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!

[JKL33]

Well, and part of the problem is that although this

Quote

"Nurses and healthcare professionals across the country expressed outrage over the case saying a conviction and possible jail time for a mistake made on the job was unfair."

may technically be true, it is a very misleading (and IRRESPONSIBLE) thing to write, without writing that there is a mixed bag of opinions about this whole thing, including a very good number of nurses and healthcare professionals who think loss of license is appropriate, and likely some who think loss of license plus jail time is appropriate.

toomuchbaloney said:

Are we a country that struggles with the notion of accountability? 

Uh, yes. And not to open a can of worms but lets not forget that we also work under and for those who refuse to take responsibility for their own serious problems and faults, screw-ups and straight up refusal to do what is right. That includes (some of) our nursing "leaders", our employers and even patients.

So, yes.

[Tenebrae, BSN, RN]

RN_SummerSeas said:

I can tell you why you don't hear from me, it's because I don't agree with you. 

Which is fine, 

You seem to want to shut down the opinions of the people who disagree with you

[Hoosier_RN, MSN]

JKL33 said:

Uh, yes. And not to open a can of worms but lets not forget that we also work under and for those who refuse to take responsibility for their own serious problems and faults, screw-ups and straight up refusal to do what is right. That includes (some of) our nursing "leaders", our employers and even patients.

100% spot on! Accountability is a major issue across the board

[Wuzzie]

Tenebrae said:

Which is fine, 

You seem to want to shut down the opinions of the people who disagree with you

I know. Ironic isn't it? ?

[Emergent, RN]

I have a feeling RV has posted on this thread...?

[mtmkjr, BSN]

Emergent said:

I have a feeling RV has posted on this thread...?

I've had that same thought! 

[Hoosier_RN, MSN]

Emergent said:

I have a feeling RV has posted on this thread...?

Good for her. At least she knows that not all of her peers think she's being mistreated by the system

[Emergent, RN]

Hoosier_RN said:

Good for her. At least she knows that not all of her peers think she's being mistreated by the system

There are many other fields of endeavor. She temperamentally unsuited for nursing. 

[Hoosier_RN, MSN]

Emergent said:

There are many other fields of endeavor. She temperamentally unsuited for nursing. 

Amen. I think that she should remain in the "influencer" business

[Granuaile, ASN, RN]

I am surprised to hear she is appealing to get her nursing license back. Like others have said, first, she didn't use the 5 rights, which could have saved her at multiple points between accessing the med and administering it to the patient, and she didn't use the nursing process, which of course includes evaluating the outcome. Pretty egregious, no matter how you look at it. I think *were* she to have her license reinstated, she should not be allowed to be responsible for providing care to patients (ie as staff nurse, charge nurse, or supervisor of other nurses, etc).

[autumnal]

No. She didn't check the medication before dispensing it from the machine and she didn't check it when she pulled it out to confirm. She failed one of the basic fundamentals of providing care: the right medication.

[DoubleblessedRN, ADN, RN, EMT-B, EMT-P]

WHY does she want her license reinstated?  WHY does she want to work as a nurse again?  Is she hurting financially?  Does she want to right a wrong?  Does she really care about people, their quality of life and making a difference?  Hard to say with so many variables.  Last year in Michigan, a three year old ventilator dependent child died while under her the care of a private duty RN.  The parents were adequately trained to care for their child, but the purpose of a private duty nurse was to care for the child while the parents slept, as the child required 24 hour care. The vent had been disconnected when this happened; I believe the nurse was changing the trach dressing or performing some other type of procedure or care which required the vent being disconnected very briefly.  The nurse had been using meth for several nights in a row when she passed out.  One or both parents found the nurse semi conscious or unconscious and their child not breathing.  The child died, and the nurse was convicted of second degree murder.  Did the nurse deserve it?  Absolutely, positively without a doubt.  It's unclear as to how long she had a substance abuse problem; she had been licensed for about fifteen years and had never been disciplined by the board of nursing, nor had there ever been any formal complaints on this nurse.  But my point is, there are sooooo many nurses with substance abuse problems who are on probation with restricted licenses in which they cannot administer meds.  They jump through all the hoops and make it through.  And then there are some nurses who are on probation for the second and third time around, and the state continues to give them every chance in the world, knowing that the nurse is a potentially very serious risk to patient safety.