…for a clean, crisp empty sheet of nursing notes!

Oh! to see perfectly horizontal black lines, inviting me to hover my delicately-balanced pen above, poised to create a work of art.

Oh! to eloquently describe my nursing care in cursive so beautiful my great-grandmother would cry.

What would I give?

I’d give my (expletive) Cerner workstation a shove into the San Francisco Bay.

Yeah, we finally entered the 21st century at work.

Computerized charting. What a crock.

Boy, do I have a rant all ready to explode for this one.

But that’s the next post.

**********

What do you do when you lose your voice?

Your blogging voice.

It used to be so easy.

****

When I started blogging in 2005 I just talked about what it was like to be a staff nurse. That was my “voice.” The stories flowed off the keyboard. Blogging was a creative outlet.

Blogging was fun.

Today, an old-school Catholic nun sits in my head, rapping my knuckles with her ruler if I even consider posting something that isn’t “prim and proper”.

The trouble is, “prim and proper” is not my style.

Now, I can write “prim and proper” with the best of them. But a blog is not the place for that. This blog is not the place for that.

And to be honest with you, I have not been all that enamored of health care in the last year or so, of watching my wonderful small community hospital become an appendage of a corporate behemoth. Or of reading about health care in terms of partisan politics every single day in the news.

I wanted to rant and blog. But I didn’t know what to say, or how to say it. Sister Super-ego wanted prim and proper, but I couldn’t produce prim and proper.

So when I went to “speak,” nothing came out.

*****

I don’t know where Sister Super-ego came from, or where I got the idea that everything produced on this blog had to look like it was ready for a peer-reviewed journal.

This blog never was and never will be a “professional publication”.

It’s just the story of the life and times of an emergency department nurse.

Time to get back to my “roots.”

If anyone is still reading, thanks for hanging in there!

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The Voice

For the life of me, I cannot remember where I found this photo, but it looks straight out of Doctor Who circa 1963.

There were nurses in one episode of Doctor Who: a race of humanoid feline nuns called the Sisters of Plentitude.

I was about to say, “You can’t make this stuff up!”, but obviously someone did!

*****

You would think that after 18 years online and more than 7 years as a blogger, I’d know better.

But no, I actually fell for a scam this week.

No money changed hands.

Worse.

They ticked me off.

*****

It has been a long time since any sort of scam-type email has come through to me.

They have improved! They don’t misspell. The grammar almost passes muster.

It seems a company wanted to use “Emergiblog” as their domain name and keyword in….wait for it…China/Asia.

You’re already smacking your head, right? “Doh!” Ding, ding, ding….scam!

The email wanted to know if I was connected with this “company” and if they were my distributor in China/Asia, because there was a conflict.

The company is a UK construction firm.

*****

Hmmmm.

I sent a cordial email back that said (a) I was not affiliated with the company who wanted the name and (b) I did not want the name registered by anyone else and (c) it would be a cold day in hell before I’d give the name up.

And that was that.

*****

Then, a second email arrives from a Yahoo address in….wait for it….China (with broken English, “Dear Sirs,”…ding…ding…ding!) saying basically, we got your message and we are going to do it anyway even though the guy who sent the first email advises us to find another name.

Okay….now you’ve done it.

Now you have pissed…me…off.

And you do not want to piss….me….off….

*****

The first rule of internet correspondence is that one remains cordial.

So, I sent a cordial response stating “oh, HELL no,” indicating that legal representation was being obtained.

You can’t swing a cat two feet in this family without hitting enough lawyers to form a firm.

It wouldn’t be hard to get exactly what I need.

But…

*****

I decided to let Web-guy extraordinaire, Shane, know what was happening.

About ten seconds later, I got the response:

“Oldest scam in the book.”

Followed by my Facebook blogger pals telling me the same thing.

How could I not have seen this?

It was only as large as a neon, freaking billboard!

I smacked my head so hard I had LOC for ten minutes.

*****

It won’t happen again.

I’m chagrined it happened at all.

How embarrassing.

The only consolation is that the threat to my blog identity brought out my killer instinct, even if I’m not blogging as much as I would like to.

One does not mess with another’s domain name.

It just isn’t done.

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Scam Me Once…

When things get absurd and all I want to do is smack my head, they make me laugh.

Case-in-point:

We were informed that Half-and-Half would no longer be provided to staff or patients. Those choosing to use creamer in their coffee would be offered Coffee-Mate, or could choose to “BYOH&H.”

