‘Chilling effect’: Healthcare groups denounce conviction of nurse in patient’s death

After RaDonda Vaught was found guilty in the highly-watched trial, advocates warn it could deter doctors and nurses from admitting mistakes and undermine patient safety.

Several healthcare groups warn that the conviction of a Tennessee nurse in the death of a patient could drive some out of the profession and threaten the safety of patients.

RaDonda Vaught, a former nurse, was convicted of gross neglect of an impaired adult and negligent homicide after a trial in Nashville, Tennessee last week. In 2017, Vaught, then a nurse at Vanderbilt University Medical Center, gave 75-year-old patient Charlene Murphey a dose of a paralyzing drug, vecuronium, instead of a sedative, Versed.

Healthcare organizations and advocates, who watched the trial intently, said they worried about the implications of the verdict.

It may only discourage nurses and doctors from admitting mistakes, said Robyn Begley, chief nursing officer for the American Hospital Association and CEO of the American Organization for Nursing Leadership.

“The verdict in this tragic case will have a chilling effect on the culture of safety in health care,” Begley said in a statement Tuesday.

“The Institute of Medicine’s landmark report ‘To Err Is Human’ concluded that we cannot punish our way to safer medical practices. We must instead encourage nurses and physicians to report errors so we can identify strategies to make sure they don’t happen again,” she said.

“Criminal prosecutions for unintentional acts are the wrong approach," Begley said. "They discourage health caregivers from coming forward with their mistakes, and will complicate efforts to retain and recruit more people in to nursing and other health care professions that are already understaffed and strained by years of caring for patients during the pandemic.”

In the Tennessee case, Vaught acknowledged making medical errors. Her attorney also said systemic problems at Vanderbilt University Medical Center played a role in the tragedy.

The American Nurses Association and Tennessee Nurses Association both said they were “deeply distressed by this verdict and the harmful ramifications of criminalizing the honest reporting of mistakes.”

“Health care delivery is highly complex. It is inevitable that mistakes will happen, and systems will fail. It is completely unrealistic to think otherwise,” the nursing associations said in a joint statement.

“The criminalization of medical errors is unnerving, and this verdict sets into motion a dangerous precedent," the nursing groups said. "There are more effective and just mechanisms to examine errors, establish system improvements and take corrective action. The non-intentional acts of Individual nurses like RaDonda Vaught should not be criminalized to ensure patient safety.

“The nursing profession is already extremely short-staffed, strained and facing immense pressure – an unfortunate multi-year trend that was further exacerbated by the effects of the pandemic. This ruling will have a long-lasting negative impact on the profession.”

The COVID-19 pandemic has exacerbated nursing shortages, healthcare leaders have said. Two out of five nurses have said they plan to leave the profession in the next two years due to the stress of the pandemic, according to a recent study published in Mayo Clinic Proceedings.

Nurses have faulted healthcare organizations for failing to provide sufficient support. Some nurses have said they are overworked to the point of exhaustion and often don’t feel safe at work.

Rebecca Love, chief clinical officer of IntelyCare, a nursing agency, said “we must acknowledge the failure of a broken system that allowed a nurse to work while being short-staffed, overworked, and unsupported - not the nurse herself - as the culprit that caused this loss to occur.”

“Vaught’s case is representative of a systemic problem, not a nursing problem,” Love said in a statement. “Rather than criminally prosecuting a nurse, we should be cross-examining the healthcare system that under-staffs its floors and overworks its nurses, making room for tragedies like this to happen. Healthcare needs an overhaul, for everyone’s safety and for the future of the nursing profession.”

Other nurses and doctors expressed their dismay over the case on social media and warned it will only make clinicians think twice about coming forward to acknowledge mistakes. Some pointed out how nurses regularly catch mistakes from doctors before patients can be harmed.

Kathryn Ivey, an ICU nurse wrote on Twitter, “Every nurse, every HCW, fears making this kind of mistake. Most of us know that it could be us, that we ALL have errors and mistakes.”

Vaught is scheduled to be sentenced May 13 and could face three to six years in prison, NPR reported. She remains free on bail until sentencing.

As of Tuesday, nearly 100,000 people have signed an online petition asking for clemency for Vaught.