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:
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unprofessional conduct,
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abandoning or neglecting a patient, and
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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!
JKL33
7,044 Posts
I agree w/ your post, and I have seen docs try to cover for mistakes too.
I imagine, but do not know, that the care providers involved were just trying to be decent human beings, by that I mean not just flat out saying that nurse killed patient. I also think there was an aspect of the sometimes sketchy ways we have been taught to document/not document things in plain language in patient charts--remember the NP's note? It's been a long time since we had our initial significantly detailed deconstruction of this event, but I seem to remember that I thought the chart note immediately following the event was rather bland/low on details. These types of things I attribute to a combination of the aforementioned collegiality/decent human being behavior + documentation "rules" which sometimes may be ill-informed and/or ill-intentioned.
In any case, once this made it to administration and especially to the extent that someone is holding evidence/items related to the incident in their office...there is clearly an obligation to do something beyond nothing.
No one in admin meant to help Radonda, there is no way risk management wasn't involved here and I think they went wellllll out of their way to "manage" the facility's risks; not the risk to RV.