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!

[Lust4life, BSN]

It's just a feeling I have. I really only know the facts that I have read online. I have nothing to base it on except, that's just the way things seem to go and I am jaded and bias. Bitter, as well. LOL

[Tenebrae, BSN, RN]

RN_SummerSeas said:

Or that is their opinion. 

Actually its a statement of fact. The Tennessee board of nursing did nothing about this case, allowed RV to keep practicing. 

Had they did their job perhaps this case would have never gone to criminal charges (this is a point of view)

 

[RN_SummerSeas, MSN, APRN, NP]

Sorry. I'm not sure what you are referring to when you quote one line of a message from days ago., not am I going back to look. The longer this thread goes on, the more I watch specific posters jump on anyone who doesn't share their views. This thread has turned into people just waiting to argue. No matter what one says one here, if it's not what certain people want to hear, they will hound others with their belief as if their belief is fact, when it is mostly opinion. And yup, this certainly is my opinion, we are allowed to have our own last I knew.

[Hoosier_RN, MSN]

RN_SummerSeas said:

No matter what one says one here, if it's not what certain people want to hear, they will hound others with their belief as if their belief is fact, when it is mostly opinion

No, many are stating FACTS presented from both the TBI and CMS investigations. Those are definitely not opinions

[Hoosier_RN, MSN]

subee said:

Why would you believe that?  What facts about her behavior have changed?  

Not a thing, but she's sat on TV and social media, crying to her followers about how bad her life is through no fault of her own. She's young and attractive, so they eat that garbage up like its dinner at a 5 star restaurant. Of course these followers would never be bothered to read, or watch, the testimony ? 

[Lust4life, BSN]

Tenebrae said:

To be allowed back into practice nurses with substance abuse issues have to go through a long process of remediation including accepting responsibility for their actions and showing what they will do to not make the same mistake

RV has done nothing to show that she has learned from her mistake or what she would do to not make the same mistake again. 

She gave a paralytic medication and walked away without without monitoring, leaving the patient fully conscious and dying and unable to  alert anyone. 

Thank you for clarifying. I was going to comment the same thing but the OP was too long to quote, in reply. LOL

It's recovered nurses, whom dealt with addiction and have recovered. 

They have nothing to do with a nurse who killed a patient. Let's not even compare the 2.

[Lust4life, BSN]

Wuzzie said:

But it wasn't a mistake. It was 12 different incidents of poor clinical judgment. 

I feel like people are nit picking at my wording that I used in my original post and I don't know why. I answered the question posed by the original poster, before I read all the pages of commentary. I see it's become heated in the chat. I'm not here for all that. 

I call it a mistake because in my mind it is hard to fathom a nurse who would intentionally cause such a death. I don't believe she was acting with malice. Since she wasn't charged with murder, apparently the court didn't either. Having said that, I don't believe she should be able to even petition for her license, she's still on probation. I had asked if revoking a license isn't actually revoking it anymore, or how does that work? I thought once revoked...it's done.

[Wuzzie]

Lust4life said:

I feel like people are nit picking at my wording that I used in my original post and I don't know why.

I'm sorry if it came across as nitpicking. The issue with the term "mistake" is that RV supporters keep calling this event a "mistake" and using the trope "we all make them" to justify letting her off the hook. They have turned her into some kind of martyr for the state of nursing today when what she did is not at all a result of the difficulties we face. Many of these supporters haven't bothered to read the CMS and TBI report to see exactly what happened and instead are relying on social media to provide the "facts". You are late to the party and likely do not realize that over the last 2 years we have had multiple threads with pages and pages of responses about what happened so we might object to characterizing her actions as a "mistake".  Of course we all make mistakes and I include myself in this but I'm willing to bet none of us have demonstrated the extreme level of poor clinical judgement RV did when she drew up a drug without looking at the vial, slammed it into Charlene Murphey and just walked away. 

[Wuzzie]

RN_SummerSeas said:

No matter what one says one here, if it's not what certain people want to hear, they will hound others with their belief as if their belief is fact, when it is mostly opinion.

Fairly certain this is directed at me. What I post is directly out of the investigations from 2 entirely separate agencies not my "opinions".  I'm no more hounding anyone than anyone else who responds. It's a discussion group. Everyone is allowed to discuss but if you (collectively, not you individually) state something that isn't supported by the facts then I'm going to make the correction. If people don't want to be corrected then don't say something that isn't factual. State your opinion all you want. No skin off my nose. But you can't ask someone to give space for your voice while telling them that they can't use theirs. Again, I encourage you to utilize the safety net of the ignore button since my posts aggravate you so much. 

[subee, MSN, CRNA]

Lust4life said:

I feel like people are nit picking at my wording that I used in my original post and I don't know why. I answered the question posed by the original poster, before I read all the pages of commentary. I see it's become heated in the chat. I'm not here for all that. 

I call it a mistake because in my mind it is hard to fathom a nurse who would intentionally cause such a death. I don't believe she was acting with malice. Since she wasn't charged with murder, apparently the court didn't either. Having said that, I don't believe she should be able to even petition for her license, she's still on probation. I had asked if revoking a license isn't actually revoking it anymore, or how does that work? I thought once revoked...it's done.

Have you ever thought about the term "negligent homocide"?  It fits the circumstances here.  "I didn't mean to kill someone when I ran into a pedestrian while on my phone or texting."  Yet they killed someone recklessly by the standards of prudent behavior and that killing can't be ignored and the consequence must be meaningful.  I don't the believe the TBN has any intention to give a license to someone so reckless.  But, of course, it is Tennessee......sigh.

[subee, MSN, CRNA]

Tenebrae said:

Actually its a statement of fact. The Tennessee board of nursing did nothing about this case, allowed RV to keep practicing. 

Had they did their job perhaps this case would have never gone to criminal charges (this is a point of view)

 

Don't you think the TBN was having conversations with the prosecutors?  Perhaps the prosecutor was happy to drop the case (hot potato) in exchange for never allowing her to practice again?

[beachbabe86]

subee said:

Don't you think the TBN was having conversations with the prosecutors?  Perhaps the prosecutor was happy to drop the case (hot potato) in exchange for never allowing her to practice again?

I am responding to the comment about the Board not doing their job.  How it works in Tennessee, is a Board investigator gets the case.  Then a team of nurses and attorneys looks at the findings and then refers the cases to what is called a screening panel.  Then a decision is made to forward the case to the entire Board for a hearing.  I don't know specifics about this case, as I had moved to another state.

That is the way it used to be.  Don't minimize the political power of Vanderbilt.  It is the largest employer in Metro Nashville and they will do anything to protect their image.

As I have previously stated, there is a property right to a professional license.  Good, bad, or indifferent that is the law.