Tuesday, April 24, 2012

Critical Care #Nurses on: The #NurseFriendly @grissomedlegal #nursingcareers #specialtynursing #nurseup

Critical Care #Nurses on: The #NurseFriendly @grissomedlegal #nursingcareers #specialtynursing #nurseup
http://www.nursefriendly.com/nursing/directory/spec/criticalcare.html

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For more information on Nursing & Patient Advocacy, Entrepreneurship: http://www.nurseup.com/

Kindly sign our petitions:

Petition: Amanda Trujillo, RN & Banner Del E. Webb Medical Center, Sun City, Arizona: Position Statements Requested
http://www.change.org/​petitions/​nurseup-com-issue-position-stat​ements-on-the-amanda-trujillo-​rn

Petition: Arizona State Board of Nursing: Remove Amanda Trujillo’s nursing license from ”under investigation” status | Change.org
http://www.change.org/​petitions/​arizona-state-board-of-nursing-​remove-amanda-trujillo-s-nursi​ng-license-from-under-investig​ation-status

Contribute to Amanda's Legal Defense Fund:
http://apps.facebook.com/fundrazr/activity/99fa97b4502c40939c18ae0da407793c?type=endorsement

Andrew Lopez, RN
Nurseup.com, A Nursing Advocacy Organization
38 Tattersall Drive
West Deptford, New Jersey 08051
856-415-9617, Fax: 856-415-9618, info@nursefriendly.com, @nursefriendly

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LinkedIn: http://www.linkedin.com/​groups/​Nurseupcom-Nursing-Healthcare-A​dvocacy-4366517

Twitter: http://www.symplur.com/​healthcare-hashtags/nurseup/

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Articles in reverse order of publication:

Cover yourself, no one wants to see that, By Guest Post, On April 13, 2012:"A lot has been written across online nursing communities about the case of Amanda Trujillo, a nurse currently defending her license with the Arizona State Board of Nursing. Regardless of your position on the case, it brings up an important question for nurses—how can nurses protect themselves in the event that their license is challenged?"
http://innovativenurse.com/cover-yourself-malpractice/

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Sifting through wreckage, April 8, 2012 By nurseinterupted:"The face of PTSD is changing, and changing fast. Once associated with war veterans (I grew up with a father who has had it since returning from VietNam), more attention is now being placed on the silent walking wounded—Nurses. Since my efforts to promote anti nurse retaliation legislation and patient’s rights legislation has taken a rather devastating blow recently, it seems a good time to begin work on writing a grant to gain funding for the healing retreat for nurses I’d like to host each year. I can’t imagine who or what could throw a wrench in that particular goal, but something positive and lasting has to come from injustice, something that even in the smallest way—helps to heal and improve our profession. Focusing my time and skills on introducing something peaceful to the wounded of our profession will also help me to get my mind off of the sad and disgusting things out there that have taken the attention away from the issues I worked so hard to bring attention to in the first place."
http://nurseinterupted.wordpress.com/2012/04/08/sifting-through-wreckage/

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Excuse me. whatever happened to critical thinking? CriticalED, Posted on April 8, 2012:"The thing that scares me about this whole issue is the lack of “critical thinking”. We as a group have been striving for decades to be considered professionals. We lay claim to concepts like critical thinking, but then throw those same concepts out the window, and let emotions and prejudice guide our behavior. Yes Banner Del Webb may be the worst hospital to work for in the country, and it the dislike for the company may run deep. The AZ BON may not be the most transparent agency around. But that should mean that they are automatically the ones that are wrong here."
http://criticaled.wordpress.com/2012/04/08/excuse-me-whatever-happened-to-critical-thinking/

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Notice of Charges with Commentary on Amanda Trujillo, Posted on April 6, 2012, Critial ED:"First of all, I'm not, and I repeat NOT an attorney. What I am is someone with 30+ years of experience. I've been a CNO (not a good one), I've been Director of Clinical Education for a 1000 bed hospital, I've been on Military Courts Martial, I've been a staff nurse, and I've even worked for the Dept of Health investigating health care organizations and providers who mess up, or are accused of messing up. I've worked with attorneys who are defending nurses in malpractice cases, and do peer reviews when there are complaints against RN's I've also been on the other side of the bar and had to defend myself after having my employment terminated, although I've never had my nursing license threatened. I am not a Banner employee and I'm not a member of the AZ Board of Nursing. I have returned to clinical nursing while I'm finishing my graduate education."
http://criticaled.wordpress.com/2012/04/06/notice-of-charges-with-commentary-on-amanda-trujillo/

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Healthcare for People Not for Profit: Transplants and Amanda Trujillo, Center for Health, Media & Policy, April 4, 2012:"Organ transplantation is a complex and challenging undertaking for both the patient and providers. It can offer the appropriate patient opportunities for greatly improved quality and length of life and it can also offer an opportunity for profiteering and conflicted behaviors. As outlined below, transplantation produces significant revenue dollars, even for a "non-profit" hospital. Estimated U.S. Average 2011 Billed Charges Per Transplant: Heart Only - $997,700 Liver – $577,100 Kidney – $262,900 Nurse Amanda Trujillo identified that a patient she cared for at Banner Del E Webb Medical Center of Arizona lacked full information about what a transplant evaluation and post-transplant self-care entailed. She says she referred the patient for a hospice case management consultation. She was then fired for overstepping her scope of practice. Arizona's scope of practice for nurses clearly dictates a nurse's role to promote the client's best interest."
http://centerforhealthmediapolicy.com/2012/04/04/healthcare-for-people-not-for-profit-transplants-and-amanda-trujillo/

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Nurse Blog Failure. With friends like these, Amanda doesn't' need enemies, CriticalED, Posted on April 3, 2012:"Yes the title is sensational. Everyone else is doing it so I guess it's OK for me to do it also, isn't it. This is a rant. Pure and Simple. A rant. If you agree or disagree. then discuss it. Don't jump up and down and discount me. I've made mistakes before. Hell I've been in front of a licensing board, I've been fired, oops no I resigned from an organization in lew of being fired, for doing something that I thought was a good choice at the time. But that's different right? Because I'm not Amanda, or it's not the same thing. First of all, I'm not a blogger. I'm a person who blogs. very poorly. I would love to be able to call myself one, but I'm a casual writer. In general I can't maintain interest long enough to be a. consistent enough, b.good enough, c. worth reading. In general I blog for myself, as a way to focus my thoughts. If people read them, then my ego is massaged. And we all need that."
http://criticaled.wordpress.com/2012/04/03/nurse-blog-failure-with-friends-like-these-amanda-doesnt-need-enemies/

Healthcare for People Not for Profit: Transplants and Amanda Trujillo, Center for Health, Media & Policy, April 4, 2012:"Organ transplantation is a complex and challenging undertaking for both the patient and providers. It can offer the appropriate patient opportunities for greatly improved quality and length of life and it can also offer an opportunity for profiteering and conflicted behaviors. As outlined below, transplantation produces significant revenue dollars, even for a "non-profit" hospital. Estimated U.S. Average 2011 Billed Charges Per Transplant: Heart Only - $997,700 Liver – $577,100 Kidney – $262,900 Nurse Amanda Trujillo identified that a patient she cared for at Banner Del E Webb Medical Center of Arizona lacked full information about what a transplant evaluation and post-transplant self-care entailed. She says she referred the patient for a hospice case management consultation. She was then fired for overstepping her scope of practice. Arizona's scope of practice for nurses clearly dictates a nurse's role to promote the client's best interest."
http://centerforhealthmediapolicy.com/2012/04/04/healthcare-for-people-not-for-profit-transplants-and-amanda-trujillo/

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Did We Trade Our Nursing Caps for the Invisible Cap of Apathy? April 2012, Carol Gino, RN @hopefulehealer @cgino8 #nurseup:"“Why are you sticking up for Amanda Trujillo?” nurses have asked me. My first response was, ”She fought back with the courage of her beliefs.” But the truth is that I believe she could be any one of us. Whether we find out she did some foolish things, or her judgment wasn’t always perfect, doesn’t mean to me that we should throw out all the other truths that her case has uncovered."
http://hopefulhealer.com/did-we-trade-our-nursing-caps-for-the-invisible-cap-of-apathy/

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Learning to be an Advocate in a fairy tale world, Posted on March 31, 2012:"I must live in a fairy tale world. My peers and I routinely advocate for patients. A couple of years ago I was at a National Training Institute and listened to my peers talk about how they had advocated for themselves and their patients, as well as each other. Has it always been a bed of roses? No, not even close. I “won” some and I “lost” some. But never once have I felt threatened or at risk for my job or my lively hood. This is very different than the picture that is being painted by the supporters of a nurse in AZ. We as a group will never know what actually happened that night, when a nurse talked to a patient and provided information. Those of you who have been doing this for years know fully well that no two people remember a situation the same way. What is being claimed is that there is a conspiracy to ruin a nurses career, The conspiracy involves a midwest hospital and the stare board of nursing. On the internet the topic has been divisive and polarizing."
http://criticaled.wordpress.com/2012/03/31/learning-to-be-an-advocate-in-a-fairy-tale-world/

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Arizona BON Keeps Trujillo Under Fire, March 21st, 2012, By Jennifer Olin, BSN, RN:"I have started this blog this way several times in the past. I am an OR nurse. What I don’t usually add here, but do in conversation with other nurses, in job interviews for nursing positions and sometimes even in casual “what do you do?” conversations is say my specialty areas are plastics and head and neck (or ENT). Apparently, if I said this in Arizona I could lose my license. At yesterday’s Arizona Board of Nursing (AZ BON) Regular Meeting Amanda Trujillo, RN, was on the agenda. She is the nurse we have been talking about for weeks now, who was fired and reported to the BON by her former employer who claims she overstepped her scope of practice—despite evidence to the contrary brought out by the BON’s own investigator." http://www.rncentral.com/blog/2012/arizona-bon-keeps-trujillo-under-fire/

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Amanda Trujillo and Nurse Advocacy, Greg Mercer, MSN, March 21, 2012:"Friends and colleagues, Nurses have a professional duty to advocate on their patients’ behalf. When our working conditions become sufficiently hostile to this mandate, we each have a simple but intimidating choice: abandon our duty out of fear or convenience, or take our advocacy a step further by publicly taking a stand for Nursing autonomy and ethical health care unfettered by corruption. Health care is big business in America: 18% of the economy and growing. I am a Psychiatric Nurse, Nurse Educator and advocate. I and many colleagues have become interested in the growing corruption in health care that degrades the integrity and quality of research, administration, regulation, and clinical practice. Given the tremendous wealth and pervasive conflicts of interest in health care today, the notion of hundreds of billions of dollars lost annually to overcharging, waste, corruption, and unneeded interventions comes as no surprise."
http://vdutton.posterous.com/ppost-by-greg-mercer-amanda-trujillo-and-nurs

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Tweet Me No Lies, March, 20, 2012 Author: Mother Jones, RN:"Someone at the ANA needs a nose job. They just told a lie. I hopped onto Twitter yesterday to check out some tweets after I learned that the ANA had mentioned Kim McAllister from Emergiblog and me in one of their messages. Here’s a screen shot"
http://www.nurseratchedsplace.com/2012/03/tweet-me-no-lies/

