Nurse Up!

Have you been following the Amanda Trujillo, RN vs Del E. Webb Medical Center, Sun City, Arizona case? It is an important one because it could happen to you.

Please take the time to learn more by reading the articles that follow, and visiting http://www.nurseup.com

Del E. Webb Medical Center, Sun City Arizona AKA Banner Health Nurse Incident @BannerHealth – vdutton’s posterous:”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. Original URL: http://vdutton.posterous.com/94287821
Andrew Lopez, RN.”
http://nurseup.com/wordpress/2012/02/del-e-webb-medical-center-sun-city-arizona-aka-banner-health-nurse-incident-bannerhealth-vduttons-posterous/

The following article is from Pat Iyer, RN the former President of the American Association of Legal Nurse Consulting. She has reviewed Amanda’s case and weighed in on it.

Amanda Trujillo – Nurse fired for being a patient advocate, @PatIyer:”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 and doctorate 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://nurseup.com/wordpress/2012/02/amanda-trujillo-rn-fired-for-being-a-patient-advocate-pat-iyer-com-patiyer-nurseup-nursefriendly-amandatrujillo/

It could happen to any nurse at the bedside who has the integrity to advocate for their patients, or that recognized an educational deficit and took action to address it. Donna Cardillo, RN of “Dear Donna” & Nursing Spectrum fame has weighed in as well.

Could What Happened to Amanda Trujillo, RN Happen To You? Donna Cardillo, RN @donnacardillorn:”In case you don’t frequent twitter, the nursing blogosphere, Facebook or other online nursing communities, Amanda Trujillo is a nurse in Arizona who is under investigation by the State Board of Nursing there. In short (you can read her account here) Amanda relates that when she became aware that a patient awaiting a liver transplant had considerable misunderstanding about the procedure and the lifelong aftercare that would be required, she spent time with the patient discussing related issues and ordered a hospice/case management consult at the patients request so the patient could explore his/her options, something that was within her scope of practice and not against her employer’s policies.”
http://www.nurse-power.com/blog/could-what-happened-to-amanda-trujillo-happen-to-you/

You could be doing patient care, encounter a patient or family with questions. After answering those questions, the patient might decide not to go with the plan of care dictated by their doctor. Being a patient advocate has almost cost Amanda her career and livelihood. How far would you go to advocate for one of your patients?

This question was asked by Theresa Brown, RN, a New York Times Bestselling Author of “Critical Care: A New Nurse Faces Death, Life, and Everything In Between” discussed this in the following article on the New York Times Blog.

When the Nurse Disagrees With the Doctor, By @TheresaBrown, October 13, 2010:”A recent conversation with a physician at my hospital was laced with tension about the different roles of doctors and nurses. “When you get down to it,” he told me, “Patients come to me for care, Theresa, not you.” Both of us were called away before we could talk more, but his words have been ringing in my head ever since. I couldn’t believe that this doctor, who had always worked well with the nurses on my floor, had just suggested, at least in my mind, that a nurse’s opinion on patient care matters less because patients don’t directly make appointments with us.
http://well.blogs.nytimes.com/2010/10/13/how-far-should-a-nurse-go/

Amanda’s case should concern you as a nurse, should concern your patients, should concern every member of the healthcare team and patient advocates.

The American public has the right to know about the Amanda Trujillo case:”Looks like the nurse is assessing her patient. I’m sure that she will talk to him about his temperature and ask him for his input as she writes up his treatment plan. Bedside nurses monitor your health and meet your daily needs. We talk to the public, our patients, and advocate for you everyday. Now imagine a time when nurses are told that they can no longer talk to you because you don’t have a right to know. You don’t have the right to know about your temperature or your health care options, and you don’t have the right to know what hospitals and nursing organizations are doing to your nurses behind closed doors. Sounds a little Orwellian doesn’t it? Well it’s happening. Just in case you haven’t heard, Amanda Trujillo was fired for teaching her patient about their healthcare options.”
http://www.nurseratchedsplace.com/2012/02/the-public-has-the-right-to-know-about-the-amanda-trujillo-case/

Why physicians should care about Amanda Trujillo by J. Doe, RN, KevinMD.com:”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.”
http://www.kevinmd.com/blog/2012/02/physicians-care-amanda-trujillo.html

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For more information, kindly visit http://www.nurseup.com

If you have been the victim of a situation like Amanda’s we’d like to hear your story. It is a story that is being repeated with the “Jackson Park Memorial Nurses” in Chicago, “Kennedy Nurses” in New York, with the “Sunrise Nurses” in Nevada, previously with the “Winkler Nurses” in Texas.

In each of these cases, it is interesting to note where the nurses turned for support. These situations happen every day. We would like Nurseup.com to become a clearinghouse for nurses in these types of situations. We want to compile lists of organizations that can help nurses in these types of situations.

Thank you for your attention in this matter.

Sincerely,
Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
http://www.nursefriendly.com info@nursefriendly.com Twitter: @nursefriendly
856-415-9617, (fax) 415-9618

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See also:

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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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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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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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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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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#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, 1 Feb, 2012, Author: Mother Jones, RN:”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.”
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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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 and doctorate 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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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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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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