Case of Nurse Charged with Homicide for Medication Error Raises Concerns

Every nurse’s nightmare.

On February 1, Radonda Leanne Vaught, a former nurse at Vanderbilt University Medical Center in Nashville, was indicted and arrested for impaired adult abuse and reckless homicide. She is accused of inadvertently administering the wrong medication and causing a patient’s death in an incident in late 2017.

This is every nurse’s nightmare.

According to the CMS report from its investigation, Vaught administered IV vecuronium (a neuromuscular blocking agent that causes paralysis and is often used during surgery) instead of IV Versed (a sedating agent) to an anxious patient undergoing a diagnostic scan. The patient stopped breathing, suffered brain damage, and subsequently died. Vaught was charged with recklessness because she overrode the automated medication dispensing system and didn’t follow standard procedures in properly checking the drug name or in monitoring the patient after administering the medication.

What the CMS report says.

The CMS report, which includes interviews with Vaught as well as witnesses and safety officers at the hospital, notes the following information about Vaught’s actions while she was in the medication system searching for the medication:

“[Vaught]. . . was talking to [an] Orientee while he/she was searching the ADC for the Versed and had typed in the first 2 letters of Versed which are VE and […]

2019-03-01T14:14:51-05:00February 12th, 2019|Nursing, nursing career|10 Comments
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Protocol to Reduce Hospital-Acquired Pneumonia Improves Outcomes, Lowers Costs

Costs. Length of stay. Patient mortality. We know that the care we provide is central to good outcomes of every kind. But how often do we get to clearly demonstrate this for hospital administration? In “A Nurse-Driven Oral Care Protocol to Reduce Hospital-Acquired Pneumonia” (free until March 1) in this month’s issue, authors Chastity Warren and colleagues describe a QI project that showcased how a simple nursing intervention decreased morbidity, mortality, and costs at their hospital.

A standardized oral care protocol.

Aware of the connection between poor oral care and hospital-acquired pneumonia, a group of nurses at their large Midwest hospital set out to devise a standardized oral care protocol for all adult patients. Patients were categorized as either ventilated, at-risk (for example, someone with a trach or with swallowing difficulties), or short-term care. The care kit and the frequency of oral care were different for each group.

Once the intervention was in place, the nurses tracked not only the incidence of hospital-acquired pneumonia in both ventilated and non-ventilated patients, but also (by creatively “triangulating” several sources of data) the adherence of staff on each unit to the protocols.

Protocol adherence.

Regarding protocol adherence—always a challenge with new protocols when multiple units and staff are involved—the authors noted that there’s still work to […]

2019-02-06T09:10:07-05:00February 6th, 2019|Nursing, nursing research|0 Comments
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Even in an Unimaginable Crisis, Nature Heals

“Eleven-year-old Olivia’s parents were ‘done,’ had reached their limit of bad news, and refused to enter the conference room. They didn’t want more information or what they perceived as pressure to withdraw life support.”

The hardest decision.

by Janet Hamlin for AJN

These words in the opening paragraph of this month’s Reflections column,”Little Sparrow,” describe a situation that will be instantly recognizable to many nurses, especially those who regularly work with people who have suffered severe head injuries or other central nervous system trauma. These two short sentences encapsulate the terrible crisis that develops when a tragic outcome seems inevitable to staff—while family members, in shock, struggle to absorb information and make decisions.

A healing garden.

In the essay, which will be free until February 20, Elaine Meyer, PhD, RN, describes her approach to one such family. While the parents of the seriously injured young girl pray for a miracle, staff are distressed because they feel they are inflicting unnecessary suffering on the child. […]

2019-02-05T08:19:55-05:00February 5th, 2019|family, Nursing, nursing stories|1 Comment
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Hodgkin Lymphoma: Knowing the Long-Term Treatment Effects

Most nurses will likely encounter a Hodgkin lymphoma (HL) survivor at some point, but will they know what to assess for?

‘Hodgkin’s is the good one to get.’

When I was going to graduate school, I worked part-time for a hematologist who mostly treated people with leukemias and lymphomas. Many of them had Hodgkin lymphoma (though we called it Hodgkin’s disease then). I administered chemotherapy, did a lot of patient teaching and a lot of listening and answering questions for this largely young group of patients. Most were close to my own age; it was easy to relate to their shock at finding out they had a life-threatening disease and that the treatment would not be easy.

I especially recall two young women—one had gone to her physician for a pre-marriage physical; the other went for a check-up because she felt she wasn’t “bouncing back” from the birth of her daughter three months previously. They were distraught at the diagnosis, and as they went through chemotherapy, they were often depressed over the side effects from the drugs: hair loss, GI upset, and fatigue.

But both of them did well. I remember the physician telling them his standard line, “If you had to get cancer, Hodgkin’s is the good one to get,” since it was often curable when […]

2019-02-01T13:09:38-05:00February 1st, 2019|Nursing|0 Comments
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Being a Bully and Being Bullied

‘Didn’t you learn that in school?’

Have you ever worked with a nasty colleague who knew everything? A nurse that the patients loved and showered with thank you cards and notes but was despised by coworkers? Unfortunately, I knew that person all too well. That bully nurse was me. It’s been nearly ten years since I received a wake-up call from another nurse and my then health care organization, making clear that I needed to change or risk heading further down a destructive path.

A few years into my nursing career—I can now admit—I thought I knew everything; the operative word here is thought. ‘Mary,’ a good colleague and still a friend today, would tell me, “I like you. I just can’t stand working with you.”

A kind person, Mary would never elaborate on my faults. In hindsight, it’s obvious to me what Mary was referring to. I could smell the blood of weaker individuals in the clinical setting and I was deliberately inconsiderate. I never raised my voice, but could be curt and make snide remarks: “Why are you bothering me now?” “Didn’t you learn that in school?”

None of the people I bullied stood up to me, so I continued. I really don’t fully understand it today. Was I power hungry? Possibly. Whatever the case, this way […]

2019-01-30T14:36:02-05:00January 30th, 2019|Nursing, nursing career|1 Comment
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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