Arizona Right to Fire, #Youtube, LoneProtestor, Another Banner Nurse, Career Almost Destroyed #nurseup #amandatrujillo
March 28, 2012 in Amanda Trujillo, Arizona, Banner Health, Banner Health Arizona, Bloggers & Blogs, Canadian Bloggers, Emergiblog, Hospitals & Healthcare Systems, Jay Doe RN Those Emergency Blues, Legal Advocacy For Nurses, Terri Polick RN Nurse Ratched, ThroughLifeAndDeath.com
Arizona Right to Fire, Youtube, LoneProtestor:”Why are nurses leaving the bedside? The morning after the Bernie Sanders event in Phoenix, Arizona, several nurses met at breakfast and discovered we had even more in common than our profession and activism . For those who worked at Banner, an alarming trend emerged: Banner seems to have a policy of firing for a trifle and then reporting to the State Board of Nursing. Is this to keep the RN so frantic fighting for career and livelihood that she won’t have the time, money, or energy to hire a lawyer? Not that it matters — as one member of the Arizona Board of Nursing once told me, “In a right to work state, you can be fired because your supervisor doesn’t like the color of your hair.”
http://www.youtube.com/watch?v=kIcQ2JfUUck
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Articles in reverse order of publication:
American Nurses Association – No More Silence – Amanda Trujillo, I-Nurse Educator, March 24, 2011:”Amanda Trujillo – the fact that I can even spell her name is a testament to how her story has impacted me both on a professional and personal level. I am sorry that she has to endure what she is going through. Quite frankly, I am enraged with the apathy and lack of social justice for this nurse! Apathy on the part of the American Nurses Association, Arizona Nurses Association, and any other organization that purports to stand with nurses and support practice related issues, but is doing nothing to support Amanda when she needs the support the most!”
http://inurseeducator.wordpress.com/2012/03/24/american-nurses-association-no-more-silence-amanda-trujillo/
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Arizona BON Keeps Trujillo Under Fire, March 21st, 2012, By Jennifer Olin, BSN, RN:”I have started this blog this way several times in the past. I am an OR nurse. What I don’t usually add here, but do in conversation with other nurses, in job interviews for nursing positions and sometimes even in casual “what do you do?” conversations is say my specialty areas are plastics and head and neck (or ENT). Apparently, if I said this in Arizona I could lose my license.
At yesterday’s Arizona Board of Nursing (AZ BON) Regular Meeting Amanda Trujillo, RN, was on the agenda. She is the nurse we have been talking about for weeks now, who was fired and reported to the BON by her former employer who claims she overstepped her scope of practice—despite evidence to the contrary brought out by the BON’s own investigator.”
http://www.rncentral.com/blog/2012/arizona-bon-keeps-trujillo-under-fire/
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Tweet Me No Lies, March, 20, 2012 Author: Mother Jones, RN:”Someone at the ANA needs a nose job. They just told a lie. I hopped onto Twitter yesterday to check out some tweets after I learned that the ANA had mentioned Kim McAllister from Emergiblog and me in one of their messages. Here’s a screen shot”
http://www.nurseratchedsplace.com/2012/03/tweet-me-no-lies/
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An Open Letter: Dear Future of Nursing, March 11, 2012 Author: Mother Jones, RN:”I choked on my breakfast this morning while I was surfing the web. It all started when I checked out the Future of Nursing: Campaign for Action website. According to the website, “The Future of Nursing:Campaign for Action is an initiative to advance comprehensive health care change. It envisions a health care system where all Americans have access to high-quality, patient-centered care, with nurses contributing to the full extent of their capabilities.” Two of their objectives is to strengthen nurse education and training, and to help enable nurses to practice to the full extent of their education. The campaign is coordinated through the Center to Champion Nursing in America (CCNA), an initiative of AARP, the AARP Foundation and the Robert Wood Johnson Foundation (RWJF).”
http://www.nurseratchedsplace.com/2012/03/an-open-letter-dear-future-of-nursing/
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Amanda Trujillo RN – fired for being a patient advocate, Posted on March 2, 2012 by Pat Iyer:”The story of Amanda Trujillo is a horrifying one. Briefly, she is a single mom who fought to get off welfare and fulfilled her dream of becoming a nurse. Not only did she become a nurse, she earned a masters degree in nursing. One night while working at Banner Health in Arizona, she took care of a patient who was being asked to undergo a liver transplant. In talking to the patient, Amanda learned that the patient did not fully understand what was going to occur. Amanda educated the patient. She explained the option of hospice instead. The patient decided against the transplant. Then the physician came in, had a well- witnessed tantrum at the hospital when he found out his patient had decided against surgery, and Amanda was fired by the hospital. Her case came up for review by the Arizona Board of Nursing. The summary of her case written by the attorney representing her is below. Amanda has been devastated in terms of her career and her finances. She is back on welfare, her dream of being a nurse shattered.”
http://www.medleague.com/blog/2012/03/02/amanda-trujillo-rn-fired-for-being-a-patient-advocate/
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Amanda Trujillo, RN: Single Mother Fighting for Her Integrity, March 02, 2012, dhoffman2, Blogher.com:”Everyone is a patient…either now or in the future. That’s a fact. Another fact is that we all die. Sometimes our deaths can be made easier. Sometimes not.
Amanda Trujillo is a nurse who tried to make a dying patient’s life and dying easier. She worked in Arizona and was fired in April 2011 after providing education and making a hospice care consult request for a patient with end-stage liver disease.
The patient had been in the hospital for 7 days and was supposed to get a pre-transplant evaluation. Unfortunately, the patient did not know anything about his/her liver disease, liver transplant or choices about treatment.”
http://www.blogher.com/amanda-trujillo-rn-single-mother-fighting-her-integrity
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Have you heard about Amanda Trujillo and her case with the Arizona Board of Nursing – A Must Read! February 25, 2012, I-Nurse Educator:”As I was blog rolling today I came across a heated issue that is lighting up the nurse blogosphere! It is the case of Amanda Trujillo, an AZ nurse that was fired from her hospital for providing patient education to a patient that had changed her mind about a surgical procedure. Amanda consulted case management in order to provide the patient with information about Hospice care. Apparently this action enraged the physician who called for Amanda’s immediate termination and a report be filed with the Arizona Board of Nursing. Subsequent to this action, her employer Banner Health, fired her and then reported her to the AzBON for functioning outside of her scope of practice as a RN for ordering a case management consult for Hospice information.”
http://inurseeducator.wordpress.com/2012/02/25/have-you-heard-about-amanda-trujillo-and-her-case-with-the-arizona-board-of-nursing-a-must-read/
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The Nurse Who Helped Too Much, Amy Tenderich, DiabetesMine:”It might be hard to believe in this day and age of “participatory medicine” and empowered patients — or in any day and age, really — but the fact is that an Arizona-based nurse was fired from her job recently for simply providing a patient too much information on his treatment options. The nurse’s name is Amanda Trujillo, a single mother living in Phoenix, and licensed nurse in Arizona since 2006. She specializes in cardiology, geriatrics, and end of life/palliative care. The sin she supposedly committed was setting up a consultation on hospice care for a patient suffering from end-stage liver disease, who was scheduled for surgery. This “interference” angered the patient’s physician, who then had Amanda fired and reported her to the Arizona State Board of Nursing, where she
is now in danger of losing her nursing license. Fellow health care professionals and patient advocates are flooding the blogosphere in support of her cause!”
