Nurse Up!

Vernon Dutton http://www.epmonthly.com/whitecoat/2012/02/amanda-trujillo/

Miranda Mcmurry Sandstedt‎^^^ that post/link is offensive ^^ trying to create a conspiracy theory implicating that AZNA’s president would serve her own personal interest over the interest professional advocacy is just wrong! Shame on them for that….Keep up the great work AZNA I’m glad you are here advocating on our behalf

Jay DoeThe appearance of conflict of interest is virtually the same as actual conflict of interest… and it’s still worth pointing out  that Teri Wicker, President of AzNA is Director of Professional Practice at Banner Del E. Webb Medical Center.

Jay DoeSeems to me a real conflict of interest when discussing Amanda Trujillo.

Joyce HarrellSo why are you not leveraging resources to address the issues of difficult or hostile workplaces? You have just admitted that too many face these difficulties. Hostile work environments need to be addressed. This issues needs to be addressed, because when people no longer want to be nurses because they don’t want to work in this type of environment… you will no longer have nurses to help advance… Just a thought.  This sounds just like the medical model. Trying to rid symptoms, and not actually getting to the root cause.

Kim McAllisterAmanda Trujillo asked for assistance from the AZNA months before any of this was ever known to anyone outside of her Banner facility, the AZBoN and herself. She received NO response whatsoever. Not even the courtesy of something akin to the above comment. A registered nurse in the state of Arizona reaches out to the AZNA and hears NOTHING in return. Until now, when the blogosphere is blowing up about this case. So the fact that Ms. Wicker is the President has such a high profile position in the very facility Ms. Trujillo was fired from AND reported to the Board from, is something VERY intriguing. Whether it has anything to do with anything, well I would hope not. It’s one heck of a coincidence, though.

Miranda Mcmurry SandstedtInteresting responses from non AZ nurses who have never worked with Amanda Trujillo or AzNA…….keep fighting the good fight ya’ll but no need to slander our professional body as we do far more good for AZ nurses than this one story depicts.

Anna Johnson Arizona Nurses Association Bylaws http://www.aznurse.org/displaycommon.cfm?an=1&subarticlenbr=14 SECTION 2. PURPOSE The purpose of AzNA shall be to foster high standards of nursing practice, promote the professional and educational advancement of nurses, and promote the welfare of nurses to the end that all people may have better nursing care. SECTION 3. FUNCTIONS c. to promote and protect the economic and general welfare of nurses, f. to represent nurses and serve as their state spokesman with allied professional, community and governmental groups and with the public, i. to promote nursing as a career, l. to provide due process policies for grievances and appeals related to these bylaws, pursuant to common parliamentary and statutory law. MY OPINION: “The case of Amanda Trujillodirectly deals with the purpose ofthe AzNA – helping set state policy to protect nurses and patients. While the AzNA can’t take a stance on an individual case – this case offers a great opportunity to address fundemental questions about the future of nursing in the State of Arizona.” CONCLUSION: “When I see the AzNA take legislative positions on issues like “guns on campus” – I see an organization lacking a basic direction in their political and policy activities.”

Carol GinoMiranda, can we have an example or two of what the professional body does so that the nurses who have no clue can understand what it does for all of us?  To have a non standardized scope of practice, to have nurses as professionals be part of a hospitals budget put all nurses int he position of non professionals.  We need a clear statement in non legalese about what our organizations do for us or when we move into expanded practice, we can get thrown under the bus and no one is watching our back.  How can any of us so without a salary for a year of so?  A bridge has to be made between the nurses in the trenches and the policy makers representing us.  This is not only Amanda’s story, it’s a story that has happened to enough of us to back her.  It’s just time now.  How long can we claim we’re professionals without autonomy and with all the responsibility the doctors won’t take?