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Amanda Trujillo, RN: The AZ BON Considers Her Case, By Jennifer Olin, BSN, RN, March 16th, 2012:"Amanda Trujillo, RN, may not be a registered nurse by this time next week. For her sake I hope that doesn’t happen. For my sake, for the sake of nursing, I hope that doesn’t happen. Trujillo is the Arizona nurse bloggers across the country have been talking about since the beginning of the year. Writers, who are nurses and physicians and concerned citizens, have taken up her story with zeal. Almost a year ago now, she was fired from her job at an Arizona hospital for, ostensibly, standing up for her patient. To recap, Trujillo advocated for one of her patients, used hospital approved teaching materials, stayed with the scope of practice routinely used at her facility and dictated by the Arizona State Board of Nursing, suggested to her patient that they might want to get information on alternative treatments from the surgery proposed by the patient's physician, and followed through on the patient's request to have a hospice consultation."
http://www.rncentral.com/blog/2012/amanda-trujillo-rn-the-az-bon-considers-her-case/

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RN Calls for Boycott on the State of Arizona, March 15th, 2012 by Nurse Talk:"RN Greg Mercer of Arlington, MA has called for a boycott on the State of Arizona in response to the Amanda Trujillo case. He is collecting signatures on change.org, here is the what they say: BOYCOTT ARIZONA FOR NURSES AND PATIENTS: After multiple invitations to a civil dialogue regarding AZ BON, Governor Brewer has not replied or addressed any of the issues raised. In fact, the only response to date hase been an increase in the seeming intimidation and abuses of power directed at a nurse, Amanda Trujillo, whose seemingly frivolous and abusive case before the Board has languished unresolved for a year to date, leaving her unemployed and impoverished." http://nursetalksite.com/2012/03/15/rn-calls-for-boycott-on-the-state-of-arizona/

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An Open Letter: Dear Future of Nursing, March 11, 2012 Author: Mother Jones, RN:"I choked on my breakfast this morning while I was surfing the web. It all started when I checked out the Future of Nursing: Campaign for Action website. According to the website, “The Future of Nursing:Campaign for Action is an initiative to advance comprehensive health care change. It envisions a health care system where all Americans have access to high-quality, patient-centered care, with nurses contributing to the full extent of their capabilities.” Two of their objectives is to strengthen nurse education and training, and to help enable nurses to practice to the full extent of their education. The campaign is coordinated through the Center to Champion Nursing in America (CCNA), an initiative of AARP, the AARP Foundation and the Robert Wood Johnson Foundation (RWJF)."
http://www.nurseratchedsplace.com/2012/03/an-open-letter-dear-future-of-nursing/

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Amanda Trujillo RN – fired for being a patient advocate, Posted on March 2, 2012 by Pat Iyer:"The story of Amanda Trujillo is a horrifying one. Briefly, she is a single mom who fought to get off welfare and fulfilled her dream of becoming a nurse. Not only did she become a nurse, she earned a masters degree in nursing. One night while working at Banner Health in Arizona, she took care of a patient who was being asked to undergo a liver transplant. In talking to the patient, Amanda learned that the patient did not fully understand what was going to occur. Amanda educated the patient. She explained the option of hospice instead. The patient decided against the transplant. Then the physician came in, had a well- witnessed tantrum at the hospital when he found out his patient had decided against surgery, and Amanda was fired by the hospital. Her case came up for review by the Arizona Board of Nursing. The summary of her case written by the attorney representing her is below. Amanda has been devastated in terms of her career and her finances. She is back on welfare, her dream of being a nurse shattered." http://www.medleague.com/blog/2012/03/02/amanda-trujillo-rn-fired-for-being-a-patient-advocate/

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Amanda Trujillo, RN: Single Mother Fighting for Her Integrity, March 02, 2012, dhoffman2, Blogher.com:"Everyone is a patient...either now or in the future. That's a fact. Another fact is that we all die. Sometimes our deaths can be made easier. Sometimes not. Amanda Trujillo is a nurse who tried to make a dying patient's life and dying easier. She worked in Arizona and was fired in April 2011 after providing education and making a hospice care consult request for a patient with end-stage liver disease. The patient had been in the hospital for 7 days and was supposed to get a pre-transplant evaluation. Unfortunately, the patient did not know anything about his/her liver disease, liver transplant or choices about treatment."
http://www.blogher.com/amanda-trujillo-rn-single-mother-fighting-her-integrity

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The Nurse Who Helped Too Much, Amy Tenderich, DiabetesMine:"It might be hard to believe in this day and age of “participatory medicine” and empowered patients — or in any day and age, really — but the fact is that an Arizona-based nurse was fired from her job recently for simply providing a patient too much information on his treatment options. The nurse’s name is Amanda Trujillo, a single mother living in Phoenix, and licensed nurse in Arizona since 2006. She specializes in cardiology, geriatrics, and end of life/palliative care. The sin she supposedly committed was setting up a consultation on hospice care for a patient suffering from end-stage liver disease, who was scheduled for surgery. This “interference” angered the patient’s physician, who then had Amanda fired and reported her to the Arizona State Board of Nursing, where she is now in danger of losing her nursing license. Fellow health care professionals and patient advocates are flooding the blogosphere in support of her cause!" https://www.diabetesmine.com/2012/03/the-nurse-who-helped-too-much.html

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Amanda Trujillo, part 2, Saturday, February 25, 2012, End of Shift Report - Stories From an Operating Room:"It gets much worse: the Arizona State Nursing Board has ordered Nurse Trujillo to undergo a mental health evaluation in retaliation for her going public with the matter.With the Boards paid psychiatrist to boot, not a disinterested third party. Whats more, they have also ordered her to turn over records from all the physicians she has ever seen for any reason. What happened to her rights of privacy? There seems to be nothing that this outrageous order could contribute to an investigation of the matter. And it turns out that the President of the board of Nursing is also in a position of authority at the hospital that fired Nurse Trujillo. Can anybody spell "conflict of interest"? This order for a mental health evaluation stinks of authoritarian excess reminding one of the KGB or Gestapo."
http://endofshiftreport.blogspot.com/2012/02/amanda-trujillo-part-2.html

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Why physicians should care about Amanda Trujillo-KevinMD by @jaydoe February 25, 2012:"For the past month, the case of Amanda Trujillo has resonated deeply among nurses, triggering an avalanche of postings on Facebook, Twitter and in the nursing blogosphere. Trujillo is the Arizona nurse who was fired in April 2011 after providing education and making a hospice care consult request for an end-stage liver disease patient. This patient was slotted for pre-transplant evaluation and had poor understanding of the disease process and treatment options. Trujillo filled in the gaps for this patient. Trujillo then requested, at the patient's own wish, a hospice team consult, documented her actions appropriately, and left a note (it was night shift) for the primary physician."

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Why physicians should care about Amanda Trujillo, by J. Doe, RN in Patient, February 25, 2012:"For the past month, the case of Amanda Trujillo has resonated deeply among nurses, triggering an avalanche of postings on Facebook, Twitter and in the nursing blogosphere. Trujillo is the Arizona nurse who was fired in April 2011 after providing education and making a hospice care consult request for an end-stage liver disease patient. This patient was slotted for pre-transplant evaluation and had poor understanding of the disease process and treatment options. Trujillo filled in the gaps for this patient. Trujillo then requested, at the patient’s own wish, a hospice team consult, documented her actions appropriately, and left a note (it was night shift) for the primary physician. These actions — the education and the hospice team consult — drew the wrath of both the primary physician, who demanded her dismissal and her license, and also her nursing director, who told Trujillo she had ”messed up all the doctors’ hard work and planning for the surgery.” The patient-requested hospice care consult was cancelled. Trujillo’s employer subsequently fired her, and reported her to the Arizona State Board of Nursing for exceeding nursing scope of practice, though in fact, nurses previously had ordered a hospice care consult without consequence. In short, many nurses believe Trujillo was fired for educating and advocating for her patient."
http://www.kevinmd.com/blog/2012/02/physicians-care-amanda-trujillo.html

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Arizona’s attack on nurses: the Amanda Trujillo case goes viral, by DA Morales on Feb. 23, 2012:"From KPHO (Phoenix CBS), Nurse says she was fired for educating patient. Inside Banner Del Webb Hospital in Sun City West, nurses are constantly tending to sick patients. That’s what Amanda Trujillo said she was doing last April when she spoke with a patient on the eve of their surgery. “I discovered that they had a very big misunderstanding about what they were about to participate in,” Trujillo told CBS 5 News. Trujillo, a licensed nurse in Arizona since 2006, said she advised the patient of possible complications. The patient decided to delay the surgery and reconsider his or her options. Trujillo said she also ordered a case management consult for the patient to be educated about hospice care. “The doctor, ultimately, is the focal point that directs care for patients,” said Banner spokesman Bill Byron, who said company policy prevents nurses from ordering a case management consult. “This is what we go to school to do. We are licensed to teach our patients, we are licensed to advocate,” said Trujillo." http://threesonorans.com/2012/02/23/arizonas-attack-on-nurses-the-amanda-trujillo-case-goes-viral/

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Matthew Browning in support of Amanda Trujillo deleted by American Journal of Nursing, February 21, 2012:"THEN THE AJN BANNED BOTH OF US FROM THEIR FACEBOOK PAGE. Matthew Browning posted the following on the American Journal of Nursing Facebook page. The implication that she somehow "broke the law" here, by the AJN's "editor" , is as grievous an injury as the BON asking for a mental health eval- maybe she was dressed like she was asking for it?? I am saddened that THIS rubbish is considered the voice of American Nursing. The time is right for a new voice for American Nurses. Nurses who advocate for their patients, their fellow nurses and their profession DESERVE a strong voice of support- not this BS waffling by some editor."
http://vdutton.posterous.com/post-by-matthew-browning-in-support-of-amanda

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In the Footsteps of Rosa Parks, Mother Jones, RN, February 20, 2012:"You must never be fearful about what you are doing when it is right.” Rosa Parks. Nurse K, the proprietor of Crass-Pollination: An ER Blog just wrote a post about the Amanda Trujillo case. She and I have very different opinions about Amanda’s case, but I encourage you to read her post because she reflects the opinion of many nurses about Amanda’s situation. Nurse K gives an accurate blow by blow description on how corporate nurse leaders wage war against their nursing staff. She explains how nurse managers orchestrate the demise of nursing careers. Make management angry and you get the axe, and there isn’t a nurse alive that hasn’t witnessed or experienced the wrath of hospital management. Nurses scatter and go underground when someone gets in trouble, and conventional wisdom states that a nurse should be contrite and take their punishment when they are abused by those who hold power. Many people are wondering why Amanda didn’t follow the same path. Some, like Nurse K, are suggesting that Amanda is committing career suicide. Other’s have told Amanda to “shut up.” The American Nurses Association and the Arizona Nurses Association won’t support an individual nurse who is “under investigation.” Egregious comments and actions are coming from the Arizona Board of Nursing. Kim McAllister from Emergiblog writes about the board’s actions here." http://www.nurseratchedsplace.com/2012/02/in-the-footsteps-of-rosa-parks/

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Amanda Trujillo: An Unfortunate Case of Career Suicide, Friday, February 17, 2012, Crass Pollination:"I used to be really poor back in the day. I'm not talking "I had a five-year-old computer and sometimes I had to go to Subway instead of somewhere that was Zagat rated." I'm talking no heat outside of a single space heater in below-freezing temps, a food budget of $10/week for three people, no functioning toilet (sh*tting outside in the snow sucks, take note), a leaky roof, and neighbors stopping by to give me and my son meat. Really, being poor sucks. I got straight As in college with all this going on." http://crasspollination.blogspot.com/2012/02/amanda-trujillo-unfortunate-case-of.html

