Should RaDonda Vaught Have Her Nursing License Reinstated?

RaDonda Vaught is seeking reinstatement of her Tennessee (TN) nursing license after a fatal medication error in 2017. Nurses General Nursing News

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Should RaDonda Vaught Have Her Nursing License Reinstated?

RaDonda Vaught Seeking Reinstatement of Nursing License

TN state nursing board's 2021 decision to revoke her nursing license will be appealed in court on Tuesday, March 28. If the appeal is successful, she will face a retrial before the Tennessee Board of Nursing.

Nursing boards generally make decisions regarding the reinstatement of nursing licenses based on various factors, including the nature and severity of an offense, the rehabilitation efforts of the individual, and their ability to practice nursing safely and competently.

If RaDonda Vaught has completed the requirements (if any) and demonstrated that she could meet the standards of safe and competent nursing practice, then it may be possible for her to have her RN license reinstated. However, this decision ultimately rests with the state nursing board.

Background

Most of us recall the RaDonda Vaught case in 2017 because it involved a fatal medication error, and she was charged with reckless homicide for the mistake. The decision to prosecute her made history because it set a precedent for criminalizing medical errors.

On December 26, 2017,  RaDonda Vaught, a 35-year-old RN, worked as a "help-all" nurse at the Nashville, Tennessee-based Medical Center. She was sent to Radiology Services to administer VERSED (midazolam) to Charlene Murphey, a 75-year-old woman recovering from a brain injury and scheduled for a PET scan.

Charlene Murphey was experiencing anxiety, and her provider ordered Versed, a sedative,  to help her through the procedure. RaDonda entered the letters "ve" for Versed (the brand name) in the automated dispensing cabinet (ADC) search field.

No matches populated the screen under the patient's profile, so RaDonda used the ADC override function and again entered "ve," this time mistakenly selecting vecuronium.

Vecuronium is a neuromuscular blocking agent, and patients must be mechanically ventilated when administered vecuronium. RaDonda reconstituted the drug and administered what she thought was one mg of Versed.

Unaware of her mistake, RaDonda left the patient unmonitored and went on to her next help-all assignment in the ED to conduct a swallow test.

Charlene Murphey was discovered about 30 minutes later by a transporter who noticed she wasn't breathing. She had sustained an unwitnessed respiratory arrest and was pulseless. She was coded, intubated, and taken back to ICU but was brain-dead and died within twelve hours.

Charges and Convictions

Legal System

On February 4th, 2019, RaDonda was indicted and arrested on charges of reckless criminal homicide and impaired adult abuse.

On May 13, 2022, she was found guilty of criminally negligent homicide and gross neglect of an impaired adult, and sentenced to 3 years of supervised probation.

Board of Nursing

On September 27, 2019, the TN Department of Health (Nursing Board) reversed its previous decision not to pursue discipline against the nurse and charged RaDonda Vaught with:

  • unprofessional conduct,
  • abandoning or neglecting a patient, and
  • failing to document the error.

On July 23, 2021, at the BON disciplinary trial, the Tennessee (TN) Board of Nursing revoked RaDonda Vaught's professional nursing license indefinitely, fined her $3,000, and stipulated that she pay up to $60,000 in prosecution costs. 

Controversial

Many opposed RaDonda Vaught being charged with a crime, including the American Association of Critical Care Nurses (AACN), the Institute of Safe Medicine Practice (ISMP), and the American Nurses Association (ANA).

If nurses fear reporting their errors for fear of criminal charges, it discourages ethical principles of honesty.

But should RaDonda be allowed to practice nursing again?

The (ISMP) felt strongly that revoking her license was a travesty and that the severity of the outcome wrongly influenced the decision. Contributing system errors were minimized, and RaDonda Vaught became the scapegoat, while Vanderbilt escaped full notoriety.

The ISMP said RaDonda displayed human error and at-risk behaviors but not reckless behavior. She did not act with evil intent and is a second victim of a fatal error. In a Just Culture, discipline is not meted out for human error.

Do you think RaDonda Vaught should be allowed to practice nursing again, and why or why not?

Thank you for your thoughts!

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Nurse Beth

About Nurse Beth, MSN

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Hi! Nice to meet you! I especially love helping new nurses. I am currently a nurse writer with a background in Staff Development, Telemetry and ICU.

