What the Amanda Trujillo Case Tells Me About Nurses Behaving Badly

Amanda Trujillo can take cold comfort that her situation is not unique. In the two years and odd months I have posted on this blog, I have written about six other cases where nurses (or nursing students) have been bullied and hounded:

• the nurse whose hospital fired her for mouthing off to the police

• the Seattle nurse who committed suicide after a fatal med error

• the nursing student expelled from her school for posting a photograph of a placenta on Facebook

• the Texas nurses arrested for reporting a physician’s negligence

• University of Manitoba nursing students victimized because nursing faculty failed to plan properly

• the two Nevada nurses fired and under police investigation for whistle-blowing faulty equipment

Some of these incidents have been resolved. The near-farcical case of the over-exposed placenta, for example, which featured an hysterical nursing program administrator and a blistering court judgment, had a satisfactory outcome resulting in the vindication of the victim. Others, like the Nevada nurses, are in progress. And some, tragically, will never be concluded.

The common thread from all of these cases is they prominently feature nurses behaving badly. Not just any nurse, not your run-of-the-mill front line nurse, but nurses in management or leadership positions.

It’s worth repeating that it is not “Banner Health” or the “hospital” behaving badly. Saying “Banner Health fired Amanda Trujillo” is a  convenient way of avoiding the unpleasant truth that it is nurses making these horrifically bad decisions, at least in the initial stages. These are nurses acting in ways that are contrary to what most nurses understand as ethical and reasonable professional behaviour.

Amanda Trujillo’s nursing director, when confronted by an angry physician, thought it ethical and reasonable and professional to behave in such a way that any objective reading would perceive as bullying and intimidating. She decided to magnify this bullying behaviour by first firing Trujillo and then reporting her to the state board of nursing. The Arizona State Board of Nursing compounded the bullying . They deemed “retaliatory” counter-complaints Trujillo made against her managers without examining the context of the original complaint, and then by deciding to label her crazy by ordering a psychiatric evaluation.  And the Arizona Nurses Association, which apparently has links to senior management at Banner Health, finds itself unable to defend a victimized nurse, even though it supposedly “supports nurses professional responsibility to advocate on their own behalf just as they advocate on behalf of their patients.” More nurses behaving, not as nurses, but as school-yard louts.

In the world where I practice, and where I think the vast majority of nurses practice, this behaviour is despicable. It is outside the norms of professional ethics. I cannot conceive of any situation or circumstance where bullying and harassment can be justified in a nursing context.

Yet there it is. We can talk endlessly about power dynamics or hostile work environments or violence in the nursing profession, but in the end, it is wrong. We all know it.

I am fortunate in having an excellent nurse manager, and I personally and through social media know many, many nurse managers — leaders, really — who to my mind exemplify the nursing ideal: compassion, empathy, insight, critical thinking, ethical practice. Yet it is evident, that for some nurses, ascension into what we commonly think as leadership positions is seen as a licence to act like gaping assholes, and bully any underling nurse that comes in their path. Their behaviour is not nursing. It is the antithesis of everything that nursing stands for. It’s toxic, and it eats away at nursing like a carcinoma. We need to call out these nurses on their bad behaviour. It looks like in this case we are.

But it is to these nurses I want to address the thrust of this post. Leadership or management means that you must act with compassion, empathy, insight, critical thinking, ethically. Period. It does not excuse you from any standards of nursing practice. If you find you are in an irredeemable conflict between your perceived duties as manager or leader, and being a compassionate, empathetic, insightful, critically thinking, ethical nurse I strongly urge you right now to resign your registration. You are not a nurse. Stop pretending to be one.

Because we need real nurses.

Because, frankly, you are a drag on the profession.