https://www.diabetesmine.com/2012/03/the-nurse-who-helped-too-much.html
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Amanda Trujillo, part 2, Saturday, February 25, 2012, End of Shift Report – Stories From an Operating Room:”It gets much worse: the Arizona State Nursing Board has ordered Nurse Trujillo to undergo a mental health evaluation in retaliation for her going public with the matter.With the Boards paid psychiatrist to boot, not a disinterested third party. Whats more, they have also ordered her to turn over records from all the physicians she has ever seen for any reason. What happened to her rights of privacy? There seems to be nothing that this outrageous order could contribute to an investigation of the matter. And it turns out that the President of the board of Nursing is also in a position of authority at the hospital that fired Nurse Trujillo. Can anybody spell “conflict of interest”? This order for a mental health evaluation stinks of authoritarian excess reminding one of the KGB or Gestapo.”
http://endofshiftreport.blogspot.com/2012/02/amanda-trujillo-part-2.html
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Why physicians should care about Amanda Trujillo-KevinMD by @jaydoe February 25, 2012:”For the past month, the case of Amanda Trujillo has resonated deeply among nurses, triggering an avalanche of postings on Facebook, Twitter and in the nursing blogosphere. Trujillo is the Arizona nurse who was fired in April 2011 after providing education and making a hospice care consult request for an end-stage liver disease patient. This patient was slotted for pre-transplant evaluation and had poor understanding of the disease process and treatment options. Trujillo filled in the gaps for this patient. Trujillo then requested, at the patient’s own wish, a hospice team consult, documented her actions appropriately, and left a note (it was night shift) for the primary physician.”
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Why physicians should care about Amanda Trujillo, by J. Doe, RN in Patient, February 25, 2012:”For the past month, the case of Amanda Trujillo has resonated deeply among nurses, triggering an avalanche of postings on Facebook, Twitter and in the nursing blogosphere. Trujillo is the Arizona nurse who was fired in April 2011 after providing education and making a hospice care consult request for an end-stage liver disease patient. This patient was slotted for pre-transplant evaluation and had poor understanding of the disease process and treatment options. Trujillo filled in the gaps for this patient. Trujillo then requested, at the patient’s own wish, a hospice team consult, documented her actions appropriately, and left a note (it was night shift) for the primary physician.
These actions — the education and the hospice team consult — drew the wrath of both the primary physician, who demanded her dismissal and her license, and also her nursing director, who told Trujillo she had ”messed up all the doctors’ hard work and planning for the surgery.” The patient-requested hospice care consult was cancelled. Trujillo’s employer subsequently fired her, and reported her to the Arizona State Board of Nursing for exceeding nursing scope of practice, though in fact, nurses previously had ordered a hospice care consult without consequence. In short, many nurses believe Trujillo was fired for educating and advocating for her patient.”
http://www.kevinmd.com/blog/2012/02/physicians-care-amanda-trujillo.html
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Arizona’s attack on nurses: the Amanda Trujillo case goes viral, by DA Morales on Feb. 23, 2012:”From KPHO (Phoenix CBS), Nurse says she was fired for educating patient. Inside Banner Del Webb Hospital in Sun City West, nurses are constantly tending to sick patients.
That’s what Amanda Trujillo said she was doing last April when she spoke with a patient on the eve of their surgery.
“I discovered that they had a very big misunderstanding about what they were about to participate in,” Trujillo told CBS 5 News.
Trujillo, a licensed nurse in Arizona since 2006, said she advised the patient of possible complications.
The patient decided to delay the surgery and reconsider his or her options.
Trujillo said she also ordered a case management consult for the patient to be educated about hospice care.
“The doctor, ultimately, is the focal point that directs care for patients,” said Banner spokesman Bill Byron, who said company policy prevents nurses from ordering a case management consult. “This is what we go to school to do. We are licensed to teach our patients, we are licensed to advocate,” said Trujillo.”
http://tucsoncitizen.com/three-sonorans/2012/02/23/arizonas-attack-on-nurses-the-amanda-trujillo-case-goes-viral/
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In the Footsteps of Rosa Parks, Mother Jones, RN, February 20, 2012:”You must never be fearful about what you are doing when it is right.” Rosa Parks.
Nurse K, the proprietor of Crass-Pollination: An ER Blog just wrote a post about the Amanda Trujillo case. She and I have very different opinions about Amanda’s case, but I encourage you to read her post because she reflects the opinion of many nurses about Amanda’s situation.
Nurse K gives an accurate blow by blow description on how corporate nurse leaders wage war against their nursing staff. She explains how nurse managers orchestrate the demise of nursing careers. Make management angry and you get the axe, and there isn’t a nurse alive that hasn’t witnessed or experienced the wrath of hospital management.
Nurses scatter and go underground when someone gets in trouble, and conventional wisdom states that a nurse should be contrite and take their punishment when they are abused by those who hold power. Many people are wondering why Amanda didn’t follow the same path. Some, like Nurse K, are suggesting that Amanda is committing career suicide. Other’s have told Amanda to “shut up.” The American Nurses Association and the Arizona Nurses Association won’t support an individual nurse who is “under investigation.” Egregious comments and actions are coming from the Arizona Board of Nursing. Kim McAllister from Emergiblog writes about the board’s actions here.”
http://www.nurseratchedsplace.com/2012/02/in-the-footsteps-of-rosa-parks/
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Amanda Trujillo: An Unfortunate Case of Career Suicide, Friday, February 17, 2012, Crass Pollination:”I used to be really poor back in the day. I’m not talking “I had a five-year-old computer and sometimes I had to go to Subway instead of somewhere that was Zagat rated.” I’m talking no heat outside of a single space heater in below-freezing temps, a food budget of $10/week for three people, no functioning toilet (sh*tting outside in the snow sucks, take note), a leaky roof, and neighbors stopping by to give me and my son meat. Really, being poor sucks.
I got straight As in college with all this going on.”
http://crasspollination.blogspot.com/2012/02/amanda-trujillo-unfortunate-case-of.html
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Boards of Nursing and the Amanda Trujillo Case, February 17, 2012, By Shawn Kennedy, MA, RN, AJN editor-in-chief:”Our prior post on the Amanda Trujillo case elicited many comments, on a variety of themes. There were also referrals and crosslinks to other sites supporting, analyzing, and weighing in on the situation, including statements from the Arizona Nurses Association and the ANA, and a post on a physician blog, “White Coat’s Call Room,” which has vowed to carry all the details once the case is decided.”
http://ajnoffthecharts.com/2012/02/17/boards-of-nursing-and-the-amanda-trujillo-case/
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Here’s What You Think About RN Amanda Trujillo’s Story, February 15th, 2012, By Jennifer Olin, 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.”
http://www.rncentral.com/blog/2012/heres-what-you-think-about-rn-amanda-trujillos-story/
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Amanda Trujillo RN, Monday, February 13, 2012, End of Shift Report – Stories From an Operating Room:”I am breaking into my usual fiction to tell you about a real travesty taking place in Arizona. Amanda Trujillo RN advised a patient who was up for a liver transplant about other options at the patients request. This is a normal and expected duty of an RN. As a result, the patient and his family decided against the liver transplant. The Surgeon involved went ballistic, threw a well documented temper tantrum, went to the Hospital administration and demanded Nurse Trujillo’s termination, which they did. He then went and filed a complaint with the Arizona State Nursing Board who have placed Nurse Trujillo under investigation. The American Nurses Association, who supposedly represent nurses has issued a fatuous, self serving masterpiece of administrative-do-nothing statement that if anything, supports the hospital, the surgeon and the state board. The Arizona State Nurses Association also has done nothing.The leadership of the state board and the state association have been seen schmoozing with other powers that be. Am I surprised? No. Am I outraged? Yes. Over the years I have seen many, many instances of Nurses having to put up with abusive behavior if not outright assault and battery by Physicians. I have yet to see any Physician receive appropriate discipline, and in most instances no discipline.”
http://endofshiftreport.blogspot.com/2012/02/amanda-trujillo-rn.html
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Re Amanda Trujillo: Open Letter to The Honorable Janice K. Brewer, Arizona Governor, Posted on February 12, 2012, Greg Mercer:”Please learn more about the important ongoing case of RN Amanda Trujillo, a conscientious Nurse who has been punished strikingly severely for providing routine patient education that inconvenienced and angered a physician who demanded her job and her license. Her State BON has still not decided her case after a year, and she remains an unemployed single mother.
