Why Nurses are Furious about the Amanda Trujillo Case

The case of Amanda Trujillo has generated a great deal of passionate commentary across the nursing blogosphere. Trujillo, as you may well know, is the nurse who was fired by Banner Health Del E. Webb Medical Center for requesting multi-disciplinary hospice care case management consult for a pre-transplant patient with end-stage liver disease. The request angered the patient’s physician — not the transplant surgeon, incidentally, nor someone with any knowledge of transplant surgery — who complained to Trujillo’s manager. After her termination, the hospital subsequently reported her to the Arizona State Board of Nursing for exceeding her scope of practice. If the Board finds against Trujillo, she may well face the loss of her license or other sanctions; in the event, her nursing career would be finished. Superficially, at least, an open and shut case, or least this is how Banner Health would like to project the controversy. Scratch the surface a little and matters change considerably.

So why are nurses so furious? Part of it is the apparent coincidence of any number of other, seemingly random bits of information outside the direct narrative of Trujillo’s story. The fact that the Arizona State Board of Nursing chose to deem Trujillo’s attempt to defend herself publicly as “retaliatory behavior”  just as her story was becoming part of the general conversation, and then ordered a psychiatric evaluation is one of those seemingly random bits. This struck me particularly. Suspicious minds might see a pattern to punish Trujillo for speaking up by publicly labelling her mentally disturbed (and in health care, as any nurse will tell you, acquiring that label is doubly damning.) For myself, I will be content to note that throughout history calling people crazy is a traditional means of discrediting those challenging authority and marginalizing dissent.

And there are other random bits: that the Arizona Board of Nursing (for example) chose to inform Trujillo’s doctoral program of the ongoing investigation just last week — some ten months after the initial complaint. The apparent close linkages between various facets of the nursing “leadership” in Arizona, which I am told is known as the “Circle of Death” for woe to any nurse who crosses it.  The secrecy, the opacity of all the institutional players, from Banner Health to the Arizona Nurses Association. The sense of arbitrary and coercive behaviour from any of these. Separately, they don’t amount to much — but together? Suspicious minds, as I said, begin to see patterns.

But there are far more substantive issues the firing of Trujillo raises. Take, for example, the matter how and why Trujllo was fired. From Trujillo’s account, it was arbitrary and unjust. Trujillo acted, she says, in good faith; her intent was to help the patient make an informed choice about his treatment options; she had made the same request for similar cases previously without consequence or objection; there was no hospital policy positively forbidding nurses to make this request. The only difference, it appears, was the physician’s annoyance, that as Trujillo’s manager put it, Trujillo had “messed up all of the work they had done, and that the doctors were nowhere near going down the hospice route.”

So there is this, a manager’s buckling under physician pressure, to do something about this turbulent nurse, a nurse who was trying to conscientiously to do her duty —-  which happened to conflict with the plans of the physician. But that is not even the really bad part. Let me put it in this way by citing an example that has weighty consequences for both nurse and patient. If nurse commits a serious medication error, best practice anywhere is for the hospital administration to do a root cause analysis. The purpose of this analysis is not to apportion blame, but to prevent the error from ever happening again. 

Once the root cause is determined, there might be changes to existing policies and procedures, and there might be education. Almost always, there is some sort of remediation of the nurse involved, because responsibility for a medication error is ultimately a shared responsibility from the nurse who administers the medication to the senior managers who are responsible for policies ensuring patient safety. For Trujillo, there was none of this — just security escorting her off the premises.

A reasoned, measured response to Trujillo’s actions, using root cause analysis, might suggest change and clarification of existing procedure for ordering case management consults. Instead, we have a nurse whose offence is so grievous that the hospital chose to fire her and then report her to the state Board of Nursing. To put it another way, even if Trujillo was completely in error in her interaction with this patient, and exceeded her scope of practice, what exact demonstrable harm was done to the patient?

I am puzzled why a clerical error — which I think is the worst possible cast one could put on Trujillo’s actions — merits termination and Board of Nursing discipline, while a serious medication error generally would not. It’s the gross inequity of outcomes which is so troublesome. Please note, in this context, nurses are generally fired and reported to regulatory bodies when there is concern they are a danger to the public.

So you have to ask yourself this simple question: even if you accept Trujillo exceeded her scope of practice, was firing her and then reporting her to the Board of Nursing proportionate to the supposed misdemeanour? Acting rashly, inequitably, without reason, and disproportionately, to my way of thinking anyway, is central to any definition of arbitrary and unjust behaviour.

We are also angry that Trujillo apparently was penalized for acting as her patient’s advocate and for attempting to ensure her patient could act with autonomy. This has serious implications for all nurses, because hobbling any nurse’s ability to act as advocate seriously jeopardizes patient care and safety. But first, the word “advocate” has been bandied about so much I want to inject a little clarity as to what exactly nurse-as-advocate means in the context of end-of-life care. This is what my own regulatory body, the College of Nurses of Ontario, says:

Nurses advocate for their clients and help implement their treatment and end-of-life care wishes. However, a client’s request to receive a treatment does not automatically bring with it the obligation for the nurse to provide the treatment.  A nurse is not obligated to implement a client’s treatment wish if it has been determined that the treatment will not benefit the client and is therefore not a part of the plan of care.

The College — no slouches in the matter of nursing ethics, by the way — goes on to tell us that that nurses act as advocates by ensuring patients have informed consent when implementing multidisciplinary care plans and by (says the College)

acting on behalf of the client to help clarify the plans for treatment when:

  • the client’s condition has changed and it may be necessary to modify a previous decision;
  • the nurse is concerned the client may not have been informed of all elements in the plan of treatment, including the provision or withholding of treatment;
  • the nurse disagrees with the physician’s plan of treatment; and
  • the client’s family disagrees with the client’s expressed treatment wishes

I think this is fairly standard nursing practice anywhere, and how all of us understand advocacy, whatever the stage of life. It is needful to point out the College phrases its language as nurses “must” not “may.” In other words, advocacy is not optional part of nursing practice. And what about patient autonomy? One of the four pillars of health care ethics, patient autonomy is the right of all patients to make informed decisions about their care and treatment, and necessarily implies outcomes matter most importantly for the patient, not the health care team. Nurse advocacy, it hardly needs to be said, is an important part of ensuring a patient can act an informed autonomous way.

So we have a situation where Trujillo was practising under universally accepted nursing standards, using the nursing process and nursing judgement, made a nursing assessment, educated her patient, in order that the patient could make an informed decision about his treatment options; in short, she acted to preserve her patient’s autonomy, and then was punished in the worst possible way for her attempts to be, well, a good nurse. Here’s her account, drawn from her lawyer’s representation to the Arizona Board of Nursing:

Having assessed the knowledge deficit related to the patient’s routine medications, disease process, associated tests and procedures, the plan of care for transplant evaluation and palliative care options, Ms. Trujillo proceeded to print out patient educational material from Banner’s website that addressed those areas. . .  Ms. Trujillo also provided materials related to hospice care per the patient’s request. Ms. Trujillo, concerned about the patient’s lack of understanding of (pts) treatment regimen and the option for comfort care, discussed her education of the patient with her clinical manager, Frances Fausto, who readily supported Ms. Trujillo’s plan of care and interventions. . .

