Here’s What You Think About RN Amanda Trujillo’s Story

February 15th, 2012

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By , BSN, RN

I rarely worry about losing my job as a nurse. I’m generally professional, mostly on time, anal retentive about patient safety and for the most part people seem to like me. I am bossy, but I am a nurse (specifically an OR nurse so that comes with the territory). I am demanding on my patient’s behalf (but sometimes that slips over into my personal life) and I hate charting (which is hard on my chart reviewers and why I love medical mission work).

I share all this because I am human; just like every nurse. Most of us don’t consider we will lose our jobs for doing our jobs, sometimes no matter how difficult we are to work alongside. Arizona nurse Amanda Trujillo never considered she would lose her job and possibly her license for being safety conscious and demanding on her patient’s behalf.

This story of one nurse’s trials and tribulations is raising many topics for consideration, discussion, even argument. Many of you have weighed in with your thoughts on the subject. I blogged one day about what made other nurse/writers pick up this banner and run with it. Many of them were kind enough to share their thoughts with us at RNCentral.

Many readers, nurses, have also shared their opinions with us about this controversial case. I also know that once I have read an article I rarely go back and read it again. But, there is some great stuff here, from nurses just like you and me. So, let’s take a look at what nurses across the country are thinking about the situations and topics surrounding Trujillo’s story.

What Threatens One Arizona RN Threatens Us All

  • Christine Esquivel says: 
”This is a travesty. Ms. Trujillo was well within her scope of practice by ordering a hospice consultation. The MD was way out of line and was probably upset over loss of revenue. As nurses we see this happen all the time and should be addressed.
  • Rene W. Neville writes: "This case is BEYOND outrageous. What is described is a perfect and extreme example of Why nurses have no desire to report unsafe practices and/or violations of Patients’ Rights. This RN appeared before the Arizona State Board of Nursing TODAY to ‘explain herself’ for doing what we ALL have a responsibility to do-Advocate for our Patients!
As of today, Jan.24,2012, her license on the Arizona State Board of Nursing’s’ Verification website is stated as: ACTIVE: UNDER INVESTIGATION.
Why should any nurse want to work in Arizona after THIS?”
  • Gail Gabel says: "What happened to this nurse can happen at anytime to any of us. I am appalled at the surgeon, the hospital that fired her and Arizona State Board for suspending her license “pending investigation” AND they send her for a psych eval. 
Since when are nurses “crazy” for educating their patients? Are we all nuts? To strip her of everything she has worked for the sake of a surgeon’s ego? 
This is tragic and should not be happening, this is the 21st Century after all.”
  • Kerri, RN, replies: ”She did the right thing to advocate for her patient. The whole issue is that she made a hospice consult without notifying the physician. If I had a patient who decided to hold off on surgery to get more information, I would have called the physician and informed him first and then suggested a case management consult. If the physician refused, then administration and the ethics committee would have been notified to protect the patient. The bottom line here is that we be advocates and protect our patients just as Amanda Trujillo did. The error lies in the order of actions that she took. We all know that nurses act with autonomy in certain situations and then let the physician know. However, when it happens with the wrong physician, it can be disastrous for the nurse’s career. I’ve seen similar situations occur where nurses were fired over it. In the case of this physician, I would bet that he wasn’t notified immediately because he’s likely one of those physicians who verbally abuse nurses when they call for orders.
This is one of those moments where it’s become obvious that there is a serious discrepancy between what is expected of nurses and what they can actually do. It’s time for physicians and hospitals to be clear on what the nursing scope of practice is because Amanda Trujillo acted within hers.”
  • Penelope Rock writes:”Indeed, the case against Amanda Trujillo is not just a case against her but a case against the nursing community. The threat against her is a threat against our licenses too if we in any case will practice patient advocacy. And above all her case is against our patients who deeply need knowledge, eh.
Thanks for sharing.“

It was early February 2012 before the American Nurses Association managed to even acknowledge that something was going on across the country in Arizona. They had been written, they had been emailed, they had been called, they had been tweeted, and messaged, and blogged before they said anything (and they didn’t say much). Other nurses noticed that, too.