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Specializes in CEN, Firefighter/Paramedic.

I've had about enough of her being called a scapegoat.  

Scapegoat is defined as being blamed for the fault of others.

Vaught consciously made several grievous errors, all of which are cardinal sins of nursing, and a human being is dead because of it.  

Frankly - the only "fault" on the part of the hospital system is that vec could be over-ridden in the pyxis.  It's not a fault of the system that she didn't read the label.  It's not the fault of the system that she didn't realize something was strange when she was reconstituting the medication.  It's not the fault of the system that she slammed a medication and walked away.

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NO and any of you who have been here for awhile know exactly why I feel that way. 

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Specializes in OR, Nursing Professional Development.

No. This was not a run of the mill medication error. The CMS report and TBI report demonstrate just how negligent this act was. 

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Specializes in Tele, ICU, Staff Development.
FiremedicMike said:

I've had about enough of her being called a scapegoat.  

Scapegoat is defined as being blamed for the fault of others.

Vaught consciously made several grievous errors, all of which are cardinal sins of nursing, and a human being is dead because of it.  

Frankly - the only "fault" on the part of the hospital system is that vec could be over-ridden in the pyxis.  It's not a fault of the system that she didn't read the label.  It's not the fault of the system that she didn't realize something was strange when she was reconstituting the medication.  It's not the fault of the system that she slammed a medication and walked away.

RaDonda's errors were grievous, and she was sanctioned by the BON as well as criminally prosecuted.

Vanderbilt did not have a policy about monitoring patients after administering Versed (midazolam), and they covered up the incident.

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Nurse Beth said:

Vanderbilt did not have a policy about monitoring patients after administering Versed (midazolam), and they covered up the incident.

That has nothing to do with what RV did and does not absolve her of anything. Hospital policies vary from facility to facility,  good nursing judgment doesn't.

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Specializes in Tele, ICU, Staff Development.
Wuzzie said:

That has nothing to do with what RV did and does not absolve her of anything. Hospital policies vary from facility to facility,  good nursing judgment doesn't.

I do not absolve RaDonda Vaught by any means.

I also do not absolve Vanderbilt of their actions. 

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Nurse Beth said:

I also do not absolve Vanderbilt of their actions. 

But that is an entirely different issue and has nothing to do with RV getting her license back. It just muddies the waters. 

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Specializes in Tele, ICU, Staff Development.
Wuzzie said:

But that is an entirely different issue and has nothing to do with RV getting her license back. It just muddies the waters. 

Here's where I stand-

  • RV should not get her license back and should never practice nursing again. She doesn't demonstrate enough insight to be safe.
  •  I believe medication errors should not be prosecuted. Healthcare professionals will then fail to self-report.
  • During the investigation, Vanderbilt failed to uphold evidence-based practice and was deceitful. This did not cause the error, but their actions, including the cover-up, were wrong.

I edited this to expand on my answer.

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Nurse Beth said:

Vanderbilt failed to uphold evidence-based practice and was deceitful.

Again, that had nothing to do with RV not actually reading the label on the vial of the medication she was given. 

Also, FTR neither did RV. How was that Vanderbilt's fault?

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Specializes in CEN, Firefighter/Paramedic.
Nurse Beth said:

RaDonda's errors were grievous, and she was sanctioned by the BON as well as criminally prosecuted.

Vanderbilt did not have a policy about monitoring patients after administering Versed (midazolam), and they covered up the incident.

I don't need a policy to tell me to monitor a patient after giving what I thought was a sedative. 

Them covering it up is their own problem, Vaught didn't get disciplined or charged for their cover up, she got in trouble for her own role in this.

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Specializes in OB.

Not to out myself too much but I live in the same general geographical area as her.  She and her husband own a farm and I see her weekly at the local farmer's market, selling their produce.  She talked to my daughter once and it took me a minute to figure out how I knew her!  So bizarre.

The fact that she is trying to get her license reinstated shows (IMO) how little self-awareness she has, which was certainly evidenced by her behavior and social media presence during the trial itself.  I hope it won't be reinstated, and highly doubt it will be.  I feel terribly for the family of the Charlene Murphey, to whom this reinstatement request must feel like a huge slap in the face.

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