Ms. Trujillo and the patient reviewed the materials over the course of the night.  After a full review of the materials the patient stated, “Had I known everything I would have to go through and the commitment I would have to make, I would not have agreed to the transplant evaluation.” The patient inquired into whether there was anything else (pt) could do besides enduring more tests, procedures or surgeries. Ms.Trujillo then explained hospice care services and the differences between symptom relief care and end of life care. The patient expressed serious concern that (pt) would not be able to commit to an extensive aftercare regimen following the transplant by stating “at this stage in (pts) life (pt) just wanted to be around family.” The patient requested to visit with a representative from hospice in order to ask some questions and gain additional information that would assist (pt) in making a more informed decision regarding (pts) course of care.

Ms. Trujillo placed a note in the chart pertaining to the assessment of knowledge deficit, the specific education provided and the palliative care discussion, in addition to, the patient’s request to see a case manager from hospice. She used the SBAR (Situation, Background, Assessment and Recommendation) format of report required in Banner policy when she handed off care of the patient to the dayshift nurse, alerting the nurse that the patient requested more information prior to being transferred to another facility for a transplant evaluation.  She also alerted the dayshift nurse that there was a nursing note in the record for the doctor to read that detailed what occurred over the course of Ms. Trujillo’s shift with the patient.

I am not seeing a lot of daylight between a world-respected professional regulatory body’s standards of nursing practice and Trujillo’s actions. I personally would do no different. Which brings us to the exact point of what disturbs and angers so many nurses: when hospitals run roughshod over a nurse’s professional and ethical judgement, when they refuse to acknowledge a nurse’s central ethical duty to sustain patient autonomy, there does not seem to be any point to acting as a professionals at all. Or maybe, that’s the real message hospital corporations want to send: that front line nurses aren’t really professionals, and larger questions of ethics and patient care are better left to higher beings — physicians, corporate managers and our nursing “leadership.”

This is why we are passionate about Amanda Trujillo. This is why we are so angry. The issues raised by the Trujillo case affect each of us, because this is how we practice nursing. By keeping patients — their wants, desires, needs, autonomy — front and centre.

Advocates for Amanda Trujillo — and I include myself in that number — have been criticized for jumping the gun, for not waiting for the other side of the story, for surely Banner Health and all the rest will have their speak. I concede the point. I accept I may be wrong. Not all facts are apparent, and some will never come out. (By the same token I am not clear what further details are needed to come out in order to form a reasonable conclusion about the situation. This isn’t the Pentagon Papers, or use a more modern reference, a WikiLeaks cache dump.) My sense of the situation, however, is that Amanda Trujillo’s position is far nearer the truth.

I say this not because of the documentation, or because I have spoken to Trujillo about her case (and five minutes on the phone with was enough to convince me of her utter veracity), or because she makes herself readily available to her supporters — she spoke with me for over an hour last evening despite an exhausting day, and was able to answer with clarity some very probing questions —  but because, sadly, her case follows the same pattern of abuse we have seen in other cases almost too numerous to count: arbitrary and vengeful behaviour from health care corporations, official investigations, attempts to discredit nurses and nursing and after a long time and huge financial and personal cost to nurse involved, vindication. And this is what frightens so many nurses: what happened to Trujillo and all the rest can easily happen to any of  us, and in the process, chip away at our collective professional integrity. So a lot of us in the nursing blogosphere and through social media are determined to hold the feet of Banner Health, the Arizona Board of Nursing and all the rest to the fire. The fact so many of us are so vehemently engaged in this issue speaks volumes about our determination to uphold the integrity of our beloved profession.

, , , , , , , , , ,

  1. #1 by Jessica Ellis on Tuesday 07 February 2012 - 1317

    Spot ON. Couldn’t agree more. One of the main reasons why most of us nurses believe Amanda’s side of the story without having to have “facts” from the opposing sides is that we’ve all been in very similar circumstances…where we felt our employment, at the minimum, was endangered based on the attitudes and demands of physicians.

    We KNOW, at the core, that these things happen frequently…not as publicly…but they happen. So sick of it, and I see this as an opportunity to not only support one of our own, but to stand up for the legitimacy of our professional practice.

    • #2 by torontoemerg on Tuesday 07 February 2012 - 1325

      I see this as an opportunity to not only support one of our own, but to stand up for the legitimacy of our professional practice.

      Exactly. I know from speaking with Amanda, this is her goal too.

      • #3 by Discreditted by Many on Tuesday 21 May 2013 - 0954

        My case in Pennsylvania is similar. The Board in their infinite wisdom feel I have overstepped my boundaries by exercising my Civil Rights. I am not saying everyone is corrupt. I encourage Nurses everywhere to speak up if you are affected.
        My “Board” wants a Mental and Physical Evaluation at my expense. I was told, “I would never work in Healthcare again” by numerous sources. Do as you are told, not what is truly right.

  2. #4 by sallie on Tuesday 07 February 2012 - 1326

    Great post. The psychiatric evaluation piece does smack of a Gulag political repression tactic. Hopefully, the AZ Board of Nursing will get all the facts, support a nurses duty of patient education and patient advocacy, and make the right decision sooner rather than later.

    • #5 by J Doe on Tuesday 07 February 2012 - 1351

      Well, from what I have heard by-the-by, I don’t have a great deal of faith that the AZBoN will act appropriately. But that bridge will be crossed soon enough.

  3. #6 by gregmercer601 on Tuesday 07 February 2012 - 1502

    I can certainly sympathize to some extent with those who have criticized Amanda’s defenders: we lack all the facts, and transparency would have obvious advantages. That said, the critics whose work I have perused came to their own strong conclusions, with on average less humility than the Nurse blogs I have followed, and based on what seems a less thorough grasp of available information – in short, self-serving and hypocritical arguments that seriously undermine the positions they have taken. I have seen the argument, for example, that because a Surgeon is expected by professional standards to provide adequate informed consent, that we should assume that it happened in this case – nonsense to anyone willing and capable of anything approaching realistic, unbiased, and critical thinking. We might just as well assume people never break the law, simply because laws exist.
    The tacit but common assumptions I have encountered, that Surgeons or any other physicians enjoy, somehow, immunity to conflicts of interest and other human temptations like ego, power, and greed, strike me as either equally grandiose and delusional if honest, or otherwise dishonest, hypocritical and self-serving. In any case, I have seen critics offer absurdly weak arguments in this matter, of which this one is but one example. Such clearly sloppy reasoning reflects poorly on them at many levels.
    Nurses, patients, and other concerned citizens simply cannot afford to wait for all the facts to come out, as there is no reason to think that such an outcome will ever fully occur, because it is much more difficult to remedy a poor decision already made than it is to influence one that may yet occur, and because those who set such a standard do not in general seem to making it in good faith, reaching a minimal level of intellectual clarity, and/or with clear and untenable bias. Any professional should aim for a higher standard, especially when demanding unfettered and unmonitored autonomy of a democratic society. With privileges come responsibilities – fail to meet such standards, and society will inevitably dismantle the privileges over time, as happens to have been steadily occurring in recent years.

  4. #7 by Lucien de Beer on Tuesday 07 February 2012 - 1522

    Has anyone started a defence fund for her? or simply a ‘salary” fund?
    Is there anyway one can contribute some monies to her for her legal fees?

