Nurses vs Hurricane Sandy

31 Oct 2012

From the Huffington Post. Photo/ John Minchillo

This is every nurse’s worst nightmare. Imagine caring for the most fragile, helpless patient while Mother Nature is going on a rampage. That’s what happened last night as hospital staff worked through the night to evacuate patients from NYU’s Langone Medical Center after heavy flooding from Hurricane Sandy caused the hospital to lose power.

According to reports, the hospital’s emergency generators lost power around midnight, the staff, using flashlights, evacuated 260 patients on med sleds at a pace of about one patient every 15 minutes. ABC News reported that some of the most venerable patients, 20 babies from the neonatal intensive care unit who relied on respirators, were carried down nine flights of stairs while a nurse manually squeezed a bag to deliver air to the baby’s lungs. I only imagine what those nurses were thinking as they recused the infants. “Hold the baby tight, go down a step, squeeze the ambu bag….repeat”. They carried these infants step by step, in the dark, sounded by howling winds and rising flood waters. It was a living nightmare.

I’m so proud of my fellow nurses. They are a credit to the profession. And you know they would do it all again if they had to because they’re nurses.

Thank you.

The War Against Amanda Trujillo

25 Apr 2012

Many of my readers are wondering why I took a break from writing about the Amanda Trujillo case. The answer is simple. This case is getting very litigious.

Several weeks ago, the Arizona Board of Nursing made their allegations against Amanda public. In the past this would have gone against the board’s policies, so you’d have to be stupid or really naive to believe that this case isn’t going to court. If you don’t already know, there has been a lot of mudslinging going on. This case involves slander, libel, and defamation of character, and the board will have to answer for their actions.

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

Unfortunately, unlike my friends, Amanda is fighting a corrupt nursing board that has close ties to her former employer, Banner Del E. Webb Medical Center. Amanda has also reached out to the Arizona Nurses Association for support, but their leadership is no help. Not surprisingly, the AzNA also has close ties to Banner Health. And then there is the American Nurses Association. They continue to “closely monitor” Amanda’s situation. I wish the ANA would stop giving lip service and actually do something to promote the nursing profession.

The Arizona Board of Nursing and Banner Health are trying to destroy Amanda because she refuses to remain silent about corruption in her state. I’ll keep you posted as new information becomes available.

Tweet Me No Lies

20 Mar 2012

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:

It all started when my blog buddy, Vernon Dutton from NursingPins wrote a message on Facebook. He shared that one of his supportive messages about Amanda Trujillo had been removed from the Iowa Nurses Association’s Facebook page. The INA contacted Vernon to let him know that the ANA had told them to take down his comment. Kim and I came out publically and called this censorship. The ANA calls it a misunderstanding. Yeah, right. The ANA hates crystal clear communication between all parties, and what we really have here is a credibility gap. The ANA has a history of waging campaigns of disinformation when they don’t like something, and this tweet is just another example of how they try to manipulate public opinion. Shame on you ANA. Your nose is growing again.

Censorship: Don’t Talk About Amanda Trujillo

15 Mar 2012

The ANA came out with a lame statement after the blogosphere went ballistic over the Amanda Trujillo case. The statement said that the ANA was going to monitor Amanda’s situation. I thought they meant that they were going to await further developments before they said anything else, but apparently I was wrong. I just found out that the ANA is monitoring Facebook pages, and that they told a least one state nursing association to censor posts and comments that are in support of Amanda Trujillo.

My blog buddy, Vernon Dutton from NursingPins went onto the Iowa Nurses Association’s Facebook page and posted a supportive comment about Amanda Trujillo. Then he got a big surprise. According to LouisianaNurse, Vernon was asked to call the INA. The person that spoke to Vernon said that ANA told the INA to take his comment down. Vernon later posted the following comment on the INA Facebook page: “The Iowa Nurses Association selectively removes posts they do not like!” As a native of Iowa, I’m very disappointed that the INA knuckled under to the demands of the ANA. This type of censorship is unacceptable. On the other hand, the INA didn’t have to give Vernon an explanation for their actions. Maybe they wanted Vernon to know about the ANA’s censorship campaign.

