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:

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. 

It's compared this way because of the similarities; The intent was not to harm but the outcome was death due to someone's actions that were a drastic departure from the norm. 

[subee, MSN, CRNA]

FolksBtrippin said:

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. 

She performed as if she were 1.  drunk or high or 2.  egregiously stupid.  Which one would you pick to take care of your family?

[FiremedicMike, BSN, RN, EMT-P]

FolksBtrippin said:

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. 

You said she should be let off because she didn't mean to kill anyone.  I picked the example of a drunk driver out of any number of other scenarios where a person didn't mean to kill someone, yet they remain criminally liable because their actions were so careless or reckless.

 

[Hoosier_RN, MSN]

FolksBtrippin said:

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. 

No one knows if she was under the influence of anything, or not, as she was never tested

[Tenebrae, BSN, RN]

FolksBtrippin said:

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

She didn't read the vial of medication

versed, a glass phial that doesnt need to be reconstituted

vercuronium bromide, has a red cap and a warning in large letters 'paralytic' and needed to be reconsituted. 

Even if I take nothing else away from this entire situation including the fact that Charlene Murphey died fully aware and suffocating and unable to speak (not that this would have helped, RV slammed the medication and walked away leaving her own}

Had she done that one thing and read the label, there is a fairly good chance Charlene Murphey would still be living and would not have died an appalling death

Its admirable to want to find the best in people and defend their actions. I don't believe that there is anything that is defensible in her actions and she shouldnt be allowed to practice ever again

FolksBtrippin said:

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. 

No, she was grossly negligent and her actions resulted in the patient suffocating to death, alone and fully aware of what was happening

[FolksBtrippin, BSN, RN]

Hoosier_RN said:

No one knows if she was under the influence of anything, or not, as she was never tested

Even if that's true, the question being posed here is not "should we let a nurse who went to work drunk and then killed someone have her license back?” I would answer no to that question. 

[FiremedicMike, BSN, RN, EMT-P]

FolksBtrippin said:

Even if that's true, the question being posed here is not "should we let a nurse who went to work drunk and then killed someone have her license back?” I would answer no to that question. 

You've got a bachelors degree, is your comprehension of this discussion really that poor?  Should I show other examples so that you can get off the alcohol?  A driver going 135 miles per hour doesn't mean to kill someone, but they were reckless and someone died as a result, same thing.

Or will you just respond with "she wasn't driving 135 miles per hour when she slammed a paralytic and walked away".

 

[Hoosier_RN, MSN]

FolksBtrippin said:

Even if that's true, the question being posed here is not "should we let a nurse who went to work drunk and then killed someone have her license back?” I would answer no to that question. 

No, but you posed a reply that way, so that's my response. By the direction that your replies are taking, it's evident that you haven't thoroughly reviewed all of the testimony and investigation. If you had, you'd be appalled like the most of the rest of us are. FBT, you are usually very rational, so I'm not understanding why you're not seeming to comprehend the evidence, testimony, and investigation as they were present and easy to access for review. It's one thing to feel empathy or try to understand, but you disregard testimony that screams "I blatantly disregarded every safety measure that I could, then trotted along my merry way" like it's not even there. Not like you at all ?‍♀️

[Kooky Korky, BSN, RN]

probably not the best idea, although did she have several good years of Nursing practice before the tragedy?

Maybe she should have to take a refresher course.

Would people trust her to be their nurse?

Maybe she could not work with patients any more.

Probably best for her if she does a different type of work.

[Kooky Korky, BSN, RN]

Hoosier_RN said:

"we all see ourselves in Vaught"

ummmmm, no, not in the least little bit

maybe they meant that we all know we could make a very serious mistake.

[toomuchbaloney]

Kooky Korky said:

maybe they meant that we all know we could make a very serious mistake.

Do you think that you could inject a paralytic into a patient after failing to read the medication label multiple times?

[Hoosier_RN, MSN]

Kooky Korky said:

maybe they meant that we all know we could make a very serious mistake.

We all know that we can make a mistake, but a great majority of is don't just keep disregarding repeated warnings, and then go about our merry way. Then try to overlook said mistake of that magnitude until someone else points it out and says they are reporting it. Then goes on social media and TV crying that they are the mistreated one...

Most of us can see ourselves in making a mistake when overwhelmed/overworked and under rested. She was none of the above. So no, my statement stands. I don't see myself in her shoes