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

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Robmoo

Robmoo, ADN, BSN, RN

Specializes in BSN, RN, CVRN-BC. Has 26 years experience. 142 Posts

A good nurse or a bad nurse?  Seriously?

Radonda over-rode the safety systems in place to protect her patients and inspite of multiple warnings gave vecuronium instead of versed.  Her patient lay there paralized but completely aware as she suffocated to death.  Good or bad?  The correct term in negligent.  Radonda was a negligent nurse and now is paying a high price for her negligence.  Yes, everyone occasionally makes mistakes, but not of this magnitude after over-riding the safety systems and ignoring mulitple warnings.

A jury will decide if her negligent behavior rises to the standard of negligent homicide.  No one is above the law.  

Emergent, RN

Specializes in ER. Has 29 years experience. 2 Articles; 4,039 Posts

The problem with some of these "safety systems" is that the constant flashing of ALERT, ALERT, causes alert fatigue, just like alarm fatigue. It creates a sensory overload that causes people to just click through all these things flashing in front of them

The most important safety system is to read the label and compared it to the order. When one relies on all the the overload of alerts sometimes one skips that final step.

hppygr8ful, ASN, RN, EMT-I

Specializes in Psych, Addictions, SOL (Student of Life). Has 20 years experience. 4 Articles; 4,630 Posts

There is certainly a lot of false equivalency to these arguments. There is also a big misunderstanding of the meaning behind criminal negligence. Criminal negligence is not a mistake. In most cases negligence is decided by the "Reasonably Prudent Person" test.  Is this the type of mistake a reasonably prudent person with the same degree of training and expertise might make under the same or similar circumstances. Ther answer is no. A reasonably prudent nurse would not have given a drug without verifying the five rights, nor would they have given a sedating agent of any kind to a patient and simply walked away without monitoring for effect. We should never say never but most of the nurses on this forum could make the reasonable argument that this type of mistake would not have happened to them. 

Lets put this in layman's terms. Since 1998 over 800 infants and children have died as a result of being left in a hot car. Now any normal adult knows that leaving an infant or child in a hot car is a recipe for disaster. So when it happens the parent is often investigated and sometimes charged with criminally negligent homicide. In some case they go to prison. Some people will say "Isn't the fact that their child died punishment enough?" I say no. Some will call me harsh but a vulnerable infant/child died as the result of the parent's negligence. I don't care what anyone says there is no way that leaving a child in a car to asphyxiate is anything but criminal. 

There is no way that a reasonably prudent nurse would pull a vial out of a pixis or omnicell and not see the bright red warning all over it and pause to clarify what they were giving. 

The fact is Rodonda V. Will probably never see a day in prison, She will most likely get time served and a reduced sentence and the nursing world will be on notice. 

Hppy

Robmoo

Robmoo, ADN, BSN, RN

Specializes in BSN, RN, CVRN-BC. Has 26 years experience. 142 Posts

15 hours ago, Emergent said:

The problem with some of these "safety systems" is that the constant flashing of ALERT, ALERT, causes alert fatigue, just like alarm fatigue. It creates a sensory overload that causes people to just click through all these things flashing in front of them

The most important safety system is to read the label and compared it to the order. When one relies on all the the overload of alerts sometimes one skips that final step.

Alarm fatigue is a real problem.  The only way that I can see to combat it is for nurses to push for shared governance.  The multitude of educators, administrators, and HIM professionals who dictate our every-day practice need a balance.  Shared governance is this balance.

We had a patient desaturate after their colonoscopy because people were ignoring the alarms because there are so many.   A similar issue happened in our PACU.  Through the nursing practice unit counsels we identified the problem, set more lenient baseline alarms on our monitors, and empowered the nurses to adjust the limits as appropriate for their patients.  It greatly reduced the number off alarms and made both environments safer.

However, alarm fatigue does not excuse this particular mistake.

Emergent, RN

Specializes in ER. Has 29 years experience. 2 Articles; 4,039 Posts

I agree that Radonda was probably destined to make a grave error eventually in her nursing career. 

My impression of her is that she has skated through life on her bubbly personality and ability to charm people. I'm sure she is a very likable lady, with a lot of other positive attributes.

But I don't think she is suited for nursing in a situation where she is giving critical medications. And, what she did I think warrants her to lose her nursing license.

To see her pulling the victim card is obnoxious. She caused a woman to have an agonizing death through her gross negligence. And, that the Board of Nursing in Tennessee is so incompetent as to just brush over her case initially is criminal. The fact that Vanderbilt covered it up is irrelevant. They shouldn't bear the brunt of this mistake. This was done by an individual who ignored every safety measure under the sun. If she had just stopped and read the label, and looked up the medication that she was giving, this never would have happened. Not everything is a systems failure.

neuron

neuron

Has 5 years experience. 551 Posts

Did the doctor not get in the same trouble for changing the cause of death?

MunoRN, RN

Specializes in Critical Care. Has 10 years experience. 8,058 Posts

I think we'll all agree that this was an error with a pretty horrific outcome, but I do find many of the comments here concerning from a patient safety standpoint.

I've been on a medical error prevention and mitigation committee for a number of years, and there are views that create a higher risk of errors, such as "I don't make errors" or "I may make errors, but not the kind that kill people". 

I'm not sure if those claiming to agree with the reckless endangerment/homicide charge really understand the basis of the charge.  Prosecutors brought the charge because she had used the override function of a medication ADC (ie Pyxis or omnicell) which the prosecutors characterized as having manipulated the system into doing, as though she had gone into the source code of the machine and changed it in order to obtain a medication.  Of course that's not what the override function is and it's actually a critical function to keep patients safe.  What this interpretation of the override function means is that every time a nurse utilizes the override function they are committing a felony (reckless endangerment). 

After the charges were initially brought, the legal team for my organization immediately put a freeze on all overrides.  It took less than a week before it killed a patient at a sister hospital.  I get the desire to express outrage at what occurred, but I also think we need to ensure that future patients aren't also harmed because we missed the forest for the trees.

Anonymous865

Anonymous865

483 Posts

13 hours ago, Wuzzie said:

Wow.  

Attempting to purchase firearms while you are awaiting trial does seem to indicate questionable judgement. 

Lying on a federal application where there is usually some wording that by signing the form you are attesting under oath that you have answered all questions truthfully is a whole other level of dumb.

Wuzzie

4,860 Posts

6 hours ago, Anonymous865 said:

Lying on a federal application where there is usually some wording that by signing the form you are attesting under oath that you have answered all questions truthfully 

Yeah, it seems like she just ignored the warning. I’m shocked, shocked I tell you. 🙄

Ida Dubois

Ida Dubois

Specializes in Nurse. Has 49 years experience. 3 Posts

I wonder if anyone suggested a psychiatric evaluation at this point. Her trying to obtain guns now is worrisome and she still does work in a medical capacity but not nursing. This gun fact/lying is a red flag to me. Cannot avoid looking at that closely.