Roy Exum
I believe it is very accurate when I claim I’ve had more surgeries than any person I’ve ever met. I also believe I personally know more people than anybody else I’ve ever been around so that doubles-down on my belief I could never be party to a lawsuit nor a criminal investigation against any medical professional of any kind. After what literally thousands of doctors, nurses and hospital administrators have done in their efforts to help me there is absolutely no way I’ll ever be anything other than grateful. Just this year – in 2019 – I’ve made 10 trips to the operating room, this following an ill-fated knee replacement last July. I knew better than anyone it was risky but, lord help, compared to the pain of the arthritis that had its grip on me, it was a no-brainer. If there is anyone to blame, a winless game since the beginning of time that I refuse to play, then I’ll accept any wrath, disappointment, or the forever chore of accepting my bad luck and doing whatever comes next.
Life is like a river. You can’t make it back up. Whether you like it or not, you ‘go with the flow’ and handle whatever you must face as best you can. I fight to stay positive, to glory in the successes, as incremental as they may be, and when I get where I’m feeling blue I simply call somebody who is struggling under a load heavier than mine and tell them what an inspiration they are to me. Works every time. You won’t find me in the company of complainers, I’m here to tell.
That brings us to a 35-year-old nurse in middle Tennessee, RaDonda Vaught. She’s been an experienced, well-trained and able floor nurse at Vanderbilt Hospital, where I have had four surgeries in the past year. I do not know RaDonda but I know about 100 just like her and Vanderbilt RNs are as good as it gets. Candidly, I am convinced our Erlanger is just as good, and better when you eliminate the drive to Nashville and back.
Back to LaRonda. In Nashville yesterday there was a hearing that set a court day of July 2020 for her charges of reckless homicide to be heard. In December of 2017, orders were written for a drug to be administer to a 75-year-old female, Charlene Murphey, of Gallatin. The patient had been admitted to the floor after suffering a subdural hematoma – a head injury that is serious yet treatable – and a sedative identified as Versed was prescribed. My doctors use the stuff on me all the time and it is commonly used at every hospital. Works like a champ.
Nurse Vaught took the patient’s chart to a drug-dispensing “safe box” like you will find at nurses’ stations in any hospital. It was later determined she was in the middle of a non-related conversation with a colleague, had several other patients under her charge, and was well-experienced at accessing the drug storage locker. She typed in “VE” (for Versed) as well as dosage information, the patient’s name code, and whatever. The machine balked, this because Vanderbilt uses the generic name for Versed, which is Midazolam.
Nurses are used to quirky drug safes so she, knowing how to override the safeguard (which has saved more lives in a crisis than hurt), released the restrictive ‘wall’ and “VE” popped out a vail of vecuronium, which is a very potent paralyzing agent. LaRonda thought it odd the vail had powder in it -- Versed is liquid – but she added a mixing agent as she had often done with other pre-mix drugs, shook the vial until the powder was absorbed, and administered the medicine to the patient.
Had she checked the vail, she would have been alerted to her mistake. Worse, on the cap where the syringe is drawn it is bright orange and bears the words, “WARNING PARALYZING AGENT.” Almost instantly the patient was too paralyzed to breathe and, by the time the accident was discovered, the brain function had stopped. She was pronounced clinically dead 12 hours after the respirator was removed.
There is little argument other than it was a tragic mistake. The Tennessee Department of Health investigated the incident, found it to be an accident, and closed the investigation with a letter stating the case “did not merit further action.” The Davidson County District Attorney’s investigators, however, found the nurse’s actions were criminal. A federal investigation ordered Vanderbilt to take further steps to safeguard the process or Medicare reimbursements could be interrupted. The hospital has complied.
Moreover, a national nurses advocacy group, “Show me your Stethoscope,” is horrified the Tennessee case will cast aside compassion and understanding that accompany doctors and nurses who quite innocently make mistakes, thankful not many to equal a death. Janie Harvey Garner, who the Nashville newspaper identified as the founder of the nursing advocacy group, said that if nurses become afraid to tell the truth without fear of prison – “people will die.”
What hospital administrators, the doctors, and most especially the “bean counters” can’t envision is that nurses are the Most Valuable Players in the whole set-up. They are who treats the patients. They are the “face” of the legendary Mayo Clinic, Boston’s Mass General, Johns Hopkins in Baltimore, Oschner’s in New Orleans, Barnes Jewish in St. Louis, Emory … I know from experience because I’ve spent the night at all of them. A lot of the Erlanger nurses know who I am … they’ve read some of my stories … and they make you feel like you are part of the family or whatever. Most of them laugh at my jokes.
That’s another thing. I have never, ever, been scared of having surgery because I have absolute confidence in each one’s abilities. Lately I have this little game I play because with their face masks, their hair covers, their sack-like scrubs, the only thing I can find that tells a tale are their eyes. But before I go la-la-la, I have yet to find anyone in the OR – particularly the older ones -- who doesn’t have the kindest eyes, if that makes any sense. It’s just a fun little game. They always want to hear a joke or two and usually tell the anesthetist to knock me out early.
Once at Mayo in Minnesota I took it too far, announcing when I was rolled into the actual surgical suite that I was a ‘Tao Buddhist,’ if ever there was such a thing, and I wanted to “cleanse the room … it will just take second.” Everybody stopped, watching, as I hopped off the gurney before they transferred my fat self to the operating table. I ran to each corner of the room, waving my good arm in the air, doing a little dance and chanting, and because they all got so tickled it held up surgery because they all had to rescrub their hands. I thought it was funny but was told never to do it again by three supervisory types.
No, I could never sue or try to harm people who messed up while they were trying to help me. I’ve had mistakes happen, a lot less than when things didn’t turn out as well as we hoped, but I haven’t yet seen a day in my life where everything was perfect in any arena. I had a great friend, who was also a brilliant lawyer, and made a pile of money doing malpractice work. Then one day he got sick and in the next 10 days saw everything from “the other side.” For what it’s worth, he refused to ever take a malpractice case again. I suspect there are a bunch of us that way.
And I’ll be pulling for the Vanderbilt nurse when her trial begins next July. Wonder what any judge or jury could do that would be worse than what’s she’s already had to live with? My stance is that she was trying to do the right thing and didn’t catch the glitch. Life happens.
royexum@aol.com