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!

[MaxAttack, BSN, RN]

FolksBtrippin said:

She didn't hurt someone on purpose. You can't teach someone not to do that, because it comes from some unknowable, unteachable place. She was careless. You can teach someone to be more careful. 

This wasn't careless; this was criminal negligence that resulted in death. She already didn't follow a single thing any of us were taught so I have little faith that a smack on the hand and a couple of online modules would make her into someone fit to care for anyone.

I know everyone makes mistakes but there's carelessness and then there's RV. Our patients are safer without her.

[Rose_Queen, BSN, MSN, RN]

FolksBtrippin said:

She didn't hurt someone on purpose. You can't teach someone not to do that, because it comes from some unknowable, unteachable place. She was careless. You can teach someone to be more careful. 

Please read the documents I've linked. They are enlightening, as is her own testimony at her BON hearing. 

[subee, MSN, CRNA]

FolksBtrippin said:

She didn't hurt someone on purpose. You can't teach someone not to do that, because it comes from some unknowable, unteachable place. She was careless. You can teach someone to be more careful. 

She WAS taught that in nursing school.  If you still can't be careful after several years of experience, you are too defective to be in nursing.  This wasn't careless; this IMHO was negligent homocide.  She meets the criteriz for that charge.

[LibraSunCNM, BSN, MSN, CNM]

FolksBtrippin said:

She didn't hurt someone on purpose. You can't teach someone not to do that, because it comes from some unknowable, unteachable place. She was careless. You can teach someone to be more careful. 

How much have you read about this case?

[FiremedicMike, BSN, RN, EMT-P]

FolksBtrippin said:

She didn't hurt someone on purpose. You can't teach someone not to do that, because it comes from some unknowable, unteachable place. She was careless. You can teach someone to be more careful. 

A drunk driver doesn't kill an innocent bystander on purpose, but their careless decisions lead to the death of someone else.  No one debates that the driver is criminally liable.  Guess what - the Vaught case is no different, egregious careless behavior that caused the death of a human.

[CrunchRN, ADN, RN]

You should not allow her to be a nurse again though. Regardless of how people may feel about whether the act was careless or not or showed blatant disregard for basic nursing care. Also, her behavior since speaks volumes.

[FolksBtrippin, BSN, RN]

FiremedicMike said:

A drunk driver doesn't kill an innocent bystander on purpose, but their careless decisions lead to the death of someone else.  No one debates that the driver is criminally liable.  Guess what - the Vaught case is no different, egregious careless behavior that caused the death of a human.

She didn't go to work drunk. So it's different.

[subee, MSN, CRNA]

FolksBtrippin said:

She didn't go to work drunk. So it's different.

She went to work grossly incompetent.  Shockingly enough Vanderbilt didn't even drug test her.  Regardless of why she was incompetent, she was unable to safely perform one of the simplest safety checks .  Sort of like a drunk driver getting  behind the wheel having no idea what a menace they are.  Clueless how incompetent she is.  Should we let the drunken driver off the hook for manslaughter because he didn't MEAN to kill when he left that bar?

[FiremedicMike, BSN, RN, EMT-P]

FolksBtrippin said:

She didn't go to work drunk. So it's different.

Are you trying to miss my point?

[Hoosier_RN, MSN]

FolksBtrippin said:

She didn't go to work drunk. So it's different.

No, she went to work acting in a totally incompetent manner. She disregarded multiple safety warnings directly related to the med. She disregarded the 5 basic rights of med administration. She didn't self report, she only reported once another nurse caught it and let her know that she was reporting it. All of this was freely admitted by RV in her own testimony. The actions that she carried out, in the manner that they were carried out, was of someone who has cut major corners on the regular. She wasn't working on a short staffed unit, she was an extra set of hands doing resource for her unit. She had been off for days before the incident. All of this again, by her own admission. Then on social media discussing how badly she's been treated, she's the one who's suffered greatly. Her remorse has been an afterthought. It's sickening. If you'd be okay with her caring for your loved ones, that's great, you're a better person than me. I wouldn't let her care for my loved ones, I'd worry myself to death

[Wuzzie]

Hoosier_RN said:

If you'd be okay with her caring for your loved ones, that's great, you're a better person than me. I wouldn't let her care for my loved ones, I'd worry myself to death

I asked this same question which has been resoundingly ignored not only by the poster to whom you are responding but by every other member who supports RV getting her license back. It smacks of it's okay for someone else's but not for mine. Unless someone can state unequivocally that they would have zero qualms with RV caring for one of their loved ones without someone babysitting her then their position that she should have her license back is disingenuous and I dare say...invalid. 

[FolksBtrippin, BSN, RN]

subee said:

She went to work grossly incompetent.  Shockingly enough Vanderbilt didn't even drug test her.  Regardless of why she was incompetent, she was unable to safely perform one of the simplest safety checks .  Sort of like a drunk driver getting  behind the wheel having no idea what a menace they are.  Clueless how incompetent she is.  Should we let the drunken driver off the hook for manslaughter because he didn't MEAN to kill when he left that bar?

Again, no, we shouldn't let a drunk driver off the hook for manslaughter because he didn't mean to kill. You can't compare a drunk driver to this case because the nurse was not drunk.