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Boards of Nursing and the Amanda Trujillo Case, February 17, 2012, By Shawn Kennedy, MA, RN, AJN editor-in-chief:"Our prior post on the Amanda Trujillo case elicited many comments, on a variety of themes. There were also referrals and crosslinks to other sites supporting, analyzing, and weighing in on the situation, including statements from the Arizona Nurses Association and the ANA, and a post on a physician blog, "White Coat's Call Room," which has vowed to carry all the details once the case is decided." http://ajnoffthecharts.com/2012/02/17/boards-of-nursing-and-the-amanda-trujillo-case/

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Open Letter to Arizona Governor Brewer re AZ BON, Greg Mercer, MSN, February 16, 2012:"Governor Brewer, You and your legislature are can make a strong improvement in the regulation of Arizona health care, at little cost, and set a positive precedent for the rest of our nation, building on your fine government reforms to date (I wish Massachusetts would follow your lead on transparency). There is no regulatory function or group whose work will not benefit over time from the sunlight of public scrutiny. Such accountability, as we have seen in the occasionally raucous debates over your BON and the case of Amanda Trujillo, can be messy at times, certainly inconvenient and irritating, but that is how a health democracy functions: involvement, and the willingness to form and express opinions, to speak and listen and do the hard work required to craft consensus."
http://grchealthcareblog.com/2012/02/16/open-letter-to-arizona-governor-brewer-re-az-bon/

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ANA, Nightingale, Churchill, Lincoln, and BONs, Greg Mercer, MSN, February 16, 2012:"There is no regulatory function or group whose work will not benefit over time from the sunlight of public scrutiny. Such accountability, as we have seen in the occasionally raucous debates over the case of Amanda Trujillo, can be messy at times, certainly inconvenient and irritating, but that is how a health democracy functions: involvement, and the willingness to form and express opinions, to speak and listen and do the hard work required to craft consensus. “Many forms of Government have been tried, and will be tried in this world of sin and woe. No one pretends that democracy is perfect or all-wise. Indeed, it has been said that democracy is the worst form of government, except for all those other forms that have been tried…” – Churchill."
http://grchealthcareblog.com/2012/02/16/ana-nightingale-churchill-lincoln-and-bons/

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Here’s What You Think About RN Amanda Trujillo’s Story, February 15th, 2012, By Jennifer Olin, BSN, RN:"I rarely worry about losing my job as a nurse. I’m generally professional, mostly on time, anal retentive about patient safety and for the most part people seem to like me. I am bossy, but I am a nurse (specifically an OR nurse so that comes with the territory). I am demanding on my patient’s behalf (but sometimes that slips over into my personal life) and I hate charting (which is hard on my chart reviewers and why I love medical mission work). I share all this because I am human; just like every nurse. Most of us don’t consider we will lose our jobs for doing our jobs, sometimes no matter how difficult we are to work alongside. Arizona nurse Amanda Trujillo never considered she would lose her job and possibly her license for being safety conscious and demanding on her patient’s behalf." http://www.rncentral.com/blog/2012/heres-what-you-think-about-rn-amanda-trujillos-story/

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Boards of Nursing-Who Do They Stand Up For? By Jennifer Olin, BSN, RN, February 14th, 2012:"How often do you think about your state’s board of nursing (BON)? I know I almost never do. I’m betting, for the most part, nurses think about their respective BONs once or twice every two to three years when their license renewals are due. We write a check, or send a credit card payment online and the BON drifts to the back of our brains for another couple of years. This may be a big mistake. Boards of Nursing have a lot of power. They regulate how — and if — we can practice as nurses; provide the licensing that allows us to do so and sets the standards for our education. And, to be honest, I don’t know who the people are on my state BON or how they get their jobs. And yes, I do get the newsletter. I skim it, read the headlines and look to see if they have added or changed any of my mandatory continuing education credits and then toss it in the trash. I am only talking about the newsletter I get from the Texas BON. I am currently licensed in two other states but they never send me anything: no newsletters, no emails—just a notice every couple of years to re-up."
http://www.rncentral.com/blog/2012/boards-of-nursing-who-do-they-stand-up-for/

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Sixty or so Legal Precedents Relevant to the Trujillo Case, Greg Mercer, MSN, February 14, 2012:"The web site www.nursinglaw.com provides, free of charge, an extensive list of legal precedents involving Nurses, arranged alphabetically by topic. The list below includes case perhaps relevant to Amanda Trujillo’s unfolding situation. I apologize in advance if unrelated material found its way to this list: putting it together has been quite the chore. As long as it is, my list represents a tiny sample of the vast resources nursinglaw.com provides. Also, please excuse the rather random formatting: it reflects cutting and pasting from the original list. I have found it very difficult at times to format without repeatedly opening links, and have deferred that task for now, invoking the time-honored privilege of the Volunteer worker… Advocate (Nurse as Patient’s)."
http://grchealthcareblog.com/2012/02/14/nurse-firing-legal-precedents/

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What Exactly Is Patient Advocacy? By Jennifer Olin, BSN, RN, February 13th, 2012:"One of the many topics raised by the case of Arizona nurse Amanda Trujillo, her firing by Banner Health, and their subsequent complaint to the state’s Board of Nursing, is did she step out of bounds while advocating for her patient? As I remember it, from day one of nursing school, it was ingrained in us that advocacy, particularly patient advocacy, is one of our most important nursing duties. I know that’s what I remember from all those years ago. Or is it? So, I went to the sources; nursing textbooks. I still had my copy of Fundamentals of Nursing (Kozier & Erb, fifth edition) and I borrowed a friend’s textbook of the same title (Potter & Perry, sixth edition); and I asked an acquaintance who is currently in nursing school to look at her version of Fundamentals (Taylor et.al., seventh edition). In this very unscientific survey I found my memory was on point. In all three texts, from different years and different authors, nurse as patient advocate is found repeatedly in the first 100-200 pages (and these textbooks have over 1500 pages apiece)."
http://www.rncentral.com/blog/2012/what-exactly-is-patient-advocacy/

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Amanda Trujillo RN, Monday, February 13, 2012, End of Shift Report - Stories From an Operating Room:"I am breaking into my usual fiction to tell you about a real travesty taking place in Arizona. Amanda Trujillo RN advised a patient who was up for a liver transplant about other options at the patients request. This is a normal and expected duty of an RN. As a result, the patient and his family decided against the liver transplant. The Surgeon involved went ballistic, threw a well documented temper tantrum, went to the Hospital administration and demanded Nurse Trujillo's termination, which they did. He then went and filed a complaint with the Arizona State Nursing Board who have placed Nurse Trujillo under investigation. The American Nurses Association, who supposedly represent nurses has issued a fatuous, self serving masterpiece of administrative-do-nothing statement that if anything, supports the hospital, the surgeon and the state board. The Arizona State Nurses Association also has done nothing.The leadership of the state board and the state association have been seen schmoozing with other powers that be. Am I surprised? No. Am I outraged? Yes. Over the years I have seen many, many instances of Nurses having to put up with abusive behavior if not outright assault and battery by Physicians. I have yet to see any Physician receive appropriate discipline, and in most instances no discipline."
http://endofshiftreport.blogspot.com/2012/02/amanda-trujillo-rn.html

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The Curious Case Of Amanda Trujillo And How Its Outcome Will Affect The Quality Of Healthcare We All Receive February 13th, 2012 by Shahina Lakhani RN, MSN, NLP:"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."
http://nursetalksite.com/2012/02/13/the-curious-case-of-amanda-trujillo-and-how-its-outcome-will-affect-the-quality-of-healthcare-we-all-receive/

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Re Amanda Trujillo: Open Letter to The Honorable Janice K. Brewer, Arizona Governor, Posted on February 12, 2012, Greg Mercer:"Please learn more about the important ongoing case of RN Amanda Trujillo, a conscientious Nurse who has been punished strikingly severely for providing routine patient education that inconvenienced and angered a physician who demanded her job and her license. Her State BON has still not decided her case after a year, and she remains an unemployed single mother. For a fine summary of the known facts, see ” thenerdynurse.com/2012/01/arizona-nurse-has-license-threatened-by-doctor-after-providing-patient-education.html ” If, as I and many others have after much research and reflection, you find her cause worthy and just, please participate in our advocacy campaign. It requires little commitment, cost, or effort:"
http://grchealthcareblog.com/2012/02/12/re-amanda-trujillo-open-letter-to-the-honorable-janice-k-brewer-arizona-governor/

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Best Selling Author and Nurse Leader Carol Gino Advocates for Embattled RN Amanda Trujillo, February 12th, 2012 by Nurse Talk (Video):"Carol Gino, New York Times' bestselling author and nurse leader advocating for Amanda Trujillo."
http://nursetalksite.com/2012/02/12/best-selling-author-and-nurse-leader-carol-gino-advocates-for-embattled-rn-amanda-trujillo/

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What's Missing in the Amanda Trujillo Story? February 10, 2012:"An easy one in my opinion... the answer is support. You can read about Amanda Trujillo's ordeal at V. Dutton's Posterous (@nursingpins) site. Whether guilty or innocent, the allegations against her have not been heard by the Arizona Board of Nursing as of yet. There are many unknowns, many questions I would like answers to, but we simply don't have that information and we may never have the complete story. So, what I can do, is offer my support to a fellow nurse, regardless of guilt or innocence. This is where the problem lies, in my most humble opinion. Nurses are for the good of people, I am betting most will agree on that. So, if we are for the "good", what happens when a fellow nurse has formal charges brought against her/him? I have read the the numerous comments on the various blogs that have written about Ms. Trujillo's experience. For the most part, it seems the majority of "voices" support her, even though all of the facts are not known. There are some skeptics, but what I find most remarkable, is the silence of the educators and associations that were founded to support nurses."
http://nursingnotes.posterous.com/whats-missing-in-the-amanda-trujillo-story

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American Nurses Association: Supporting Nurses, Until You Need It, Emergiblog, February 9, 2012:"I have always considered the American Nurses Association my professional organization. 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."
http://www.emergiblog.com/2012/02/american-nurses-association-supporting-nurses-until-you-need-it.html

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Healthcare Providers Strive For Excellence, February 8th, 2012, By Jennifer Olin, BSN, RN, @JOlin2 :"Hospitals and other healthcare facilities that earn Magnet Recognition are examples of how nurses and nursing care can influence patient outcomes. It is a great honor and it is one healthcare providers spend a lot of time and money to achieve. However, there are only about 400 Magnet hospitals around the world and thousands of fine healthcare institutions employing nurses everywhere you look."
http://www.rncentral.com/blog/2012/healthcare-providers-strive-for-excellence/

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Why Nurses are Furious about the Amanda Trujillo Case, February 7, 2012, Those Emergency Blues:"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."
http://torontoemerg.wordpress.com/2012/02/07/why-nurses-are-furious-about-the-amanda-trujillo-case/