Kim McAllisterAh, Miranda! I hear you about many of us being non-Arizona nurses. That thought has crossed my mind and it is unfortunate that the AZNA came into my consciousness as a result of learning of Amanda’s plight. On the one hand I was glad to see this post and on the other it was frustrating to hear yet another organization unable to speak out. It is so easy to make a complaint to a BoN (any BoN), rendering the accused a person of suspicion, unworthy of support until cleared, yet not needing support after they ARE cleared. It’s like a Catch-22. I’m glad the AZNA is working for the nurses, I’m just sorry the circumstances preclude them being able to stand behind Amanda.

Miranda Mcmurry SandstedtI am not dis-advocating for Ms. Trujillo by any means; she deserves to plead her case in front of the BON as we all do and I wish her well. AzNA is not a labor union and is not designed to conduct labor disputes. Our state’s legislative climate is one which often conflicts with the nursing agenda of patient and professional advocacy and therefore resources are utilized to promote that agenda.

Arizona Nurses AssociationPoint of clarification: When AzNA first became aware of this case, Teri Wicker, AzNA President identified a conflict of interest (between AzNA and her employer) and voluntarily recused herself related to any AzNA discussions or decisions.

Arizona Nurses Association Joyce, Great question. AzNA has been traveling around our state for years speaking to various nursing groups on the topic of workplace civility. In fact we just presented to a group of nurses two weeks ago. There are great resources on the nurse advocacy page of our website. Take a look at the Workplace Civility Toolkit that is available. http://aznurse.org/displaycommon.cfm?an=1&subarticlenbr=8

Renae WrightAnna Johnson: In response to your conclusion statement: “When I see the AzNA take legislative positions on issues like “guns on campus” – I see an organization lacking a basic direction in their political and policy activities.” I would like to cite subsection b of section 3. Functions, which you failed to highlight in your posting: b. to promote legislation and speak for nurses in regard to legislative action AzNA takes stances on legislative measures that affect nurses and has decided to oppose SB1474—weapons, universities, college grounds. This is in direct alignment with the AzNA mission “to advance and promote professional nursing in Arizona” because it supports nursing faculty members who have expressed concern and an intention to leave the classroom if the bill passes. We all know of the nurse faculty shortage, and the passage of this bill could have detrimental effects on our supply of nurses if there are no instructors to teach them. Please also remember the 2002 shooting at the University of Arizona College of Nursing where a failing student took the lives of three faculty members before taking his own life. Regardless of whether guns should or should not be on campus, this is an issue that impacts nurses who teach at our public institutions and these faculty members feel that it could jeopardize their safety. AzNA is the voice of nurses in Arizona.

Kim McAllisterThank you for this statement – it is appreciated! I will make a point to note this in my next blog post, also. It is only fair to do so! “Point of clarification: When AzNA first became aware of this case, Teri Wicker, AzNA President identified a conflict of interest (between AzNA and her employer) and voluntarily recused herself related to any AzNA discussions or decisions.”

Carol GinoMiranda, can you see that standing for “nursing” and not taking any position on an individual nurse even a broad one..like “we do understand the scope of practice is a grey area but a doctor throwing a fit is pretty black and white.  it’s sort of like saying “the gallbladder in 132″ rather than  recognizing a “nurse” is a person and “nursing” is a concept that hasn’t yet been realized.  They keep increasing the requirements and lowering the support.  Strikes me a lot like “Wall Street” vs. “Main Street”  Maybe its a communication problem but why aren’t they lobbying for direct pay instead of combining us with the bedpans and the gauze pads as part of a hospital budget?”  There’s no way autonomy can exist if some corp has to take responsibility for our actions.

Vernon Dutton http://grchealthcareblog.com/2012/02/12/re-amanda-trujillo-open-letter-to-the-honorable-janice-k-brewer-arizona-governor/

Carol GinoIs there any organization that does advocate for the “nurse.”  Like ethics of nurses have us vow advocacy but ANA doesn’t back us if we advocate.  And that it’s not a union, is apparent but the AMA isn’t a union either.

