I just attended a meeting in which a roomful of nurses had not ever heard Amanda Trujillo’s name, so evidently this is a topic that needs to be blogged about. Agree or disagree, nurses should be talking about this case, and nursing students in particular should be debating it in policy and leadership classes, because this nurse’s conduct and the outcome of the case may be of peculiar importance in setting precedent for our profession.
The furor started with this blog post from Amanda Trujillo, an RN in Arizona. The crux of the matter is that she discovered a patient under her care may not have truly given informed consent, and she educated the patient and initiated a social work/hospice consult (ordering the consult without a physician’s order would be the part where she may have practiced outside her scope). Per her report, the physician had a “tantrum,” her facility fired her, and her license is under investigation with the Arizona Board of Nursing. The last two points have been verified with numerous bloggers. A black hole exists insofar as witnesses of said tantrum or any spokespeople from Banner Health or the Arizona BoN, other than, basically, “we can’t talk about it right now.” Which they probably really shouldn’t.
Emotions are running high among the nursing blogosphere and Twitterverse over this case. Some of us think this is an obvious example of the establishment trying to take away nurses’ duty and skills regarding patient advocacy and education. Some of us think the nurse is outright lying because no one has sprung to her defense from the facility where she worked. Some of us think she is in the right but is handling the controversy unprofessionally by publicly naming her employer, representatives of which probably cannot legally defend themselves currently. Some of us think she may have been right in principle but left some of the story out (questions I have heard include, Does Banner have a procedure for nurses ordering consults? Why was this not simply made into a teaching opportunity? Why did she receive no support from her nurse manager?). The point has been made that throughout this case, it is not physician vs. nurse; it is nurses who are largely responsible for Ms. Trujillo’s censure and unemployment.
Since the precipitating incident, Amanda Trujillo is not employable. The Arizona BoN has stated her license is not suspended as claimed originally, so theoretically she is free to work as far as I can tell by consensus of news articles (Google her name for many such), but bad judgment may come in to play here. What hospital will hire a nurse who brings down a media storm such as this? It’s a sticky wicket. Nurses have to speak up: for our patients, for ourselves, for our profession. But in this case, is she giving us a bad name by doing so in the way she has? Most recently, evidently a psychiatric consult has been ordered on Ms. Trujillo, a fact I present because it raises more issues that cannot be answered with only one side of the story. Is the BoN simply trying to discredit her (a fait accompli by the mere ordering of the consult), or are there truly facts the public does not know? I don’t know. I am just asking questions to provoke thought and debate.
I debated blogging about this case because it is difficult to do so impartially. Many issues are warring here, but I think they are all important to the nursing profession and worthy of discussion. For more in-depth summaries and opinions, please see posts by Those Emergency Blues and Emergency Physicians Monthly.