“Corporate” decided this would make a good cost-cutting measure.

*****

“Corporate” is like the “Not Me” character in the “Family Circus” comic. Blamed for everything, but never actually seen.

Normally, this would have engendered an eye-rolling, how-much-money-do-they-think-they-will-save, 5-minute conversation and that would have been that.

However, the email noted:

Half-and-Half would be available for all physicians and administrators!

Say what?

*****

I thought it was a joke. It sounded like a “Scrubs” script where Carla and Lavern refuse to let the doctors have break room coffee until they get their Half-and-Half back.

But, no.

This was legit.

And I was pissed.

Not at the loss of the half-and-half, but the principle of the thing.

Surely the idea that physicians and administrators were more important than staff or patients, or were superior groups to be coddled and pampered was a remnant of the 1950s, something to be looked back on as a relic of a less enlightened time!

Er, no.

*****

This was such a slap in the face to the staff, and in writing, no less!

Combined with everything “Corporate” has done (or been blamed for) over the last year, it was just too much.

Then one day, I walk in and see the “Will Work for Half-and-Half” jar.

With donations in it!

I LOL’s until I had chest pain.

That’s the kind of humor that permeates my department.

And that is why I work where I work.

Working with colleagues who have a great collective sense of humor is worth its weight in…well, Half-and-Half!!!!

And right now, that stuff is like gold in my ER….

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Will Work for Half-and-Half

We’ve come a long way from my 1962 Barbie with the starched white uniform and blue, red-lined cape. She carries a hot water bottle and wears the best cap ever.

Now, Barbie wears scrubs with sparkly pants and carries charts with hearts on them.

Give them credit, this comes with an otoscope and a stethoscope.

I was about to give hell for the hooker-high open-toed shoes, then I realized my Barbie wears open-toed white pumps.

No controversy here, moving along.

*****

I’ve been busy!

First, I was blogging for multiple sites, which left me little time or energy for my own blog. It was a great experience, and I learned much about writing under pressure. I will say this: blogging with deadlines is totally different than having your own “space” and just putting down thoughts and communicating with readers.

Writing became something I had to do instead of something I wanted to do. I didn’t want to lose my passion for blogging, so I made the decision to scale back to writing solely for Emergiblog. I want to thank Masters In Nursing.com and AllHealthCareJobs.com for the opportunity to be on their writing staffs.

Then, life has gotten a bit exciting!

*****

My youngest daughter, Rebecca, graduated from nursing school last month!

She sat for the NCLEX at the end of May, and passed with the minimum number of questions needed.

Am I a proud mom?

You better believe it!

And the minute she passed the NCLEX, the job interviews started coming!

We are keeping our fingers crossed.

*****

In March, we became grandparents for the first time!

Ewan was born to my oldest daughter, Lillian, and son-in-law Jim. I was in the delivery room when he was born. The last delivery I saw was in nursing school and I fainted at that one! I’m happy to say I did not faint when Ewan was born!

He’s a big guy, 9 pounds, 12 ounces and 22 inches long at birth. At 2 months he weighed 13 pounds. Nana (me) is getting pumped biceps just lifting him.

*****

As if that weren’t enough, I’ve been spending the last month on a different type of baby:

I’ve been fostering these four feral kittens, caught by my son around his apartment complex.

It’s fun! I feed them, pet them, scoop their cat box, and in return they treat me like a human cat tree and eat my earrings.

Fortunately, they all now have homes and I will be saying good-bye by the end of the week.

*****

Oh, and did I mention I’m working a ton of overtime?

Yep, things have been jumping around here, but in a good way.

My writing mojo is back now that the pressure is off to produce on deadline. My goal for my MSN is on hold – somehow, there are just other things I want to focus on right now.

School will always be there.

Babies grow up.

How well I know that…

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World Turning

I am not militant.

I am not a bleeding heart, I don’t embrace every cause du jour, nor do I hop on what someone termed a “clown car of supporters” for whatever happens to run across the blogosphere on a given day.

I am as straight-arrow, by-the-book, trust-the-Establishment as you will find in this world.

So when I say that I am reeling; when I say that I would take to the streets about something that has happened…when I say that I am questioning everything I thought I knew about authority, power…and nursing…

I’m not bluffing, over-reacting or being hysterical.