For a fine summary of the known facts, see ” thenerdynurse.com/2012/01/arizona-nurse-has-license-threatened-by-doctor-after-providing-patient-education.html ” If, as I and many others have after much research and reflection, you find her cause worthy and just, please participate in our advocacy campaign. It requires little commitment, cost, or effort:”
http://grchealthcareblog.com/2012/02/12/re-amanda-trujillo-open-letter-to-the-honorable-janice-k-brewer-arizona-governor/
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Healthcare Providers Strive For Excellence, February 8th, 2012, By Jennifer Olin, BSN, RN, @JOlin2 :”Hospitals and other healthcare facilities that earn Magnet Recognition are examples of how nurses and nursing care can influence patient outcomes. It is a great honor and it is one healthcare providers spend a lot of time and money to achieve. However, there are only about 400 Magnet hospitals around the world and thousands of fine healthcare institutions employing nurses everywhere you look.”
http://www.rncentral.com/blog/2012/healthcare-providers-strive-for-excellence/
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Why Nurses are Furious about the Amanda Trujillo Case, February 7, 2012, Those Emergency Blues:”The case of Amanda Trujillo has generated a great deal of passionate commentary across the nursing blogosphere. Trujillo, as you may well know, is the nurse who was fired by Banner Health Del E. Webb Medical Center for requesting multi-disciplinary hospice care case management consult for a pre-transplant patient with end-stage liver disease. The request angered the patient’s physician — not the transplant surgeon, incidentally, nor someone with any knowledge of transplant surgery — who complained to Trujillo’s manager. After her termination, the hospital subsequently reported her to the Arizona State Board of Nursing for exceeding her scope of practice. If the Board finds against Trujillo, she may well face the loss of her license or other sanctions; in the event, her nursing career would be finished. Superficially, at least, an open and shut case, or least this is how Banner Health would like to project the controversy. Scratch the surface a little and matters change considerably.
So why are nurses so furious? Part of it is the apparent coincidence of any number of other, seemingly random bits of information outside the direct narrative of Trujillo’s story. The fact that the Arizona State Board of Nursing chose to deem Trujillo’s attempt to defend herself publicly as “retaliatory behavior” just as her story was becoming part of the general conversation, and then ordered a psychiatric evaluation is one of those seemingly random bits. This struck me particularly. Suspicious minds might see a pattern to punish Trujillo for speaking up by publicly labelling her mentally disturbed (and in health care, as any nurse will tell you, acquiring that label is doubly damning.) For myself, I will be content to note that throughout history calling people crazy is a traditional means of discrediting those challenging authority and marginalizing dissent.”
http://torontoemerg.wordpress.com/2012/02/07/why-nurses-are-furious-about-the-amanda-trujillo-case/
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Amanda Trujillo, Whitecoat, Emergency Physicians Monthly, February 6, 2012:”I finally took the time to read some other blogs today. One of the issues that I found disturbing was the case of Amanda Trujillo. There are a lot of bits and pieces out there about what actually happened in this case. This blog post was reportedly an e-mail from Amanda describing the events. A summary of the post follows. Amanda was a registered nurse of six years , specializing in cardiology, geriatrics, and end of life/palliative care. In April 2011, she was caring for a dying patient at Banner Del E. Webb Medical Center who had agreed to a major invasive surgery recommended by a staff surgeon. Amanda used materials from her hospital to educate the patient about the details of the surgery and the aftercare.
The patient became upset, stating that the surgeon never explained details of the surgery or what had to be done after the surgery (complex lifetime daily self care). Amanda also discovered that the patient “had no idea” that surgery could be refused or that the patient could enroll in hospice care. She educated the patient on those options as well.”
http://www.epmonthly.com/whitecoat/2012/02/amanda-trujillo/
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The Nurse: The Swiss Army Knife of Healthcare, by carol-gino on February 5, 2012:”Okay so, after reading a ton of books trying to find a definition of nursing that matched my experience, I fell asleep with no clear cut answer to my question, “What is a nurse?”
I mean it’s not that I haven’t been pondering that for a very long time, it’s just that nothing so far has satisfied me. I’ve seen brilliant bedside nurses–and I don’t mean nurses who only cared for patients with superb care and compassion– I mean smart, really smart diagnosticians. Nurses who doctors asked, “What do you think is going on with this patient?” And when they answered, there was true appreciation and respect from the doctor to that nurse. They were colleagues, no question there.
I’ve seen ICU nurses, who both doctors and patients trusted to look at a monitor, administer meds — both stat and with standing orders — who saved patients lives time and time again, before a doctor ever could get to the Unit.
http://hopefulhealer.com/the-nurse-the-swiss-army-knife-of-healthcare/
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The Case of Amanda Trujillo, February 2, 2012, By Shawn Kennedy, AJN editor-in-chief:”Amanda Trujillo, MSN, RN, is a nurse who until recently worked at Banner Del Webb Hospital in Sun City, Arizona, until she was fired for, as she claims, just doing what she’s obligated to do as a nurse—specifically, providing a patient information about a surgical procedure in an attempt to support fully informed decision making. (You can read her e-mail detailing her story here. She did not, as she has pointed out in comments, ever attempt to directly obtain informed consent herself.)
Amanda Trujillo.
Ms. Trujillo says that, when the patient had a change of heart about the surgery, she requested a hospice consult. After a physician complained that Trujillo had overstepped her scope of practice, the hospital filed a complaint with the Arizona Board of Nursing, which has launched an investigation.”
http://ajnoffthecharts.com/2012/02/02/the-case-of-amanda-trujillo/
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#NurseUp and Educate On!! Support Each Other! ER Nurses Care, Thursday, February 2, 2012:”Nurses all over the US are upset and simply can’t understand how on earth a nurse could be fired for being a patient advocate, educating her patient on all aspects of their care and explaining in detail treatment plans, which led to a greater understanding by her patient and subsequent change in plans. Amanda Trujillo is an advocate for her patients, she did what we all do every shift that we work, make sure our patients understand what is wrong with them, the plan of care, which includes educating them on any treatments, procedures, medications, surgeries, activities or anything else the patient or family asks of us.
http://ernursescare.blogspot.com/2012/02/nurseup-and-educate-on-support-each.html
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Tsunami: A Conversation with Amanda Trujillo (Part 3 of 3), by Nursetopia on February 2, 2012:”Amanda nailed this situation during our call when she said, “This is bigger than me.” She explained her actions – reaching out to colleagues via emails and social media – is not about revenge or getting even with any organization. She understands the Arizona Board of Nursing must investigate her because she was reported, however, the reason she was reported – a case management consult construed as a medical order – is the bothersome part. “We all make mistakes, realize them, use them to change, give thanks for them, and move on. If I had done something wrong, I could take it. If I had done something wrong.”