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Amanda Trujillo, Whitecoat, Emergency Physicians Monthly, February 6, 2012:"I finally took the time to read some other blogs today. One of the issues that I found disturbing was the case of Amanda Trujillo. There are a lot of bits and pieces out there about what actually happened in this case. This blog post was reportedly an e-mail from Amanda describing the events. A summary of the post follows. Amanda was a registered nurse of six years , specializing in cardiology, geriatrics, and end of life/palliative care. In April 2011, she was caring for a dying patient at Banner Del E. Webb Medical Center who had agreed to a major invasive surgery recommended by a staff surgeon. Amanda used materials from her hospital to educate the patient about the details of the surgery and the aftercare. The patient became upset, stating that the surgeon never explained details of the surgery or what had to be done after the surgery (complex lifetime daily self care). Amanda also discovered that the patient “had no idea” that surgery could be refused or that the patient could enroll in hospice care. She educated the patient on those options as well." http://www.epmonthly.com/whitecoat/2012/02/amanda-trujillo/

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The Nurse: The Swiss Army Knife of Healthcare, by carol-gino on February 5, 2012:"Okay so, after reading a ton of books trying to find a definition of nursing that matched my experience, I fell asleep with no clear cut answer to my question, "What is a nurse?" I mean it's not that I haven't been pondering that for a very long time, it's just that nothing so far has satisfied me. I've seen brilliant bedside nurses–and I don't mean nurses who only cared for patients with superb care and compassion– I mean smart, really smart diagnosticians. Nurses who doctors asked, "What do you think is going on with this patient?" And when they answered, there was true appreciation and respect from the doctor to that nurse. They were colleagues, no question there. I've seen ICU nurses, who both doctors and patients trusted to look at a monitor, administer meds — both stat and with standing orders — who saved patients lives time and time again, before a doctor ever could get to the Unit.
http://hopefulhealer.com/the-nurse-the-swiss-army-knife-of-healthcare/

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The Case of Amanda Trujillo, February 2, 2012, By Shawn Kennedy, AJN editor-in-chief:"Amanda Trujillo, MSN, RN, is a nurse who until recently worked at Banner Del Webb Hospital in Sun City, Arizona, until she was fired for, as she claims, just doing what she’s obligated to do as a nurse—specifically, providing a patient information about a surgical procedure in an attempt to support fully informed decision making. (You can read her e-mail detailing her story here. She did not, as she has pointed out in comments, ever attempt to directly obtain informed consent herself.) Amanda Trujillo. Ms. Trujillo says that, when the patient had a change of heart about the surgery, she requested a hospice consult. After a physician complained that Trujillo had overstepped her scope of practice, the hospital filed a complaint with the Arizona Board of Nursing, which has launched an investigation."
http://ajnoffthecharts.com/2012/02/02/the-case-of-amanda-trujillo/

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#NurseUp and Educate On!! Support Each Other! ER Nurses Care, Thursday, February 2, 2012:"Nurses all over the US are upset and simply can't understand how on earth a nurse could be fired for being a patient advocate, educating her patient on all aspects of their care and explaining in detail treatment plans, which led to a greater understanding by her patient and subsequent change in plans. Amanda Trujillo is an advocate for her patients, she did what we all do every shift that we work, make sure our patients understand what is wrong with them, the plan of care, which includes educating them on any treatments, procedures, medications, surgeries, activities or anything else the patient or family asks of us. http://ernursescare.blogspot.com/2012/02/nurseup-and-educate-on-support-each.html

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Tsunami: A Conversation with Amanda Trujillo (Part 3 of 3), by Nursetopia on February 2, 2012:"Amanda nailed this situation during our call when she said, "This is bigger than me." She explained her actions – reaching out to colleagues via emails and social media – is not about revenge or getting even with any organization. She understands the Arizona Board of Nursing must investigate her because she was reported, however, the reason she was reported – a case management consult construed as a medical order – is the bothersome part. "We all make mistakes, realize them, use them to change, give thanks for them, and move on. If I had done something wrong, I could take it. If I had done something wrong." Amanda's story is a ripple culminating in a tsunami of change and ideas and discussions. When asked what she'd like other nurses to know, she provided three thoughts:" http://nursetopia.net/2012/02/02/tsunami-a-conversation-with-amanda-trujillo-part-3-of-3/

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A Letter From the Arizona Nurses Association,February 1, 2012, Author: Mother Jones, RN, @motherjonesrn:"I wrote a letter to the Arizona Nurses Association when I learned that the association was not coming to the aid of Amanda Trujillo. If you haven't heard, Amanda was fired from Banner Del E. Webb Medical Center after she educated one of her patients about their upcoming liver transplant. I wrote about it here and here. I couldn't understand why the association was twiddling its thumbs until I learned that Teri Hill, the president of AzNA is also the Director of Professional Practice at Banner Del E. Webb Medical Center. This is what I wrote: "I've been a registered nurse for 35 years and I had thought I had seen everything until I read about the persecution of Amanda Trujillo. I wondered why the Arizona Nurses Association wasn't backing her until I learned that you are affiliated with the hospital that fired Ms. Trujillo. Shame on you for throwing a nurse under the bus just to appease a doctor that obviously has an anger management issue. Sorry the hospital lost out on a billable procedure, but the patient had a right to know about all of their treatment options. I hope your membership throws you all out of office for not backing Ms. Trujillo. You are a disgrace to the nursing profession.""
http://www.nurseratchedsplace.com/2012/02/a-letter-from-the-arizona-nurses-association/

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Waves: A Conversation with Amanda Trujillo (Part 2 of 3), by Nursetopia on February 1, 2012:"Nurses throughout the U.S. and Canada are standing beside Amanda Trujillo, RN, MSN. We're talking about this everywhere – in blogs, social media, our offices, you name it. Admittedly, Amanda is a shy person; she's not accustomed to this attention. Yet, she says, "For the first time, I feel safe; for the first time, I don't feel alone." Why does Amanda's story resonate with so many of us? Because the majority of us have faced a sliver of Amanda's story. We've each felt alone in our careers – in certain situations – at one point or another, and we don't think anyone should have to do that. Despite what most believe, there is a strong cohort of nurses who don't eat our profession's young; rather, we take them under our wings and mentor them. It's unfortunate so many nurses do not get to see this amazing group of nurses because they typically find one another, encourage one another, and make their organizations great. The same is true for the bullies – those nurses that really should never provide care for people because they are constantly tearing down everyone they meet. They find one another, too, creating hostile and toxic environments, driving nurses away from the profession and making them think they are failures."
http://nursetopia.net/2012/02/01/waves-a-conversation-with-amanda-trujillo-part-2-of-3/

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An Update on AZ Nurse Amanda Trujillo Case, Submitted by Mech on Wednesday, 1 February 2012:"Amanda Trujillo, a registered nurse in Arizona, has been scuffling with her case on patient advocacy for several months already. On January 24, 2012, her case was supposedly to be heard. But unfortunately, it has been postponed and rescheduled on March. And what is reason for delaying it? The AZ BON don't like Amanda's online activity and feel she threatened a former boss. Thus, they are requiring her to undergo first a psychiatric evaluation. With the popularity that Amanda Trujillo's case is receiving online, it made me realized then how important social media is in healthcare industry. They are not only beneficial in promoting health awareness but also allow people in nursing scrubs to share their experiences. Additionally, social media makes it possible for nurses to extend their support to fellow professionals in nursing scrubs like AZ nurse Amanda Trujillo who is currently in a dilemma.
http://www.scrubpoint.com/2012/02/01/an-update-on-az-nurse-amanda-trujillo-case/

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Ripples: A Conversation with Amanda Trujillo (Part 1 of 3), by Nursetopia on January 31, 2012:"I know there are people who have read and read and read about Amanda Trujillo. In fact, there are so many great posts, I don't know who to link to so you can see them all. Be sure to check out The Nerdy Nurse, Those Emergency Blues, Emergiblog, iCoachNurses, Nurse Ratched's Place, and Vern Dutton's page. There are a plethora of links between those fabulous blogs. Still, there are many who have no idea what is happening in Arizona. You can read Amanda's story in her own words; please, do. I spoke with Amanda via telephone for over an hour, listening to her tell her story and asking questions. The many subsequent posts are for Amanda as well as inspired by her. I thank her for sharing her time and story with me so I can share it with you in hopes you will share it with others. This must stop."
http://nursetopia.net/2012/01/31/ripples-a-conversation-with-amanda-trujillo-part-1-of-3/

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A Conversation with Amanda Trujillo (Part 1 of 3), by Nursetopia on January 31, 2012:"I know there are people who have read and read and read about Amanda Trujillo. In fact, there are so many great posts, I don't know who to link to so you can see them all. Be sure to check out The Nerdy Nurse, Those Emergency Blues, Emergiblog, iCoachNurses, Nurse Ratched's Place, and Vern Dutton's page. There are a plethora of links between those fabulous blogs. Still, there are many who have no idea what is happening in Arizona. You can read Amanda's story in her own words; please, do. I spoke with Amanda via telephone for over an hour, listening to her tell her story and asking questions. The many subsequent posts are for Amanda as well as inspired by her. I thank her for sharing her time and story with me so I can share it with you in hopes you will share it with others. This must stop.
http://nursetopia.net/2012/01/31/ripples-a-conversation-with-amanda-trujillo-part-1-of-3/

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Amanda Trujillo – Nurse fired for being a patient advocate, Pat Iyer, January 30, 2012:"The story of Amanda Trujillo is a horrifying one. Briefly, she is a single mom who fought to get off welfare and fulfilled her dream of becoming a nurse. Not only did she become a nurse, she earned a masters degree in nursing. One night while working a Banner Health in Arizona, she took care of a patient who was being asked to undergo a liver transplant. In talking to the patient, Amanda learned that the patient did not fully understand what was going to occur. Amanda educated the patient. She explained the option of hospice instead. The patient decided against the transplant. Then the physician came in, had a well- witnessed tantrum at the hospital when he found out his patient had decided against surgery, and Amanda was fired by the hospital. Her case came up for review by the Arizona Board of Nursing. The summary of her case written by the attorney representing her is below. Amanda has been devastated in terms of her career and her finances. She is back on welfare, her dream of being a nurse shattered."
http://www.avoidmedicalerrors.com/2012/01/amanda-trujillo-nurse-fired-for-being-a-patient-advocate/

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Here’s the plan: Lets make the powers WANT to help Amanda T, Greg Mercer, January 29, 2012:"I have a plan, and much evidence suggests it could work. Forget “support,” forget “standing by,” forget sympathy and empathy and outrage, for a moment. We now have achieved plenty of all of those things. I think we should offer more – ensure Amanda retains her license, her good name, and her career. I surely can’t offer certainty, but I can offer a fair shot of success, without asking more than many Nurse are already offering. My last posts have been lengthy, so here’s a short version – I suggest the full ones if you can find the time, worth it, please trust me on that. My plan makes more sense if you know a bit more about the history and successes of Social Media advocacy outside of Nursing. The short version: initially tiny groups of plain old average powerless people, with much less credibility and wherewithal than that of the average Nurse, have repeatedly used Social Media to organize. Using these tools they have defeated the following in some way – all real well-documented examples, I give my word and reputation on it. These examples are more fully describes in other posts"
http://grchealthcareblog.com/2012/01/29/heres-the-plan-lets-make-the-powers-want-to-help-amanda-t/