Pardon my unprofessional language, but there is some bad s*** going down in Arizona.

**********

The Arizona Board of Nursing has gone from ridiculous to abusive in the Amanda Trujillo case.

It wasn’t bad enough that they felt clicking a box on a computer that would order a case management hospice consult should mean enduring:

(a) a detailed interrogation about every facet of your entire career,

(b) or that talking about your situation should lead to a psychiatric evaluation, including obtaining signed releases from all your physicians for the last six years and seeing a board appointed PhD. Yep, clicking that box meant giving up all your protected HIPAA information! I can’t repeat that enough, it’s that appalling.

But that’s old news, isn’t it?

Here’s the new stuff.

********

Amanda received a letter from her university stating they were informed by the AZBoN that her license was under investigation.

Still, old news, you say? But wait!

A Board staff member wrote a letter denying it!

At Amanda’s request to keep the name of her university out of the spotlight, I’ve not listed it here. I have seen:

(a) the letter from her university stating they were “notified by the AZ Board of Nursing that your license is under investigation” (that’s a direct quote, italics mine.) Not that they looked it up, not that they deduced, but that they were notified.

(b) I’ve seen the BoN letter requesting confirmation of her attendance and,

(c) I’ve seen the BoN letter from a staff member who denies reporting it and is “…not aware of any other Board staff member doing so.” (Italics mine.)

So who the hell did?

Amanda’s university was notified by somebody at the Board. A request for confirmation of attendance is not a notification that a license is “under investigation.” Nowhere on the letter for confirmation does it say or intimate that the license is “under investigation.”

But it gets better…

********

Amanda is now being charged with using false “academic credentials”!

Yeah, this is what you do when (a) the original charges aren’t legitimate, (b) you’re angry that someone had the ovaries to not be afraid and stick up for herself, (c) they weren’t intimidated by the psychiatric evaluation, and (d) you need to ramp up the intimidation factor.

And I’ve seen the letters for this, too.

Amanda was accepted into a different university’s Acute Care Nurse Practitioner doctoral nursing program in the Fall of 2010. She began using the designation “S” following the professional designation, to denote “Student” on the auto sig on her email.

Due to some major health issues that included surgery, Amanda was unable to start the program. In November of 2010, she resigned from her job at the Mountain Vista Medical Center, using her personal email.

She had forgotten to take the “DACNP-S” off the “MSN, RN, DACNP-S” of her personal email auto sig.

********

So they are investigating this, per the Nurse Practice Act, for deceiving, harming or defrauding the public and/or stating or inferring she was a nurse practitioner through the use of the initials.

Boy, I hope all the public harmed by those six initials on her personal email sought help.

The Board found this terrible, egregious action of professional malfeasance during their extremely thorough investigation of Amanda’s career. For the record, the Arizona Board spends an average of 7 months investigating the average complaint, on which they average 17 hours (see this open letter to Arizona’s governor, by RN Greg Mercer.)

They must really be gunning for something here. If they had anything on the original complaint, this would have been over long before now.

What the hell is going on?

********

And let’s remember what brought this all on.

Patient education and a referral for a case management hospice consult.

No injury. No death. No tort.

An informed patient. A change of heart. A fuming physician.

And the nursing management at Banner Del E. Webb Medical Center, who feels that patient advocacy is something to be punished and reported to the Arizona Board of Nursing.

And apparently the Arizona Board of Nursing doesn’t take kindly to being questioned and operating out in the open.

In the meantime, the American Nurses Association is “monitoring closely” and the Arizona Nurses Association is working hard for the nurses of Arizona, but can’t support an individual nurse who is under investigation.

********

I’m not here telling anyone they need to support Amanda.

Whether you are for her or against her or couldn’t care less one way or the other, so be it.

This is a damn scary story.

What is scarier to me is the idea that Amanda should have shut up, kept her head down and just tried to get another job.

Is that what nursing is about? Are we so whipped by needing our paychecks that we don’t dare speak out about anything, anywhere, anytime?

The nurses in Texas spoke out and there was support from all over the country.

Does a nurse need to be arrested before anyone cares?

*********

Something bad is happening in Arizona.

From the halls of Banner Health, to the inner workings of the Arizona Board of Nursing, something is wrong.

You can ignore it, vilify Amanda, write her off as “oh there must be something else”, or make fun of those of us who do support her, but the fact is this is not right.