Amanda’s story is a ripple culminating in a tsunami of change and ideas and discussions. When asked what she’d like other nurses to know, she provided three thoughts:”
http://nursetopia.net/2012/02/02/tsunami-a-conversation-with-amanda-trujillo-part-3-of-3/
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A Letter From the Arizona Nurses Association,February 1, 2012, Author: Mother Jones, RN, @motherjonesrn:”I wrote a letter to the Arizona Nurses Association when I learned that the association was not coming to the aid of Amanda Trujillo. If you haven’t heard, Amanda was fired from Banner Del E. Webb Medical Center after she educated one of her patients about their upcoming liver transplant. I wrote about it here and here. I couldn’t understand why the association was twiddling its thumbs until I learned that Teri Hill, the president of AzNA is also the Director of Professional Practice at Banner Del E. Webb Medical Center.
This is what I wrote:
“I’ve been a registered nurse for 35 years and I had thought I had seen everything until I read about the persecution of Amanda Trujillo. I wondered why the Arizona Nurses Association wasn’t backing her until I learned that you are affiliated with the hospital that fired Ms. Trujillo. Shame on you for throwing a nurse under the bus just to appease a doctor that obviously has an anger management issue. Sorry the hospital lost out on a billable procedure, but the patient had a right to know about all of their treatment options. I hope your membership throws you all out of office for not backing Ms. Trujillo. You are a disgrace to the nursing profession.”"
http://www.nurseratchedsplace.com/2012/02/a-letter-from-the-arizona-nurses-association/
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Waves: A Conversation with Amanda Trujillo (Part 2 of 3), by Nursetopia on February 1, 2012:”Nurses throughout the U.S. and Canada are standing beside Amanda Trujillo, RN, MSN. We’re talking about this everywhere – in blogs, social media, our offices, you name it. Admittedly, Amanda is a shy person; she’s not accustomed to this attention. Yet, she says, “For the first time, I feel safe; for the first time, I don’t feel alone.”
Why does Amanda’s story resonate with so many of us? Because the majority of us have faced a sliver of Amanda’s story. We’ve each felt alone in our careers – in certain situations – at one point or another, and we don’t think anyone should have to do that. Despite what most believe, there is a strong cohort of nurses who don’t eat our profession’s young; rather, we take them under our wings and mentor them. It’s unfortunate so many nurses do not get to see this amazing group of nurses because they typically find one another, encourage one another, and make their organizations great. The same is true for the bullies – those nurses that really should never provide care for people because they are constantly tearing down everyone they meet. They find one another, too, creating hostile and toxic environments, driving nurses away from the profession and making them think they are failures.”
http://nursetopia.net/2012/02/01/waves-a-conversation-with-amanda-trujillo-part-2-of-3/
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An Update on AZ Nurse Amanda Trujillo Case, Submitted by Mech on Wednesday, 1 February 2012:”Amanda Trujillo, a registered nurse in Arizona, has been scuffling with her case on patient advocacy for several months already. On January 24, 2012, her case was supposedly to be heard. But unfortunately, it has been postponed and rescheduled on March. And what is reason for delaying it? The AZ BON don’t like Amanda’s online activity and feel she threatened a former boss. Thus, they are requiring her to undergo first a psychiatric evaluation.
With the popularity that Amanda Trujillo’s case is receiving online, it made me realized then how important social media is in healthcare industry. They are not only beneficial in promoting health awareness but also allow people in nursing scrubs to share their experiences. Additionally, social media makes it possible for nurses to extend their support to fellow professionals in nursing scrubs like AZ nurse Amanda Trujillo who is currently in a dilemma.
http://www.scrubpoint.com/2012/02/01/an-update-on-az-nurse-amanda-trujillo-case/
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Ripples: A Conversation with Amanda Trujillo (Part 1 of 3), by Nursetopia on January 31, 2012:”I know there are people who have read and read and read about Amanda Trujillo. In fact, there are so many great posts, I don’t know who to link to so you can see them all. Be sure to check out The Nerdy Nurse, Those Emergency Blues, Emergiblog, iCoachNurses, Nurse Ratched’s Place, and Vern Dutton’s page. There are a plethora of links between those fabulous blogs.
Still, there are many who have no idea what is happening in Arizona. You can read Amanda’s story in her own words; please, do. I spoke with Amanda via telephone for over an hour, listening to her tell her story and asking questions. The many subsequent posts are for Amanda as well as inspired by her. I thank her for sharing her time and story with me so I can share it with you in hopes you will share it with others. This must stop.”
http://nursetopia.net/2012/01/31/ripples-a-conversation-with-amanda-trujillo-part-1-of-3/
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Here’s the plan: Lets make the powers WANT to help Amanda T, Greg Mercer, January 29, 2012:”I have a plan, and much evidence suggests it could work. Forget “support,” forget “standing by,” forget sympathy and empathy and outrage, for a moment. We now have achieved plenty of all of those things. I think we should offer more – ensure Amanda retains her license, her good name, and her career. I surely can’t offer certainty, but I can offer a fair shot of success, without asking more than many Nurse are already offering.
My last posts have been lengthy, so here’s a short version – I suggest the full ones if you can find the time, worth it, please trust me on that. My plan makes more sense if you know a bit more about the history and successes of Social Media advocacy outside of Nursing. The short version: initially tiny groups of plain old average powerless people, with much less credibility and wherewithal than that of the average Nurse, have repeatedly used Social Media to organize. Using these tools they have defeated the following in some way – all real well-documented examples, I give my word and reputation on it. These examples are more fully describes in other posts”
http://grchealthcareblog.com/2012/01/29/heres-the-plan-lets-make-the-powers-want-to-help-amanda-t/
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Here’s how you can REALLY help Amanda T and other Nurses, Greg Mercer, RN, @gregmercer1, January 28, 2012:”I have a few more ideas to offer about Amanda Trujillo’s situation, about Social Media, about powers Nurses already have, and those we COULD have and soon, IF we decide to make it so. It wouldn’t require much from most individual Nurses, really, not much at all: for most of us, a few minutes here and there, perhaps a few dollars occasionally. Very little in comparison to the hard work we put in every day.
What do Nurses need most? What do Nurses like Amanda need most? They need more power, plain and simple. Everything else is details.
Here’s a thought: what about sending peanuts? Whoa, where did that come from? This, my friends, is a teaser: a preview of one of the real success stories later on in this post. Ordinary little people got mad, and instead of complaining and waiting for someone else to save them, they got organized, they sent lots and lots of peanuts. By so doing they quickly, cheaply, and rather easily forced a large Corporation to change its ways against its will. TRUE STORY, people. Check it out: unless you want Nursing to stay as is or get worse.”
http://grchealthcareblog.com/2012/01/28/heres-how-you-can-really-help-amanda-t-and-other-nurses/
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Arizona Nurse Has License Threatened By Doctor After Providing Patient Education, January 22, 2012 By The Nerdy Nurse:”There are times in my nursing career when I am so very proud of how far we have come in advancing our profession. Unfortunately, there are also times where I am reminded that this is still very much an uphill climb we must make in order to legitimately participate in truly collaborative healthcare. Today is one of those days in which I am reminded we still have battles to win.