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Here’s how you can REALLY help Amanda T and other Nurses, Greg Mercer, RN, @gregmercer1, January 28, 2012:"I have a few more ideas to offer about Amanda Trujillo’s situation, about Social Media, about powers Nurses already have, and those we COULD have and soon, IF we decide to make it so. It wouldn’t require much from most individual Nurses, really, not much at all: for most of us, a few minutes here and there, perhaps a few dollars occasionally. Very little in comparison to the hard work we put in every day. What do Nurses need most? What do Nurses like Amanda need most? They need more power, plain and simple. Everything else is details. Here’s a thought: what about sending peanuts? Whoa, where did that come from? This, my friends, is a teaser: a preview of one of the real success stories later on in this post. Ordinary little people got mad, and instead of complaining and waiting for someone else to save them, they got organized, they sent lots and lots of peanuts. By so doing they quickly, cheaply, and rather easily forced a large Corporation to change its ways against its will. TRUE STORY, people. Check it out: unless you want Nursing to stay as is or get worse."
http://grchealthcareblog.com/2012/01/28/heres-how-you-can-really-help-amanda-t-and-other-nurses/

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The Trujillo case, the truth, and BONs, January 28, 2012, Greg Mercer:"I have recently been exploring the controversy around AZ RN Amanda Trujillo, like so many others well before me – thanks to so many conscientious Nurses for raising awareness that finally got past my innate philosophical skepticism. You see, I’m very cautious: I try not to assume the truth of most ANYTHING before some careful scrutiny, especially anything from our various public media. Less but solid information is a far better foundation than lots of questionable data: inconvenient and tedious at times, but sound practice. And as cognitive science proves, we humans frequently fool ourselves: we confuse the plausible and/or vivid with the factual – a tremendous source of erroneous belief and thus misguided action. So, there it is – my skepticism slows me down but hopefully keeps me optimally within the bounds of truth. Reality is universally more complex, nuanced, and tedious than our pictures of it."
http://grchealthcareblog.com/2012/01/28/the-trujillo-case-the-truth-and-bons/

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RN Amanda Trujillo Becomes a Call to Arms, By Jennifer Olin, BSN, RN, January 28th, 2012:"It has been a call to arms. The story of Amanda Trujillo, RN, is sweeping the nursing blogosphere in just a matter of days. From the initial story released via Vernon Dutton, RN to the many followup blogs, a national petition and a support group seemingly grown out of nowhere, nurses are banding together to help one of their own. When Trujillo was first fired she reached out for support to nursing organizations in her home state of Arizona. That support was not forthcoming. As the months passed and her hearing in front of the Arizona State Board of Nursing was put off Trujillo decided to take matters into her own hands and look for support elsewhere. Long a fan of nurse/author Echo Heron, Trujillo sent her an email about her troubles. Heron forwarded that email to Dutton. I recently spoke with Trujillo about her decision to seek help from strangers." http://www.rncentral.com/blog/2012/rn-amanda-trujillo-becomes-a-call-to-arms/

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Stop the Bullying Now -- Stand up for Nurses and Patients, Kathy Quan RN BSN, The Nursing Site, January 26, 2012:"photo from Flickr Have you heard about the plight of Amanda Trujillo, an RN who was fired by Banner health in Arizona for educating a patient in the process of obtaining informed consent? The physician threw a well documented tantrum because the patient decided against the procedure after being educated. The physician demanded the nurse be fired and he has filed a complaint against the RN with the AZ Board of Nursing. This keeps her from being hired anywhere else in AZ. Listen to this interview and read more about this case. You can also sign a petition for the AZ BRN to remove the "under investigation" status from Amanda's license. Follow this situation on FACEBOOK."
http://www.thenursingsiteblog.com/2012/01/stop-bullying-now-stand-up-for-nurses.html

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The Nurse Stands Alone… @Emergiblog, January 24, 2012, #nurseup #AmandaTrujillo #nursefriendly:"Nurses talk a great game. In the Halls of Academia and the Ivory Towers of Those Who Claim to Advance The Profession, it’s all “Nursing Is An Independent Profession” and we tirelessly “Fight For Our Right To Practice To The Full Extent Of Our Education And Training”. Unless you’re down in the trenches doing patient care every day and someone gets angry that you have dared to advocate. And if that Someone is a Doctor, well, the bigwigs scatter to the four corners of the ring. Musn’t create controversy. Hell, they aren’t even standing on your side of the arena."
http://www.emergiblog.com/2012/01/the-nurse-stands-alone.html

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Arizona Nurse Has License Threatened By Doctor After Providing Patient Education, January 22, 2012 By The Nerdy Nurse:"There are times in my nursing career when I am so very proud of how far we have come in advancing our profession. Unfortunately, there are also times where I am reminded that this is still very much an uphill climb we must make in order to legitimately participate in truly collaborative healthcare. Today is one of those days in which I am reminded we still have battles to win. The following blog post is related to an email that was originally sent to @EchoHeronAuthor. It was then posted on Vernon Dutton's Posterous, Amanda Trujillo case will go before the Arizona State Board of Nursing on January 24th, 2012. Her story is one of an archaic medical model in which the doctor's word is supreme and we are all just nurse maids here to do their bidding. This is an indication that there are many who do not wish to continue to advance toward collaborative healthcare in which we work as a team to provide patients with the best care possible. This is also an example of persons who may not be in medicine for the right reasons."
http://thenerdynurse.com/2012/01/arizona-nurse-has-license-threatened-by-doctor-after-providing-patient-education.html

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Patricia Iyer, former president of the American Association of Legal Nurse Consultants explains and prepared a video statement:"The story of Amanda Trujillo is a horrifying one. Briefly, she is a single mom who fought to get off welfare and fulfilled her dream of becoming a nurse. Not only did she become a nurse, she earned a masters degree in nursing. One night while working at Banner Health in Arizona, she took care of a patient who was being asked to undergo a liver transplant. In talking to the patient, Amanda learned that the patient did not fully understand what was going to occur."
http://nurseup.com/wordpress/2012/02/amanda-trujillo-rn-fired-for-being-a-patient-advocate-pat-iyer-com-patiyer-nurseup-nursefriendly-amandatrujillo/

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Banner Health, Arizona Board of @Nursing: A Personal Vendetta? Emergiblog:"Sorry, no. 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."
http://www.emergiblog.com/2012/01/banner-health-arizona-board-of-nursing-a-personal-vendetta.html

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Nurses associations, my very own arcade claw machine by Kevin Ross, January 29, 2012:"It seems that there isn't any shortage of things to write about here at Innovative Nurse when it comes to fellow nurse Amanda Trujillo. Search Twitter for #NurseUp, and all of the amazing nurse bloggers out there (links below), that have kept you somewhat up to speed on the case of Amanda. So, I was on Tweetchat this past Sunday with some of these amazing nurse bloggers, leaders, and entrepreneurs out there and the support is just off the hook (save that hook reference for a sec). I know we're here for a bigger cause than Amanda. I just can't believe it took something like this to bring us together. We're here for the nursing profession, and in support of our ability to work collaboratively and to advocate for our patients. There are nursing professionals I've never even met that are pouring themselves into this cause with great vigor. Watch out because the energy behind this is unstoppable."
http://innovativenurse.com/nurses-association-arcade-claw-machine/

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Innovative Nurse: Why did you choose to publicly support Amanda Trujillo, RN? by Kevin On January 28, 2012:"Jennifer Olin, BSN, RN from RN Central reached out about the Amanda Trujillo story to ask, “How did you pick up this story, and why did you decide to run with it?” My comment below just touches on what this really means to me, and everything that we’ve already done as a core group at the #NurseUp movement is just the beginning. You can read the article posted on RN Central from the slide show below to hear from a number of nurse bloggers out there who have helped with this tremendous cause."
http://innovativenurse.com/innovative-nurse-amanda-trujillo/

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Voices For Amanda Trujillo, Jay Doe, Those Emergency Blues, January 28, 2012:"Each of them eloquently speaks to the heart of what we do as nurses — and why nurses find how Amanda Trujillo was fired and subsequently reported to the Arizona State Board of Nursing so troubling. (Via The Innovative Nurse.)"
Facebook: http://www.facebook.com/people/Jay-Doe/100000771416457
Twitter: http://twitter.com/#!/TorontoEmerg
http://torontoemerg.wordpress.com/2012/01/28/voices-for-amanda-trujillo/

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Amanda Trujillo: Exposing the Truth, By Jessica Ellis | January 26th, 2012:"For those followers of this blog that are not yet aware of what has recently come to the attention of the nursing community, I wanted to make sure to promote awareness of the landmark case out of Arizona concerning Amanda Trujillo. This nurse has taken her case to the public nursing community in order to gain support for herself, and our profession as a whole. The truth has been exposed. We who have been in the nursing profession know it, and now it is time to take the truth to the public. FACT: Nurses and the core of our profession–patient care–are at the mercy of the medical and political powers-that-be when we interfere with the revenue of hospitals, doctors, and the government, including the boards of nursing that govern our practice in each state."
http://www.nursesnetwork.com/2012/01/26/amanda-trujillo-exposing-the-truth/

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The power of social media #NurseUp, By Kevin On January 25, 2012:"If you’ve been following Innovative Nurse, and the other nurse bloggers and innovators out there, then you’ve probably gotten a dose of how powerful social media can be. Just a few short days ago, I heard about Amanda Trujillo’s story and decided to plant my feet firmly on the ground, my fingers firmly on my keyboard, and I took a stance. Drafting an open letter to the Arizona Board of Nursing on Amanda’s behalf just seemed like the least I could do for her. She didn’t reach out to me, I’ve never met her in person, and yet, it’s as if I actually know her. The connection is unbreakable. She’s a nurse. I know what that means. I take a lot of pride in who I am, and everything I’ve done as a nurse. I’m sure you know where I’m coming from if you too are a nurse. We are on the front lines, we are the armor, and together we’re impenetrable." http://innovativenurse.com/power-social-media-nurseup/

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Arizona Nurse Has License Threatened By Doctor After Providing Patient Education January 22, 2012 By The Nerdy Nurse:"There are times in my nursing career when I am so very proud of how far we have come in advancing our profession. Unfortunately, there are also times where I am reminded that this is still very much an uphill climb we must make in order to legitimately participate in truly collaborative healthcare. Today is one of those days in which I am reminded we still have battles to win. The following blog post is related to an email that was originally sent to @EchoHeronAuthor. It was then posted on Vernon Dutton’s Posterous, Amanda Trujillo case will go before the Arizona State Board of Nursing on January 24th, 2012. Her story is one of an archaic medical model in which the doctor’s word is supreme and we are all just nurse maids here to do their bidding. This is an indication that there are many who do not wish to continue to advance toward collaborative healthcare in which we work as a team to provide patients with the best care possible. This is also an example of persons who may not be in medicine for the right reasons."
http://thenerdynurse.com/2012/01/arizona-nurse-has-license-threatened-by-doctor-after-providing-patient-education.html

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Advocating for a fellow Nurse: Amanda Trujillo, MSN, RN, DNSc-NP(s), Kevin Ross, January 22, 2012, #RN, @innovativenurse #nurseup #nursefriendly:"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. http://innovativenurse.com/advocating-fellow-nurse/

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Del E. Webb Medical Center, Sun City Arizona AKA Banner Health Nurse Incident @BannerHealth, January 15, 2012:"This is the original post which prompted us to mobilize and form the "Nurseup" movement. It reprints an email Amanda Trujillo, RN sent to Echo Heron, RN http://www.echoheron.com/ We are deeply grateful to Vernon Dutton, RN @nursingpins for bringing this issue to our attention and continuing to support it tirelessly."
http://nurseup.com/wordpress/2012/02/del-e-webb-medical-center-sun-city-arizona-aka-banner-health-nurse-incident-bannerhealth-vduttons-posterous/