Miranda Mcmurry SandstedtI love that all this is directed at me LOL? I do not speak for the association but I stand behind my support of AzNA; my comments were not meant to offend rather to defend an organization that has worked dilligently to promote the nursing profession within MY state. For outsiders to imply impropriety is offensive and detracts from the organization’s good works.  I’m not here to debate Ms. Trujillo’s issue(s). I’d love to carry on this conversation in private but this platform is not appropriate.

Joyce Harrell ‎Carol Gino… Hummm an organization that advocates for the nurse. maybe that is what we are starting to form, and just don’t realize it yet.

Jay Doe‎@AzNA I echo Kim’s sentiments, and thank you for the clarification. Is the true of other Board members who are associated with Banner? I might point out engaging with any us at an earlier stage of the discussion might have been helpful.

Jay Doe‎@Miranda Sandstedt I think these are/were legitimate questions, especially when AzNA opacity has been notable. It’s remarkable that is taken more or less 3 weeks of publicity for AzNA to begin a dialogue. I am sure, incidentally AzNA does many good things — which doesn’t detract fro legitimate questions about how institutions like the AzNA deal with questions of hostile work environments and abuse of frontline nurses. We are told AzNA doesn’t deal with individual cases — so maybe the question needs to be why? Is this appropriate in an environment where protections for front line nurses are non existent?

Vernon DuttonMiranda Mcmurry Sandstedt – smiling, none of this is directed at you.

Kim McAllisterLOL , sorry MIranda – you had the best comments so it was more like a dialog! : )

Arizona Nurses AssociationIt may be helpful for nurses to know that AZNA does support individual nurses that seek advice and assistance from us. Nurses reach out to our association for various reasons. Some examples are advice dealing with bullying issues, scope of practice questions and concerns with leadership or management. Each issue is handled on an individual basis with respect to confidentiality.

Terri PolickWhy didn’t you respond to Amanda’s letter?   She was bullied by a doctor and by her hospital administration.

Arizona Nurses AssociationKim McAllister suggests in one of her postings that Amanda asked AzNA for assistance and received no response. Actually, Amanda first reached out to AzNA on September 14th at 1:00 a.m., and as I am the AzNA board member in the position most directly related to her query, responded at length to her the very next day. The most impressive aspect of our communications over the next several days was that Amanda’s concern was not only focused on herself, but on patients in hospitals all over with a terminal diagnosis who are never exposed to the palliative and hospice care options to make informed decisions concerning their health and future. Her reach out to AzNA was not so much for support for herself, but for legislative action to gain patients the right to information about all of their options, not just the one that the surgeon or another provider would like them to consider. I chair AzNAs Public Policy Committee, a group of 30 AzNA member volunteers who devote some of their time to helping AzNA to advance and promote professional nursing in Arizona. They are selfless and dedicated. When a legislator files a bill one week to allow concealed carry on the campuses of state colleges and universities, and the bill is scheduled to be heard in committee the following week, they jump into action. They review the bill ASAP, compare its provisions to the AzNA Public Policy Agenda (created and revised by the AzNA membership), and recommend a position for AzNA to take to the hearing. In the last five weeks these volunteers have done this for more than 120 bills related to nursing practice and public health care policy. I know I’m biased, but I think the committee members are super hero nurses. They definitely walk the walk. The committee reviewed HB2510 and mirror bill SB1447; palliative care; patient information; during last years’ legislative session. This bill required attending providers of patients with a terminal diagnosis to inform their patients of palliative and hospice care options in addition to other treatment options. Exactly the provisions that Amanda, and most nurses I suspect, would want for patients everywhere. Unfortunately, although AzNA and other associations supported this legislation, it was never heard in the Senate and it was bowled over by a striker in the House to get Spice added to Arizona’s dangerous drugs list. Could this legislation have been successful had AzNA worked and lobbied harder? Could AzNA have worked hard enough to get this legislation to be considered again this session? Perhaps! AzNA and its components work hard every day for nurses and our patients in Arizona. Do we have many resources? Sadly we do not. Today only a little more than 2% of all Arizona registered nurses and APRNs are members of the association. Member dues and member volunteerism is what fuels AzNA resources and its ability to meet the needs of nurses and their patients statewide. While membership is at an all time high through the hard work of the AzNA membership committee volunteers and AzNA members throughout the state, I wonder if HB2510 or SB1447 could have become statute if one in ten Arizona nurses were members of AzNA instead of one in fifty. I acknowledged Amanda’s request last September, and will continue to do my best to see patient rights advance in our state though this legilsative session and those in the future. Respectfully, Ray Kronenbitter, RN, MSN, PCCN Director of Governmental Affairs Arizona Nurses Association

