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!

[HiddenAngels]

LibraSunCNM said:

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.

I wouldn't even want to practice again, I'd still be traumatized.  She should just sell eggs from her farm.

[LibraSunCNM, BSN, MSN, CNM]

Wuzzie said:

My irritation comes when people appear to use what Vandy did as a smokescreen to cover up just how egregiously awful a nurse RV is. It's two different issues, marginally related but different. 

This.  Also when nurses use this case in the larger argument of how poorly nurses are treated overall, like RV is some sort of martyr.  Nope!

[HiddenAngels]

Wuzzie said:

As a prudent nurse if I was unsure I would consult a pharmacist and clarify with the ordering physician what monitoring the patient required.   

This could never be said enough

[LibraSunCNM, BSN, MSN, CNM]

HiddenAngels said:

I wouldn't even want to practice again, I'd still be traumatized.  She should just sell eggs from her farm.

Agreed.  I think her actions throughout this tragedy speak volumes about her personality and general mental stability .

[toomuchbaloney]

LibraSunCNM said:

This.  Also when nurses use this case in the larger argument of how poorly nurses are treated overall, like RV is some sort of martyr.  Nope!

This is largely where social media comes in.  

[Rose_Queen, BSN, MSN, RN]

Regardless of whether or not the TN BON reinstates her license, I can't imagine any employer wanting to take the risk of having her on staff. 

[toomuchbaloney]

Rose_Queen said:

Regardless of whether or not the TN BON reinstates her license, I can't imagine any employer wanting to take the risk of having her on staff. 

And yet, something tells me that she would work somewhere as a nurse if she had a license. 

[LibraSunCNM, BSN, MSN, CNM]

Rose_Queen said:

Regardless of whether or not the TN BON reinstates her license, I can't imagine any employer wanting to take the risk of having her on staff. 

Of course.  Which leads me to believe she's just doing this to prove a point, which further cements my belief that she is not in touch with reality, on many levels.  Or maybe she wants to start doing the guest speaker circuit, who knows.

[Wuzzie]

LibraSunCNM said:

Which leads me to believe she's just doing this to prove a point, which further cements my belief that she is not in touch with reality, on many levels.  

There does seem to be some sort of disconnect there. 

[toomuchbaloney]

LibraSunCNM said:

Of course.  Which leads me to believe she's just doing this to prove a point, which further cements my belief that she is not in touch with reality, on many levels.  Or maybe she wants to start doing the guest speaker circuit, who knows.

I think that social media gives people like her an audience, support, a platform.  If the US v. Them positions in the arguments about her are at all political on social media then a dark money activist group will eventually get involved to whip up division and spread the discontent.  

[Tenebrae, BSN, RN]

Wuzzie said:

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

Exactly. She screwed up and killed a patient. 

Only it wasnt a quick kill, the patient suffocated to death while fully conscious and unable to alert anyone (even if RV hadnt of left her on her own)

I have seen nothing to indicate she has learned a damm thing from this and wouldnt replicate the exact same mistake

[Tenebrae, BSN, RN]

Nurse Beth said:

... I believe medication errors should not be prosecuted. Healthcare professionals will then fail to self-report.

If the board of nursing had of done their job it most likely wouldn't gone to criminal charges. IMO

The BON littlerally patted her on the hand and went 'oh dear you won't do it again will you?"

What they should have asked was 'What did you learn from this and what are you going to do to make sure you never make a mistake like this again?" or something similar.