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Are You On Fire? January 2nd, 2012 by Amanda Trujillo, RN, MSN:"A forest fire is destructive and dangerous, it wipes out all that is good and healthy and beautiful. It exerts its power and overwhelms everything in its path. In nursing many of us come to a point in our career where the fire has overwhelmed our soul and we haven’t realized it or stopped to take a moment to appreciate the toxicity of the smoke surrounding us. We may fail to do the important growth work that is so integral to how we care for others. We forget to periodically evaluate our own forest—to look for the old and the brittle, the dry bushes, the dry earth, the lack of flora."
http://nursetalksite.com/2012/01/02/are-you-on-fire/

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Being A Naive Nurse Will Get You Thrown To The Wolves, @jaydoe, 11/07/10. #Nurseup:"In matters related to practice, errors, or sentinel events, are nurses far too naïve when it comes to dealing with their employers, regulatory bodies, or police? Nurses falsely assume that all of these authorities will act in, or at least be mindful of, their best interests. The thought that any of them might act solely in their own self-interest (at best) or in bad faith (at worst), is probably beyond most of us. The fact is none of them have a nurse’s interest as their top priority, if in fact they consider it all. Aside from a duty to ensure patient safety, hospitals have a legal, fiduciary obligation to protect themselves from liability issues and legal action." http://nurseup.com/wordpress/2012/03/being-a-naive-nurse-will-get-you-thrown-to-the-wolves/

 

Could What Happened to #AmandaTrujillo #RN Happen To You?? Donna Cardillo, RN @donnacardillorn #nurseup

Could What Happened to #AmandaTrujillo #RN Happen To You?? Donna Cardillo, RN @donnacardillorn #nurseup:”In case you don’t frequent twitter, the nursing blogosphere, Facebook or other online nursing communities, Amanda Trujillo is a nurse in Arizona who is under investigation by the State Board of Nursing there. In short (you can read her account here) Amanda relates that when she became aware that a patient awaiting a liver transplant had considerable misunderstanding about the procedure and the lifelong aftercare that would be required, she spent time with the patient discussing related issues and ordered a hospice/case management consult at the patients request so the patient could explore his/her options, something that was within her scope of practice and not against her employer’s policies.”

http://www.nurse-power.com/blog/could-what-happened-to-amanda-trujillo-happen-to-you/

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For more information on Nursing & Patient Advocacy, Entrepreneurship: http://www.nurseup.com/

Kindly sign our petitions:

Petition: Amanda Trujillo, RN & Banner Del E. Webb Medical Center, Sun City, Arizona: Position Statements Requested

http://www.change.org/​petitions/​nurseup-com-issue-position-stat​ements-on-the-amanda-trujillo-​rn

Petition: Arizona State Board of Nursing: Remove Amanda Trujillo’s nursing license from ”under investigation” status | Change.org

http://www.change.org/​petitions/​arizona-state-board-of-nursing-​remove-amanda-trujillo-s-nursi​ng-license-from-under-investig​ation-status

Contribute to Amanda’s Legal Defense Fund:

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Andrew Lopez, RN
Nurseup.com, A Nursing Advocacy Organization
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Articles in reverse order of publication:

Cover yourself, no one wants to see that, By Guest Post, On April 13, 2012:”A lot has been written across online nursing communities about the case of Amanda Trujillo, a nurse currently defending her license with the Arizona State Board of Nursing. Regardless of your position on the case, it brings up an important question for nurses—how can nurses protect themselves in the event that their license is challenged?”

http://innovativenurse.com/cover-yourself-malpractice/

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Sifting through wreckage, April 8, 2012 By nurseinterupted:”The face of PTSD is changing, and changing fast. Once associated with war veterans (I grew up with a father who has had it since returning from VietNam), more attention is now being placed on the silent walking wounded—Nurses. Since my efforts to promote anti nurse retaliation legislation and patient’s rights legislation has taken a rather devastating blow recently, it seems a good time to begin work on writing a grant to gain funding for the healing retreat for nurses I’d like to host each year. I can’t imagine who or what could throw a wrench in that particular goal, but something positive and lasting has to come from injustice, something that even in the smallest way—helps to heal and improve our profession. Focusing my time and skills on introducing something peaceful to the wounded of our profession will also help me to get my mind off of the sad and disgusting things out there that have taken the attention away from the issues I worked so hard to bring attention to in the first place.”

http://nurseinterupted.wordpress.com/2012/04/08/sifting-through-wreckage/

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Excuse me. whatever happened to critical thinking? CriticalED, Posted on April 8, 2012:”The thing that scares me about this whole issue is the lack of “critical thinking”. We as a group have been striving for decades to be considered professionals. We lay claim to concepts like critical thinking, but then throw those same concepts out the window, and let emotions and prejudice guide our behavior. Yes Banner Del Webb may be the worst hospital to work for in the country, and it the dislike for the company may run deep. The AZ BON may not be the most transparent agency around. But that should mean that they are automatically the ones that are wrong here.”

http://criticaled.wordpress.com/2012/04/08/excuse-me-whatever-happened-to-critical-thinking/

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Notice of Charges with Commentary on Amanda Trujillo, Posted on April 6, 2012, Critial ED:”First of all, I’m not, and I repeat NOT an attorney. What I am is someone with 30+ years of experience. I’ve been a CNO (not a good one), I’ve been Director of Clinical Education for a 1000 bed hospital, I’ve been on Military Courts Martial, I’ve been a staff nurse, and I’ve even worked for the Dept of Health investigating health care organizations and providers who mess up, or are accused of messing up. I’ve worked with attorneys who are defending nurses in malpractice cases, and do peer reviews when there are complaints against RN’s I’ve also been on the other side of the bar and had to defend myself after having my employment terminated, although I’ve never had my nursing license threatened. I am not a Banner employee and I’m not a member of the AZ Board of Nursing. I have returned to clinical nursing while I’m finishing my graduate education.”

http://criticaled.wordpress.com/2012/04/06/notice-of-charges-with-commentary-on-amanda-trujillo/

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Healthcare for People Not for Profit: Transplants and Amanda Trujillo, Center for Health, Media & Policy, April 4, 2012:”Organ transplantation is a complex and challenging undertaking for both the patient and providers. It can offer the appropriate patient opportunities for greatly improved quality and length of life and it can also offer an opportunity for profiteering and conflicted behaviors. As outlined below, transplantation produces significant revenue dollars, even for a ”non-profit” hospital. Estimated U.S. Average 2011 Billed Charges Per Transplant: Heart Only – $997,700 Liver – $577,100 Kidney – $262,900 Nurse Amanda Trujillo identified that a patient she cared for at Banner Del E Webb Medical Center of Arizona lacked full information about what a transplant evaluation and post-transplant self-care entailed. She says she referred the patient for a hospice case management consultation. She was then fired for overstepping her scope of practice. Arizona’s scope of practice for nurses clearly dictates a nurse’s role to promote the client’s best interest.”

http://centerforhealthmediapolicy.com/2012/04/04/healthcare-for-people-not-for-profit-transplants-and-amanda-trujillo/

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Nurse Blog Failure. With friends like these, Amanda doesn’t’ need enemies, CriticalED, Posted on April 3, 2012:”Yes the title is sensational. Everyone else is doing it so I guess it’s OK for me to do it also, isn’t it. This is a rant. Pure and Simple. A rant. If you agree or disagree. then discuss it. Don’t jump up and down and discount me. I’ve made mistakes before. Hell I’ve been in front of a licensing board, I’ve been fired, oops no I resigned from an organization in lew of being fired, for doing something that I thought was a good choice at the time. But that’s different right? Because I’m not Amanda, or it’s not the same thing. First of all, I’m not a blogger. I’m a person who blogs. very poorly. I would love to be able to call myself one, but I’m a casual writer. In general I can’t maintain interest long enough to be a. consistent enough, b.good enough, c. worth reading. In general I blog for myself, as a way to focus my thoughts. If people read them, then my ego is massaged. And we all need that.”

http://criticaled.wordpress.com/2012/04/03/nurse-blog-failure-with-friends-like-these-amanda-doesnt-need-enemies/

Healthcare for People Not for Profit: Transplants and Amanda Trujillo, Center for Health, Media & Policy, April 4, 2012:”Organ transplantation is a complex and challenging undertaking for both the patient and providers. It can offer the appropriate patient opportunities for greatly improved quality and length of life and it can also offer an opportunity for profiteering and conflicted behaviors. As outlined below, transplantation produces significant revenue dollars, even for a ”non-profit” hospital. Estimated U.S. Average 2011 Billed Charges Per Transplant: Heart Only – $997,700 Liver – $577,100 Kidney – $262,900 Nurse Amanda Trujillo identified that a patient she cared for at Banner Del E Webb Medical Center of Arizona lacked full information about what a transplant evaluation and post-transplant self-care entailed. She says she referred the patient for a hospice case management consultation. She was then fired for overstepping her scope of practice. Arizona’s scope of practice for nurses clearly dictates a nurse’s role to promote the client’s best interest.”

http://centerforhealthmediapolicy.com/2012/04/04/healthcare-for-people-not-for-profit-transplants-and-amanda-trujillo/

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Did We Trade Our Nursing Caps for the Invisible Cap of Apathy? April 2012, Carol Gino, RN @hopefulehealer @cgino8 #nurseup:”“Why are you sticking up for Amanda Trujillo?” nurses have asked me. My first response was, ”She fought back with the courage of her beliefs.” But the truth is that I believe she could be any one of us. Whether we find out she did some foolish things, or her judgment wasn’t always perfect, doesn’t mean to me that we should throw out all the other truths that her case has uncovered.”

http://hopefulhealer.com/did-we-trade-our-nursing-caps-for-the-invisible-cap-of-apathy/

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Learning to be an Advocate in a fairy tale world, Posted on March 31, 2012:”I must live in a fairy tale world. My peers and I routinely advocate for patients. A couple of years ago I was at a National Training Institute and listened to my peers talk about how they had advocated for themselves and their patients, as well as each other. Has it always been a bed of roses? No, not even close. I “won” some and I “lost” some. But never once have I felt threatened or at risk for my job or my lively hood. This is very different than the picture that is being painted by the supporters of a nurse in AZ. We as a group will never know what actually happened that night, when a nurse talked to a patient and provided information. Those of you who have been doing this for years know fully well that no two people remember a situation the same way. What is being claimed is that there is a conspiracy to ruin a nurses career, The conspiracy involves a midwest hospital and the stare board of nursing. On the internet the topic has been divisive and polarizing.”

http://criticaled.wordpress.com/2012/03/31/learning-to-be-an-advocate-in-a-fairy-tale-world/

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Arizona BON Keeps Trujillo Under Fire, March 21st, 2012, By Jennifer Olin, BSN, RN:”I have started this blog this way several times in the past. I am an OR nurse. What I don’t usually add here, but do in conversation with other nurses, in job interviews for nursing positions and sometimes even in casual “what do you do?” conversations is say my specialty areas are plastics and head and neck (or ENT). Apparently, if I said this in Arizona I could lose my license. At yesterday’s Arizona Board of Nursing (AZ BON) Regular Meeting Amanda Trujillo, RN, was on the agenda. She is the nurse we have been talking about for weeks now, who was fired and reported to the BON by her former employer who claims she overstepped her scope of practice—despite evidence to the contrary brought out by the BON’s own investigator.” http://www.rncentral.com/blog/2012/arizona-bon-keeps-trujillo-under-fire/