If I’m wrong, then I’m wrong and I’ll be the first to post it.

I’m not wrong.

Related articles

• Banner Health, Arizona Board of Nursing: A Personal Vendetta? (emergiblog.com)
• Hush, Hush…Keep It Down Now, Voices Carry (emergiblog.com)
• Everybody Look What’s Goin’ Down… (emergiblog.com)
• American Nurses Association: Supporting Nurses, Until You Need It (emergiblog.com)
• Banner Health Strikes Blow Against Patient Advocacy, Fires RN (emergiblog.com)
• The Nurse Stands Alone… (emergiblog.com)
• Mandated by Law, Obligated by Ethics… (emergiblog.com)
• Tsunami: A Conversation with Amanda Trujillo (Part 3 of 3) (nursetopia.net)
• Amanda Trujillo: A Fellow Nurse on the Ropes (digitaldoorway.blogspot.com)

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When Nurses Attack At the Highest Levels: A Blatant Abuse of Power

Every registered nurse in the state received a copy.

In the back, they would list the names of the nurses who had received a disciplinary decision on their license.

I used to read that, seeing if I recognized anyone I knew.

I never did.

But I would look and see just what it took to get dinged by the BRN.

Felonies and/or drug associated activities were about 99.9% of the cases.

It takes pretty serious stuff for the CA BRN to hit your license.

*****

The thing that bothers me most about the Amanda Trujillo case; the thing that makes me furious when I stop and think of everything surrounding it, is this belief that a nurse accused is required to, pardon my bluntness, keep their mouth shut.

Now, let me try and work this out…

Anyone can place a complaint with a Board of Nursing.

Anyone.

For any reason, any motive. In this case it was Banner Del E. Webb Medical Center who filed the complaint with the Arizona Board of Nursing.

This complaint is public record. The fact that you have a complaint on file with the Arizona BON, and the date it is filed is public record.

But…ask the Arizona Board of Nursing for a copy, and you are told you cannot disclose what the complaint says. Can’t fax it. Can’t copy it. Can’t quote it.

Keep your mouth shut.

*****

So, ten months pass, during which the nurse investigator assigned to the case tells you your charting, care plan, nursing diagnosis, and nursing care are above and beyond the call of duty and recommends that your case be dismissed as this is no danger to the public.

The Board says no, and proceeds to investigate/interrogate your entire career up to that point, with a fine tooth comb.

They don’t find anything.

So, this nurse reaches out to an author she admires (Echo Heron) and the story makes the Internet via the nursing blogs and all hell supposedly breaks loose.

Keep your mouth shut!

The Board isn’t happy she is speaking out.

She posts her response to the complaint with the patient information redacted.

Her attorney is mad! She’s a bad nurse! Bad, bad nurse!

Keep your mouth SHUT!

You are accused. We will tell you if you are relevant. We will tell you when and if you may speak.

Stand back and shut up, for you are the accused.

*****

When you speak up, or have others speak up on your behalf, you are considered to be “retaliating“.

This buys you a psychiatric evaluation, courtesy of the Board.

For that, they want releases from every single physician you have seen for the past six years.

All your HIPAA stuff? They’ll own it.

Now step back and think of everything you have asked your physician about in the last six years. You comfortable with that in the hands of a state Board of Nursing, with ties to national nursing organizations and a member who works for Banner Health? You comfortable with that in the hands of a Board appointed psychiatrist?

That’s what you get for not keeping your mouth shut.

And to top it off, after ten months, someone on the Board will call your university directly and inform them you are under investigation.

Keep your mouth shut.

*****

Even nursing colleagues have doubts.

“She must have done something else.”

“No one gets fired for just one thing.”

“We don’t know all the facts.”

“There’s two sides to every story.”

And…

“She ought to keep her mouth shut.”

Does anyone even think for one minute how gutsy it was to go public…

and NOT keep your mouth shut?

*****

That’s the problem.

Nurses do keep their mouths shut. All the time.

Because they are afraid. Isolated.

Fear of retribution by their employers. Doctors. Corporations who wave HIPAA like it’s the national flag.

And I’m sorry, but hospital corporations like Banner Health and state Boards of Nursing do NOT work in secrecy and isolation.

A nurse was FIRED and her LICENSE put up for investigation by an employer. THIS IS HUGE, PEOPLE. To fire a nurse for allegedly not following your policy is one thing. To go after her license is quite another.