Greg Mercer‎”Applaud”? – I applaud the effort of your “selfless” and “dedicated… super hero nurses” – but it may be time to move beyond the same old lobbying into more innovative approaches.  Conflicts of interest and abuses of power will never change much without public scrutiny and involvement – laws without the resources or will for enforcement will not suffice.  “Leveraging”  and “sacred [duties] to advocate..”  remain mere words, whether drawn from Dilbert’s world or elsewhere, signifying nothing helpful in of themselves, lacking credibility unless accompanied by visible substance.  This case is only about an “individual complaint” on a rather superficial view – conflicts of interest and  working conditions affect all Nurses and all Americans.  They deserve more attention than corporate boilerplate, and even that only in response to a building grass-roots wave to which AZNA has offered nothing substantive, and now, only grudging image-of-support.  Nurses in AZ deserve better.  The old ways have left Nurses in a weak and unfavorable position, and more of the same will only perpetuate the status quo – remember John Dryden’s definition of insanity” trying the same things over and over, and yet expecting different results.

Terri PolickSound like you were very busy during the last legislative session.  So let me ask you this.  What type of legislation are you going to champaion that will keep Amanda’s situation from happening to another nurse?  It’s sad that state assocation membership rolls keep dropping.  Prehaps they would spike if state associations were more active in advocating for their membership and for nurses who provide bedside care.  Someone asked why outsiders were getting involved in Amanda’s case.  I am speaking out because what happens to one nurse  happens to us all.  Please keep fighting the good fight, but don’t forget to fight for Amanda.

Carol GinoAnd please have what you do FOR nurses clearly enough stated that if I wanted to convince nurses to join any nursing organization, I could give them a list of benefits that they could see were imperative for them to support so they could be supported when they needed it.

Vernon Dutton http://www.emergiblog.com/2012/02/hush-hush-keep-it-down-now-voices-carry.html

Kim McAllisterHi Ray – I stand corrected in my statement that Amanda had not heard from the AZNA. I actually thought there had been zero communication from any quarter, and only heard of your communication yesterday. I appreciate the clarification and when I can get to my blog (night shift, traveling today), will put a link up to this facebook page so readers can see the dialog first hand – there’s good stuff here.

Terri Polick Nurses Care, Do You? http://www.nurseratchedsplace.com/2012/02/show-me-how-much-you-care-azna/

Jasmine Christine BhattiI understand that what has happened to Amanda is hard for many of us to comprehend. She has endured a lot, yet she continues to fight for the rights of nurses and patients because she is passionate about her beliefs. That is what nursing is all about. We are all advocates. It is what we do each and every single day. However, I must ask those of you who have posted here to examine yourselves. How many of you dedicate hours volunteering every month towards improving your profession? How many of you take the time to become involved in creating safer practices and unifying our scope of practice? Besides blogging stories and opinions, what actions do you take in your own home states? Are you involved in your own nursing associations and if not why? @Terri, I was especially disappointed in reading your post above. Instead of leaving bits of sarcasm towards a gentle, honest, genuine and knowledgeable man named Ray, why don’t you offer to help create supportive legislation? We must become the solution we wish to see. Florence Nightingale herself said, “I think one’s feelings waste themselves in words; they ought all to be distilled into actions which bring results”. Such wisdom from many years past. I couldn’t have said it better myself.