    • #8 by gregmercer601 on Tuesday 07 February 2012 - 1607

      I prefer not just to play the game we are presented, in which the rules are stacked against us, the necessary connections and inside information that permit success withheld and hidden. Instead, lets start a new game, the new Social Media advocacy game, the same stuff that made mighty Koman cave in days under the weight of a largely spontaneous, disorganized, entirely brand new group of people. A much smaller wave of influence could promptly resolve Amand’a problems just as decisively. Given options A and B by the traditional powers, I say let’s create option C! Let’s organize ourselves a new force, a new power center in health care! We can move mountains if we unite, organize, and use the tools we have been given to full effect – Others all over the world have already started and succeeded by now. What are we waiting for – Let’s do it now!

    • #9 by The Nerdy Nurse on Tuesday 07 February 2012 - 1618

      Yes, we have!

      You can contribute directly via the FundRazr http://goo.gl/NwERj

    • #10 by Andrew Lopez, RN on Tuesday 07 February 2012 - 1820

      Hello Lucien,

      Thank you for asking and posting a comment.

      On http://www.nursefriendly.com/amanda/

      there are links to both a petition to have the investigation dropped, and a fundraising link where you can donate to her legal defense fund.

      Any questions, drop us a line. We have links to #nurseup and #amandatrujillo on the page also so you can catch the latest updates.

      Best wishes,

      Andrew Lopez, RN

  5. #11 by gregmercer601 on Tuesday 07 February 2012 - 1608

    Interested? Make a difference with this case: we can most certainly influence the outcome in a positive way. Its easy to join and participate, you don’t even need to leave home. Details:
    Join now!

  6. #12 by Anonymous on Tuesday 07 February 2012 - 1618

    The more pertinent question, really, is this: why are so many people NOT yet furious about this case? So many times in recent years, various Powers have tried to hide behind arguments like “You can trust us,” “the situation requires secrecy,” ” our critics are too ignorant to understand what we’re doing,” ” everyone should respect official channels,” and on and on. So many times, when facts come to light against such Power’s best efforts, it turns out all that secrecy served the Power more than anyone else – hiding sloppy practices, poor judgement, errors, corruption – potent motives, as so frequent in human history, to hide from public scrutiny. What makes Banner Health Corp. or the AZ BON so immune from such transparency, especially in light of the obvious desire for transparency on the part of the party they claim so piously to be protecting (simultaneously punishing her for eliminating their ability to keep this episode secret)? Bland general press releases hardly answer this argument – they only bolster it.

    • #13 by J Doe on Tuesday 07 February 2012 - 1851

      I think in part because many nurses — I won’t hazard a percentage — are simply apathetic. Or smug. Or have the attitude of “I’m all right Jack,” Or think change is impossible. The lesson of activism is we’re always ahead of the crowd, and that prophets aren’t liked that much.

      • #14 by Greg Mercer, MSN on Tuesday 07 February 2012 - 1959

        I fully agree, but I try not to judge – I’ve spent much of my career in that place – fatigue, distraction, stress and learned helplessness can beat anyone down. The exciting thing, for me, about this is that Social MEdia changes the whole playing field – we can connect and organize with no geographic limits or cost, and we have much great ability to exert real world influence as never possible before.
        Which just have to sell that truth to enough folks, get them just a teeny bit involved – that’s all it takes for most people, a click here and a letter there, easy stuff but powerful in aggregate. Our pool of prospects is massive – 3 million RNs in America alone, and patients, families, friends, others – who doesn’t want a better health care system?

      • #15 by Andrew Lopez on Friday 27 April 2012 - 1802

        I would venture Jay, that most don’t know about about the Amanda Trujillo, MSN, RN & Banner Health Del E. Webb Medical Center situation. We are working feverishly to rectify that for National Nurses Week :)

  7. #16 by The Nerdy Nurse on Tuesday 07 February 2012 - 1644

    This is beautifully written and speaks to the core of what Amanda’s story is so powerful and impacting to nurses. She is the every nurse.
    The outcomes of this will no doubt impact how we are seen as professionals.

    This does make you question whether or not hospitals want us to be professional or merely robots who do as we are told. It certainly is easier when you speak only when spoken to and don’t question orders or authority.

    Being an advocate is difficult, and many nurses shy from this role, which is unfortunate and detrimental to patient care. If Banner Health is successful in silencing Ms. Trujillo, they will be successful in continuing to promote a culture of fear among nurses which will most certainly threaten not only the autonomy, but also the safety of patients in their facilities.

    The tangled web of politics of the healthcare of Arizona is scary for the patients and nurses who are involved. I wonder just how deep this rabbit hole goes.

  8. #17 by Norman on Tuesday 07 February 2012 - 2148

    Trujillo is not “every nurse,” as has been alleged, she is Ms. Trujillo. If anyone can truly “spend 5 minutes” on the phone with someone and know they are telling the truth I can only hope you don’t work in an ER surrounded by drug seekers.
    This story smacks of propaganda put in place by a “willing victim,” Trujillo, and an echo-chamber of electronic writers who are pushing the story about “employer abuse,” and a “culture of fear” for one reason only. Let’s face facts, whether guilty or innocent, Trujillo will never work as an RN in Arizona again, she’s radioactive, and if she is truly in a DNSc programme she has to, on some level, be marginally intelligent enough to realize that. She’s not going to be rehired by her employer and no one else would touch her, an a bedside RN, or as an ARNP.
    We’re therefore left with only one option, and the most likely outcome of this entire episode of the awful use of social media to gang-up on one side of the story, dismissing any other POV, is that Trujillo is being used by a pawn of a willing movement of online activists and other forces to be the face of unionization. She’s a female hispanic in a growing field and will soon become the poster-child of “employer abuse” and “culture of fear” that the forces of unionization only pray come along every 20 years, and whose arguments have been tested by online activists for weeks now.

    • #18 by Greg Mercer, MSN on Tuesday 07 February 2012 - 2213

      Such anger – have we really come to a place where nothing anyone says or does can ever be taken at face value, even tentatively? It has surprised me just how many total strangers at first glance know what various bloggers have done for background research on a given topic, all their secret motives, and all the reasons why no one should make a decision or take a side in anything until they have been granted permission. I can understand disagreeing, even with heat and passions – that’s healthy and necessary for any democracy. What I fail to understand is any attack on others’ character and motives based on pure speculation – not surmises but limited data, but instead simply offering as fact whatever plausible story jumps to mind.
      Why should anyone listen to anyone else making a hasty, judgmental, and cynical rant about how irritated they are with all these hasty, judgmental, and cynical rants? Why is it so offensive for people to have opinions and express them? I doubt anyone feels forced to read fairly obscure specialty blogs – they’re hardly etched inside anyone’s eyeballs, are they? Why can’t we save our anger and offense for substantive matters, instead of sniping over relative trivia? Our media options are virtually infinite these days – if people feel the need to avoid exposure to anything they disagree with, it can be arranged. They can safely and comfortably avoid learning anything new or taking even any trivial risk with their thin skin, ever again. Would that be desirable? Sounds like a private Hell or self-imposed exile to me, but it might be a nice respite at times for the neighbors.