You say you want the whole story?

The only way you are going to get the whole story is to get it out of the secrecy of corporate hallways and state boardrooms and start talking about it.

Stop keeping your mouth shut.

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Hush, Hush…Keep It Down Now, Voices Carry

And I mean “my” organization.

I didn’t always agree with the political candidates they backed, the health care legislation they promoted, or the fact that my dues paid for political lobbying I might not agree with.

They didn’t support the National Nurse for Public Health, a very grass roots movement started by staff nurses and a cause very near and dear to my heart.

But, bottom line, they were for nursing, and I was a nurse, so they were there for me.

And while I most definitely took advantage of the online benefits, I never really needed the ANA for any personal, professional help or support.

Which was good.

Because it won’t be there if I do.

*****

When Amanda Trujillo was first fired and then reported to the Arizona Board of Nursing by Banner Del E. Webb Medical Center for patient advocacy, she reached out to both the Arizona Nurses Association and the American Nurses Association for help and support.

She heard nothing.

But lately, lo and behold, there have been statements.

Here is the statement from the American Nurses Association, taken from their Facebook page:

“The American Nurses Association (ANA) is closely monitoring the case of Amanda Trujillo, MSN, RN, and has been in contact with her attorney. ANA strongly supports nurses and their right and responsibility to engage in patient education and advocacy.

ANA appreciates how difficult it is for a nurse to undergo an investigation of his or her practice by the state board of nursing. To be clear, ANA expects the Arizona Board of Nursing to follow its standard procedure, to render an unbiased judgment in this case, and to be fully transparent in its findings.

ANA advises that any nurse who has been alerted by the board of a complaint and an impending investigation retain legal counsel. It is the role of legal counsel to represent the nurse during the process. In addition, ANA cautions nurses and the public not to rush to judgments about complex cases based on social media postings or other media coverage.”

So, let me get this straight.

The ANA is “closely monitoring” the case. And they strongly support nurses…etc. BUT, if you are an RN who is under investigation they aren’t going to back you as an individual for one second.

Then again, if you are exonerated, their support is no longer needed!

What a win/win for the ANA! They can give lip service to your right to practice, but if you are being dragged through the mud by your state board, their lips are sealed. If you aren’t guilty of anything, well, hey! Great! Now you don’t need their support anyway!

Oh, but they appreciate the difficulty!

Ah, but they don’t have all the facts, you say.

Please. Nobody died in the Banner case. Nobody was harmed in the Banner case. A box was checked on a computer that sent an order for a case management hospice consult. Didn’t sign a patient up for hospice, just arranged for a nurse to talk to a patient.

For that, a one sentence complaint accusing an RN of practicing outside her scope gets sent to the Arizona Board of Nursing.

And the ANA can’t find it within themselves to commit to supporting the individual nurse.

They sure had no problem ramping up the support for the RNs in Texas! And that was BEFORE all the facts were in!

*****

The next part should send chills up your spine.

“…and has been in contact with her attorney.”

The American Nurses Association has never contacted Amanda Trujillo about this at all. EVER.

She never gave them permission to contact her attorney. Never got a note or a call saying, “Hi Amanda, legally, we can’t speak with you about the case directly, but we would like to call your attorney, can we have his number?”

How did they get his contact information? Wasn’t from Amanda.

And the contact? Whatever it was had nothing to do with supporting her through this ordeal.

That’s a given.

*****

And finally:

“…ANA cautions nurses and the public not to rush to judgments about complex cases based on social media postings or other media coverage.”

Yeah, I just bet they do.

Well, folks, this is a social media posting.

You aren’t going to get the story from the Arizona Board of Nursing. All they do is threaten you if you speak out and ask for your entire medical history for the last five years so they can do a psychiatric evaluation because of retaliatory behavior. No story from them.

You aren’t going to get the story from Banner Health. Remember, they fired a nurse for patient advocacy. Not something you want to shout from the roof tops.

You aren’t going to get the story from the Arizona Nurses Association because their President happens to be the Director of Professional Practice at Banner Del E. Webb Medical Center, and they are connected to the ANA.

You aren’t going to get the story from the American Nurses Association because Amanda is under investigation, so they aren’t taking a stand.

So it looks like social media postings for now.

I apologize for my shortcomings.

Look for “other media coverage” to be hitting soon.

*******************

Jennifer Olin, at RN Central.com writes about this topic here, at ANA Finally Acknowledges Amanda Trujillo.

