An open letter to the Arizona State Board of Nursing.
Disclaimer, I have not been directly contacted by Amanda Trujillo, nor do I know her personally or professionally. I am also writing to you based on the information that I have available to me.
To the Arizona State Board of Nursing:
To whom it may concern,
I am writing to you on behalf of Amanda Trujillo, MSN, RN, DNSc-NP(s) regarding the case attached below. I have not been contacted directly by Amanda Trujillo, and I have neither a personal or professional relationship other than that she is a fellow nurse in need of my support.
Based on the information I have (to my knowledge the same case documents that you also have), I would like to ask the board to carefully consider the information presented by both Ms. Trujillo and her legal team. From my understanding, it appears that Amanda Trujillo evaluated the health status of her patient based on her own clinical assessments and also data collected while being treated by the medical team at Ms. Trujillo’s place of employment during this time. It also appears from the information that Amanda Trujillo provided health teaching, counseling, and advocacy for her patient, which to my understanding of the Nurse Practice Act is well within her scope of practice.
As a nurse and patient advocate, I make certain that each and every patient I provide services to does in fact receive the highest quality nursing care while on my case. It should go without saying, but part of this care involves my ongoing support to ensure that my patient is knowledgeable about their diagnoses, medications, and ordered treatment plan. It is my job to protect the health and safety of each and every patient that I come into contact with, and to advocate for their needs based on my clinical judgement.
I am not in any way assuming that the treating physician was negligent, however considering that this is, and should have been a collaborative approach in the patient’s care, Amanda Trujillo was making her own nursing diagnosis based on her clinical assessment, which again to my knowledge is within her scope of practice as a registered nurse. She apparently discovered a deficit in her patient’s knowledge about their treatment options, and it appears that she acted ethically in supporting her patient’s wishes to seek additional information, and referred the patient to a case management specialist as per protocol.
I realize that these cases can carry with them a great deal of emotion due to the sensitive nature that our number one priority as licensed nurses is to protect our patient’s health and safety. It seems that Amanda’s duty to uphold the rights of her patient is being challenged, and the circumstances in which this transpired seems to have been initiated and fueled by emotion, and not based on facts. I just ask that you please consider all of the information presented to you, evaluate this case objectively, and if Amanda Trujillo is exonerated from these allegations, that she have the opportunity to continue to practice professional nursing.
Thank you in advance for your time and your consideration in this matter.
Kevin Ross, R.N., BSN
Amanda, I wish you the best on January 24th, and I have personally marked this on my calendar as a day to not only advocate for you, but to all of my fellow nurses out there that are practicing with great integrity and upholding our responsibility to provide safe and ethical patient care. To my fellow nurses, and to you Amanda, I assure you of my undying commitment to this profession that lateral abuse and nurse retaliation will not be tolerated in my presence, and that my voice will be heard with yours. Nurses, one united voice can be very powerful. Let’s use it for something amazing; to elevate nursing to the highest level as one of the most honorable and respected professions.
Please review the information regarding Amanda’s case, make an informed decision, and if you’re in support then let’s help her win this fight. If you would, please e-mail the Arizona State Board of Nursing at firstname.lastname@example.org in support of Amanda to let them know you’re following her case.
[UPDATE: Her case has been postponed by the BON, and they’ve apparently recommended a psych evaluation due to Amanda’s “internet activity.” I reiterate that our community reached out to Amanda, and her crime is that she is publicly grateful? Listen in on Amanda’s interview on RN.FM Radio]
Thanks for providing more information about what happened with the patient .
David from http://certifiedmedicalassistants.net/
The latest on the case: Facing a Crossroads, #AmandaTrujillo, MSN, RN & the Arizona State Board of Nursing:”At the heart of Amanda’s case is Patient Advocacy. Her patient was having second thoughts about a Liver Transplant evaluation, and Amanda helped fill in the gaps. The doctor, Dr. Keng-Yu Chuang (Source AZBON public records), who had only offered the liver transplant, went ballistic when the patient asked for Hospice info instead. He demanded the hospital serve Amanda’s head up on a platter and that the Arizona State Board of Nursing be contacted.”http://nurseup.com/wordpress/?p=2850
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." http://www.truthaboutnursing.org/news/2012/may/trujillo.html
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."http://nurseinterupted.wordpress.com/2012/05/09/the-moment-of-impact-april-21-2010/
The day that changed Amanda's life forever. To follow her case and others, kindly visit http://www.nurseup.com
Thank you @innovativenurse for following Amanda's case, this is from her blog.
1,000 Shades of Nursing: Why are we "really" celebrating Nurses Week? May 9, 2012 By Amanda Trujillo, MSN, RN, @nurseinterupted:"There was an interesting tweet chat taking place this evening with regards to Nurses Week and how everyone celebrated their week or reflected on their profession. Several great view points were offered up. My own perception of Nurses Week is that it is a metaphor for every way our profession has stagnated, failed to progress, remaining fractured and at odds with itself about where it should be and how it should get there. Hell, we’re still trying to bridge the gap between academic nursing and clinical nursing. It’s not difficult to empathize with some of the views raised this evening: The disdain with the recycled food offerings, the traditional ice cream social that makes some of us seethe inside, the hospital logo stamped on nursing "swag," the lack of any gifts of appreciation, the "lumping in" of Nurse Week with "Hospital Week," or whether we even need the proverbial "pat on the head" as one nurse blogger put it. Im conflicted: As a profession—HOW are we leading, and HOW are we advocating?