The ANA is truly “monitoring the situation.” Big Brother is proud of you.

Show Me the Scholarship Money

15 Mar 2012

Going to nursing school is an expensive proposition. Are you looking for a way to pay for your nursing education? I little birdie told me about the “Back to School” Nursing Scholarship from They are offering three scholarships in the amount of $2,500 each to aspiring and current nurses who are pursuing:

A second degree BSN or direct entry MSN degree
An RN to BSN
An MSN, DNP or PhD in nursing

Deadline for applications is April 15, 2012. Go get yourself some free money. Click here for further information.

An Open Letter: Dear Future of Nursing

11 Mar 2012

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).

I thought, “What a great idea,I want to get involved,” so I clicked on a link to get more information about the nursing action coalition in my home state. The states are listed in alphabetical order, and Arizona was the second state on the list. Before I could scroll down to find my state, I noticed who is serving on Arizona’s Action Coalition leaders. Ready? They are the same people who are trying to strip Amanda Trujillo of her nursing license. I couldn’t believe what I was seeing. Check out the screen shot from the Future of Nursing website.

The hypocrisy of the Arizona BON and the Arizona Nurses Association is overwhelming, so I sent off a letter to the organizers of the Future of Nursing campaign:

I am writing to you because I have great respect for your organization and because you may not be aware of news coming out of Arizona. Members of the Arizona Action Coalition are involved in a scandalous abuse of power case against Nurse Amanda Trujillo. Amanda was fired from her job at Banner Health Del W. Webb Medical Center for acting as a patient advocate within her scope of practice. Now she is in danger of losing her nursing license. More disturbing is the news that the Arizona BON, who has close ties to Banner Health, has also ordered Amanda to undergo a psychiatric evaluation because she went public with her story. This abuse of power is unacceptable and goes against the mission of the Robert Wood Johnson Foundation. Sadly, the Arizona Nurses Association is passively standing by as these events take place. Perhaps it’s because their president, Teri Wicker, is the Director of Professional Practice Banner Del E. Webb. The AzNA denies this of course, but I’m sure that they wouldn’t publicly admit to a conflict of interest.

I respectfully request that your organization learn more about Amanda’s case and take a second look at the members of Arizona Action Coalition. They are serving their own best interests, not the interests of the public, or the nursing profession.

Sincerely, Mother Jones, RN

I wonder if I’ll get a response. In the meantime I want to thank the Arizona BON and the Arizona Nurses Association for my close bout with aspiration pneumonia. It was greatly appreciated.

The Arizona Board of Nursing Thinks You’re Stupid

26 Feb 2012

I learned a long time ago that behavior is predictable. Past behavior is a good indicator of how an individual or organization will respond to current events. I don’t know why I was shocked to learn that the Arizona Board of Nursing is upping the ante on Amanda Trujillo. After all, she didn’t roll over and play dead when Banner Del E. Webb Medical Center and the BON tried to shut her down when she publicized her story. Now the BON is charging Amanda with using false academic credentials. Amana used the letter “S” at the end of her professional designation to indicate that she was a student back in 2010, and she forgot to change the auto sign on her personal email account when she dropped out of school due to illness. This buffoonery about credentials is an old ploy from the BON playbook. Do you remember the case of the Heart Attack Grill?

Let me refresh your memory. I first wrote about this story in 2006. It all started when the Heart Attack Grill—a theme restaurant whose specialties included the Quadruple Bypass Burger and Flatliner Fries, cooked in pure lard, opened for business. The waitresses, who are called “nurses,” wear skimpy, cleavage-baring outfits, high heels, and thigh-high stockings while serving artery-clogging meals. The BON took one look at the waitresses and sprang into action because it apparently thought that the public was too stupid to figure out that the waitresses weren’t really nurses. I wouldn’t think that the young woman in the picture was a nurse. Would you? The nursing board asked the Arizona attorney general to put the kibosh on the grill’s use of the word “nurses,” saying, “Only a person who holds a valid and current license to practice professional nursing may use the title ‘Nurse.’”

