I can’t believe that this is really happening, but maybe again, I can. Banner Health fired an Arizona nurse because she did the right thing, and now the Arizona Board of Nursing is threatening her nursing license because she is an excellent nurse. The whole incident smacks of unbridled greed and hubris.
The nurse is Amanda Trujillo. I found out about Amanda’s plight via Vernon Dutton’s twitter feed , and by reading this story that was posted at The Nerdy Nurse. This is Amanda’s story in her own words:
My name is Amanda Trujillo. I’m a registered nurse of six years , specializing in cardiology, geriatrics, and end of life/palliative care. Back in April of this year I was caring for a dying patient whom I had discovered had no clue about what they were about to participate in when they agreed to get a major invasive surgery. When I properly educated the patient using the allowed materials by my employer they became upset that the physician never explained details of the surgery or what had to be done after the surgery (complex lifetime daily self care). The patient also had no idea that they had a choice about whether they had to get the surgery or not or that there were other options. They asked about hospice and comfort care and I educated the patient within my nursing license and the nursing code of ethics. The patient requested a case management consult to visit with hospice to explore this option further in order to make a better decision for their course of care. I documented extensively for the doctor to read the next day and I also passed the info on to the next nurse taking over, emphasizing the importance of speaking with the doctor about the gross misunderstanding they had about the surgery. The doctor became enraged, threw a well witnessed tantrum in the nursing station, refused to let the patient visit with hospice, and insisted I be fired and my license taken. He was successful on all counts.
A very wise nurse once told me, “Put a dollar sign at the end of any question you have about hospital policy, and you will find your answer.” Truer words were ever spoken, especially in the case of Amanda Trujillo. Amanda’s only “crime” was affecting the hospital’s bottom line. The transplant surgeon lost out on a huge billable, threw a temper tantrum, and the hospital threw Amanda under the bus to appease the physician. Apparently Banner Health and their holier-than-thou surgeon don’t understand than patients have the right to know all their treatment options, and that nurses are mandated by our code of ethics to tell them the truth. Why isn’t Banner Health going after the doctor who threw his fit and refused to allow a patient to visit with hospice? Oh wait, I just need to look at that dollar sign at the end of my question. I’m sure it’s less expensive to provide comfort care to a dying patient than it is to perform surgery and put them through needless suffering. I guess they think that it’s more important to deplete a patient’s bank account than it is to give compassionate care.
Then comes the question about where the Arizona Nurses Association and the American Nurses Association stand in all of this. They stand in silence. I couldn’t understand why until I read this post written by Kim McAllister from Emergiblog. Kim wrote that Robin Schaeffer, MSN, RN, CNE, Executive Director of the Arizona Nurses Association is affiliated with Banner Health. No sir, no conflict of interest there. I thought nursing associations were supposed to represent, you know, nurses, not big business. The whole thing is so incestuous.
Now to add insult to injury, the Arizona BON postponed Amanda’s hearing for two months and ordered her to get a psychiatric evaluation. Why? Because she has the grit to fight back and tell her story on the Internet. If fighting for the right to practice nursing the right way makes you crazy, then we should all be so insane. I stand with Amanda Trujillo and I hope you do too.
Amanda Trujillo’s full story can be found at Vern Dutton’s website.
Please read The Persecution of Amanda Trujillo to learn more about this case.
Email the Executive Director of the Arizona State Board of Nursing, Joey Ridenour, RN, MN, FAAN: firstname.lastname@example.org