    • #19 by The Nerdy Nurse on Tuesday 07 February 2012 - 2231

      wow… honestly, I hadn’t thought anything about unions. Good to know that others know my intentions better than I do.

      We can’t be advocating for Amanda and for our profession because we are passionate about nursing and advocacy? Nah. We’ve all got to have a political dog in the fight.

      Thanks for enlightening me on why I choose to write about Amanda.

      • #20 by Greg Mercer, MSN on Tuesday 07 February 2012 - 2240

        I can’t say I respect the hate much, but I do like to see it – backlash in any struggle means you’re being heard, yes? And you’re getting through enough to elicit such a passionate response as that – good sign indeed, thanks Norman for some inspiration.

    • #21 by J Doe on Tuesday 07 February 2012 - 2232

      Well, if I can tell your having a STEMI by looking at you for five minutes at triage, I should have this one nailed.

      Seriously though, if you want to have a serious discussion, don’t start by insulting me, then launching into a bizarre conspiracy theory about unionization. This is so silly that you talking about black helicopters and tin foil hats at the same time would raise your credibility.

      On the other hand, CONGRATULATIONS! You are my very first troll. Thank you!

  9. #23 by Greg Mercer, MSN on Tuesday 07 February 2012 - 2236

    Also, for clarification and I can hardly speak for anyone else – I have never been involved with any labor union, and have no plans for such. Labor unions in health care, for me, are a mixed bag, and risk introducing yet another layer of money and power to further distort clinical practice. I would just as soon have money and clinical practice completely divorced, if such were at all possible or practical: I do not offer support to anyone seeking to add yet more voices trying to milk the giant cash cow that is health care. I am interested in improving the system if at all possible, not suck its blood, and it dismays me just how many people seem unwilling to offer a friendly stranger the benefit of the doubt, even cautiously. I’ve never lived in a particularly opulent fashion working as a Nurse, and I would have a difficult time learning how to if I could – its never been much of a priority. I dropped out of medical school with excellent (90+ percentile Nationally on 2nd year Boards) prospects, into near-volunteer Group Home work, the into Nursing and now into academics. I’ve never made a “pawn” out of anyone, and I sell power, hope, engagement, and the ability to make a positive difference with work, smarts and some luck. I’d appreciate saving us all the wild speculation about cultures of fear and secret union meetings, demands we accept just how darn hopeless another “radioactive” (nice) human being’s situation is, and demands we leave her to her own devices lest we offer others offense.
    I can see where talk of management, abuses of power and civil rights might be construed to hint at unionization – maybe a union is plotting inAZ right now, I wouldn’t know – but I cannot effectively reason with people who seem willing to confidently assume I am saying what I have never said, out of motives I have never had, on behalf of allies I have never met. Outside of a clinical context, I have little interest in serious debate with someone having a simultaneous conversation with voices in his head, of a sort, including my own voice: fictionalized and distorted to include motives I do not have. Life is too short, and there is too much to do, to waste too much time on screechy background noise.

  10. #24 by Jennifer Olin, RN on Tuesday 07 February 2012 - 2245

    I must say I am behind Amanda Trujillo and I really don’t like unions. I am from Texas, a right-to-work state and I will live and die by that right. I was forced in a previous career to belong to a union and I resented every minute and dollar of it. I love being a nurse; I have seen nonsense like what happened to Trujillo, although never taken this far, and I think it stinks of bullying and bad behavior on the parts of the physician, nursing management and administration at Banner Health.

  11. #25 by sallie on Tuesday 07 February 2012 - 2303

    AT put herself in the bullseye (and no matter how you see her, that took courage). Too often in nursing we are expected to be good (quiet) girls (and boys) and not stand up for ourselves. Not a union fan, but in ATs case there would have been at least a modicum of protection and support for her on-the-job. It’s obvious she can’t expect any support from nursing organizations.

    Although I don’t agree with all ATs tactics (or tweets and posts), accused people have the right to advocate for and defend themselves. It’s been ten months since the incident, how long should she have to wait for a resolution from the AZBoN? I wonder if this delay is due to the quasi-incestuous relationships between Banner Health, AZBoN, and the AZNA (so many Banner Health employees in AZNA leadership positions and AZNA working on legislation to reauthorize AZBoN).

    Nurses have the duty to provide patient education and patient advocacy even if you work in a hospital..

    • #26 by Amanda Trujillo on Wednesday 08 February 2012 - 0606

      Hi Sally, thank you so much for your feedback, what is your twitter handle?

      • #27 by Volunteer Nurse Advocate on Friday 17 February 2012 - 1912

        Amanda, I know of a gastroenterologist who also had a run in with a nurse then moved to Arizona. There is nothing in his record because the record was sealed. Can you at least post some initials?

  12. #28 by Lynda Thomas-Shell on Wednesday 08 February 2012 - 0224

    Amanda, you are in my thoughts and Prayers. I could not imagine what you are going though right now.

  13. #29 by Wander on Wednesday 08 February 2012 - 0255

    Amanda is why you need a union, nurses. Otherwise, the Banners of the world will always abuse the power, define the terms of engagement, and win.

  14. #30 by midwest woman on Wednesday 08 February 2012 - 0805

    Bank Of America’s charging 3 bucks for each debit card use, Verizon’s surcharge for paying online……all were reversed through intense social media outburst.
    If I felt had been unfairly fired with my liscence on the line with added insult of a psych eval, I sure as hell would have used the same outlets.
    Unfortunately, even if AzBON rules in her favor, I’m not naive enough to believe it will probably impact her ability to get a job.
    I also don’t think this one case will be enough to change the culture of dispensable nurses.
    In my state, the BON strikes me as a group of anal retentive ivory tower folks who learned sbout bedside nursing from the books and have never been in the trenches.
    I am glad this came to light and people are discussing but am just not optimistic that true change will come.

    • #31 by Greg Mercer on Wednesday 08 February 2012 - 1451

      The way I see it, possibly because I know basically nothing about any BON, let alone AZ’s, whomever has power, or wealth, or prestige, or something valuable to lose in any form, is likely to be very careful, deliberate, cautious. If you drive a $60,000 car, you generally drive much more timidly than do folks like me in a used Civic. Little people have more to gain and less to lose: thus more decisive and bold. With Social Media, we little people can at times raise a voice the old school powers will heed, without gaining (alas) the wealth, prestige etc. or all the baggage that goes with it.

  15. #32 by CC on Wednesday 08 February 2012 - 1606

    What is so bad about unions? In Canada there are Nurses Unions in every province that steps up to protect nurses in cases like this……our professional body which is seperate exists to protect the public – not the nurse.

    I would hope that the investigating body of the professional side would take all FACTS into consideration and would go on that, rather than some suspect complaint by an MD and subsequent cowering butt-covering by the hospital.

    In Canada, MDs have what is called “hospital privileges” and are not the “moneymakers” and so wouldn’t have quite the clout that an American MD would have in the system south of the border. That isn’t to say that an MD up here couldn’t wreak havoc with a nurses’ career if he chose to……It just wouldn’t – hopefully – get as far (hopefully we have learned from the Susan Nelles situation).

    My sister and husband are soon moving to AZ and I will warn them in advance of the Banner hospital system – to stay away. I have also sent a comment/complaint on the Banner system. I am also planning on making a donation to the defense fund of Amanda Trujillo (interestingly enough, same last name as my mother-in-law) because no nurse should ever have to suffer through this…..and it COULD happen to any one of us.

