The Curious Case Of Amanda Trujillo And How Its Outcome Will Affect The Quality Of Healthcare We All Receive

[You can watch a video by Carol Gino about the Amanda Trujillo case to get up to speed.]

A long time ago when I was in nursing school and then when I taught nursing, I remember making care plans. A large portion of the work our student nurses did was to make care plans for their patients. This was an integral part of their clinical experience.

During post clinical conference, which was at the end of each clinical day we went over what happened that day. We also discussed how well the students were able to follow the care plan. How we could improve our care and make patients feel better?

The main focus of our discussion were the patients, their symptoms and how to help them feel better. Each one of our care plan goals started with, “Patients will…..”. We emphasized patient education and their well being.

That was a long time ago. I’d think that nursing would have come a long way by this time. I’d think by now nurses would be celebrated as patient advocates and liaison between all the different groups that come in contact with the patients, including the physicians. Unfortunately, this is far from the truth.

Unfortunately, the clock has turned backward on nursing in a lot of ways. Yes, we have more nurses with advanced degrees. We have nurses in very influential positions in healthcare with a lot of clout. However, it is the clinical bedside nurse who has lost out during this “advancement.”

The patients in hospitals are much sicker than they used to be a few decades ago. As a result, their needs are more emergent, more intense and more difficult to take care of. No wonder nurses hop from room to room, patient to patient trying to meet all those needs.

Typically, if a nurse has five patient for an eight hour shift, she has less than an hour and a half per patient to address all their needs, pass out meds, take calls from their family, communicate with the doctor, help the CNA as needed, finish their documentation and oh yes, attend any mandatory inservices their company requires them to take and still be done without any overtime.

Sorry… what??? You think I left something out? Oh yeah… the pee break, right? Well they are few and far between for a typical nurse. Does anybody see anything wrong with this picture?

Despite all the chaos and running around, most nurses can’t stand to see their patients suffer. So we make sure that we advocate for them. We try our best to educate them on their treatment plan, because its ingrained in us.

We have been taught over and over again that our patients are our primary responsibility and their well being and education is our primary job.

This is what Amanda Trujillo of Arizona did not too long ago. A patient requested information and she provided hospital approved material along with a request for more information from hospice as per patient’s request.

This is not unusual for a nurse. In a typical day we do a lot of teaching to our clients, their families, CNAs and anyone else who needs information. The only difference this time perhaps was that the doctor’s idea of what the patient needed to know and what the patient actually wanted were different.

This is not an unusual scenario. Communication gaps happen often. The only way to prevent a communication gap from becoming a disaster, especially in a healthcare setting where life and death decisions are made every minute, is to have checkpoints.

Yes, someone has to go after a doctor to ensure that patient and the family actually did understand what they had been presented with but to also provide more information and listen to their concerns.

At one of the hospitals I worked for, our case managers, who were also nurses, routinely spoke to patients undergoing surgeries and treatment to make sure there was no communication gap. In addition, these case managers communicated with the staff regularly to alert them of issues and help them continue the conversation as needed. This way we all were on the same page and our patients made informed decisions.

In case of Amanda Trujillo and her patient, the patient obviously had concerns. Any nurse, anyone who considers themselves a patient advocate, would have provided more information.

It is heartbreaking to see that instead of being praised for her concern for the patient, she was fired from her job and may even lose her license. It is also sad to note that the outburst by the physician at the nursing station was not addressed as unprofessional.

Currently Amanda Trujillo awaits the Arizona board of nursing decision on whether she should be able to keep her license. Her act of advocating for her patients could result in her inability to work as a nurse and earn a livelihood.

This is an outrage! An atrocity that will put nursing in dark ages. This one decision, to take away Amanda Trujillo’s license would make the nurses nationwide fear for their license. They would fear that their license could be snatched from them for doing the right thing for the patients if it does not sit right with those in power.

The nursing profession will definitely lose if this were to happen, but the biggest loser will be patients. There might be people who would set their conscience aside to be able to feed their family. But there will be no patient advocates!

