Scared to Take a Job in ICU Because of Radonda Vaught Conviction

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Scared to Take a Job in ICU Because of Radonda Vaught Conviction

Hi Nurse Beth,

I am a nurse of 7 years currently working in informatics and outpatient GI. Most of my RN experience is in outpatient. I was a new grad on an acute care unit, but I failed out of the new grad program (3 month program), so I moved to outpatient and I've never looked back. To my surprise, I've been offered an interview for UCLA's experienced RN ICU training program. I applied months ago thinking I would be auto-rejected.

I never thought I'd get a call for an interview! I never considered ICU as an option for me due to my lack of experience, but I think it would be a great learning experience for me, but I'm also terrified. The position doesn't even ask for recent acute care experience, which is surprising, but 2 years of RN experience. I've also noticed that I tend to get bored of a RN job around the 2 year mark. I think maybe because in the outpatient setting, things become routine after a while and I stop learning.

So if I were to do ICU, I definitely don't think I would get bored. I also jump at every opportunity to learn new skills, so I have a thirst for knowledge. However, I'm also scared that I don't have the skills to be an ICU nurse. Even though it's a training program (I'm assuming 6 months), I'm not sure I'd be ready after the training ends. And now with the Radonda Vaught verdict, I feel like my liability would increase significantly if I made a mistake. If I fail out of this program, I may be blacklisted from UCLA, and it's a great hospital that I'd love to join. I've also heard that once you move outpatient, it's hard to transition back to inpatient.

I wouldn't be just transitioning back to inpatient, but jumping from outpatient to ICU. That's a staggering leap! Of course I'm getting ahead of myself, since I haven't even been offered the job yet. It's just an interview, but I'm excited and nervous! Looking for your advice. Thanks!

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6 Answers

Specializes in Tele, ICU, Staff Development.

Dear Excited and Nervous,

Congrats on landing a UCLA ICU interview! Go for it.

You are easily bored and you love to learn- both are often the flip side of being bright. You need to be challenged, and you're being offered a shot at a nationally recognized hospital. 

It's not inaccurate to say that it's difficult to move back into inpatient once you've spent any time at all in inpatient, and yet you're being given an opportunity.

Typically new nurses in ICU are gradually given more complex patients. Even after orientation or graduation from an ICU fellowship, you may not be given fresh open hearts or balloon pump patients. There will be ongoing training and validation before you are assigned higher acuity patients.

New grads are routinely hired directly into ICU and succeed. You have many more transferable skills and job experience than a new grad.

Do not make your decision out of fear. Remember that Radonda Vaught did not follow basic safety measures in her practice with tragic and preventable results.

You can do this.

Best wishes and interview well, my friend.

Nurse Beth

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Tips for Avoiding Medication Errors

Nurses are typically allowed a mistake, ex; Radonda Vaught, albeit that was bad one. I can imagine a med-surg nurse might have been unfamiliar with those meds but an ICU nurse would never confuse Versed for vec. Plenty of RNs from my class went straight to ICUs. A decent hospital should defend you in any lawsuits.

Specializes in Critical Care.

As someone new to the specialty, you will make mistakes (it comes with the territory; we all do!!); you will learn and hopefully grow from them. The key is to practice in a safe manner, following your hospital policies and using common sense; in Radonda's case, she did not have either...this is why most ICU nurses are not empathetic with her situation. UCLA is an amazing facility (I work at UC San Diego), with a very supporting work environment. Enjoy this new position and welcome to the ICU.

Specializes in orthopedic/trauma, Informatics, diabetes.

No offense, but if you "failed" out of a new grad program (not sure that is even a possibility-normally, it's just "not a good fit") and get bored after 2 years, I am concerned. Good ICU is busy but boring, if it's not boring, something bad is happening (same as anesthesia and L&D) and you would need to be able to handle it. 

Nurses make mistakes. Anyone that says they don't or haven't is lying, perhaps to themselves. The Rodanda case was not a mistake. That was wanton disregard for everything we are taught. 

Specializes in BSN, RN, CVRN-BC.
2 hours ago, floydnightingale said:

Nurses are typically allowed a mistake, ex; Radonda Vaught, albeit that was bad one. I can imagine a med-surg nurse might have been unfamiliar with those meds but an ICU nurse would never confuse Versed for vec. Plenty of RNs from my class went straight to ICUs. A decent hospital should defend you in any lawsuits.

One would think, but a colleague who had worked in one of the ICUs in which I worked made the same mistake.  This was before Ms. Vought.  She had worked in the ICU for a little over a year since graduating from nursing school.  The patient suffered an anoxic brain injury and died a while later.  She left the state and kept her license.  I'm not sure how.

Specializes in Geriatrics, Dialysis.
On 4/13/2022 at 10:09 AM, floydnightingale said:

Nurses are typically allowed a mistake, ex; Radonda Vaught, albeit that was bad one. I can imagine a med-surg nurse might have been unfamiliar with those meds but an ICU nurse would never confuse Versed for vec. Plenty of RNs from my class went straight to ICUs. A decent hospital should defend you in any lawsuits.

I doubt any hospital would defend a nurse in this or any malpractice situation. The hospital is only interested in protecting themselves from any liability and in cases where their liability is fairly clear cut, even in cases where it is not the hospital attorneys are likely to settle to avoid the bad publicity generated by a trial.  The only way for a nurse to make sure somebody is on their side in a medical malpractice situation is to carry their own liability  insurance. 

That being said, the Rodanda Vaught situation is pretty extreme so there is no need to let that scare you away from ICU nursing. As long as you remain safe in your practice you certainly wouldn't make that kind of mistake. The amount of safety measures she bypassed when giving that med instead of the correct one is not a series of mistakes most nurses would make.

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