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American Nurses Association: Supporting Nurses, Until You Need It

This photo has a very “Twilight Zone” feel to it.

The only thing missing is Mr. Serling.

Unless he’s standing at the other end of the table…

<cue theme music…>

**********

The nursing blogosphere is on fire with the Amanda Trujillo story, but there haven’t been too many comments from our physician blogger colleagues.

Dr. Dean over at the Millionaire Nurse Blog, dedicated one of his The Best in Nurse Blogs: Amanda Trujillo Edition to the topic, and followed it with a discussion of nurse/physician/healthcare team communication.

Today, I found this post by Dr. Terry Simpson at Your Doctor’s Orders, entitled Transplant or Hospice. Dr. Simpson has some valid opinions as a physician.

Unfortunately, they are buried in a lack of understanding of a registered nurse’s scope of practice, overwhelming arrogance and the use of an image of the book “Angel of Death” to make his point.

Everyone needs to go read this post.

Go ahead. I’ll wait.

This is what nurses are up against on a daily basis.

Not all physicians.

Not most physicians.

But enough physicians.

**********

The idea that nurses are supposed to just “take care” of the patient and defer all questions and education to the physician is mind-boggling.

Dr. Simpson posits that there is a time and a place to discuss end-of-life care.

And that the doctor is the one who makes that decision.

Seriously?

What happens when the patient asks about it?

“There, there Mrs. Smith, don’t worry your pretty little head about stuff like that. Doctor Welby will be in first thing in the morning and he’ll take care of everything. You just get some rest.”

Don’t worry that you will be transferred. Don’t worry that you will be undergoing extensive testing. Don’t worry about what a transplant entails or what it means for your life. Don’t worry about how old you might be or how involved your care might be or what resources you have.

We know what’s best.

Well, the doctor knows what’s best.

In your depressed, ill state, you can’t possibly know what you want or understand what it all means, or have the strength to make the right decision.

The doctor will decide when it’s time for you to know what you need to know.

Some doctors call that autonomy.

Whose autonomy?

**********

So, I guess as patients, we have a choice.

We can wait, and only ask questions of our physician, who may, like Dr. Simpson, tell us what we need to know when we need to know it based on their professional judgement.

Or, we can ask questions of the entire healthcare team, including our registered nurse, and receive information and education that will enable us to have a discussion with our physician about our health and what we should do.

You know, exercise our autonomy.

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(Not) Everybody’s Talkin’

This is the problem.

There is a huge injustice being perpetrated against a nurse right this moment.

It’s getting worse.

And the ones who got the party started aren’t happy that it isn’t quiet.

That their moves, and their motives, are under public scrutiny.

That nurses are talking.

Because if you are quiet, it means they’ve got you frightened.

If you are quiet, it’s harder for the next nurse to speak out.

If you are quiet, it is easier to intimidate and retaliate against nurses with impunity.

*****

I received a call from the Arizona Board of Nursing this morning. I am not able to obtain a copy of the Banner Del E. Webb Medical Center complaint against Amanda Trujillo, RN, MSN.

They are able to tell me that a complaint was filed, and what date it was filed, but the actual content of the complaint is confidential. A copy goes to the RN involved.

I appreciated the call, they could easily have sent an email.

That doesn’t mean I won’t see a copy of it, it just means I can’t get a copy from the AZBoN.

*****

Well, it gets worse.

Today, ten months after the original complaint was filed, Amanda was advised that the Arizona Board of Nursing had called her university and reported that she is under investigation. Amanda is studying for her DNP.

Amanda got the email from her university, informing her of what they had been told.

WHAT???

Is it normal for boards of nursing to actively report registered nurses to their universities?

By phone?

While the investigation is still going on?

*****

I talked to a nurse investigator in Nevada, who said absolutely “NO”, they did not report nurses to universities., That until the case is decided, it’s confidential and there is no way of knowing that the nurse was in school or what school she attended.

There has been no disciplinary action against Amanda Trujillo by the Arizona Board of Nursing.

So why are they calling her university?

Why now?

*****

This has gone past a regular investigation of a complaint against the license of a registered nurse and has all the markings of a personal vendetta.

I’m no Morley Safter or Mike Wallace.

This blog isn’t 60 Minutes.

I’m just a blogging staff nurse who is aghast at what she is seeing and I have questions.

