Standing with Amanda Trujillo

27Jan2012 Author: Mother Jones, RN

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.

Visit a Facebook page set up to support Amanda here.

Email the Executive Director of the Arizona State Board of Nursing, Joey Ridenour, RN, MN, FAAN: jridenour@azbn.gov

Complain to Banner Health here.

Tags: Amanda Trujillo, American Nurses Association, Arizona Nurses Association, Arizona Nursing Board, Banner Health, nurse

15 Responses to “Standing with Amanda Trujillo”

Carol Gino
January 27th, 2012 at 11:49 am
It’s Time. Nurses are grown up. WE deserve the respect and status that comes with our responsibility for being a nurse. If we didn’t know what we were doing, a doctor would never be called because you can’t say to a doctor, “there are funny lines on this monitor” you have to know what those funny lines mean. Nursing organization have just heaped more “requirements” on us, but not given us the support or the benefits we need to implement them. I believe Amanda did what many good nurses do in her situation. WE arm the patients with knowledge and give them a choice. That’s self determination. I hate what’s happened to Amanda, and I love how we’ve all come together to support her. Let’s not let this keep happening because we’re afraid of speaking up. Nurses have to have a voice in order for healthcare to have anything to do with healing.
The Angry Medic
January 27th, 2012 at 5:40 pm
I ain’t no nurse, but I read about this fiasco over at Emergiblog and my blood boiled enough for me to reach out for my valium. This makes about as much sense as Justin Bieber’s popularity (which is to say none, in case there are Beliebers about – STAY THE HELL AWAY FROM ME. Cough).

In other news, I’m real glad you’re still up and going Momma Jones. I was afraid you’d be gone. I’ll be back to stalk!
Kate Loving Shenk
January 27th, 2012 at 5:54 pm
Fighting back is exactly what we all need to do. Leadership is lacking in our profession. This is the perfect example of why that is.

The corporate takeover of our medicine, food, and much more is what the people of this country are dealing with everyday. Thanks to the occupy movement, fighting back is getting more commonplace. We will see much more of this.

Thank you for posting and sharing.
Greg Mercer, MSN
January 27th, 2012 at 7:22 pm
As I imagine it, Health Care is a HUGE pool, a full sixth of the US economy. It has millions of inhabitants, many of them powerless guppies (typical patients), lots of sharks (that would be corporations – people? No, I’d say sharks made up of lots of people), and lots of other fish of various sizes and dispositions – the care givers, mostly a loose confederation, schooling here and there for protection, doing their best for the guppies who visit this massive, scary, chaotic pool. Its not a ‘system’ in the usual sense – its an ecosystem, wild and dangerous, with predators and prey. Fish Amanda apparently, in the course of doing The Right Thing (always risky, always right) offended a slightly larger and more prestigious Surgeon fish. Perhaps resentful that the MBA-run Corporate Sharks increasingly run his life, waste his time, look down on him, make him dance for his supper more and more each day, like most Physicians these days. Feeling small and vulnerable, resentful, no longer the invincible giant he’d imagined himself, he lashes out at an easy/safe scapegoat – Amanda. Worse, he recruits a corporate Shark for his attack – he’s weakened, but not entirely powerless just yet. So begins another feeding frenzy, just like a nature show but metaphorical and human. Of course money’s a factor, it always is in this pool, but there is also ego, power, prestige, reputation, politics – ask any politician about ‘ObamaCare’, you’ll see what I mean – an irresistible chest of priceless treasures. The lesson here? We Nurse fish need to do more than complain – we need to learn to school better, to form our own Shark perhaps – without more power to defend our interests and those of our patients, some will continue to live, some will be devoured, and all will live in perpetual fear. This pool shows no sign of becoming any less scary any time soon – indeed, all signs point to nothing but more crowding, more ruthlessness, higher stakes. I’d suggest we hop to it and start seing to the big picture, instead of watching the Amandas of the pool get eaten in passive sorrow.
Marsha
January 28th, 2012 at 3:18 pm
Yes I agree the AZBON/Banner Health has gone too far in firing Amanda Trujillo and now threatening her license for empowering a patient to refuse painful and unnecessary surgery and make his own INFORMED choice of how to end his days. We need to support her and stand with her in this travesty of justice. We need to stand up for our profession. Thank you for posting this.
Greg Mercer, MSN
January 28th, 2012 at 6:22 pm
Thanks for your response – we have lots of enthusiasm and agreement on the internet, ut I fear by itself that might accomplish much on the ground – I still meet Nurses, non-SocMedia folks, there are many – who haven’t heard of this case, at all. Also, I fear a Banner Health or a BON might well be able to weather this kind of criticism.. That said, Nurse bloggers have built up an impressive and growing, very energetic committed group – now is the time to take a next step, bring our voices into the real world, not just the net. I have examples on my latest blog post from a great SocMedia book, Clay Shirky’s Here Comes Everybody: The Power of Organizing Without Organizations. We can plausibly, with no more effort than all this blogging requires, and very little need for much individual time or money, make a far greater impact on Amanda’s plight than we have so far – save her license, maybe even get an apology from Banner. Its alls at grchealthcareblog.com What might work, it turns out, it finding a cheap, convenient symbolic protest ‘gift’ to deliver via interent delivery of some sort to Banner and/or AZ BON. Some TV viewers not long ago spontaneously up and decided they wanted CBS not reverse its decision to cancel the show Jericho, they organized with simple SocMedia tools like we use, and with surprisingly little time, effort or cost convinced enough people to send protest peanuts (see the book or the blog, it makes sense with a little more detail) to CBS headquarters. They managed to send TWENTY TONS of people, one cheap little package at a time, flooded CBS with delivery people and reporters (what a story!), and they got their wish – show renewed. If they can do it for something so trivial, think what Nurses could do! Please asks folks for ideas – the gift/prop, the delivery method, the destination. When such ploys work , they work fast, and there have been many other examples. Let me know what you think
Tammy Swofford
January 30th, 2012 at 9:20 am
Each person has the right to determine the course of their care. And yes, nurse advocacy for patient rights is one of the tenets of our profession.