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Amanda Trujillo and Nurse Advocacy, Greg Mercer, MSN, March 21, 2012:”Friends and colleagues, Nurses have a professional duty to advocate on their patients’ behalf. When our working conditions become sufficiently hostile to this mandate, we each have a simple but intimidating choice: abandon our duty out of fear or convenience, or take our advocacy a step further by publicly taking a stand for Nursing autonomy and ethical health care unfettered by corruption. Health care is big business in America: 18% of the economy and growing. I am a Psychiatric Nurse, Nurse Educator and advocate. I and many colleagues have become interested in the growing corruption in health care that degrades the integrity and quality of research, administration, regulation, and clinical practice. Given the tremendous wealth and pervasive conflicts of interest in health care today, the notion of hundreds of billions of dollars lost annually to overcharging, waste, corruption, and unneeded interventions comes as no surprise.”

http://vdutton.posterous.com/ppost-by-greg-mercer-amanda-trujillo-and-nurs

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Tweet Me No Lies, March, 20, 2012 Author: Mother Jones, RN:”Someone at the ANA needs a nose job. They just told a lie. I hopped onto Twitter yesterday to check out some tweets after I learned that the ANA had mentioned Kim McAllister from Emergiblog and me in one of their messages. Here’s a screen shot”

http://www.nurseratchedsplace.com/2012/03/tweet-me-no-lies/

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Amanda Trujillo, RN: The AZ BON Considers Her Case, By Jennifer Olin, BSN, RN, March 16th, 2012:”Amanda Trujillo, RN, may not be a registered nurse by this time next week. For her sake I hope that doesn’t happen. For my sake, for the sake of nursing, I hope that doesn’t happen. Trujillo is the Arizona nurse bloggers across the country have been talking about since the beginning of the year. Writers, who are nurses and physicians and concerned citizens, have taken up her story with zeal. Almost a year ago now, she was fired from her job at an Arizona hospital for, ostensibly, standing up for her patient. To recap, Trujillo advocated for one of her patients, used hospital approved teaching materials, stayed with the scope of practice routinely used at her facility and dictated by the Arizona State Board of Nursing, suggested to her patient that they might want to get information on alternative treatments from the surgery proposed by the patient’s physician, and followed through on the patient’s request to have a hospice consultation.”

http://www.rncentral.com/blog/2012/amanda-trujillo-rn-the-az-bon-considers-her-case/

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RN Calls for Boycott on the State of Arizona, March 15th, 2012 by Nurse Talk:”RN Greg Mercer of Arlington, MA has called for a boycott on the State of Arizona in response to the Amanda Trujillo case. He is collecting signatures on change.org, here is the what they say: BOYCOTT ARIZONA FOR NURSES AND PATIENTS: After multiple invitations to a civil dialogue regarding AZ BON, Governor Brewer has not replied or addressed any of the issues raised. In fact, the only response to date hase been an increase in the seeming intimidation and abuses of power directed at a nurse, Amanda Trujillo, whose seemingly frivolous and abusive case before the Board has languished unresolved for a year to date, leaving her unemployed and impoverished.” http://nursetalksite.com/2012/03/15/rn-calls-for-boycott-on-the-state-of-arizona/

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An Open Letter: Dear Future of Nursing, March 11, 2012 Author: Mother Jones, RN:”I choked on my breakfast this morning while I was surfing the web. It all started when I checked out the Future of Nursing: Campaign for Action website. According to the website, “The Future of Nursing:Campaign for Action is an initiative to advance comprehensive health care change. It envisions a health care system where all Americans have access to high-quality, patient-centered care, with nurses contributing to the full extent of their capabilities.” Two of their objectives is to strengthen nurse education and training, and to help enable nurses to practice to the full extent of their education. The campaign is coordinated through the Center to Champion Nursing in America (CCNA), an initiative of AARP, the AARP Foundation and the Robert Wood Johnson Foundation (RWJF).”

http://www.nurseratchedsplace.com/2012/03/an-open-letter-dear-future-of-nursing/

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Amanda Trujillo RN – fired for being a patient advocate, Posted on March 2, 2012 by Pat Iyer:”The story of Amanda Trujillo is a horrifying one. Briefly, she is a single mom who fought to get off welfare and fulfilled her dream of becoming a nurse. Not only did she become a nurse, she earned a masters degree in nursing. One night while working at Banner Health in Arizona, she took care of a patient who was being asked to undergo a liver transplant. In talking to the patient, Amanda learned that the patient did not fully understand what was going to occur. Amanda educated the patient. She explained the option of hospice instead. The patient decided against the transplant. Then the physician came in, had a well- witnessed tantrum at the hospital when he found out his patient had decided against surgery, and Amanda was fired by the hospital. Her case came up for review by the Arizona Board of Nursing. The summary of her case written by the attorney representing her is below. Amanda has been devastated in terms of her career and her finances. She is back on welfare, her dream of being a nurse shattered.” http://www.medleague.com/blog/2012/03/02/amanda-trujillo-rn-fired-for-being-a-patient-advocate/

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Amanda Trujillo, RN: Single Mother Fighting for Her Integrity, March 02, 2012, dhoffman2, Blogher.com:”Everyone is a patient…either now or in the future. That’s a fact. Another fact is that we all die. Sometimes our deaths can be made easier. Sometimes not. Amanda Trujillo is a nurse who tried to make a dying patient’s life and dying easier. She worked in Arizona and was fired in April 2011 after providing education and making a hospice care consult request for a patient with end-stage liver disease. The patient had been in the hospital for 7 days and was supposed to get a pre-transplant evaluation. Unfortunately, the patient did not know anything about his/her liver disease, liver transplant or choices about treatment.”

http://www.blogher.com/amanda-trujillo-rn-single-mother-fighting-her-integrity

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The Nurse Who Helped Too Much, Amy Tenderich, DiabetesMine:”It might be hard to believe in this day and age of “participatory medicine” and empowered patients — or in any day and age, really — but the fact is that an Arizona-based nurse was fired from her job recently for simply providing a patient too much information on his treatment options. The nurse’s name is Amanda Trujillo, a single mother living in Phoenix, and licensed nurse in Arizona since 2006. She specializes in cardiology, geriatrics, and end of life/palliative care. The sin she supposedly committed was setting up a consultation on hospice care for a patient suffering from end-stage liver disease, who was scheduled for surgery. This “interference” angered the patient’s physician, who then had Amanda fired and reported her to the Arizona State Board of Nursing, where she is now in danger of losing her nursing license. Fellow health care professionals and patient advocates are flooding the blogosphere in support of her cause!” https://www.diabetesmine.com/2012/03/the-nurse-who-helped-too-much.html

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Amanda Trujillo, part 2, Saturday, February 25, 2012, End of Shift Report – Stories From an Operating Room:”It gets much worse: the Arizona State Nursing Board has ordered Nurse Trujillo to undergo a mental health evaluation in retaliation for her going public with the matter.With the Boards paid psychiatrist to boot, not a disinterested third party. Whats more, they have also ordered her to turn over records from all the physicians she has ever seen for any reason. What happened to her rights of privacy? There seems to be nothing that this outrageous order could contribute to an investigation of the matter. And it turns out that the President of the board of Nursing is also in a position of authority at the hospital that fired Nurse Trujillo. Can anybody spell ”conflict of interest”? This order for a mental health evaluation stinks of authoritarian excess reminding one of the KGB or Gestapo.”

http://endofshiftreport.blogspot.com/2012/02/amanda-trujillo-part-2.html

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Why physicians should care about Amanda Trujillo-KevinMD by @jaydoe February 25, 2012:”For the past month, the case of Amanda Trujillo has resonated deeply among nurses, triggering an avalanche of postings on Facebook, Twitter and in the nursing blogosphere. Trujillo is the Arizona nurse who was fired in April 2011 after providing education and making a hospice care consult request for an end-stage liver disease patient. This patient was slotted for pre-transplant evaluation and had poor understanding of the disease process and treatment options. Trujillo filled in the gaps for this patient. Trujillo then requested, at the patient’s own wish, a hospice team consult, documented her actions appropriately, and left a note (it was night shift) for the primary physician.”

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Why physicians should care about Amanda Trujillo, by J. Doe, RN in Patient, February 25, 2012:”For the past month, the case of Amanda Trujillo has resonated deeply among nurses, triggering an avalanche of postings on Facebook, Twitter and in the nursing blogosphere. Trujillo is the Arizona nurse who was fired in April 2011 after providing education and making a hospice care consult request for an end-stage liver disease patient. This patient was slotted for pre-transplant evaluation and had poor understanding of the disease process and treatment options. Trujillo filled in the gaps for this patient. Trujillo then requested, at the patient’s own wish, a hospice team consult, documented her actions appropriately, and left a note (it was night shift) for the primary physician. These actions — the education and the hospice team consult — drew the wrath of both the primary physician, who demanded her dismissal and her license, and also her nursing director, who told Trujillo she had ”messed up all the doctors’ hard work and planning for the surgery.” The patient-requested hospice care consult was cancelled. Trujillo’s employer subsequently fired her, and reported her to the Arizona State Board of Nursing for exceeding nursing scope of practice, though in fact, nurses previously had ordered a hospice care consult without consequence. In short, many nurses believe Trujillo was fired for educating and advocating for her patient.”

http://www.kevinmd.com/blog/2012/02/physicians-care-amanda-trujillo.html

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Arizona’s attack on nurses: the Amanda Trujillo case goes viral, by DA Morales on Feb. 23, 2012:”From KPHO (Phoenix CBS), Nurse says she was fired for educating patient. Inside Banner Del Webb Hospital in Sun City West, nurses are constantly tending to sick patients. That’s what Amanda Trujillo said she was doing last April when she spoke with a patient on the eve of their surgery. “I discovered that they had a very big misunderstanding about what they were about to participate in,” Trujillo told CBS 5 News. Trujillo, a licensed nurse in Arizona since 2006, said she advised the patient of possible complications. The patient decided to delay the surgery and reconsider his or her options. Trujillo said she also ordered a case management consult for the patient to be educated about hospice care. “The doctor, ultimately, is the focal point that directs care for patients,” said Banner spokesman Bill Byron, who said company policy prevents nurses from ordering a case management consult. “This is what we go to school to do. We are licensed to teach our patients, we are licensed to advocate,” said Trujillo.” http://threesonorans.com/2012/02/23/arizonas-attack-on-nurses-the-amanda-trujillo-case-goes-viral/

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Matthew Browning in support of Amanda Trujillo deleted by American Journal of Nursing, February 21, 2012:”THEN THE AJN BANNED BOTH OF US FROM THEIR FACEBOOK PAGE. Matthew Browning posted the following on the American Journal of Nursing Facebook page. The implication that she somehow ”broke the law” here, by the AJN’s ”editor” , is as grievous an injury as the BON asking for a mental health eval- maybe she was dressed like she was asking for it?? I am saddened that THIS rubbish is considered the voice of American Nursing. The time is right for a new voice for American Nurses. Nurses who advocate for their patients, their fellow nurses and their profession DESERVE a strong voice of support- not this BS waffling by some editor.”