Who has ties to the Arizona Board of Nursing? What pull, if any, does Banner Health have with the AZBoN? What pull, if any does the doctor whose public display of rage set all this in motion, have with the Arizona Board of Nursing?

What ties does the Arizona Board of Nursing have with Amanda’s university?

*****

And let’s keep in mind why all this is happening.

A patient received education concerning their condition and upcoming procedure, and a referral for a case management consult for hospice placed at the patient’s request.

No patient was harmed. No patient was killed. No medication given. No procedure done.

A patient was given information.

Informed.

Empowered.

And god help the nurse who had the audacity to facilitate this autonomy, this right.

How can you not be outraged?

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Banner Health, Arizona Board of Nursing: A Personal Vendetta?

I have a twitter account and although I went to Facebook kicking and screaming, I’m firmly ensconced in the world of status updates, messages, and the occasional “poke.”

I never miss BlogWorld New Media Expo, and if I can make it to BlogHer, I will be at the party (can you say “swag”?)

You might say I’m into social media.

The best thing about social media? It enhances the ability of people to band together, to support causes, and each other.

This week, we’ve seen nurses band together online to support one of our own, fired and in danger of losing her license for acting as a patient advocate and providing patient education.

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Patients use social media to band together with others who share the same challenges, to find support and encouragement.

They use the internet and social media to gather information; to be able to decide, in discussions with their healthcare provider, the best treatment to pursue.

The “patient” is you. And me. We are all patients.

Knowledge is power. Knowledge empowers a us to advocate for ourselves.

But what happens when you are sick, lying in a hospital bed with new information flying fast and furious, with no time (or access) to “look it up”. No time to find an “online support group”.

What if the quality of the rest of your life depends on the decision you make with the information you get, now.

Who advocates for you/us then?

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The entire healthcare team advocates for you.

Nurses and physicians advocate for you.

They advocate for you by making sure you have all the information you need to make an informed decision on any plan of care.

They advocate for you by telling you all of the options open to you, including no treatment.

They advocate for you by making sure you understand all of the information and education provided.

They advocate for you by respecting the fact that you are able to advocate for yourself and respecting the decisions you make.

Doing all these things is the right thing to do.

It’s also the law.

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When a nurse assesses that a patient does not have the information needed to make an informed decision about their care, either because they have not been informed, or because they did not understand the information provided, the nurse has a duty to:

a. provide the missing information, or the needed education and/or

b. refer the patient to the appropriate source of information

There is no choice.

It’s not a case of making a note and hoping the next shift deals with it.

It’s not a case of thinking, “oh well, they need this surgery/procedure anyway.”

The nurse is mandated by law, and obligated ethically to act if they discover a patient does not have the information they need to make an informed decision about their care.

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Here’s the ethical principle in operation here, as defined by the American Nurses Association, who have a great website on nursing ethics:

Autonomy: agreement to respect another’s right to self-determine a course of action; support of independent decision making.

This is why the firing of Amanda Trujillo, RN, MSN, an experienced transplant RN, by Banner Del E. Webb Medical Center is so mind-boggling.

She was doing exactly what she was supposed to do as a registered nurse, for a patient with a knowledge deficit regarding an upcoming transplant.

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For the record, to those who have written to say I don’t have both sides, Banner Health isn’t talking. They made a statement on their Facebook page to that effect.

I have written to the Arizona Board of Nursing for a copy of the original complaint, which should be public record.

I’ll post any response I get from them.

In the meantime, Amanda’s legal response to the original complaint, which answers the complaint point-by-point, can be found at vdutton’s posterous.

I encourage you to read the comments, as there is some interesting dialog there, as well

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I am not militant.

I rant now and again, but I am very happy in my corner of the couch with my trusty old MacBookPro.

But I would take to the street for this.

I am that angry.

If I thought for one minute that there was more to this case, I’d be watching from the sidelines,too.

My gut tells me, there is not.

My nursing instinct tells me there is not.

My nursing instinct tells me that a hospital corporation got upset because a “rainmaker” (in the legal world, that means “moneymaker”) got angry at an RN, ergo, she must be punished.

Most hospitals just fire people, Banner Health reports them to the Arizona Board of Nurses.

God help the nurses at Banner Health, because I’d be watching my derriere 24/7 if I worked there.

Corporate healthcare at it’s finest.

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Mandated by Law, Obligated by Ethics…