.)

I stumbled across the podcast when searching for when her trial starts. 

Spoiler alert - she's the "Good Nurse" featured on the podcast.

The host gives a version of the case starting about 30 minutes 30 seconds.  Radonda starts speaking around 40 minutes.

I'm surprised her lawyer would allow her to speak publicly.

The trial is currently scheduled for 3/22/2022.

[Wuzzie]

51 minutes ago, dream'n said:

I'm worried about the grey area that this case opens up for other nurses

But it doesn’t open anything up. This is not the first time a nurse has faced criminal charges for bad practice so it isn’t precedent setting. We’ve discussed this on earlier threads. Nurses are just not being thrown in jail right and left as some would think is going to happen. 

 

[Wuzzie]

49 minutes ago, dream'n said:

Every nurse has made a mistake; therefore, every nurse has at one time or another practiced sub-par and unsafely.

It’s the totality of the poor decisions she made that changes things. She ignored multiple, multiple warnings including her own confusion over the need for reconstitution which she admits in her statements to the TBI and in the CMS report. 

[JKL33]

20 hours ago, Anonymous865 said:

The news coverage made a big deal about the override function.  I don't remember VUMC or CMS making that an issue.  Perhaps you are thinking of the news coverage? 

I went back and am going through the CMS report again. You are right. I think what stuck in my mind was a few little things like the regulatory officer telling the CMS investigators, when asked whether safety committees reviewing this incident had looked at the help-all role specifically with regard to this situation....the response was along the lines of never having heard the term ["help-all"], it wasn't a VUMC term, "but believe me we are going to look into it..." Like, when? It's already almost a year later (10 months or so) at the time that statement was made. And if you don't know what goes on in a nursing unit then maybe don't make an ambiguous statement that could easily sound like NO ONE at VUMC has any clue what RV means by "help-all".....meanwhile every single nurse here instantly knew what she meant even if we don't call it that in our own respective workplaces.

I admit I read into it, but at the same time it does make it sound like just one more thing...she (RV) didn't do this and didn't do that, even this role she alleges she was filling is something we here at VUMC have never heard of before.

I think you are right about the override function possibly being more the news, but it is stated multiple times in the report that override is for STAT situations. I get that's a fact....but at the same time everybody who has an inkling of how things work knows that, in practice,  like it or not/right or wrong, "STAT" frequently means "we need it urgently and/or way before pharmacy is going to take their sweet time putting it on the profile, and this is how that is done (override)...."

ETA: Here is the report in case anyone didn't see it first time around...

[JKL33]

20 hours ago, Anonymous865 said:

I don't think that VUMC got the DA on board to help them out.

I have cousins who are lawyers in Nashville.  They know the DA.  He spent probably 30 years of his career as a defense attorney.  He ran for office because he wanted to clean up the DAs office.  My cousins know him professionally not socially.  They say he is highly respected in the legal community by both defense and prosecution.

I would say it is more likely that the DA pursued this because the TBON took no action at all.  You had a nurse who carelessly caused a death and the TBON didn't even require a few hours of CE on safe medication administration.  She still had an unencumbered license.  DAs feel obligated to act if they feel their community is at risk.

 

I think people would like to believe what is in your last paragraph. That's what we want to believe, we want to see justice being served and people being protected. I don't think it's realistic. I do not think that's how the world works and I don't think prosecutors of large metro areas spend their days looking into how regulatory agencies adjudicate matters like this. RV isn't the first nurse in Tennessee who killed someone, she isn't the first one to have been reckless, she isn't the first one to cause someone's death due to recklessness, she isn't the first one to receive what many of us would consider to be an appallingly inappropriate seal of approval from a BON. You and I may not think the BON's actions were appropriate (I sure don't!) but at the same time their apparent take on the issue IS consistent with the opinion of other well-regarded entities, such as ISMP and nursing organizations. [Again, I don't agree with those professing the party line of "just culture" in this case and all of that]--but many others are speaking of this along those lines and it's very possible that the BON also holds that view and holds it thoughtfully (even if you or I don't agree with its application in this instance).

