Sure. To begin with, I defer to the jury in this case, there was an RN and a respiratory therapist on the jury, and they convicted. Very well.
Based on what I read in the last couple of days I don’t think I would have, perhaps they know something I don’t, perhaps I know something they don’t.
Caveat: I’m a bedside nurse working for a large, for-profit healthcare corporation, and I have some bias about the way they present themselves to the community and the way they actually behave (their actions in this case, to me, are as good as an admission that their safety protocols were flawed).
This is a complicated case and I’m getting a lot of my opinion from this timeline and its embedded links.
The RaDonda Vaught case is confusing. This timeline will help. (msn.com)
The links are to, in order of occurrence, the anonymous tip to the state and the feds (the hospital did not report in the way they are required to), to the letters from the Tenn nursing board to the nurse and the hospital, and to the corrective action plan struck between the hospital and the feds. The corrective action plan is long, redundant, and has a lot of step by step details about what happened that day.
Couple of interesting points, the anon tip is very thorough and specific, whoever wrote it had seen the post event analysis, they weren’t someone who just heard about it in the breakroom. Also, the letter from the Tenn dept of health to the hospitals’ Chief Nursing Officer (I think), in explaining that they won’t be pursuing action against the nurse’s license, concludes with the statement “We appreciate you notifying our office of your concerns, and while the outcome may not have met your expectations, please be assured that a legal assessment was made based on the statutes and rules governing this profession.” Italics added because I find this odd.
Shortly after this, the feds arrive for an unannounced audit, the corrective action plan that resulted included changes to the automatic medication dispenser, as well as changes to the transport and monitoring policy. Any one of which probably would have prevented the outcome, had they been in place at the time.
Some timeline details. The patient was already in the Radiology dept. they were the ones to obtain the order for sedation. The primary nurse (who was not Vaught) told radiology they could not come but would send another nurse and that the pt would not need to be monitored. Vaught, who was on her way to the ER, was asked to stop by radiology, gave the drug and left, the pt was moved into a holding area, and later was discovered unresponsive.
I did not see a statement from Vaught as to whether or not she believed the someone in radiology would be monitoring the pt, but the corrective action plan suggests to me that there was ambiguity in the chain of responsibility.
Blah, that’s enough for tonight, I’ll answer questions, if people have them.