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!

[mtmkjr, BSN]

floydnightingale said:

How did I get the idea that she was in the ED but new to it? So she was some kind of float? I don't agree with the practice of throwing people into EDs, but a neuro ICU nurse should have had some familiarity with Versed.

There's a lot of misinformation out there. Radonda Is surrounded by supporters who have a different narrative. I'm not an ED nurse but would feel comfortable doing a swallow test. She wasn't being asked to do anything outside of her normal practice. 

And you are exactly right. She should have known. She had given versed multiple times -in fact she was so confident in herself, she thought she didn't even need to look at the vial. 

[klone, MSN, RN]

floydnightingale said:

How did I get the idea that she was in the ED but new to it? So she was some kind of float? I don't agree with the practice of throwing people into EDs, but a neuro ICU nurse should have had some familiarity with Versed.

She was not in the ED. She was an ICU nurse, helping an ICU patient who was getting a CT. She was an extra body that day, so they sent her to radiology to give this ICU patient (who was being discharged home, stable) an anxiolytic prior to her scan. Not new, not in the ED, not overworked, not stressed out (all by her own admission in court).

[subee, MSN, CRNA]

klone said:

She was not in the ED. She was an ICU nurse, helping an ICU patient who was getting a CT.

CT rhymes with ED.  Maybe that is the source of the confusion:)

[klone, MSN, RN]

LOL

I think people are getting confused because after she gave the IVP that killed Ms. Murphey, she was heading down to the ED to do another task.

[Wuzzie]

floydnightingale said:

How did I get the idea that she was in the ED but new to it? So she was some kind of float? I

No she wasn't any kind of float. Her unit was overstaffed for the day so she was acting as a resource or "help all" nurse providing assistance on her own unit to her fellow staff members. She was asked by one of them to give the Versed to one of their patients who was down in radiology for a scan. Please read the investigation documents that are linked earlier in this post. What you appear to believe happened isn't anywhere near what actually did. 

 

[toomuchbaloney]

floydnightingale said:

How did I get the idea that she was in the ED but new to it? So she was some kind of float? I don't agree with the practice of throwing people into EDs, but a neuro ICU nurse should have had some familiarity with Versed.

Only you know for certain how you came to that incorrect conclusion.  The rest of us just imagine that you failed to read the actual documents and evidence in the case and then felt well enough informed to offer a poorly informed opinion.  

Any nurse, in any department, in any healthcare setting, should have some familiarity with safe medication administration. RV demonstrated that she did not possess that fundamental familiarity or discipline, therefore she should not be a nurse in any setting.  

Read the facts and evidence of the case. 

[JKL33]

floydnightingale said:

How did I get the idea that she was in the ED but new to it? So she was some kind of float?

Because at that place the neuro ICU nurses are tasked with doing the swallow screens on pts in the ED (stupid and mostly unnecessary task at that point in care IMO, but whatever). So RV had plans to head to the ED to do one of those swallow screens after she got done pushing the "Versed" down somewhere in a radiology holding room on another neuro ICU stepdown pt (who is the patient in question).

These were a couple of the known tasks she took on in the neuro ICU "help all" role (extra RN) that day.

[JKL33]

floydnightingale said:

a neuro ICU nurse should have had some familiarity with Versed.

Yes, and in fact when they pull "Versed" and find themselves holding a vial of white powder, maybe they should do more than ??‍♀️?

[Been there,done that, ASN, RN]

RV is appealing the licensure revocation, based on a technicality. If she had any insight into her actions, she would KNOW she is not fit to provide patient care. 

 Three years  or probation is a slap on the wrist . She is making more money off of her notoriety , than she would ever make as a nurse. Book and movie to follow. 

[Hoosier_RN, MSN]

Been there,done that said:

RV is appealing the licensure revocation, based on a technicality. If she had any insight into her actions, she would KNOW she is not fit to provide patient care. 

I'm not sure that she has that self realization. She certainly hasn't demonstrated that capability up to this point

[ScorpianNurse, MSN, DNP, PhD, RN, APRN, NP, CNM]

 

After reading the entire article, it appeared there are several severe situational differences with industry policymakers. My prayer is for this situation to be revisited and possibly considered as a way to educate industry policymakers. 

[subee, MSN, CRNA]

Quote

 

ScorpianNurse said:

After reading the entire article, it appeared there are several severe situational differences with industry policymakers. My prayer is for this situation to be revisited and possibly considered as a way to educate industry policymakers. 

 

What?