The following blog post is related to an email that was originally sent to @EchoHeronAuthor. It was then posted on Vernon Dutton’s Posterous, Amanda Trujillo case will go before the Arizona State Board of Nursing on January 24th, 2012.
Her story is one of an archaic medical model in which the doctor’s word is supreme and we are all just nurse maids here to do their bidding. This is an indication that there are many who do not wish to continue to advance toward collaborative healthcare in which we work as a team to provide patients with the best care possible. This is also an example of persons who may not be in medicine for the right reasons.”
http://thenerdynurse.com/2012/01/arizona-nurse-has-license-threatened-by-doctor-after-providing-patient-education.html
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http://nursetopia.net/2012/01/31/ripples-a-conversation-with-amanda-trujillo-part-1-of-3/
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Amanda Trujillo – Nurse fired for being a patient advocate, Pat Iyer, January 30, 2012:”The story of Amanda Trujillo is a horrifying one. Briefly, she is a single mom who fought to get off welfare and fulfilled her dream of becoming a nurse. Not only did she become a nurse, she earned a masters degree in nursing. One night while working a Banner Health in Arizona, she took care of a patient who was being asked to undergo a liver transplant. In talking to the patient, Amanda learned that the patient did not fully understand what was going to occur. Amanda educated the patient. She explained the option of hospice instead. The patient decided against the transplant. Then the physician came in, had a well- witnessed tantrum at the hospital when he found out his patient had decided against surgery, and Amanda was fired by the hospital. Her case came up for review by the Arizona Board of Nursing. The summary of her case written by the attorney representing her is below. Amanda has been devastated in terms of her career and her finances. She is back on welfare, her dream of being a nurse shattered.”
http://www.avoidmedicalerrors.com/2012/01/amanda-trujillo-nurse-fired-for-being-a-patient-advocate/
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Banner Health, Arizona Board of @Nursing: A Personal Vendetta? Emergiblog:”Sorry, no. This is the problem.
There is a huge injustice being perpetrated against a nurse right this moment.
It’s getting worse.
And the ones who got the party started aren’t happy that it isn’t quiet.
That their moves, and their motives, are under public scrutiny.
That nurses are talking.
Because if you are quiet, it means they’ve got you frightened.
If you are quiet, it’s harder for the next nurse to speak out.
If you are quiet, it is easier to intimidate and retaliate against nurses with impunity.
I received a call from the Arizona Board of Nursing this morning. I am not able to obtain a copy of the Banner Del E. Webb Medical Center complaint against Amanda Trujillo, RN, MSN.”
http://www.emergiblog.com/2012/01/banner-health-arizona-board-of-nursing-a-personal-vendetta.html
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Nurses associations, my very own arcade claw machine
by Kevin Ross, January 29, 2012:”It seems that there isn’t any shortage of things to write about here at Innovative Nurse when it comes to fellow nurse Amanda Trujillo. Search Twitter for #NurseUp, and all of the amazing nurse bloggers out there (links below), that have kept you somewhat up to speed on the case of Amanda.
So, I was on Tweetchat this past Sunday with some of these amazing nurse bloggers, leaders, and entrepreneurs out there and the support is just off the hook (save that hook reference for a sec). I know we’re here for a bigger cause than Amanda. I just can’t believe it took something like this to bring us together. We’re here for the nursing profession, and in support of our ability to work collaboratively and to advocate for our patients. There are nursing professionals I’ve never even met that are pouring themselves into this cause with great vigor. Watch out because the energy behind this is unstoppable.”
http://innovativenurse.com/nurses-association-arcade-claw-machine/
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Voices For Amanda Trujillo, Jay Doe, Those Emergency Blues, January 28, 2012:”Each of them eloquently speaks to the heart of what we do as nurses — and why
nurses find how Amanda Trujillo was fired and subsequently reported to the Arizona State Board of Nursing so troubling. (Via The Innovative Nurse.)”
Facebook:
http://www.facebook.com/people/Jay-Doe/100000771416457
Twitter: http://twitter.com/#!/TorontoEmerg
http://torontoemerg.wordpress.com/2012/01/28/voices-for-amanda-trujillo/
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Amanda Trujillo: Exposing the Truth, By Jessica Ellis | January 26th, 2012:”For those followers of this blog that are not yet aware of what has recently come to the attention of the nursing community, I wanted to make sure to promote awareness of the landmark case out of Arizona concerning Amanda Trujillo. This nurse has taken her case to the public nursing community in order to gain support for herself, and our profession as a whole.
The truth has been exposed. We who have been in the nursing profession know it, and now it is time to take the truth to the public. FACT: Nurses and the core of our profession–patient care–are at the mercy of the medical and political powers-that-be when we interfere with the revenue of hospitals, doctors, and the government, including the boards of nursing that govern our practice in each state.”
http://www.nursesnetwork.com/2012/01/26/amanda-trujillo-exposing-the-truth/
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The power of social media #NurseUp, By Kevin On January 25, 2012:”If you’ve been following Innovative Nurse, and the other nurse bloggers and innovators out there, then you’ve probably gotten a dose of how powerful social media can be. Just a few short days ago, I heard about Amanda Trujillo’s story and decided to plant my feet firmly on the ground, my fingers firmly on my keyboard, and I took a stance. Drafting an open letter to the Arizona Board of Nursing on Amanda’s behalf just seemed like the least I could do for her.
She didn’t reach out to me, I’ve never met her in person, and yet, it’s as if I actually know her. The connection is unbreakable. She’s a nurse. I know what that means. I take a lot of pride in who I am, and everything I’ve done as a nurse. I’m sure you know where I’m coming from if you too are a nurse. We are on the front lines, we are the armor, and together we’re impenetrable.”
http://innovativenurse.com/power-social-media-nurseup/
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Arizona Nurse Has License Threatened By Doctor After Providing Patient Education January 22, 2012 By The Nerdy Nurse:”There are times in my nursing career when I am so very proud of how far we have come in advancing our profession. Unfortunately, there are also times where I am reminded that this is still very much an uphill climb we must make in order to legitimately participate in truly collaborative healthcare. Today is one of those days in which I am reminded we still have battles to win.
The following blog post is related to an email that was originally sent to @EchoHeronAuthor. It was then posted on Vernon Dutton’s Posterous, Amanda Trujillo case will go before the Arizona State Board of Nursing on January 24th, 2012.
Her story is one of an archaic medical model in which the doctor’s word is supreme and we are all just nurse maids here to do their bidding. This is an indication that there are many who do not wish to continue to advance toward collaborative healthcare in which we work as a team to provide patients with the best care possible. This is also an example of persons who may not be in medicine for the right reasons.”
http://thenerdynurse.com/2012/01/arizona-nurse-has-license-threatened-by-doctor-after-providing-patient-education.html
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Advocating for a fellow Nurse: Amanda Trujillo, MSN, RN, DNSc-NP(s), Kevin Ross, January 22, 2012, #RN, @innovativenurse #nurseup #nursefriendly:”An open letter to the Arizona State Board of Nursing.
Disclaimer, I have not been directly contacted by Amanda Trujillo, nor do I know her personally or professionally. I am also writing to you based on the information that I have available to me.