Thank you @innovativenurse for following Amanda's case, this 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." http://www.nurseratchedsplace.com/2012/04/the-war-against-amanda-trujillo/
Amanda what it is they do not like is the fact that you have rallied nurses around this issue. The fact of the matter is as nurses we are patient's advocates.
What a crock. Consults are generally always ordered by a nurse. Dietary consults are considered our responsibly.
"It seems that Amanda’s duty to uphold the rights of her patient is being challenged, and the circumstances in which this transpired seems to have been initiated and fueled by emotion, and not based on facts."
Agree. Amanda Trujillo's case had indeed awaken some of our instinct on justice as well as to fight together as nurses. This is not just a battle of Amanda but of whole nurses and even patient's advocate as well. :)
Thanks for the share,
I'll support any nurse who stands up for the rights of our patients. If that patient was uninformed and they went through treatment that they found out later was more then they understood it to be. And that patient filed a lawsuit against the hospital and its medical staff. Should my name appear in those progress notes I would be on the list of people that would be getting sued for not educating my patient properly. Finger pointing has a snowball effect. I'll bet that MD would really be sorry because he would be sitting in the front row of the accused.
@Sheila Bounds@TrishDescafano Thank you so much for your support. Yes, as a patient advocate, and as a nurse who works very closely with the physician teams, they have openly expressed their gratitude for my services to provide that education. I can take that extra time to listen to the patient, and help safely coordinate care with the physician based on what the patient wants.
Not every patient wants to be "cured," even with all of these great medical advances to extend life. Patients have a right to come to terms and choose quality (whatever time is left), rather than quantity.
She dd everything correctly, and should be commended for her efforts. Some nurses would not have gone the extra mile. This nurse has heart, what it takes to not be a good nurse, but a great nurse. There is nothing stated in this info that she went against hospital policy, and therefore, she should be exonerated with full reimbursement of wages lost due to termination. So many patients need education, and some do get it. Some don't. A lot of patients don't, and then a big surprise awaits them at the end of the tunnel. Kudos to This nurse. I stand for her, and every other nurse that remains a patient advocate. I am also a nurse advocate, and for years, I've been saying things need to change. Try and get a doc to write a consult for case mgt., he/she will tell YOU to go ahead...they don't have time for each and every patient, and welcome the education department to take up the slack.
This is a case of an MD who feels they have a right to be "GOD". Nurses must deal with uneducated patients on a daily, nightly basis. We are there 24/7 and we advocate.We do not discriminate or just say "Oh Well my patient is not informed, not worthy, or smart enough for further education." This nurse Amanda did what all nurses have the obligation to do. We swore an oath to advocate for our patients on behalf of our patients when they are uninformed or not educated properly by the medical staff. Which I can say happens often and on a daily/nightly basis. Good for you Amanda and your attorney for standing up for" Nurses Rights and Nurses Duty" to continue to advocate for human beings that are sometimes thrown into the world of medicine with no clue or idea what their rights or options are. Shame on the hospital and it's board of directors for not backing up it's nurses that humanly represent the" people" that keep their business running 24/7.
Hello Everyone, glad to see this gaining traction. Would like to see Amanda practicing again when all is said, done :)
How can the business of medicine or healthcare even consider replacing primary care physicians with nurse practitioners if no one can stop a doctor from intimidating a nurse, and having her fired because she educated or gave the patient a choice he or she didn't. What good is more education for nurses if we are going to be stopped and chastised when we do what our code of ethics demands that we do. That is to advocate and educate a patient. Isn't it scary how far we haven't come? And who is supposed to be taking up this fight for the principles of the nursing profession? I don't like this at all!! It reminds me of "You've come a long way, baby!" Really? We really have to stand together or we will fall apart! Support Amanda. #Nurseup
It's a shame that we have to re-educate our own medical community to remember that we nurses are also clinicians, and some of us with a tremendous amount of experience and knowledge. A collaborative medical model is supposed to exist as it is in the best interest of the patient. We make every attempt, but it's nearly impossible to have our finger on the "pulse" in every situation. A collective approach sets the patient and the clinical team up for success to ensure health and safety.
All due respect to my fellow healthcare providers, but it doesn't matter what credentials you have after your name. The patient is at the top of this hierarchy, and ultimately should be able to make an informed decision about their plan of care.
As a #patient and after reading the above documents, I am in total support of this nurses actions to make sure her patient was fully informed of choices available to them to enable patient to act as a free moral agent on their own behalf when presented with the facts.
1) If doctors were involved in all case study consultations they would 't have time to "doctor".
2) I commend this nurse for caring enough for her patient to go the extra mile
Furthermore, she was insightful enough to realize this patient had not been fully informed by their physician beforehand, or obviously had no complete understanding of what was about to be done to them!
I am thankful that these kinds of nurses of conscience exist. And fully support this nurse.