    Having worked in the USA, I have seen first hand what sort of system that depends on making money can do to harm their patients. I would say that Amanda SAVED the hospital from possible lawsuit resulting from needless surgery.

    • #33 by Wander on Wednesday 08 February 2012 - 1902

      Yes, what’s wrong with unions? If there were a nurses union where Amanda worked, she never would have been fired. There’s no way a public school teacher, cop, firefighter or prison guard would be treated the way she was. Why? Because with unionized employees who have reps to defend them, management cannot get away with colluding with big shots and favored service providers.

      • #34 by Greg Mercer on Wednesday 08 February 2012 - 2242

        To clarify, I do not argue against unions in general and recognize thier value. I argue against polarized, black and white absolutes of all kinds. No human organization has all benefits and no side effect risk, and having a functioning union is a very different prospect than trying to unionize. Current regulations and politics make unionizing complex and costly, and employers often manage to prevent unions from moving in at all. It is no coincidence that American union membership has declined for decades – the rules of the game have shifted. Also , Unions can be used to protect bad apples or forstall reform.
        My main priority with unions is not to permit efforts to address Nursing professional & civil rights advocacy in other ways be confused with a union drive. I lack the time and commitment to become any sort of union rep, and want to focus my limited resources on a project I can manage – hence my emphasis on Social Media advocacy as an alternative strategy. I’m interesting in doing something myself or with others, creating something, more than in discussing what ‘somebody’ should do. Unionization is not a project within my means.

  16. #35 by J Doe on Wednesday 08 February 2012 - 2241

    I think the last few comments have illuminated the elephant, or rather couple of elephants in the room. The first elephant is the cultural thing that nurses should throw their careers away and go gently (and quietly) in to the good night when confronted with allegations such as those facing Trujillo. Hence the reaction of some nurses — and all of the glorious leadership contained within the ANA and AzNA — that we should “trust the process,” a ludicrous notion when our collective experience tells us otherwise, that the “process” is stacked against the frontline nurse on every level.

    The second elephant is: who actually unequivocally represents front line nurses? Who can act as advocate for someone like Trujillo? Clearly, it is not the so-called professional associations like the ANA. In the present climate in the U.S., “union” is a dirty word, and there are many nurses who believe rugged individualism (or something) will save their silly asses when dealing with a billion dollar behemoth like Banner Health, and the same behemoth will always act honourably and fairly.

    I’ve had the experience of working in a non-unionized workplace in the U..S. and unionized workplaces in Canada (which for nurses are the vast majority), and I will tell you baldly that I will take the unionized hospitals without a second thought. Maybe this is what is so galling about Trujillo’s situation — Wander is quite right — in a unionized workplace, her firing would have never happened and is almost unthinkable.

    This comment will no doubt inflame our resident Troll. :)

  17. #36 by RN to MD on Wednesday 08 February 2012 - 2348

    Question is “Why are nurses furious with the Trujillo case?” One reason being is she stepped out of her scope of practice. Another reason is she didn’t advocate for the patient as best as she could as a nurse. And also, she tore apart the treatment plan that the healthcare team seems to have been working very hard on. She should have FIRST consulted with the attending, the surgeon, and other doctors on the case regarding the patient’s lack of confidence with the surgery or treatment plan. Due to the lack of details of the patient’s case, this “major invasive surgery,” as Trujillo quoted, could also have been life-changing for the patient! Liver transplants have a high success rate! Trujillo should have been a better patient advocate, become a good liaison to her team members and involve the physicians in the plan to question hospice. Trujillo should’ve called the surgeon right away BEFORE calling a hospice consult (which she had without an order) and inform the surgeon and simply say, “Hey Doc! This patient needs more information from you, can you come over and explain it to them?” Maybe the patient just needed reassurance from the surgeon or maybe not. Who knows the actual details, but don’t just rip apart the team’s plan of care without consulting anybody about it. You can’t just call case management and tell them the patient needs hospice without consulting the physician or without an order. This wasn’t her decision and it wasn’t her right to alter the plan of care behind the surgeons’ back…and this is what got her fired. Her nurse manager and hospital didn’t even support her. Why? Because she made a mistake. She enacted solely without discussing the issue with her team members. Her being fired could’ve been prevented if she had just stopped being so gung-ho with, “I’m an independent nurse who can make my own orders without the doctors’ knowledge” kind of attitude. Granted, she claims this is all about being there for her patient. It was nice that she acknowledged the patient’s concerns. However, her method of correcting the issue was wrong. So why are nurses so furious like I am about this case? Its making us look like we can’t critically think before we do something that can alter a patient’s life. I understand why the surgeon was so angry at Trujillo.

    • #37 by torontoemerg on Thursday 09 February 2012 - 0908

      A couple of points:

      1. The patient was for pre-transplant assessment, ie was not slated for transplant surgery. The physician who began all this was a gastroenterologist, not a surgeon.

      2. I think you are conflating two issues, first whether it is appropriate for a nurse to educate and advocate for her patient, and second, whether the request for a multidisciplinary team consult was beyond her scope of practice. As I suggest, nurses are obligated to advocate and educate their patients. It isn’t optional and is not physician dependent. As to the second, it seems you’re arguing semantics as this consult had previously between ordered by nursing staff without consequence.

  18. #38 by TS on Tuesday 14 February 2012 - 1713

    As RN to MD indicates, there is always more than one perspective on how to treat a situation and we can’t just blindly side with AT. I am a new RN and have much to learn both with nurisng application and surviving the hospital environment. While I don’t agree with all that RN to MD presumes, we can’t ignore that there is more to the picture. Why couldn’t the surgery evaluation and hospice consult be in place at the same time? The Board of Nursing is there to work through all perspectives. l live in Arizona and have sat as an audience member to the BON – I saw a wide range of rulings including cases being dismissed for lack of a case. The board appeared to take their work seriously asking pertinent questions and not making any decisions lightly. My point is that there are a lot more lighter rulings than can take place besides losing the license. Whether or not any ruling is warranted is another question. I don’t know all the facts and haven’t even read all AT’s information, but it does seem like there is a level of unprofessionalism, respect, and support and that is the part that scares us newbies who are definitely going through a learning curve. As a single mother, I totally understand the fear of losing a hard sought nursing license for something such as this issue and since no patient was harmed I want to believe that the BON will see revokation as the unnecessary extreme no matter what the circumstances.

    Other areas: why isn’t hospice (and there is a national assocation) in an uproar that nurses can’t call for a consult if criteria is met and patient desires (in other words who makes sure it is done), under what circumstances, if any, do the local and national nurses assocation get involved at the lower level, how can we speed up the process of getting a ruling from the BON, how do we ascertain that a patient has been given all options so that making an informed decision, under what circumstances do others need to be involved in the decision making, etc etc.

    When all is said and done, hopefully AT will find a RN career with a company that recognizes the situation as a gateway for positive learning for both health professionals and patient rights. After all, if front-line nurses are the last line of defense for patients then we should be allowed to act to that level (with realistic parameters of communication to weed out the mavericks). And that is only the tip of my rambling thoughts on this situation.

