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?