ANA Finally Acknowledges RN Amanda Trujillo

  • Greg Mercer says: “As expected for a large traditional organization with too much to lose to take any risks, ANA offers mostly standard boilerplate likely approved by liability attorneys as safe prior to any public release. Also as expected, we are told to trust the system in all its facets, and distrust anyone with the audacity to suggest otherwise. It seems traditional organizations in most all their variety have one thing in common: disdain and distrust, and perhaps fear, of Social Media upstarts increasingly encroaching on formerly unquestioned prestige and influence and power. The world is changing, and disapproval will not change that fact. It is wiser, in my humble opinion, to learn to put new realities to best use than it is to try to fight them – ask the buggy whip makers who tried to hold on as those pesky new-fangled automobiles came out. Passing fad? Social media is the next big thing – hop on or recede into history.”
  • Naomi replies: “ANA strongly supports nurses and their right and responsibility to engage in patient education and advocacy.”
Do they, really? Is this not what Amanda did?? Why doesn’t the ANA support their nurses like the AMA supports their docs?”
  • Aidel says: “Amanda did the right thing. It is no surprise that the ANA is not being supportive. If patients getting procedures were giving truly INFORMED consent, there would be a whole lot fewer procedures happening, which is bad for business, which is why we won’t see any meaningful change in this area. Physicians, hospitals, drug companies, and insurance companies (all for different reasons) have a long history of lying to patients. Morally indefensible but TRUE.”
  • Nancy Wilson writes: “It is becoming increasingly obvious that we cannot rely on our professional organizations to support us when the chips are down. It is time for nurses to take a stand for each other and for our profession. If we don’t others will do it for us and we won’t like the outcome.”
  • Annie says: “Because the doctors bring in patients which equals money for the hospitals. It always boils down to money and power.”
  • Naia McCoy comments: “My brother did not get proper informed consent and he is now dead because of severe Prozac side effects. I will not go into the details. I am not sure I understand what has happened to the medical field but if they cannot even protect their “own” (nurses)…then something is terribly, wrong and unjust in this country. Time to practice the art of nursing in another more caring place.”
  • Shahina Lakhani, MSN, RN, replies: “Jennifer, you have made some great points in this article. The fact that it took 10 months for Amanda’s case to be finally recognized is a proof to how unsupported the nurses are. If it was AMA a doctor would be innocent until proven otherwise, but for nurses it is guilty from the beginning and often without a chance of a fair investigation. Social media has brought nurses together like never before. Our challenge now is to create and maintain alliances at larger scale with each other, nurses for nurses. It is a great shift but one that is desperately needed so nurses can come out of this big hole of being treated as maids and gofers and finally claim our rightful place as partners in healthcare.”
  • Carolyn Nelson, RN, BSN, says: “Money is the root of evil. And this is no exception. I, too, have been sited where I work of saying the truth to our patients and being placed on three days off. Amanda did the same as I and as many nurses have in the past. Go Amanda.”
  • Jessica Ellis writes: “Yes, well…it’s all so clear, isn’t it? The ANA and other prof orgs are all about protecting themselves and their revenues. They can’t possibly take sides and support nurses through difficult times until proven either innocent or guilty. Seems that “guilty until proven innocent” is more the reality in the nursing world…and it takes going viral in social media to get even a NEUTRAL-sounding response from the orgs.”
  • Diane Levine, RN, BSN, comments: “Amanda, you know in your heart you did the right thing. As nurses we are responsible and obligated to be sure patients understand why they are there, what is happening to them, and how the physician can treat it if possible. It is also important the patient is well aware of the risks and the benefits either way. If their physician has not explained it fully or in a way the patient can comprehend it’s our responsibility to step in at this point and be sure we can help them to be educated. Nurses are teachers too. In fact its one of the jobs we do that I enjoy best! This whole incident sounds to me as if the physician was scared you were talking his patient out of his surgery where he could be a HERO! Second, it sounds as if when you speak of hospice as an alternative with a patient you are discussing death. Death is a very scary topic to anyone. Always was, probably always will. There is something about the unknown that scares us, even though there’s so much peace and tranquility to be learned and understood as well. We need more nurses like you to help us all in that journey! You Go Girl!!! Whoever hires you will be one very Lucky Employer!! Remember…God’s time Not Your time. Good Luck.”

So, that’s what you all are saying. We need to keep talking, on forums like this one, at our professional meetings, telling our organizations we don’t want them to do what they think is best, we want them to do what we think is right. Hospitals don’t run if they don’t have nurses; organizations don’t meet if we don’t join, and patient’s don’t get proper, safe care if we don’t stand up for them when they can’t stand up for themselves.

I may be bossy, I may be demanding, but I never thought of myself as revolutionary. That’s what this is starting to feel like; a revolution for nurses to claim their professionalism, their skills and their rights as members of the health care TEAM.

8 Responses to “Here’s What You Think About RN Amanda Trujillo’s Story”

  1. Nancy Wilson Says:

    I am so honored you included my comment in this post! I would like to further comment on what Shahina said about nurses being guilty until proven innocent. I can’t emphasize enough how important it is to be supportive to nurses undergoing investigative processes like these. Too often these nurses are shunned as if their bad luck is contagious. This is often more traumatizing damaging than the actual incident. Yes it is time for a revolution in nursing!