  19. #39 by motherjonesrn on Tuesday 14 February 2012 - 2145

    Hello TS. Thank you for your thoughtful comments. The fact is that more patient and bioethics organizations are commenting about Amanda’s situation as they learn about the case. I am hopeful that this case will shed light on what nurses must endure everyday, and that new legislation will be passed that will protect nurses from this type of abuse.

    To RN to MD: I can’t imagine calling a doctor in the middle of the night to get his or her approval to put in for a consult. I can hear the conversation now, “Hello Doctor, is it OK if I put in a consult for patient X? Yes, I know what time it is. CLICK!

    You said that there was a lack of communication, and I agree. The doctor could have called Amanda to see what happened before demanding her head of a silver platter. Amanda documented everything in the chart as a way of communicating with the treatment team. Your comments make it sound like the treatment team holds all the power in the situation and that Amanda messed things up. Need I remind you that the patient hold the ultimate power in his or her healthcare decisions.

  20. #40 by Denise on Monday 20 February 2012 - 2200

    According to hospice Medicare regulations, a patient is allowed to self refer for service. A patient can not be admitted to service without a signed physician’s order, but the referral for patient information can come from anybody including friends, relatives, nurses, CNAs, absolutely anybody. Under that reg she did nothing wrong.

  21. #41 by ellen-ottawa on Saturday 10 March 2012 - 1333

    It’s just just nurses & other medical professionals who are concerned. As a potential patient, I want nurses to be able to speak up for me, against anyone who thinks they know better than I do what is the best for ME. A nurse is much more likely to listen to me than a busy specialist or hospital administrator. Though I must say, I have not personally had a problem — y e t….

    • #42 by ellen-ottawa on Saturday 10 March 2012 - 1334

      I mean NOT JUST nurses……!

      • #43 by gregmercer601 on Saturday 10 March 2012 - 1952

        I turns out there are many factors in this case which all well-informed, reasonable people can agree on:
        1) Boards of Nursing (BONs) operate largely outside of public awareness, even with the the Nursing profession.
        2) They often consist of political appointees, as they do in Arizona, where they work and are budgeted within the Governor’s office.
        3) On examination of their rules, the AZ BON operates with very little accountability or transparency, and little or no protection against frivolous complaints filed to harass and/or defame Nurses.
        4) At least among the (nonrandom and unscientific, of course)sample I have surveyed, including many random strangers, there are many confident allegations that Banner HR practices are abusive and unethical, and include rampant misuse of BON complaints.
        5) In this case, there are multiple serious conflicts of interest between AZ BON and Banner Health: two Banner employees and a contractor doing much business with the company.
        6) The abuse and suppression of Nurses who offer education and advocacy directs attacks patient safety and encourages corruption, waste, and neglect of Informed Consent.
        7) Government officials who do nothing about such issues when informed of them, thereby aid and abet such corruption, and may even enter into an informal conspiracy when significant conflicts of interest are involved.

        Therefore, this cases is not just about one Nurse and her story – it is about corporate and government corruption, health care waste, and the abuse of Nurses and patients.

        In response to this corruption and the attack on Nurses’ ability to advocate and educate patients free of retaliation, we have put up a Change.org petition to boycott Arizona until we see some BON changes – please check it out & help us spread the word, next Hearing is 3/19 and AZBON reauthorization is still in the Legislature – we’re running out of time on this unusually opportune time for positive change.

        See http://www.change.org/petitions/governor-state-of-arizona-address-corrupting-factors-in-the-arizona-board-of-nursing




  22. #44 by Larry Waters on Monday 12 March 2012 - 1528

    I’m not a nurse, but I spent four years in and out hospitals helping to care for my father & mother at the end of their lives. I’ve seen how abusive some doctors can be, so I sent an e-mail to the Arizona Nursing Board:

    “To Whom It May Concern, Nurse Trujillo ought to be commended for putting her patient first and making sure she was fully informed about her options. If what she says is true, her actions were exemplarily, and the reaction of the physician and hospital reprehensible. I hope the Arizona Board Of Nursing will do the right thing and not only vindicate her, but stand with her publicly, so that her reputation is restored.”

    I would also like to say that I have encountered honest and compassionate physicians who made our difficult decisions easier and our lives richer.

    Larry Waters

    Here are some other useful contacts:

    Arizona State Board of Nursing
    4747 North 7th Street – Suite 200, Phoenix, AZ 85014
    602-771-7800 | 602-771-7888 Fax | arizona@azbn.gov

    Banner Del E. Webb Medical Center
    14502 W. Meeker Blvd. Sun City West, AZ 85375
    (623) 524-4000

  23. #45 by Veronica Mitchell on Tuesday 13 March 2012 - 0746

    While this is an appalling story I am sad to say that it does not surprise me. When push comes to shove between a nurse and a doc the nurse most often gets the shove. It seems to be a dirty little secret in our profession.
    I have a confession to make. I have been a CNO for 25 years. And folks, we get bullied too!
    I have often wished nurse execs would come clean about this. We are ok as long as we don’t rock the boat, or as one CEO put it– you are too “nursie

    • #46 by gregmercer601 on Tuesday 13 March 2012 - 1841

      Veronica, we could very much use your insights – please contact at grchealthcare@hotmail.com

      Nurses are smart, and tough: we can handle anything! Why should we lay down and take abuse, and let our patients take the same? If we decide otherwise, even a fraction of us, we become unstoppable: let’s get to work, now!

  24. #47 by Veronica Mitchell on Tuesday 13 March 2012 - 0803

    While this is an appalling story I am sad to say that it does not surprise me. When push comes to shove between a nurse and a doc the nurse most often gets the shove. It seems to be a dirty little secret in our profession.
    I have a confession to make. I have been a CNO for 25 years. And folks, we get bullied too!
    I have often wished nurse execs would come clean about this. We are ok as long as we don’t rock the boat, or as one CEO put it– you are too “nursie” and the docs don’t like it. Here is some news, nurse execs get fired a lot. They go quietly with signed contracts and hush money and have the same worries as any other member of a group that has been undeniably historically oppressed. It stinks!
    The literature as well as the media is rich with stories and research about the negative impact on patient care when excellent nursing practice is squelched.
    I wish I knew the answer. The problem is complex and pervasive and so solutions cannot be linear. Factor in economics, the docs bring patients to hospitals, and the dynamics become clear. Patients receive care from many providers when hospitalized. But the need for 24/7 care determines whether they are admitted or receive services in the community. Why this is not a huge societal DUH is beyond me.

    The ANA and orher organizations could start by eliminating such terms as “nursing workforce” as this language is anti professional.
    And lord knows we nurse execs could use some kind of structure where governing bodies provide support of our “authority”.

    • #48 by torontoemerg on Tuesday 13 March 2012 - 1028

      Thanks Veronica for these insights. I am sometimes (I think) to hard on nurse managers, not realizing they are subject to their own pressures. And you’re quite right about the complexity of the problem.