Vernon Dutton http://www.nurse-power.net/blog/

Greg MercerTalk is cheap.

Terri PolickActually jasmine, I’m very active in nursing politics. Google me.  That’s why am appalled by what I’m seeing. 

Terri PolickYou need to examine yourself.

Greg MercerAs I see it, use of social media for public advocacy is possibly the most efficient and effective tool for positive change available today, offering unprecedented ablitity to unite and organize Nurses without geographic or financial limits.  I agree we risk, in our zeal and eagerness for results, straying at times into undue negativity or unfair attacks on likely conscientious but unfamiliar Nurses like those at AZNA.  We must remain careful to consider fairness and civility and the reputation of Nursing.  On the other hand, public debate in the democratic tradition is inherently messy and contentious, we learn from our errors, and passionate engagement is a requirement for any democracy to thrive.  I, for one, promise to continue my open debates, while carefully self-monitoring, and appreciating all feedback, positive and especially negative: harder to hear, less gratifying but essential for growth.  I would not ask AZNA to act as a labor union if that is not your chosen path, but please consider the systemic issues highlighted by this case, and address those publicly : conflicts of interest, protection against misuse of the BON complaint system, transparency, protection of Nurse advocacy and pt education : public discussion of such issues could complement legislative action, and Orgs like AZNA are in an optimal position to offer coordination to help us all help Nursing most effectively.

Andrew Lopez Jasmine, but calling attention to Amanda Trujillo and her situation, we can improve working conditions for nurses nationwide. If raising awareness and activism isn’t “being involved in our profession” then I don’t know what is.  For more information, visit http://www.nurseup.com/

Brittney Wilson‎”Too many of us face or have faced difficult or hostile workplaces, which is why AzNA leverages its resources on behalf of all Arizona nurses to advance and promote professional nursing.” – So the needs of the many out weigh the needs of the few? What about the precedence this will set for ALL nurses if the AzBON take her license? Fear will be struck in the heart of every patient advocate.

Brittney WilsonThis isn’t just about Amanda, this is about EVERY nurse!

Jasmine Christine Bhatti‎@ Andrew- I don’t disagree that calling attention to a situation can improve current methods/standards.  However, one must always consider these things:  Is it the right time, the right place, the right way, and the right audience with the right approach and tone.  If any of them are incorrect, no matter the best of intentions, it can be counterproductive and ultimately lead to failure or unwanted results.  @Greg- Social media is such a wonder, and I agree with you regarding democracy and being open to debate.  Without this, there cannot be growth or improvement.  You definitely have the ability to share your thoughts and opinions with grace and tact.  I appreciate that.  It is always important to note that there is more to any story than one side, and by giving your readers the facts and letting them create their own opinions (free from unbiased views) is the best gift you can give.  I agree with what you are saying, but again it brings me back to the thought that things must be done in the right order.  You don’t run before your shoelaces are tied, because otherwise you will just trip. @Teri- I am sorry but when I googled your name, all I found was a link to Amazon for a book titled “Modern Fiesta”, your blog called “Nurse Ratched’s Place” (which is a wonderful title to represent our profession), your Facebook page and linked in profile. Please note that I did read some of your blog entries, but I actually had to stop reading.  I imagine that you have seen so much in your 25 years as a psych nurse, but sadly you have become so disillusioned with the profession.   I am sad to see this happen to any nurse. Also, I have taken upon your request,  and I have examined myself.  At the end of the day, I couldn’t be any more proud or lucky    I have been blessed with great faculty, great mentors, wonderful gifts from God and I know that my future that is so bright.  I have only been a nurse for 8 months, but feel free to google my accomplishments so far.

Vernon Dutton http://www.emergiblog.com/2012/02/when-nurses-attack-at-the-highest-levels-a-blatant-abuse-of-power.html