Tammy Swofford, R.N.
Greg Mercer, MSN
January 30th, 2012 at 9:57 am
A few of us have come up with a form of protest that may help Amanda’ cause. There are multiple posts on grchealthcareblog.com, a summary and others with background about successful uses of Social Media to achieve real world change. Details to follow, on blog and via Twitter @gregmercer1, and here if I can remember!
Aaron Tabacco, RN, BSN, PhD Student
January 30th, 2012 at 12:13 pm
Have you tried creating a petition through change.org?? I think they have been very successful on a number of issues. We must put national level pressure on both all parties involved to uncover justice here.
Jo
January 31st, 2012 at 2:12 pm
Dear MJ,

This story is disturbing. I wish I knew more details, but that would involve the patient’s private medical info. Informed consent is legal issue, as well as a medical one. Did the patient actually withdraw consent for a scheduled life-saving procedure, and if so, why? Did the patient say, “the nurse talked me out of it?” Was there something more going on with the patient than a knowledge deficit? Sounds like much more counseling was needed for the patient to even be able to give proper informed consent, and that should not fall to only one staff nurse and a case manager to provide. Hospice ends treatment, and if that’s what the patient wished, then of course it must be respected. But it’s just so extreme to fire a nurse and put her license in jeopardy, that it made me wonder if there was more to the story (??!)
Carol Gino
January 31st, 2012 at 2:49 pm
Have you never been threatened or chastised for making a nursing judgement because of the politics of the “business of medicine?” What more can there be and if there was why wouldn’t Banner or one of the nursing organizations make some kind of comment on it? Nurses have been at the bottom of the pecking order for as many years as I’ve been a nurse. Thing is that now they are increasing the requirements to become a nurse, and decreasing the support for nurses who practice what they’ve learned.
Dawn Lawson, RN, CCRN
February 1st, 2012 at 6:31 am
I would love to see each and every one of us send one of the patient education materials our hospitals provide us with to both Banner and the AZ BON all by Priority Mail so that someone has to sign for each and every package…I find it interesting how Banner not only got Amanda fired for Educating her patient, but that the AZ BON is actually holding up this statement by delaying the proceedings and hearing…maybe 30,000 pieces of patient education material (all hospital approved pamphlets or materials) sent individually, each requiring a signature from Banner CEO or AZ BON Members might remind them that Patient education isn’t just above and beyond what nurses do its required by employers and not something a fellow RN should be punished for!!
Kate Loving Shenk
February 1st, 2012 at 8:17 am
PS Whatever happened to the patient???
Mother Jones, RN
February 1st, 2012 at 8:40 am
I don’t know. Patient confidentiality, but I’m sure the outcome was not good given that the patient requested to talk to someone from hospice.
Del E. Webb Medical Center, Sun City Arizona AKA Banner Health Nurse Incident @BannerHealth – vdutton’s posterous | Nurse Up!
February 22nd, 2012 at 9:06 pm
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