To the Arizona State Board of Nursing:
To whom it may concern,
I am writing to you on behalf of Amanda Trujillo, MSN, RN, DNSc-NP(s) regarding the case attached below. I have not been contacted directly by Amanda Trujillo, and I have neither a personal or professional relationship other than that she is a fellow nurse in need of my support.
http://innovativenurse.com/advocating-fellow-nurse/
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Del E. Webb Medical Center, Sun City Arizona AKA Banner Health Nurse Incident @BannerHealth, January 15, 2012:”This is the original post which prompted us to mobilize and form the “Nurseup” movement. It reprints an email Amanda Trujillo, RN sent to Echo Heron, RN http://www.echoheron.com/
We are deeply grateful to Vernon Dutton, RN @nursingpins for bringing this issue to our attention and continuing to support it tirelessly.”
http://nurseup.com/wordpress/2012/02/del-e-webb-medical-center-sun-city-arizona-aka-banner-health-nurse-incident-bannerhealth-vduttons-posterous/
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Being A Naive Nurse Will Get You Thrown To The Wolves, @jaydoe, 11/07/10. #Nurseup:”In matters related to practice, errors, or sentinel events, are nurses far too naïve when it comes to dealing with their employers, regulatory bodies, or police? Nurses falsely assume that all of these authorities will act in, or at least be mindful of, their best interests. The thought that any of them might act solely in their own self-interest (at best) or in bad faith (at worst), is probably beyond most of us. The fact is none of them have a nurse’s interest as their top priority, if in fact they consider it all. Aside from a duty to ensure patient safety, hospitals have a legal, fiduciary obligation to protect themselves from liability issues and legal action.”
http://nurseup.com/wordpress/2012/03/being-a-naive-nurse-will-get-you-thrown-to-the-wolves/
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Preformatted Form Posts, Tweets 
by NurseFriendly
Arizona State Board of Nursing: Amanda Lucia Trujillo: Notice of Charges & Del E. Webb Medical Center, Sun City, Arizona
March 28, 2012 in Amanda Trujillo, Arizona, Arizona Nursing Association AzNA, Arizona State Board of Nursing, Banner Health, Banner Health Arizona, Bloggers & Blogs, Comments on The Amanda Trujillo RN Situation, Del E. Webb Medical Center, GRCHealthcare, Greg Mercer, Hospitals & Healthcare Systems, Informed Consent, Informed Patient Choices, Legal Advocacy For Nurses, Making All Treatment Options Known To Patient, Nurse Abuse, Nurse Bullying, Nurse Intimidation, Nursing Blogs, Patient Advocacy, Remove Amanda Trujillo's nursing license from "under investigation" status, RN & Banner Del E. Webb Medical Center, Social Network Public Postings, State Boards of Nursing, Sun City, Sun City
Update 3/28/12:
“TO: Governor Janice Brewer, and Joey Ridenour, Executive Director AZ BON
FROM: Greg Mercer, MSN
Many of us are curious and disturbed by the seemingly official AZ BON document apparently released to a private blogger and published yesterday with the inaccurate implication that the allegations enclosed are proven facts:
http://nurseup.com/wordpress/2012/03/arizona-state-board-of-nursing-abuse-governor-janice-brewer-and-joey-ridenour-executive-director-az-bon/
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3/30/12 Update:
Andrew Lopez, RN: Incidentally #3 & #22 are the same & completely bogus, her attorney addressed it in July, yet it still appears. Andrew Lopez
22. On or about April 14, 2011, at or around 5:12 a.m., Respondent practiced outside her scope when s…he ordered a “case management social service consult” for patient D.F. requesting a “home hospice evaluation.” Respondent documented that the ordering physician was Dr. Pedro R. Rodriguez. On or about January 13, 2012, Respondent admitted to Board staff during interview that Respondent had not spoken to Dr. Rodriquez or any other physician, and did not have a verbal or telephone order from Dr. Rodriquez authorizing a consult order to evaluate patient D.F. for hospice.
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http://vdutton.posterous.com/94287821
“It is standard knowledge that the Cerner electronic health records system in place at Webb contains a box that states, “Nurse Ordered.” Why would this box exist if nurses were never allowed to “order” anything? The Complainant contends that Ms. Trujillo overstepped her scope of practice by ordering the consult; however, it is standard practice of the hospital to allow nurses the freedom to do the exact thing alleged in the Complaint.
Ms. Trujillo was allowed to order case management consults on numerous occasions prior to this and was never told by the hospital that this practice was not allowed or outside the scope of her practice. It is apparent that the hospital is simply trying to appease and placate an angry physician by filing this Complaint against Ms. Trujillo.
She looks forward to discussing this matter with the Board, if necessary, and hopes to conclude this matter expediently.
SUBMITTED: July 11, 2011
ROBERT CHELLE LAW”
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Thanks to Megen Duffy, NotNurseRatched for releasing this: Original URL:
http://notratched.net/wp-content/uploads/2012/03/Trujillo-Notice-of-Charges.doc
ARIZONA STATE BOARD OF NURSING
4747 North 7th Street, Suite 200
Phoenix, Arizona 85014-3655
602-771-7800
IN THE MATTER OF THE REGISTERED
NURSE LICENSE NO. RN137552
ISSUED TO:
AMANDA LUCIA TRUJILLO
RESPONDENT
NOTICE OF CHARGES
CASE NO. 1104073
The Arizona State Board of Nursing (“Board”) has sufficient evidence of the conduct described in the factual allegations that, if not rebutted or explained, justifies disciplinary action pursuant to A.R.S. §§ 32-1606, -1663 and -1664.
FACTUAL ALLEGATIONS
1. Amanda Lucia Trujillo (“Respondent”) holds Board issued registered nurse (“RN”) license no. RN137552.
2. The Board has authority pursuant to A.R.S. §§ 32-1606, 32-1663, and 32-1664 to impose disciplinary sanctions against the holders of nursing licenses for violations of the Nurse Practice Act, A.R.S. §§ 32-1601- 1669.
3. On or about April 26, 2011, the Board received a complaint from Banner Del E. Webb Medical Center (“Banner Del Webb”) alleging that Respondent practiced beyond the scope of her license on or about April 14, 2011, by writing an order without the permission of the patient’s physician. Based upon this information, the Board conducted an investigation.
4. On or about December 9, 2011, the Board received a copy of an email authored by Respondent and sent by Respondent to numerous individuals and circulated on the internet in which Respondent identified herself as “MSN, RN, DNSc-NP(s).” Respondent does not have a DNSc (Doctor of Nursing Science) degree and is not licensed as a Nurse Practitioner in Arizona. Based upon this information, the Board conducted an investigation.
5. From on or about June, 2005, through on or about August, 2010, Respondent was employed as a RN at Mayo Clinic Hospital (“Mayo Clinic”) in Phoenix, Arizona.
6. On or about June 14, 2009, Mayo Clinic received a written complaint from patient D.H. alleging that on or about June 7, 2009, between 8:30 a.m. and 12:00 p.m., Respondent caused emotional distress to patient D.H. by refusing to give patient D.H. her inhaler despite patient D.H.’s repeated requests. On or about January 13, 2012, Respondent admitted to Board staff during interview that Respondent did not give patient D.H. her inhaler for approximately 2.5 hours because Respondent felt that she had “other critical situations” to address.
7. On or about September 21, 2009, while employed as a RN at Mayo Clinic, Respondent self-reported acting outside her scope of practice by removing an indwelling urinary Foley catheter from a male urology patient at the patient’s request without a physician’s order, and without consulting a physician or nursing supervisor. Respondent’s actions resulted in the urology physician having to re-insert the patient’s indwelling urinary Foley catheter thereby delaying the patient’s discharge from Mayo Clinic.