    • #49 by gregmercer601 on Tuesday 13 March 2012 - 1838

      Thanks for your support: we’re natural allies, so let’s help each other!
      Our movement aims to transcend geography, as we’re on-line, and to support ethical CNOs by increasing the public shame and cost of treating Nurses unfairly. We expect to make poor treatment of Nurses, anywhere in America, too risky and expensive to consider – some of the benefits of Unionization without all the baggage and regulations and geographical limitations. We take no unified stand on Unions, but act as a supplement and alternative. We plan to continue our grass-roots movement against government and corporate corruption, and for unfettered, unbiased education and advocacy by Nurses to protect patients and give them the care they deserve. Arizona is a test case – if we fail the forces of corruption and greed will take heart, but if we succeed we will have successfully drawn a line in the stand – no further! – from which we can push back against corrupt government and business forces for our health, care, and rights.
      Will Amanda’s legacy teach others to submit and take no risks for right?
      Or will her case, and Arizona, be remembered as a modern Lexington & Concord, the beginning of the end of tyranny?
      The answer, of course, is up to all of us: our actions, today and into the future, will shape the answer. Each of us has no choice to take a side: to do nothing is to support the status quo and worse.
      Unite and take action, we implore you!

  25. #50 by Anonymous on Wednesday 28 March 2012 - 0544

    I am in total agreement with Amanda. As a recently former employee of banner health ( I refuse to even acknowledge them as a proper noun) I was on the receiving end of endless harassment and was targeted for the sole purpose of a managers subjective opinion of me as a person. My performance was never an issue. The harassment got so bad that I had to make the choice to leave. I am not alone in this sentiment either. I know many former nurses from banner who faced similar treatment to what I had received. They promote a culture of not supporting their nurses. Finally this is being brought to light.

    • #51 by deepo on Sunday 26 August 2012 - 1830

      Know what you mean, happened to me. It’s like a high school clique. It’s not just nursing, either. People climbing over each other to get ahead. The honest guy loses.

  26. #52 by Andrew Lopez on Thursday 26 April 2012 - 0001

    Thank you Jay for following Amanda’s case, here is the latest.

    Red Flags & Questions I See in the Amanda Trujillo, ARNP Case, April 25, 2012 By Beth Boynton:”Amanda Trujillo is an ARNP yet was practicing as an RN. Now maybe there is a perfectly good explanation for this. Third shift is typically tough to staff and given our economy and the financial needs and family commitments, perhaps this was a perfect job opportunity for Amanda. But, honestly, I wonder why she wasn’t practicing as an ARNP rather than an RN? Scope of practice is an important issue in the case and quite different for RNs and ARNPs. Banner health could face serious liability issues if their RNs on duty are practicing out of scope.”

    More info: http://www.nurseup.com

  27. #53 by Andrew Lopez on Friday 27 April 2012 - 1803

    Thank you Jay for following Amanda’s case, here is the latest:

    The War Against Amanda Trujillo, April 25, 2012, Mother Jones, RN, Nurse Ratched’s Place:”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.”

    Kindly leave comments, encourage the bloggers supporting Amanda to keep on blogging!

  28. #54 by Andrew Lopez on Thursday 17 May 2012 - 1202

    Thank you Jay for following Amanda’s case, this is from her blog.

    The Moment of Impact: April 21, 2010: by #AmandaTrujillo, MSN, RN, #nurseup #nursefriendly #healthcare:”The day my life collided with something greater than I could ever wrap my head around in this lifetime…..I heard a quote recently that conveys the enormity of the year’s events…its message, perfection, but not in the way I would like to envision life perfected, the way I want it, the way I wanted it, the way I thought I had it…..in any case, I like this quote because it encompasses the past, the present, and the future all at once.”

    The day that changed Amanda’s life forever. To follow her case and others, kindly visit http://www.nurseup.com

  29. #55 by Andrew Lopez on Monday 21 May 2012 - 0957

    Thank you Jay for following Amanda’s case, this is from TruthAboutNursing.org

    Fired for educating a patient? TruthAboutNursing.org, May 2012:”On February 1, the Phoenix CBS affiliate KPHO-TV ran a short but good item by Peter Busch about veteran local nurse Amanda Trujillo, who said she had been fired by Banner Del Webb Hospital and had a complaint filed against her with the state board of nursing because she had educated a patient about the risks of an upcoming surgery and scheduled a consult about hospice. A hospital spokesman reportedly said that “the doctor, ultimately, is the focal point that directs care for patients” and that “company policy” forbids nurses to order a case management consult. The report does not mention other accounts suggesting that these events were set in motion because the patient’s surgeon was displeased that the patient had decided against the surgery.”

    For the latest, please visit: http://www.nurseup.com/

  30. #56 by Helen on Monday 02 July 2012 - 0010

    She clocked in thousands of hours as a nurse and this is all they could get on her? Where are the injured patients? There are none. The Board could suspend every license in the state if they wanted to using the nurse practice act. I don’t think Florence Nightingale herself could survive their scrutiny. They need to get real.

  31. #57 by marie on Friday 24 August 2012 - 1715

    LONG LIVE AMANDA TRUJILLO> America needs a modern day Nightingale like you. One who advocates for her patient’s rights. You are to be commended for your role as a poster child to what REAL nurses are to be; smart, independent and knowledgeable. I will keep you in my prayers. If you lose your license, it is the loss of the Nursing profession. Move to California, we need bright nurses like you.

  32. #58 by Angelica on Friday 21 September 2012 - 2157

    It’s a shame you don’t have a donate button! I’d most certainly donate to this fantastic blog! I suppose for now i’ll settle
    for bookmarking and adding your RSS feed to my Google account.
    I look forward to brand new updates and will talk about this site with my Facebook group.
    Chat soon!

  33. #59 by chris hobbes on Monday 26 November 2012 - 2141

    Amanda Trujillo

    To my village, today I lost my battle with the AZBON. I will be disciplined for educating a patient via the use of learning assessments, the nursing process, nursing diagnoses, and nursing care plan. I will be disciplined for obtaining a case management/social services consult for this patient. I will also be disciplined for bringing this case to the media because of the violation to the patient’s right to choose their own care. Arizona has just set a new precedence for the profession and hope you all are cautious from now on because not even strict adherence to what we learned in school and acting within your license or educational preparation will protect you from a corporation intent on taking you down for interfering with profitmaking. Please send prayers, I have spent every day of 2 years working on remaining faithful that “right” would come out on top and that “good” would win over “bad” and I am very disillusioned that all the hard work to do what was right and to make it better for other nurses after me was for nothing. Because, in the end, they can still do anything and everything they want to destroy a career and a mother.

  34. #60 by supplement on Saturday 25 January 2014 - 1554

    You have made some really good points there. I looked on the internet to
    learn more about the issue and found most individuals
    will go along with your views on this site.

  35. #61 by porno on Wednesday 28 May 2014 - 0053

    I do believe this is certainly one of many such a great deal substantial information for me. Exactly what satisfied examining a person’s report. However desire to statement upon many common difficulties, The site style is ideal, your content articles is within truth superb : N. Very good procedure, many thanks

  36. #62 by Susan on Monday 16 June 2014 - 1023

    Having been jerked around by a pre-admin nurse, after my doctor had done a truly life-saving job working on my emotional state prior to surgery, I can say that messing with a patient’s hope is a sorry, stupid,, negative, hostile, agenda-driven thing to do. It sounds to me that the furious doctor in the case this article is about had every right to, well, be furious. Just thought you geniuses might want a patient’s point of view.