Secondly it quickly becomes problematic to talk about a prosecutor who is supposedly only acting out of a noble sense of obligation and just concerned about the community being at risk but then there's the matter that the major hospital system is pulling the kind of thing they've pulled and he isn't doing anything about that. I think it's safe to say that a major hospital corporation that can't figure out how to conduct a proper basic  investigation (still having the unsecured RV syringes laying around in someone's office a year later), who couldn't manage to put this matter on their safety agenda for any of the intervening months that CMS reviewed, couldn't figure out how to report a sentinel event and subsequent patient DEATH to CMS....these people pose far more danger for the community than RV.

I do not believe that things are where they are right now because of good intentions and justice and blah, blah, blah.

It doesn't follow. The DA heard about RV because VUMC was being investigated by CMS.....for running a *** show and covering up a death for which RV (and thus THEY) is/are responsible. And hearing that, hearing about these TWO things (not one) I'm supposed to believe that the DA's sense of ethics and righteous indignation led him to utilize his legal prowress to charge RV? Okay fine, but his ethics and sense of righteous indignation and desire to protect the community hasn't yet led him to the honchos at the medical center affiliated with the university where he is faculty.  So I really can't believe what you want to believe.

[CommunityRNBSN, BSN, RN]

I learned that there has only been one case in the US-- EVER-- of a doctor being convicted on criminal charges because of an action they took while working.  If you heard the Dr. Death podcast, the doctor was Christopher Duntsch.  If you compare his actions vs. the error that Radonda V. made, there is no comparison.  I would hate to see nurses being handled in the criminal justice system when doctors aren't.

 

https://pubmed.ncbi.nlm.nih.gov/17199622/

Quote

The prosecution of Charles Cullen, a nurse who killed at least 40 patients over a 16-year period, highlights the need to better understand the phenomenon of serial murder by healthcare professionals. The authors conducted a LexisNexis search which yielded 90 criminal prosecutions of healthcare providers that met inclusion criteria for serial murder of patients. In addition we reviewed epidemiologic studies, toxicology evidence, and court transcripts, to provide data on healthcare professionals who have been prosecuted between 1970 and 2006. Fifty-four of the 90 have been convicted; 45 for serial murder, four for attempted murder, and five pled guilty to lesser charges. Twenty-four more have been indicted and are either awaiting trial or the outcome has not been published. The other 12 prosecutions had a variety of legal outcomes. Injection was the main method used by healthcare killers followed by suffocation, poisoning, and tampering with equipment. Prosecutions were reported from 20 countries with 40% taking place in the United States. Nursing personnel comprised 86% of the healthcare providers prosecuted; physicians 12%, and 2% were allied health professionals. The number of patient deaths that resulted in a murder conviction is 317 and the number of suspicious patient deaths attributed to the 54 convicted caregivers is 2113. These numbers are disturbing and demand that systemic changes in tracking adverse patient incidents associated with presence of a specific healthcare provider be implemented. Hiring practices must shift away from preventing wrongful discharge or denial of employment lawsuits to protecting patients from employees who kill.

There are lots of instances of health workers prosecuted for crimes against their patients. 

[Wuzzie]

41 minutes ago, CommunityRNBSN said:

I learned that there has only been one case in the US-- EVER-- of a doctor being convicted on criminal charges because of an action they took while working. 

https://www.Google.com/search?q=micahel+swango&rlz=1C1GCEV_en&oq=micahel+swango&aqs=chrome..69i57.3632j0j4&sourceid=chrome&ie=UTF-8

https://www.barclaydamon.com/alerts/physician-convicted-on-HIPAA-criminal-charges

https://nypost.com/2014/06/24/plastic-surgeon-sentenced-for-fatal-liposuction/

[CommunityRNBSN, BSN, RN]

10 hours ago, Wuzzie said:

https://www.Google.com/search?q=micahel+swango&rlz=1C1GCEV_en&oq=micahel+swango&aqs=chrome..69i57.3632j0j4&sourceid=chrome&ie=UTF-8

https://www.barclaydamon.com/alerts/physician-convicted-on-HIPAA-criminal-charges

https://nypost.com/2014/06/24/plastic-surgeon-sentenced-for-fatal-liposuction/

I'll give you the "botched liposuction" guy.  That was criminal recklessness and might be in the same arena as the RV case.  The other two are irrelevant though-- one was committing fraud for pharmaceutical kickbacks (so, not related to medical treatment) and the other was a serial killer.

