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!

[subee, MSN, CRNA]

NurseGerard said:

Yes, I agree, but how many nurses have we worked with fit that archetype? I think it's important to hear in their own words, certainly these videos in the context of talking about the tragedy of Ms Murphey's death and what we need to understand about the circumstances and learn from them.

I can't recall that in  45 year career, I came across a nurse who killed a patient.  No, I woukd never want to be in the room with someone as clueless as her.  Is she not still blaming "the system"? 

 

[Kaitey M]

I've worked with 2 that were involved in "clean kills" that were recognized. 

Both cases were uncorrected esophageal intubations. 

I do wonder how many have killed someone through abject inexperience or incompetence? 

RaDonda is still blaming the system failure. Tho I will admit this **** still stinks no matter how it's spread.

Due to the spineless ANA branding her as the real 'victim', a position that's unforgivable in and of itself, but their support and message surrounding Ms. Vaught has allowed her to actually profit from her crime.

The ANA is wasting all manners of money & nurse legislative capital to convince states to legislatively initiate laws to prevent nurses that make common med or other errors from being charged criminally without specific intent. Seems wholly unnecessary, reckless disregard is what it is. Unintended consequences are inevitable here. Why not push for legal mandated staffing ratios? Shameful. 

 

 

[subee, MSN, CRNA]

Kaitey M said:

I've worked with 2 that were involved in "clean kills" that were recognized. 

Both cases were uncorrected esophageal intubations. 

I do wonder how many have killed someone through abject inexperience or incompetence? 

RaDonda is still blaming the system failure. Tho I will admit this **** still stinks no matter how it's spread.

Due to the spineless ANA branding her as the real 'victim', a position that's unforgivable in and of itself, but their support and message surrounding Ms. Vaught has allowed her to actually profit from her crime.

The ANA is wasting all manners of money & nurse legislative capital to convince states to legislatively initiate laws to prevent nurses that make common med or other errors from being charged criminally without specific intent. Seems wholly unnecessary, reckless disregard is what it is. Unintended consequences are inevitable here. Why not push for legal mandated staffing ratios? Shameful. 

 

 

Wow.  How is it even possible to have an esophageal intubation undetected since the late 20th century?  I have never heard of that as a cause of death.

[FiremedicMike, BSN, RN, EMT-P]

subee said:

Wow.  How is it even possible to have an esophageal intubation undetected since the late 20th century?  I have never heard of that as a cause of death.

For whatever reason, waveform capnography still isn't the gold standard in the hospital, even though we learned this in EMS years ago.

You can fool colormetric devices.. you can mishear lung sounds.. you can't fool waveform capnography.

 

[subee, MSN, CRNA]

FiremedicMike said:

For whatever reason, waveform capnography still isn't the gold standard in the hospital, even though we learned this in EMS years ago.

You can fool colormetric devices.. you can mishear lung sounds.. you can't fool waveform capnography.

 

I would think that anyone with normal hearing can tell the sound of air being forced into the stomach sounds very different than lung sounds.  Mind blown.

[NurseGerard]

Kaitey M said:

RaDonda is still blaming the system failure. Tho I will admit this **** still stinks no matter how it's spread.

Due to the spineless ANA branding her as the real 'victim', a position that's unforgivable in and of itself, but their support and message surrounding Ms. Vaught has allowed her to actually profit from her crime.

The ANA is wasting all manners of money & nurse legislative capital to convince states to legislatively initiate laws to prevent nurses that make common med or other errors from being charged criminally without specific intent. Seems wholly unnecessary, reckless disregard is what it is. Unintended consequences are inevitable here. Why not push for legal mandated staffing ratios? Shameful. 

ANA is in a box - RaDonda's actions undermine "most trusted" so they've got to double down or risk losing the money and goodwill value they squeeze from that cliche - it's also a way to sell fear (this could be YOU!), which is effective for a sizable chunk of the 5.2 million RN's who make no effort to understand what happened, or even who are sloppy and half-assed enough to realize yeah, it could be them

The other piece that can't be ignored - RaDonda is white, young, says she made a mistake and admitted it, etc and thus superficially projects an acceptable image of nursing to the public, augmented by one of the most powerful forces in our culture, white woman's tears

 

[subee, MSN, CRNA]

NurseGerard said:

ANA is in a box - RaDonda's actions undermine "most trusted" so they've got to double down or risk losing the money and goodwill value they squeeze from that cliche - it's also a way to sell fear (this could be YOU!), which is effective for a sizable chunk of the 5.2 million RN's who make no effort to understand what happened, or even who are sloppy and half-assed enough to realize yeah, it could be them

The other piece that can't be ignored - RaDonda is white, young, says she made a mistake and admitted it, etc and thus superficially projects an acceptable image of nursing to the public, augmented by one of the most powerful forces in our culture, white woman's tears

 

Nursing would be more trusted if the ANA refused to have anything to do with this person. and encouraged mandated ratios.  

[LWitcher, BSN]

Some of these comments are very cold. Just be careful and prayerful that you don't find yourself in the exact same or similar situation. YES we all know there are multiple things that she could have done different, but we are all HUMAN, not robots as some like to think, and one does not know how he or she may react in a situation such as this one was. Never condoning the actions, or dismissing the heartbreak for the family, but why not reinstate her license, she does not have to be in patient care but she will be able to educate and help some other nurse, NP, physician, whomever not make the same tragic error that she did.       

[chemdawg, MSN]

It is my understanding that she was not truthful and did not show remorse. 

[mtmkjr, BSN]

LWitcher said:

Some of these comments are very cold. Just be careful and prayerful that you don't find yourself in the exact same or similar situation. YES we all know there are multiple things that she could have done different, but we are all HUMAN, not robots as some like to think, and one does not know how he or she may react in a situation such as this one was. Never condoning the actions, or dismissing the heartbreak for the family, but why not reinstate her license, she does not have to be in patient care but she will be able to educate and help some other nurse, NP, physician, whomever not make the same tragic error that she did.       

I think that is due to the frustration over the lack of self-reflection/assessment on Radonda's part and of the flocks around her who want to shift blame away from her and disregard appropriate consequences.

I think had there been remorse, acceptance of her grave neglectfulness in disregarding all the very basic safety measures, accept the consequences, and not try to shake it all off and move on, but instead devote herself to activities that promote medication safety in nursing practice, who knows maybe we would all be supporting that and not pushing back so hard on her efforts to regain her license. I think there would be a lot of grace and empathy had that been the case

[NurseGerard]

LWitcher said:

Some of these comments are very cold. Just be careful and prayerful that you don't find yourself in the exact same or similar situation. YES we all know there are multiple things that she could have done different, but we are all HUMAN, not robots as some like to think, and one does not know how he or she may react in a situation such as this one was. Never condoning the actions, or dismissing the heartbreak for the family, but why not reinstate her license, she does not have to be in patient care but she will be able to educate and help some other nurse, NP, physician, whomever not make the same tragic error that she did.       

No - you're throwing up all kinds of rhetorical distractions and in your feelings

I am NOT RaDonda, the nursing colleagues I know and trust are NOT RaDonda and HUMANITY requires us to center Mrs Murphey first last and always 

the discussion about license is over done fini kaput

she's getting paid $10,000 a pop to talk when she really needs to go somewhere be quiet and get support from folks who love her

[Wuzzie]

LWitcher said:

she will be able to educate and help some other nurse, NP, physician, whomever not make the same tragic error that she did.   

She doesn't need a license for this and doesn't seem to be interested in doing it

LWitcher said:

and one does not know how he or she may react in a situation such as this one was.

Oh I know....I would have read the damn vial!