  37. #63 by Scaricare Fifa 15 on Wednesday 24 September 2014 - 2015

    Hi! I could have sworn I’ve visited this website before but after browsing through some of the articles I realized it’s new to me.
    Anyhow, I’m certainly delighted I found it and I’ll be book-marking it and
    checking back regularly!

  38. #64 by Call of Duty Advanced Warfare Crack on Monday 20 October 2014 - 0709

    Wonderful, what a web site it is! This webpage gives useful
    data to us, keep it up.

  39. #65 by african fashion week on Wednesday 16 December 2015 - 1213

    Good short article man! Thank you for posting it! I’ll have a look at your other posts on the site, hope to see some more incredible content!

  40. #66 by Anonymous on Monday 18 January 2016 - 0014

    The BON eats its own! Had a license for 14 yrs., spotless- no complaints against me by facilities or patients. However, I failed to report a DUI to the board- and came under investigation in a state that I hadn’t ever practiced in. I was good at what I did; but they tried to find as much evidence as they could- to bolster their case. By the time they were done with me, I was roadkill. Amazing, how easily a career can be destroyed; even if your great at what you do. It’s all about the fear of liability. NO actual mistakes made on the job- just the fear of what MIGHT happen. WOW! If after 14 years they’re not convinced, I don’t know that there is anything anyone could say to sway them. This is an unfair tack to take. Now I have a public ‘disciplinary’ action on the ‘world wide web’ FOREVER. They say they are ‘protecting the public’ but they have it posted to the BON site as well; anyone can look it up. Additionally, criminal records are public record. And as ‘background-check crazy’ as most employers seem to be today, people can find out anything they want. If it was my responsibility to ‘tell on myself’- and lose my livelihood- than perhaps the public should educate themselves. Why put my name on the Internet indefinitely?! During the investigation, they even contacted my employer (the city)- though I was not working in the healthcare industry at the time. They suggested in my psych. eval. that I had lied on my city application, because I didn’t disclose my ‘deferred prosecution’ DUI; which I was actually within my right to do- for a ‘non-licensing’ city agency (they also only asked for ‘convictions’). I also talked about it to the city employee that interviewed me. Because of this investigation, conducted by the BON, the city won’t hire me again. Though I did nothing wrong during my employment w/ the city. The BON gave me the opportunity to secure my license, ‘if’ I agreed to the terms of the contract; drawn up by the BON (after paying 500.00 dollars for a psych. eval). I decided to let my license go. Let’s face it folks- after receiving a discipline on your license for an undisclosed misd. record, good luck finding a job. I also didn’t have the $$ for all the stipulations that the BON made. It was just a set up for failure. Well, if nothing else, I found out that I was sane (and had an official IQ of 139). So, went back to school, received a STEM Scholarship, and a BS degree in Env. Science; Bio minor- w/ honors. Unfortunately, it’s not easy to get a job when I have a pubic Board of Nursing disciplinary action on the internet; “Criminal Record” and “Unprofessional Conduct.” Just type in my name- and there it is…on 2 websites. Doesn’t say what the ‘criminal’ record is- just CRIMINAL record ….FOREVER! I didn’t disclose it, because I needed an income that might support me; not a vacation to the Fiji Islands or a Coach purse- I needed a roof over my head! Not because I’m a monster; as I wrote above- NEVER hurt a patient- EVER. I wish I had never worked in the healthcare industry; not because of the patients I met, and the lives I helped, the people that touched my life- but because of the devastation that the BON is capable of. I have a hard time ‘feeling’ for an industry that is entrusted to care for patients, but would so easily eat their own.

  41. #67 by click for source on Monday 30 May 2016 - 1106

    I really did not recognized a lot of factors, but because of you, I do then!

  42. #68 by other on Monday 30 May 2016 - 1202

    Properly, that is actually intriguing. Certainly never believed to check out short article similar to this! Wonderful job!

  43. #69 by datarecoverysoftwaref.xyz/taxonomy_category.xml on Wednesday 01 June 2016 - 1851

    I had no tip concerning this, till I review your article. What I can claim more? Merely Incredible!

  44. #70 by visit site on Wednesday 01 June 2016 - 2007

    I had no suggestion regarding this, till I review your article. Exactly what I can point out more? Simply Exceptional!

  45. #71 by meetgodlysingles.xyz on Sunday 12 June 2016 - 1945

    Greetings, decent post, I like how you create every little thing from your perspective … In any case outstanding write-up mam!

  46. #72 by best supplement for skinny body on Wednesday 24 August 2016 - 1503

    I would like to thank you for the efforts you’ve put in writing this site.
    I’m hoping to see the same high-grade blog posts by you in the future as well.
    In fact, your creative writing abilities has encouraged me to get my very own site now ;)

  47. #73 by Web Master on Tuesday 12 June 2018 - 1829

    Should you wish not to receive any communication from us please drop us an email back to

  48. #74 by Web Master on Tuesday 12 June 2018 - 1839

    Nemnozhko Limited, 3rd Floor, 207 Regent Street, London W1B 3HH.

  49. #75 by arbeitskleidung kaufen on Thursday 20 December 2018 - 0401

    Toller Artikel. Vielen Dank.

  1. Current Events: Amanda Trujillo | Blog @ Online LPN to RN
  2. The Best In Nurse Blogs: The Nerdy Nurse Advocating for Nurses Edition | The Millionaire Nurse Blog
  3. Why Nurses are Furious about the Amanda Trujillo Case, Those Emergency Blues, @torontoemerg #nurseup #nursefriendly | Nurse Up!
  4. Del E. Webb Medical Center, Sun City Arizona AKA Banner Health Nurse Incident @BannerHealth – vdutton’s posterous | Nurse Up!
  5. “What Has Your Nursing Association Done For You Lately? What would they be doing differently for Amanda Trujillo, RN in the Banner Del E. Webb Medical Center, Sun City, Arizona situation? | Nurse Up!
  6. “What Has Your Nursing Association Done For You Lately? What should they be doing differently for Amanda Trujillo, RN in the Banner Del E. Webb Medical Center, Sun City, Arizona situation? | Nurse Up!
  7. Nurseup.com, A Nursing Advocacy Organization | Nurse Up!
  8. Scrubs Magazine: Arizona BON Keeps Trujillo Under Fire | Notes from the Nurses’ Station www.rncentral.com | Nurse Up!
  9. Arizona Right to Fire, #Youtube, LoneProtestor, Another Banner Nurse, Career Almost Destroyed #nurseup #amandatrujillo | Nurse Up!
  10. #Georgia #Nurses, Could This Happen To You? Learn More Today or Risk Your License Tomorrow #nurseup #nursefriendly | Nurse Up!
  11. District of Columbia Nurses, Could This Happen To You? Learn More Today or Risk Your License Tomorrow #nurseup #nursefriendly #amandatrujillo | Nurse Up!
  12. American Nurse Today (Facebook): A “Position Statement” on the “Amanda Trujillo, RN vs Banner Del E. Webb Medical Center, Sun City Arizona” situation is respectfully requested. This could happen to any one of your readers, they nee
  13. streamray cams
  14. #Nurseup #AmandaTrujillo, #RN, #Blogposts Let us know what is missing! We want them all :) #nursefriendly | Nurse Up!

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: