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Such mistakes often end up in malpractice lawsuits, but criminal prosecutions are rare. After Vaught was charged in 2019, the Institute for Safe Medical Practices issued a statement saying it had “worrisome implications for safety.”
“In an era when we need more transparency, cover-ups will reign due to fear,” the statement read. “Even if errors are reported, effective event investigation and learning cannot occur in a culture of fear or blame.”
Many nurses are “already at their breaking point … after a physically, mentally and emotionally exhausting two years caring for patients with COVID,” said Liz Stokes, director of the American Nurses Association’s Center for Ethics and Human Rights. Vaught’s prosecution gives them one more reason to quit, she said.
“This could be me. I’m an RN as well,” she said. “This could be any of us.”
Vaught was steeped in the idea of Just Culture and says she has “zero regrets” about telling the truth, but her candor was used against her at trial. Assistant District Attorney Brittani Flatt quoted from her interview with a Tennessee Bureau of Investigation agent in closing arguments: “I definitely should have paid more attention. I should have called the pharmacy. I shouldn’t have overridden, because it wasn’t an emergency.”
It is easy to judge Vaught’s actions in retrospect, Lambert said, but overrides and workarounds are an extremely common part of healthcare, he said: “This is typical, not aberrant or bizarre, behavior.”
Meanwhile, Vaught’s honesty about her mistake has already brought about safety improvements, and not just at Vanderbilt. Because vecuronium should only be used on patients who have a breathing tube inserted, some hospitals have moved it and other paralytic drugs out of automatic dispensing cabinets.
“At my hospital, they’ve changed their policy and put paralytics into a rapid intubation kit because of this,” said Janie Harvey Garner, who founded the nurse advocacy organization Show Me Your Stethoscope. She said that because Vaught owned up to the mistake, Murphey’s death “has probably saved lives.”
While Murphey’s death may serve as a cautionary tale for other nurses, Vaught, now awaiting a sentence of up to eight years, told The Associated Press in an interview that she thinks about her patient every day.
Vaught, 37, discovered that she and Murphey lived in the same small community of Bethpage, about an hour northeast of Nashville, and that she and members of Murphey’s family have mutual friends. It would only be a matter of time before she met one of them in person.
“I’ve imagined so many times how I would feel if this were my grandma, my family member, my husband,” she said.
Recently, while buying farm supplies, she was talking with the young man behind the counter when he recognized her, and told her he was Murphey’s grandson. Instead of reproaching her, he ended up comforting her and patting her on the shoulder, she said.
“He was so kind. He was so incredibly kind,” Vaught said. “I took his grandma away, and he just kept telling me to take care of myself. There are good people in this world.”
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