Back then I just thought the board was made up of educated idiots. Now it’s pretty apparent that the BON is also malicious. The board is investigating Amanda for deceiving, harming, or defrauding the public and/or stating or inferring that she was a nurse practitioner because she forgot to change the auto sign on her personal email account. It’s significant to note that the current charges lodged against Amanda are related to something that happened way before her run in with Banner Health. That means that the BON has been wasting taxpayers’ money trying to dig up dirt on Amanda. Why? Because it thinks that it can get away with it and that the public is stupid. The BON is charged with protecting the public’s welfare, not going after restaurants that call their waitresses nurses, or persecuting nurses who educate their patients about their healthcare options.

The Arizona BON is on a campaign to discredit Amanda Trujillo. I wonder what they will try next. Based on their past behavior, I’m sure it will be amazing.

In the Footsteps of Rosa Parks

20 Feb 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.

Rosa Parks made history when she refused to move to the back of the bus and she was persecuted for her actions. She wasn’t trying to start a movement when she refused to move. She said that she was tired and just trying to get home. Amanda Trujillo wasn’t trying to start a movement either. All she did was write to fellow nurse Echo Heron about being fired from Banner Del E. Webb Medical Center, and her situation with the Arizona BON. Echo passed the letter on to Vernon Dutton and from there her letter went viral. Now Amanda is being persecuted for her actions. A lot of people have asked me why the Amanda Trujillo case resinates with nurses. It’s because nurses are tired of being treated like second class citizens. Nurses have few rights and little protection in the workplace. We are abused and bullied by nurse executives who cherish corporate profits. Frankly, we’re tired of being told to go to the back of the healthcare bus. And God help the nurse who says no, they aren’t moving. He or she is ridiculed, fired, dragged before the state board of nursing and threatened with the loss of their nursing license. Now, with the support of others, Amanda is fighting back. She’s isn’t doing this for herself, she is fighting for our patients and the nursing profession. Great changes begin with one person.

Rosa Parks said that you must never be fearful about what you are doing when it is right. Amanda is doing the right thing and she will win, and by doing so, we will all win in the end.

Please visit Nurse Up! to learn more about the Amanda Trujillo case.

Show Me How Much You Care, AzNA

15 Feb 2012

This photo is inspiring. These members of the New York State Nurses Association marched on Albany in 1971. They took to the streets to advocate for their patients and for the nursing profession. Their spirit lives on as state nurses associations fight for the rights of nurses to advocate for their patients. Well, their spirit lives on in just about every state except Arizona.

There is a big discussion going on over at the Arizona Nurses Association’s Facebook page about the Amanda Trujillo case. Many of their members think that their organization has been unfairly depicted in social media and are voicing their displeasure. I’m all about public discourse, and I welcome the dialogue. It’s about time that nursing organizations are finally talking about this case.

Some additional details have come out about Amanda Trujillo’s case. To recap, Banner Del E. Webb Medical Center fired Amanda Trujillo after she educated a patient that was slated to begin pre-transplant testing the next day. The patient had a transplant knowledge deficit and changed their mind about the possibility of surgery after receiving all the facts. Amanda wrote a nursing order requesting a hospice case management consult at the patient’s request. It’s noteworthy to mention that this discussion happened in the middle of the night. Amanda wrote detailed notes in the patient’s chart about what had transpired during the night, and passed the information on to the oncoming shift. The doctor came in the next day, threw a royal hissy fit at the nurses station, and the rest as they say is history. Now Amanda is fighting for her personal and professional life in front of the Arizona Board of Nursing.

Now let’s get back to the AzNA Facebook page. The AzNA wrote a post stating that it applauds the nurses who have spoken out on Amanda Trujillo’s situation. Thanks AzNA, but I don’t think that you’re really clapping. One nurse was upset that outsiders, nurses who do not live in Arizona, are butting into this case. She wrote, “Interesting responses from non AZ nurses who have never worked with Amanda Trujillo or AzNA.” I’m a little perplexed by this nurse’s comment. You don’t have to be an Arizona resident to be angry about what’s happening to Amanda. I believe Amanda because her story is all too common. There isn’t a nurse alive who hasn’t seen or been a victim of this type of abuse. The events surrounding this case are outrageous, and it’s my ethical duty to denounce the activities of hospitals or nursing organizations that perpetrates or condones abuse. Let me break that down for you. Amanda’s case is my business because I’m a nurse.