  2. Caryl J Carver, RN, BSN Says:

    Does anybody in the circle of nurses who have been following Amanda’s story have any resources in the media? We as nurses need to do more than talk, we need to get organized and do something so this never happens again to any nurse. GODSPEED, AMANDA TRUJILLO!!

  3. Andrew Lopez, RN Says:

    Hello Caryl,

    We e-mail, tweet and contact the media every day. We’ve gotten a few responses, a tv interview with KPHO Arizona and several unpublished interviews.

    Seems like they are waiting to “get all the facts” To date, only Amanda’s side has been told. Much to the chagrin of the Arizona
    State Board of Nursing, Del E. Webb.

    It is highly unlikely that they will admit to firing a nurse at the whim of an attending physician.

    We will continue publicizing this issue till it does catch on mainstream. Then we’ll press it even more :)

    Thank you for you comment. You can find more resources at http://www.nurseup.com

    Andrew Lopez, RN

  4. Denise Says:

    People that do not ordinarily work with hospice do not know or understand this point, but you DO NOT need an order for a hospice referral. Hospice is designed to allow anybody to refer a potential patient if you think the patient is eligible. This includes a nurse, the post man, the pool boy, you dear aunt, sister, niece, brother… Need I go on. A referral simply notifies a hospice company that a person in I’ll health might benefit from service. The hospice then sets up a meeting with the patient, obtains medical history to help determine eligibility, and if appropriate, will contact the ATTENDING physician of the patients choosing to obtain an order to admit the patient. Also, you can be on hospice while being on the transplant list. Most people in need of an organ transplant are hospice eligible, they have the option to revoke their benefit if and when they receive word that an organ march has been made.

    This whole controversy seems to be nothing more than a power trip by the physician treating this patient in the hospital. It sickens me that this could be me or any other nurse tomorrow just for doing your job and trying to do it well.

  5. FormerBannerScapeGoat Says:

    This is Arizona. Things move at a snails pace. It is also a very Republican state. Nursing is viewed as a “social” job. The politicians do not see it as their rightwing base. I highly doubt that the legislature will do anything for the rights of nurses. Or the rights of patients for that matter. I hope I am wrong.

  6. momRN Says:

    I bet that Banner hospital thought she would just go away. AZ is a ‘right to work’ state and they really don’t even have to have a reason to fire you. Kudos to Amanda for sticking up for herself and NOT letting this go. I was recently fired over a petty charting indiscrepancy as well – nope I couldn’t even give my side of the issue – also in a RTW state. I did find another job but the more research I do it is apparent that nurses get fired quite often. And what about this ‘nursing shortage?’

  7. Andrew Lopez, RN Says:

    Thank you Jennifer Olin for following Amanda’s case, here is the latest.

    Red Flags & Questions I See in the Amanda Trujillo, ARNP Case, April 25, 2012 By Beth Boynton:”Amanda Trujillo is an ARNP yet was practicing as an RN. Now maybe there is a perfectly good explanation for this. Third shift is typically tough to staff and given our economy and the financial needs and family commitments, perhaps this was a perfect job opportunity for Amanda. But, honestly, I wonder why she wasn’t practicing as an ARNP rather than an RN? Scope of practice is an important issue in the case and quite different for RNs and ARNPs. Banner health could face serious liability issues if their RNs on duty are practicing out of scope.”
    http://www.confidentvoices.com/2012/04/25/red-flags-questions-i-see-in-the-amanda-trujillo-arnp-case/

  8. Andrew Lopez, RN Says:

    Thank you Jennifer Olin for covering Amanda’s case, here is the latest:

    The War Against Amanda Trujillo, April 25, 2012, Mother Jones, RN, Nurse Ratched’s Place:”I still support Amanda Trujillo and some people who have read the allegations against Amanda have questioned my judgment. Frankly, I don’t believe these allegations because I personally know two other nurses who have been reported to their nursing boards by their former employers. One of my friends was reported to the BON after she spoke up about unsafe nursing practices at a shady nursing home, and the other was reported after he chastised hospital administration for placing psychiatric patients and staff in an unsafe environment. Their former employers cooked up all kinds of false allegations against my friends who are both stellar nurses. Their former employers crucified their character, but in the end they were both cleared of any wrongdoing by their respective state nursing boards. There is an escalating pattern of abuse as more unscrupulous employers are using nursing boards as the ultimate scare tactic to keep nurses “in their place. ” Amanda is just another victim of this ploy.”
    http://www.nurseratchedsplace.com/2012/04/the-war-against-amanda-trujillo/

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