Should RaDonda Vaught Have Her Nursing License Reinstated?

[Nurse Beth]

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 Vanderbilt University 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!

[KalipsoRed21, BSN, RN]

toomuchbaloney said:

I didn't compare the killer to addicts or nurse diverters.

I did. And that's just how I feel about it as respectful as I can relay that sentiment. But thank you for your thoughts.

[KalipsoRed21, BSN, RN]

Hoosier_RN said:

Apparently not what we were taught. But they are taught the 5 (now 7 or 8 or more) rights of med admin. But I've taught in the last 15 years. A few others on here have as well, so for that one poster that acts like patient safety isn't taught anymore, I say bull-loney! We all know better. Regardless of company culture, personal accountability still overrides all of that when patient safety is at stake, be it patient care, med admin, or patient teaching. We are the final stop on the patient journey to health

And in my opinion, that view of accountability is how we will always have 440,000 medical error deaths a year....or more. Thanks again.

[toomuchbaloney]

KalipsoRed21 said:

I did. And that's just how I feel about it as respectful as I can relay that sentiment. But thank you for your thoughts.

It's not a respectful sentiment. Most health professionals who are "addicts" manage to practice without killing their patient. RV couldn't even not kill a patient while she was not addicted, not over worked, not asked to do something outside of her scope and not ignored and unsupported.  She simply practiced criminal professional negligence while alert and oriented and unimpaired. 

[toomuchbaloney]

KalipsoRed21 said:

And in my opinion, that view of accountability is how we will always have 440,000 medical error deaths a year....or more. Thanks again.

Putting irresponsible, reckless and criminally negligent nurses at the bedside will improve that statistic how?  Accepting substandard professional practice will reduce medical errors, in your opinion? 

[subee, MSN, CRNA]

toomuchbaloney said:

I didn't compare the killer to addicts or nurse diverters.

See my apology above.   I did a twofer blooper:(

[Tenebrae, BSN, RN]

KalipsoRed21 said:

True, I feel we are in scary big trouble. That picking out the poor outcomes and holding those nurses for their fault in the problem alone just placates a system to feel that "Justice has been preformed", when no Justice has. =

This wasnt just a poor outcome

The patient died. 

Fully conscious and aware that they were suffocating. 

Giving her a licence back is not remotely close to seeing justice performed because she hasn't learned a damm thing and I would have no confidence she wouldnt make the same mistake

[monz1987, RN]

The nurse is human and humans make mistakes. Im sure she will learn from this mistake as well as it caused someone to lose her life and for her family to go through emotional, physical experiences. Im also sure she has gone through the repercussions from her mistakes as she is currently on probatiom and also has to live with her actions relating to the patient's death. However, I do believe with mistakes, should come forgiveness and a second chance for her, but maybe not be allowed to work at the bedside. Instead, she could be one of the nurses that can help advocate for better hospital policies and protocols to keep patients safe relating to medication administration/use of pyxis systems with checks and balances and restricting use of overriding medications. She can also help with developing specific duties/aggressive training needed when a nurse is put as "helping hands" for the shift on the floor so they know how to safely handle patients . I It should be emphasized to not put an orientee with a nurse that is "helping hands" nor should they be assigned patients for that shift. All this can result in trying to reduce medication error and provider safer care for patients for other nurses. 

[Hoosier_RN, MSN]

KalipsoRed21 said:

And in my opinion, that view of accountability is how we will always have 440,000 medical error deaths a year....or more. Thanks again.

If we have 0 accountability, do you think it will be better? Tell me how you would fix the problem, since appropriate accountability doesn't seem to be on the menu of your answers

Also, you keep mentioning nurses who are caught diverting and using. You are aware that they go through programs that are ridiculously long, expensive, and have to jump through crazy hoops to even hope to keep their license, right? If not, mosey on over to the Recovery threads on here, it's eye opening as well. They don't get to say that they're sorry, sit at home for 90 days, or even just a year, then come back to work full force unrestricted. Sometimes they wait a long time to come back restricted. And they didn't kill or harm anyone, except themselves

RV was willfully negligent and caused a death. She didn't serve any time in prison, so losing her nursing license seems like a just sentence when someone's life was needlessly lost due to said negligence.

Ms Murphy's family has been beyond gracious to her. Had that been my mom, furious would have been the nice word used for me and my siblings!

[Wuzzie]

monz1987 said:

Instead, she could be one of the nurses that can help advocate for better hospital policies and protocols to keep patients safe relating to medication administration/use of pyxis systems with checks and balances and restricting use of overriding medications.

Except she seems to have a problem with following existing policies and well...reading.

[MaxAttack, BSN, RN]

Wuzzie said:

Except she seems to have a problem with following existing policies and well...reading.

No they might be on to something here. Maybe there wasn't a specific policy that a paralyzing agent shouldn't be pushed on a fully awake patient without a secure airway? 

I can't ? By that logic serial killers should be the ones writing textbooks on healthy lifestyle habits.

[Googlenurse, ASN, BSN, RN]

Question: Can she still work in the medical field( just not as a licensed nurse)?

 

Even though her license was revoked, could she work as a PCT or in insurance?  Or open up her own non medical home care company that provides home health aides?
 

Can she go back to school for PT and work as one? 
 

Let's say she does get her license back. Can she work in homecare where no medication administration is involved?

[Wuzzie]

Googlenurse said:

Let's say she does get her license back. Can she work in homecare where no medication administration is involved?

I think the more pertinent question is not can she but should she. Medications aren't the issue. Her poor judgement is. I wouldn't want her to take care of my dog.