[RNNPICU, BSN, RN]

On 2/9/2022 at 1:56 PM, ThePrincessBride said:

I'm not arguing that she was negligent...she clearly was. But I believe when she gave that med, she fully believed that she was giving versed and had no intention of harming Charlene, let alone killing her. Intent matters when facing criminal charges (hence why there is 1st degree murder vs. 2nd, 3rd degree, etc). She practiced in a manner that was not only common but encouraged at her facility (again, not right, but it just speaks on the fact that this was a system wide problem).

Why she forgot to double check the med...maybe short staffing, rushed, stressed, I don't know, doesn't excuse her poor practice. 

She has already been punished. She will never work as a nurse ever again and her livelihood is gone. Why do you think she should be punished as a criminal? She's not a criminal...she's just a terrible nurse who is no longer a threat to the public as she has been stripped of her title.

except for a nurse that has given both versed and vecuronium.  Versed does not need to be diluted. Vecuronium is in powder form and needs to be reconsitituted with 10ml  of NS. In a vial of versed there are 2ml.  In a reconstituted  vial of vecuronium you have 10 ml. V ery very different.

[Tenebrae, BSN, RN]

On 2/9/2022 at 1:11 PM, ThePrincessBride said:

I think she should lose her license...but I don't think she should be criminally charged as that is a precedent that I don't want to take. Nurses are human beings and human being make mistakes. This, unfortunately, was one that ended someone's life.

I'm undecided. 

She should never have been allowed to practice as a nurse without some serious and intensive remediation. The board of nursing totally screwed up in choosing to do nothing about her case. Perhaps she wouldnt have ended up being criminally charge if the BON had actted properly

[0.9%NormalSarah, BSN, RN]

On 2/9/2022 at 10:43 AM, ThePrincessBride said:

We typically stay away from paralytics in the NICU. It is very, very rare (and I work at a Level III NICU). Usually, if a baby is thrashing, we give pain medications. 

But still...if a paralytic is given, it is policy that there is someone there for airway (NNP in my facility) and 2 RNs to pull the med (can't even pull the med from the pyxis without another RN) and 2 RNs to scan the med and double check it at bedside. 

We give paralytics to those who either already have an airway and mechanical vent support or in preparation of doing so. I’ve often given a push of paralytic to get a patient more compliant with the vent when they were adequately sedated but still asynchronous, and no it didn’t require another nurse. It simply requires me to be careful in checking and administering the med like any other. We run plenty of infusions, too.

That’s the whole problem, any ICU nurse would read “-onium” or “-curium” at the end of the drug and should immediately think paralytic. The viles also all have a warning on them that says, “warning, paralyzing agent.” Unfortunately it sounds like she just didn’t take a good look at the vile and my heart really hurts for her and the patient by her making this string of errors, which is why I haven’t commented on this story until now. But these drugs should still be available for override in emergency situations. 

As for the podcast, I’m insulted they think nurses don’t typically know the trade versus generic names of at least common critical meds. I most certainly do, and if I ever get confused I look it up - sets me straight real quick. It still scares me crapless to have to give emergency meds and actually most IV medications, and I always double and triple check and make darn sure I know what I’m giving. I pray I don’t lose my composure in a busy moment and fail to adequately check, causing a patient this terrible harm. 

[CharleeFoxtrot, BSN, RN]

On 2/8/2022 at 2:36 PM, Wuzzie said:

I see what you're saying but in an unusual turn of events have to disagree with you. There is only one victim here and that is Charlene Murphee. I truly hope that people don't lose sight of that. 

This, absolutely. The rest is just bullpucky smoke and mirrors.