8. On or about February 9, 2010, while employed as a RN at Mayo Clinic, Respondent came to a non-work related meeting wearing white scrubs and stopped in a patient’s room to socially say hello to the patient whom she had recently cared for. After being with the patient for an hour, Respondent came out of the patient’s room and stated that she had spent the time “educating the patient” despite the fact that Respondent was not on-duty and not assigned to the patient. On or about January 13, 2012, Respondent admitted to Board staff that she did visit the patient on her day off and answered many of the patient’s questions because she felt she “could not ignore the questions,” but Respondent denied “educating” the patient.
9. On or about April 23, 2010, while employed as a RN at Mayo Clinic, Respondent ordered a cheeseburger and fries for a cardiac diet patient contrary to physician’s orders and without an order from the attending physician while employed as a RN at Mayo Clinic. On or about January 13, 2012, Respondent claimed during an interview with Board staff that Respondent obtained a verbal order from a Physician Assistant for the cheeseburger and fries, and that the Physician Assistant forgot to enter the order.
10. On or about August 10, 2010, Mayo Clinic placed Respondent on a corrective action plan to monitor Respondent for critical thinking, organization, work processes, timely response to requests and orders, and appropriate completion of orders. Mayo Clinic also advised Respondent that she would need to work three shifts under the supervision of a preceptor before being allowed to work independently with patients. Respondent thereafter resigned her RN position at Mayo Clinic on or about August 11, 2010. Respondent is not eligible for rehire at Mayo Clinic.
11. In Respondent’s August 11, 2010, resignation email to Mayo Clinic, Respondent identified herself as “Amanda Lucia Trujillo, MSN, RN, DACNP-S” when Respondent had not graduated with a “DACNP degree,” was not studying for a “DACNP degree,” and was not licensed as a Nurse Practitioner in Arizona.
12. On or about January 13, 2012, Respondent stated to Board staff that Respondent resigned from Mayo Clinic on or about August 10, 2010, because Respondent felt that she “was not safe anymore” and had “lost her edge” due to what Respondent described as a “medical condition.”
13. On or about July, 2010, through September, 2010, Respondent was employed as a RN at Valley Home Care in Phoenix, Arizona.
14. It is the standard of care for a licensed RN to delineate and maintain boundaries that establish appropriate limits and parameters of a professional relationship. It is also the standard of care for a licensed RN to maintain a patient’s privacy and confidentiality. Respondent fell below the standard of care while employed as a RN at Valley Home Care in Phoenix, Arizona, when Respondent repeatedly took her 14 year old daughter and her adult brother with her on home health visits, and left her family members “in the car” while Respondent conducted the home health visits. On or about January 13, 2012, Respondent admitted to Board staff that she took her daughter and brother with her on home health visits and further admitted that on at least one occasion, Respondent’s brother knocked on the patient’s door asking to use the bathroom while Respondent was conducting the home health visit.
15. On or about September 1, 2010, through November 1, 2010, Respondent was employed as a RN at Mountain Vista Medical Center (“Mountain Vista”) in Mesa, Arizona.
16. On or about October 25, 2010, Respondent’s nursing supervisor at Mountain Vista issued a corrective action to Respondent for disruptive behavior during computer class, challenging processes such as physician rounding in a loud and inappropriate manner, verbally challenging or attacking other staff and narcotic discrepancies involving Temazepam and Percocet. Respondent submitted her voluntary resignation to Mountain Vista on or about November 8, 2010. Respondent is not eligible for rehire at Mountain Vista.
17. The standard of care of a licensed RN requires the RN to use accurate academic and professional credentials when identifying him or herself to ensure credibility and competence to the consumers of nursing care. Respondent fell below the standard of care on or about November 8, 2010, when Respondent submitted a November 8, 2010, resignation letter to Mountain Vista in which Respondent identified herself as “Amanda Lucia Trujillo, MSN, RN, DACNP-S” when Respondent had not graduated with a “DACNP degree,” was not studying for a “DACNP degree,” and was not licensed as a Nurse Practitioner in Arizona.
18. From on or about November 29, 2010, until May 21, 2011, Respondent was employed as a RN at Banner Del Webb in Sun City West, Arizona.
19. On or about February 23, 2011, while employed as a RN at Banner Del Webb, Respondent failed to appropriately respond or assist patient B.M. with a feeding tube insertion site dressing change telling patient B.M. to “deal with the dressing himself.” The resource nurse, who was not assigned to patient B.M., responded to patient B.M.’s requests for assistance and found patient B.M. crying and complaining of burning and pain at the insertion site. The resource nurse medicated patient B.M. for pain, assisted patient B.M. back to bed, cleaned the insertion site, and applied a new dressing. Respondent denies these allegations.
20. On or about March 15, 2011, while employed as a RN at Banner Del Webb, Respondent suggested calling a false code on patient M.S., who was not in cardiac or respiratory arrest, so that Respondent could administer anti-arrhythmic medications (Adenosine and Amiodarone) pursuant to Advanced Cardiac Life Support guidelines without a physician’s order. When the Rapid Response team and other staff intervened on patient M.A.’s behalf and refused to allow Respondent to administer either Adenosine or Amiodarone to patient M.A. without a physician’s order or a physician present in the room, Respondent became angry and left patient M.A.’s room, leaving patient M.A. scared, crying and hooked up to the EKG monitor on the defibrillator on the crash cart.
21. It is the standard of care of a licensed RN to plan and provide patient education based on the patient’s learning needs and establish an environment conducive to the patient’s emotional and physical well-being as well as to the patient’s learning needs. Respondent fell below the standard of care on or about April 13 and 14, 2011, when Respondent failed to appropriately assess patient D.F.’s emotional and physical readiness to learn, failed to appropriately assess patient D.F.’s post-operative learning needs, and further failed to implement an appropriate teaching strategy for patient D.F. causing patient D.F. to become overwhelmed and experience distress, confusion, and anxiety. Specifically, patient D.F. was a 56 year old patient admitted to Banner Del Webb on or about April 7, 2011, after she fell at home and sustained a head laceration and fractured her left hip. Although the April 7, 2011, admitting History and Physical stated that a liver transplant was a possible option, several physician progress notes stated that patient D.F. would need to postpone a liver transplant evaluation until after her discharge. Despite the fact that patient D.F. was not scheduled for a liver transplant surgery, had not been evaluated for a liver transplant, was not on the liver transplant list, and was recovering from a serious fall and fractured hip, Respondent provided patient D.F. with approximately 305 pages of written information including 172 pages of written information about liver transplants in the middle of the night (between approximately 1:00 a.m. and 3:00 a.m.) and told patient D.F. that if she got a liver transplant, patient D.F. would “have to wear a mask all of the time after the transplant anytime you are in public,” and “the transplant people will ask you things and hound you and hound you and you won’t be able to live alone anymore.” Additionally, Respondent initiated a conversation about hospice with patient D.F. after Respondent medicated patient D.F. with intravenous Morphine and assessed patient D.F. as being “sad and somber” with poor eye contact and a psychosocial status as “not within defined limits.” While patient D.F. was under the under the influence of narcotics, recovering from hip surgery, and exhibiting abnormal psychosocial status, Respondent engaged in “teaching” for approximately 90 minutes and suggested that Respondent consider hospice and gave Respondent written information from a local hospice agency (Hospice of the Valley).