Everyone, nurses and non nurses, patients and future patients, doctors, NPs, PAs etc, are going to be on the receiving side of healthcare. Therefore, we all have a great deal to lose from such an action.

I urge each one of us to stand up for our rights to receive compassionate and competent healthcare. I urge everyone reading this to contact Arizona Board of Nurses and ask them to clear Amanda Trujillo’s license and compensate her for all the pain she has been put through.

  • Suprnrs

    This is outrageous!  Where is there justice for nurses like Amanda who did what she was supposed to do as a patient advocate?  When are doctors going to ‘man’ up and take responsibility?  The fact that this nurse lost her job and may possibly lose her license to practice is wrong….where’s Gloria Allred?

  • http://www.facebook.com/profile.php?id=27701254 Amanda Trujillo

    Shahina….
    Thank you for not presuming my guilt until proven innocent. This blog post brought me to tears–a waterfall actually! Youve given me a little more strength to keep pushing forward for everyone–because that is what this is about—all of you out there, the new nurses coming up, the safety of patients…and the preservation of the sanctity and integrity of our profession and its future. i love nursing so much Shahina, I miss it terribly–so much it hurts–but if this is the only way I can be a nurse right now and do some good—then Im staying the course.   

  • Pingback: #Nurseup #AmandaTrujillo, #RN, #Blogposts Let us know what is missing! We want them all :) #nursefriendly | Nurse Up!()

  • http://www.nursefriendly.com/social/ Andrew Lopez, RN

    Thank you for covering 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.”http://www.nurseratchedsplace.com/2012/04/the-war-against-amanda-trujillo/

  • http://www.nursefriendly.com/social/ Andrew Lopez, RN

    Thank you Shahina 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.”
    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

  • http://www.nursefriendly.com/social/ Andrew Lopez, RN

    Thank you Shahina & Nursetalk 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.”
     http://www.truthaboutnursing.org/news/2012/may/trujillo.html

  • Hirene

    I read the Az Nurse Board statement and what they fail to take into account is that she clocked in thousands of hours as a nurse and I don’t think they could find ANY nurse that didn’t have a few glitches in his/her performance.  In short, they are nitpicking.  Also, they drill nurses in being “culturally sensitive” but ignore the more personal and warm bedside Latino nursing and expect everyone to follow the harsh, Anglo, you-are-just-a-parlo-maid model.  There are nursing make loads of errors, and some real slick ones who ignore deteriorating patients but they never get in trouble.  I don’t think she is a dangerous nurse at all, in fact, just the opposite. 

  • http://pearyb.blogspot.com/ Peary Brown

    Having been a nurse for many years, and with a good record, I know precisely the Amanda Trujillo case and that the evidence against her is bogus. I also was disciplined by the Az Board for actions that never involved a patient or violations of the nurse practice act. How can this be you ask? The idea that a doctor can do and say anything and get away with it is well known to every nurse whoever held a bedpan. My case involves a physicians’ complaints and misdemeanors which only violate the civil standard in the nurse practice act. The physician discharged a patient, after putting a huge hole in her esophagus, allowing her to drink fluids, never told her, never told the the consulting physician; she was my significant other and was at home. On the 4th day after discharge she was the color of a car tire, pulse 140, temp 104, bp 86sbp, very confused. Her subsequent course was life support and 2 years of multiple surgeries. The convolutions of this story are monumentally criminal with a physician whose history was horrible. Bad doctors are out here. Nurses are scared to death to make it known. The details of my behavior by this physician to the Board are lies. The Board put me on probation which can be lived with, except, the patients’ head fell off and the doctor said it was OK. Nothing else matters except the lip service of quality care and the $ is all that matters. So I could go to another state and get a license without stipulations, I know this as factual. Its sad this Board of Az is. Allowing a physician to perjure themselves is suborning perjury which IS, Which is from the Az attorney general. What the fuck, is going on?? Go Amanda.
    The Care Just Isn’t There, Make a difference, Please, Amanda.