The conviction of US nurse RaDonda Vaught, found guilty last month in an accidental injection death, has sparked fear and outrage among many nurses, who have been faced with long hours, mounting responsibilities and staffing shortages.
Emma Moore (29), a nurse practitioner at a community health clinic in Portland, Oregon, said she felt overwhelmed and undertrained, and while coronavirus patients flooded the clinic for two years, she struggled to keep up.
On 25 March, nearly 4,000km away in a Tennessee courtroom, former nurse RaDonda Vaught was convicted of two felonies and now faces eight years in prison for a fatal medication mistake. The reality struck home for many nurses.
Like many other, reports Kaiser Health News (KHN), Moore wondered if that could be her. She’d made medication errors before, although none so grievous. But what about the next one? In the pressure cooker of pandemic-era health care, another mistake felt inevitable.
Four days after Vaught’s verdict, Moore quit. She said the verdict contributed to her decision.
“It’s not worth the possibility or the likelihood that this might happen,” Moore said, “if I’m in a situation where I’m set up to fail.”
In the wake of Vaught’s trial – an extremely rare case of a healthcare worker being criminally prosecuted for a medical error – nurses and nursing organisations have condemned the verdict through tens of thousands of social media posts, shares, comments and videos. They warn that the fallout will ripple through their profession, demoralising and depleting the ranks of nurses already stretched thin by the pandemic.
Ultimately, they say, it will worsen health care for all.
Statements from the American Nurses Association, the American Association of Critical-Care Nurses, and the National Medical Association each said Vaught’s conviction set a “dangerous precedent”. Linda Aiken, a nursing and sociology professor at the University of Pennsylvania, said it would make nurses less forthcoming about mistakes.
“One thing everybody agrees on is it’s going to have a dampening effect on the reporting of errors or near misses, which then has a detrimental effect on safety,” Aiken said. “The only way you can really learn about errors in these complicated systems is to have people say, ‘Oh, I almost gave the wrong drug because …’”
“Well, nobody is going to say that now.”
KHN reports that fear and outrage about Vaught’s case have swirled among nurses on Facebook, Twitter and Reddit. On TikTok, a video platform increasingly popular among medical professionals, videos with the "#RaDondaVaught" hashtag totalled more than 47m views. Vaught’s supporters catapulted a plea for her clemency to the top of Change.org, a petition website. And thousands also joined a Facebook group planning to gather in protest outside her sentencing hearing in May.
Ashley Bartholomew, 36, a nurse who followed the trial through YouTube and Twitter, echoed the fear of many others. Nurses have long felt forced into “impossible situations” by mounting responsibilities and staffing shortages, she said, particularly in hospitals operating with lean staffing models.
“The big response we are seeing is because all of us are acutely aware of how bad the pandemic has exacerbated the existing problems,” Bartholomew said. “Setting a precedent for criminally charging [for] an error is only going to make this exponentially worse.”
Vaught, who worked at Vanderbilt University Medical Center in Nashville, was convicted in the death of Charlene Murphey, a 75-year-old patient who died from a drug mix-up in 2017. Murphey was prescribed a dose of a sedative, Versed, but Vaught accidentally withdrew a powerful paralyser, vecuronium, from an automated medication-dispensing cabinet and administered it to Murphey.
Prosecutors argued that Vaught overlooked many obvious signs that she’d withdrawn the wrong drug, and did not monitor Murphey after she was given the deadly dose. Vaught owned up to the error but said it was an honest mistake, not a crime.
Some of Vaught’s peers support the conviction. Scott Shelp, a California nurse with a small YouTube channel, posted a self-described “unpopular opinion” that Vaught deserves to serve prison time. “We need to stick up for each other,” he said, “but we cannot defend the indefensible.”
Shelp said he would never make the same error as Vaught and “neither would any competent nurse”.
Vaught was acquitted of reckless homicide but convicted of a lesser charge, criminally negligent homicide, as well as gross neglect of an impaired adult. As outrage spread across social media, the Nashville district attorney’s office defended the conviction, saying in a statement it was “not an indictment against the nursing profession or the medical community”.
“This case is, and always has been, about the one single individual who made 17 egregious actions, and inactions that killed an elderly woman," said the office’s spokesperson, Steve Hayslip.
“The jury found that Vaught’s actions were so far below the protocols and standard level of care, that the jury (which included a long-time nurse and another health care professional) returned a guilty verdict in less than four hours.”
The office of Tennessee Governor Bill Lee confirmed he is not considering clemency for Vaught despite a Change.org petition that had amassed about 187,000 signatures as of April 4.
But the controversy is far from over. As of April 4, more than 8,200 people had joined a Facebook group planning a march in protest outside the courthouse during her sentencing on 13 May 13
See more from MedicalBrief archives:
Nurse faces 8 years in jail following criminal prosecution over fatal injection
US nurse on trial for reckless homicide over administration of deadly drug
Coming into line with international practice on criminalisation of doctors
Call for SA Law Reform Commission review on criminal charges against doctors
UK killer nurse's case sent back to Court of Appeal