22. On or about April 14, 2011, at or around 5:12 a.m., Respondent practiced outside her scope when she ordered a “case management social service consult” for patient D.F. requesting a “home hospice evaluation.” Respondent documented that the ordering physician was Dr. Pedro R. Rodriguez. On or about January 13, 2012, Respondent admitted to Board staff during interview that Respondent had not spoken to Dr. Rodriquez or any other physician, and did not have a verbal or telephone order from Dr. Rodriquez authorizing a consult order to evaluate patient D.F. for hospice.
23. On or about January 13, 2012, Board staff disclosed to Respondent and her attorney the names and statements of witnesses related to Respondent’s performance issues at Banner Del Webb, Mountain Vista Medical Center, Valley Home Care and Mayo Clinic Hospital. After Respondent learned the names and statements of the witnesses, on or about January 13, 2012, Respondent left a voicemail for the Director of Nursing at Valley Home Care threatening to file a defamation lawsuit against the Director of Nursing.
24. On or about January 14, 2012, Respondent emailed another witness, a staff nurse at Banner Del Webb, threatening to file a defamation lawsuit against that witness.
25. On or about January 15, 2012, Respondent texted a third witness, another staff nurse at Banner Del Webb, threatening to file a defamation lawsuit against that witness.
26. On or about December 9, 2011, Respondent circulated an email to multiple recipients and on the internet in which Respondent identified herself as “Amanda Lucia Trujillo MSN, RN, DNSc-NP(s)” when Respondent had not graduated with a DNSc degree, was not studying for a DNSc degree, and was not licensed as a Nurse Practitioner in Arizona.
27. Respondent failed to respond to an Investigative Questionnaire asking for a full and complete explanation of Respondent’s use and/or misuse of the “DACNP-S” and “DNSc-NP(s)” credentials.
28. Beginning on or about December 9, 2011, and continuing until the present day, Respondent has deceived the public by repeatedly stating in various interviews and written correspondence that:
(a) Respondent “specialized” in end of life/palliative care when Respondent has no professional nursing experience in hospice or palliative care nursing;
(b) Patient D.F. had agreed to get a “major invasive surgery” (i.e. liver transplant) or was scheduled for a “major invasive surgery” (i.e. liver transplant) in the immediate future when patient D.F. was not scheduled for a liver transplant surgery, had not agreed to get liver transplant surgery, had not been evaluated for a liver transplant surgery, was not on the liver transplant list, and was not scheduled for any other “major invasive surgery” on or about April 13-14, 2011.
(c) Patient D.F. asked Respondent about hospice and/or requested a “case management consult to visit with hospice” when in fact the case manager who spoke to patient D.F. the following morning stated that it was the Respondent, not patient D.F., who initiated the conversation about hospice. In addition, patient D.F. told the Respondent’s nursing supervisor that the Respondent “educated” patient D.F. that if patient D.F. had a liver transplant, patient D.F. would have to wear a mask “all of the time … anytime you are in public” and “the transplant people will hound you and hound you and won’t be able to live alone anymore.”
(d) Patient D.F.’s physician refused to let patient D.F. visit with a hospice representative when in fact it was patient D.F. who requested that the case manager cancel the hospice consult which the case manager did at patient D.F’s request.
29. It is the standard of care of a licensed RN to maintain a patient’s privacy and confidentiality. Respondent fell below the standard of care beginning on or about December 9, 2011, and continuing through February 2011, when Respondent violated patient D.F.’s privacy and confidentiality by repeatedly posting private and confidential information on social media and the internet, as well as disclosing in radio and other interviews, private and confidential information about patient D.F. including patient D.F.’s dates of hospitalization, place of hospitalization, purported diagnoses, purported knowledge deficits, purported nursing care, and purported treatment decisions.
30. On or about January 24, 2012, the Board issued an Interim Order requiring Respondent to obtain a psychological evaluation at the Board’s expense. Respondent failed to comply with the Interim Order by March 9, 2012, which was 35 days after the date of service of the Interim Order.
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ALLEGED VIOLATIONS
1. The conduct and circumstances described in the Findings of Fact constitute violations of A.R.S. §§ 32-1663 (D) as defined in 32-1601 (18) (d) (Any conduct or practice that is or might be harmful or dangerous to the health of a patient or the public); (h) (Committing an act that deceives, defrauds or harms the public); (i) (Failing to comply with a stipulated agreement, consent agreement or board order); and (j) (Violating a rule that is adopted by the Board pursuant to this chapter); (effective September 30, 2009); Specifically:
A.A.C. § R4-19-403 (1) (A pattern of failure to maintain minimum standards of acceptable and prevailing nurse practice); (effective January 31, 2009).
A.A.C. § R4-19-403 (2) (Intentionally or negligently causing physical or emotional injury); (effective January 31, 2009).
A.A.C. § R4-19-403 (3) (Failing to maintain professional boundaries or engaging in a dual relationship with a patient, resident, or any family member of a patient or resident); (effective January 31, 2009).
A.A.C. § R4-19-403 (9) (Failing to take appropriate action to safeguard a patient’s welfare or follow policies and procedures of the nurse’s employer designed to safeguard the patient); (effective January 31, 2009).
A.A.C. § R4-19-403 (12) (Assuming patient care responsibilities that the nurse lacks the education to perform, for which the nurse has failed to maintain nursing competence, or that are outside the scope of practice of the nurse); (effective January 31, 2009).
A.A.C. § R4-19-403 (25 a.) (Failing to: a. Furnish in writing a full and complete explanation of a matter reported pursuant to A.R.S. § 32-1664); (effective January 31, 2009).
A.A.C. § R4-19-403 (31) (Practicing in any other manner that gives the Board reasonable cause to believe that health of a patient or the public may be harmed); (effective February 2, 2009).
2. The conduct and circumstances described in the Findings of Fact constitute violations of
A.R.S. §32-1636(C)(effective May 9, 2002): (Use of titles or abbreviations: D. Only a person who holds a valid and current certificate issued pursuant to this chapter to practice as a registered nurse practitioner in this state may use the title “nurse practitioner”, “registered nurse practitioner” or “nurse midwife”, if applicable, or use any words or letters to indicate the person is a registered nurse practitioner. A person who is certified as a registered nurse practitioner shall indicate by title or initials the specialty area of certification.)
WHEREFORE, the Arizona State Board of Nursing alleges that grounds exist that, if proven, would constitute a basis to impose disciplinary sanctions pursuant to A.R.S. §§ 32-1606, 32-1663, and 32-1664.
Pursuant to A.R.S. § 32-1663(F), Respondent may file with the Board a written request for hearing within 30 days after service of this Notice of Charges to Vicky Driver, at Arizona State Board of Nursing, 4747 North 7th Street, Suite 200, Phoenix, AZ 85014-3655. THE BOARD MAY CONSIDER RESPONDENT’S FAILURE TO REQUEST A HEARING WITHIN THIS TIME AS RESPONDENT’S ADMISSION BY DEFAULT TO THE ALLEGATIONS STATED IN THE NOTICE OF CHARGES. The Board may then take action pursuant to A.R.S. § 32-1663 (D), as defined in A.R.S. § 32-1601 (8) without conducting a hearing. For answers to questions regarding the Notice of Charges, contact Vicky Driver at (602) 771-7852.
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Dated this day of , 2012.
SEAL
.
Joey Ridenour, R.N., M.N., F.A.A.N.
Executive Director
COPIES mailed this day of , 2012, by Certified Mail No. and First Class Mail to:
By:
Legal Secretary
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