Other nurses have said that Amanda should have called and reported these events to the doctor before going off shift. Have you ever called a doctor in the middle of the night about something that could have waited until normal hours of operation?

Nurse: “Hello Doctor. It’s Night Nurse. I need to tell you that your patient is asking questions about his healthcare options. Yes, I know what time it is.”
Doctor: “WTF!!!!!!!!!” CLICK.

More to the point, why didn’t the doctor call Amanda and talk to her before demanding her head on a silver platter? Communication with the health care team is a two way street. And incidentally, the last time I checked the patient has the final say about their treatment plan.

Then there was the comment posted by Ray Kronenbitter, RN, MSN, PCCN, Director of Governmental Affairs Arizona Nurses Association. Here are the first few lines of his statement:

“Kim McAllister suggests in one of her postings that Amanda asked AzNA for assistance and received no response. Actually, Amanda first reached out to AzNA on September 14th at 1:00 a.m., and as I am the AzNA board member in the position most directly related to her query, responded at length to her the very next day. The most impressive aspect of our communications over the next several days was that Amanda’s concern was not only focused on herself, but on patients in hospitals all over with a terminal diagnosis who are never exposed to the palliative and hospice care options to make informed decisions concerning their health and future. Her reach out to AzNA was not so much for support for herself, but for legislative action to gain patients the right to information about all of their options, not just the one that the surgeon or another provider would like them to consider.”

We stand corrected, Ray. You wrote a letter to Amanda. Good for you. Amanda wanted to hear from the president or vice president of your organization, but that’s beside the point. You did an excellent job of sidestepping the main issue. Amanda was focused on her survival, not on legislative issues, and judging by the tone of your response (yes, I’ve read it), you knew that her life was sinking. The first few lines of your letter were very compassionate, then you started trailing off when you talked about how the AzNA advocates for patients. How can you say that when the AzNA won’t back Amanda? Patient advocacy doesn’t start at the State House, it starts at the patient bedside. I wish your board would remember that the next time they chime in on the subject. As a sidenote, I think it’s only fair to mention that Teri Wicker, the President of the AzNA recused herself due to her connection to Banner Health. It’s been duly noted, but unfortunately a perceived conflict of interest is just as damaging as an actual one.

I think that Ray and I would agree on one point. Banner Health fired Amanda because health care is all about money. The administration backed the physician; after all going from the money maker ‘surgery’ to the money loser ‘hospice’ does not contribute in a positive way to the organization’s annual reimbursements. Right, Ray?

The nurses of the New York State Nurses Association summed it up pretty well in 1971. Nurses Care….Do You?

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. She checked a box on the hospital’s computer screen that sent an order for a case management hospice consult per the patient’s request. Now she and other nurses are being told that they don’t have the right to talk about this case in a public form. The Arizona State Board of Nursing has ordered Amanda to get a psych evaluation due to her “erratic behavior” as evidenced by her chutzpah for speaking up, and the ANA has asked the public not to jump to conclusions about complex cases based on information in the press and found on social media websites. I want to thank the ANA for patting our heads and telling us that everything is going to be all right, but the public has a right to know that their health and welfare is in jeopardy.

There are conversations going on over at LinkedIn on the ANA’s discussion board you need to check out. There are comments from members with strong ANA ties that are enlightening. One nurse wrote that the public doesn’t have the right to know everything and another nurse said that the ANA has always been there to support nurses when the state association has found that the nurse needs that support. Personally, I don’t agree with either statement. I invite you to join the conversation and tell them what you think.

This issue isn’t only about Amanda, it’s about the American public. The health care industry is trying to bully nurses into not talking about abuses in the system and they will stop at nothing to achieve their goal. We will not be silenced. Strong patient advocacy makes for stronger patients who have more control over their own health care decisions. The American public has a right to know.

Nurse Ratched

There has been a lot of chatter in the blogosphere about medical bloggers and HIPAA regulations so let me make this very clear: I write composite stories about many different people that I've cared for over the years.

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Amanda Trujillo, MSN, RN, DNSc-NP(s) Media & Blogger Coverage