http://vdutton.posterous.com/post-by-matthew-browning-in-support-of-amanda

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In the Footsteps of Rosa Parks, Mother Jones, RN, February 20, 2012:”You must never be fearful about what you are doing when it is right.” Rosa Parks. Nurse K, the proprietor of Crass-Pollination: An ER Blog just wrote a post about the Amanda Trujillo case. She and I have very different opinions about Amanda’s case, but I encourage you to read her post because she reflects the opinion of many nurses about Amanda’s situation. Nurse K gives an accurate blow by blow description on how corporate nurse leaders wage war against their nursing staff. She explains how nurse managers orchestrate the demise of nursing careers. Make management angry and you get the axe, and there isn’t a nurse alive that hasn’t witnessed or experienced the wrath of hospital management. Nurses scatter and go underground when someone gets in trouble, and conventional wisdom states that a nurse should be contrite and take their punishment when they are abused by those who hold power. Many people are wondering why Amanda didn’t follow the same path. Some, like Nurse K, are suggesting that Amanda is committing career suicide. Other’s have told Amanda to “shut up.” The American Nurses Association and the Arizona Nurses Association won’t support an individual nurse who is “under investigation.” Egregious comments and actions are coming from the Arizona Board of Nursing. Kim McAllister from Emergiblog writes about the board’s actions here.” http://www.nurseratchedsplace.com/2012/02/in-the-footsteps-of-rosa-parks/

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Amanda Trujillo: An Unfortunate Case of Career Suicide, Friday, February 17, 2012, Crass Pollination:”I used to be really poor back in the day. I’m not talking ”I had a five-year-old computer and sometimes I had to go to Subway instead of somewhere that was Zagat rated.” I’m talking no heat outside of a single space heater in below-freezing temps, a food budget of $10/week for three people, no functioning toilet (sh*tting outside in the snow sucks, take note), a leaky roof, and neighbors stopping by to give me and my son meat. Really, being poor sucks. I got straight As in college with all this going on.” http://crasspollination.blogspot.com/2012/02/amanda-trujillo-unfortunate-case-of.html

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Boards of Nursing and the Amanda Trujillo Case, February 17, 2012, By Shawn Kennedy, MA, RN, AJN editor-in-chief:”Our prior post on the Amanda Trujillo case elicited many comments, on a variety of themes. There were also referrals and crosslinks to other sites supporting, analyzing, and weighing in on the situation, including statements from the Arizona Nurses Association and the ANA, and a post on a physician blog, ”White Coat’s Call Room,” which has vowed to carry all the details once the case is decided.” http://ajnoffthecharts.com/2012/02/17/boards-of-nursing-and-the-amanda-trujillo-case/

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Open Letter to Arizona Governor Brewer re AZ BON, Greg Mercer, MSN, February 16, 2012:”Governor Brewer, You and your legislature are can make a strong improvement in the regulation of Arizona health care, at little cost, and set a positive precedent for the rest of our nation, building on your fine government reforms to date (I wish Massachusetts would follow your lead on transparency). There is no regulatory function or group whose work will not benefit over time from the sunlight of public scrutiny. Such accountability, as we have seen in the occasionally raucous debates over your BON and the case of Amanda Trujillo, can be messy at times, certainly inconvenient and irritating, but that is how a health democracy functions: involvement, and the willingness to form and express opinions, to speak and listen and do the hard work required to craft consensus.”

http://grchealthcareblog.com/2012/02/16/open-letter-to-arizona-governor-brewer-re-az-bon/

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ANA, Nightingale, Churchill, Lincoln, and BONs, Greg Mercer, MSN, February 16, 2012:”There is no regulatory function or group whose work will not benefit over time from the sunlight of public scrutiny. Such accountability, as we have seen in the occasionally raucous debates over the case of Amanda Trujillo, can be messy at times, certainly inconvenient and irritating, but that is how a health democracy functions: involvement, and the willingness to form and express opinions, to speak and listen and do the hard work required to craft consensus. “Many forms of Government have been tried, and will be tried in this world of sin and woe. No one pretends that democracy is perfect or all-wise. Indeed, it has been said that democracy is the worst form of government, except for all those other forms that have been tried…” – Churchill.”

http://grchealthcareblog.com/2012/02/16/ana-nightingale-churchill-lincoln-and-bons/

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Here’s What You Think About RN Amanda Trujillo’s Story, February 15th, 2012, By Jennifer Olin, BSN, RN:”I rarely worry about losing my job as a nurse. I’m generally professional, mostly on time, anal retentive about patient safety and for the most part people seem to like me. I am bossy, but I am a nurse (specifically an OR nurse so that comes with the territory). I am demanding on my patient’s behalf (but sometimes that slips over into my personal life) and I hate charting (which is hard on my chart reviewers and why I love medical mission work). I share all this because I am human; just like every nurse. Most of us don’t consider we will lose our jobs for doing our jobs, sometimes no matter how difficult we are to work alongside. Arizona nurse Amanda Trujillo never considered she would lose her job and possibly her license for being safety conscious and demanding on her patient’s behalf.” http://www.rncentral.com/blog/2012/heres-what-you-think-about-rn-amanda-trujillos-story/

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Boards of Nursing-Who Do They Stand Up For? By Jennifer Olin, BSN, RN, February 14th, 2012:”How often do you think about your state’s board of nursing (BON)? I know I almost never do. I’m betting, for the most part, nurses think about their respective BONs once or twice every two to three years when their license renewals are due. We write a check, or send a credit card payment online and the BON drifts to the back of our brains for another couple of years. This may be a big mistake. Boards of Nursing have a lot of power. They regulate how — and if — we can practice as nurses; provide the licensing that allows us to do so and sets the standards for our education. And, to be honest, I don’t know who the people are on my state BON or how they get their jobs. And yes, I do get the newsletter. I skim it, read the headlines and look to see if they have added or changed any of my mandatory continuing education credits and then toss it in the trash. I am only talking about the newsletter I get from the Texas BON. I am currently licensed in two other states but they never send me anything: no newsletters, no emails—just a notice every couple of years to re-up.”

http://www.rncentral.com/blog/2012/boards-of-nursing-who-do-they-stand-up-for/

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Sixty or so Legal Precedents Relevant to the Trujillo Case, Greg Mercer, MSN, February 14, 2012:”The web site http://www.nursinglaw.com provides, free of charge, an extensive list of legal precedents involving Nurses, arranged alphabetically by topic. The list below includes case perhaps relevant to Amanda Trujillo’s unfolding situation. I apologize in advance if unrelated material found its way to this list: putting it together has been quite the chore. As long as it is, my list represents a tiny sample of the vast resources nursinglaw.com provides. Also, please excuse the rather random formatting: it reflects cutting and pasting from the original list. I have found it very difficult at times to format without repeatedly opening links, and have deferred that task for now, invoking the time-honored privilege of the Volunteer worker… Advocate (Nurse as Patient’s).”

http://grchealthcareblog.com/2012/02/14/nurse-firing-legal-precedents/

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What Exactly Is Patient Advocacy? By Jennifer Olin, BSN, RN, February 13th, 2012:”One of the many topics raised by the case of Arizona nurse Amanda Trujillo, her firing by Banner Health, and their subsequent complaint to the state’s Board of Nursing, is did she step out of bounds while advocating for her patient? As I remember it, from day one of nursing school, it was ingrained in us that advocacy, particularly patient advocacy, is one of our most important nursing duties. I know that’s what I remember from all those years ago. Or is it? So, I went to the sources; nursing textbooks. I still had my copy of Fundamentals of Nursing (Kozier & Erb, fifth edition) and I borrowed a friend’s textbook of the same title (Potter & Perry, sixth edition); and I asked an acquaintance who is currently in nursing school to look at her version of Fundamentals (Taylor et.al., seventh edition). In this very unscientific survey I found my memory was on point. In all three texts, from different years and different authors, nurse as patient advocate is found repeatedly in the first 100-200 pages (and these textbooks have over 1500 pages apiece).”

http://www.rncentral.com/blog/2012/what-exactly-is-patient-advocacy/

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Amanda Trujillo RN, Monday, February 13, 2012, End of Shift Report – Stories From an Operating Room:”I am breaking into my usual fiction to tell you about a real travesty taking place in Arizona. Amanda Trujillo RN advised a patient who was up for a liver transplant about other options at the patients request. This is a normal and expected duty of an RN. As a result, the patient and his family decided against the liver transplant. The Surgeon involved went ballistic, threw a well documented temper tantrum, went to the Hospital administration and demanded Nurse Trujillo’s termination, which they did. He then went and filed a complaint with the Arizona State Nursing Board who have placed Nurse Trujillo under investigation. The American Nurses Association, who supposedly represent nurses has issued a fatuous, self serving masterpiece of administrative-do-nothing statement that if anything, supports the hospital, the surgeon and the state board. The Arizona State Nurses Association also has done nothing.The leadership of the state board and the state association have been seen schmoozing with other powers that be. Am I surprised? No. Am I outraged? Yes. Over the years I have seen many, many instances of Nurses having to put up with abusive behavior if not outright assault and battery by Physicians. I have yet to see any Physician receive appropriate discipline, and in most instances no discipline.”

http://endofshiftreport.blogspot.com/2012/02/amanda-trujillo-rn.html

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The Curious Case Of Amanda Trujillo And How Its Outcome Will Affect The Quality Of Healthcare We All Receive February 13th, 2012 by Shahina Lakhani RN, MSN, NLP:”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.”

http://nursetalksite.com/2012/02/13/the-curious-case-of-amanda-trujillo-and-how-its-outcome-will-affect-the-quality-of-healthcare-we-all-receive/

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Re Amanda Trujillo: Open Letter to The Honorable Janice K. Brewer, Arizona Governor, Posted on February 12, 2012, Greg Mercer:”Please learn more about the important ongoing case of RN Amanda Trujillo, a conscientious Nurse who has been punished strikingly severely for providing routine patient education that inconvenienced and angered a physician who demanded her job and her license. Her State BON has still not decided her case after a year, and she remains an unemployed single mother. For a fine summary of the known facts, see ” thenerdynurse.com/2012/01/arizona-nurse-has-license-threatened-by-doctor-after-providing-patient-education.html ” If, as I and many others have after much research and reflection, you find her cause worthy and just, please participate in our advocacy campaign. It requires little commitment, cost, or effort:”

http://grchealthcareblog.com/2012/02/12/re-amanda-trujillo-open-letter-to-the-honorable-janice-k-brewer-arizona-governor/

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Best Selling Author and Nurse Leader Carol Gino Advocates for Embattled RN Amanda Trujillo, February 12th, 2012 by Nurse Talk (Video):”Carol Gino, New York Times’ bestselling author and nurse leader advocating for Amanda Trujillo.”

http://nursetalksite.com/2012/02/12/best-selling-author-and-nurse-leader-carol-gino-advocates-for-embattled-rn-amanda-trujillo/

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What’s Missing in the Amanda Trujillo Story? February 10, 2012:”An easy one in my opinion… the answer is support. You can read about Amanda Trujillo’s ordeal at V. Dutton’s Posterous (@nursingpins) site. Whether guilty or innocent, the allegations against her have not been heard by the Arizona Board of Nursing as of yet. There are many unknowns, many questions I would like answers to, but we simply don’t have that information and we may never have the complete story. So, what I can do, is offer my support to a fellow nurse, regardless of guilt or innocence. This is where the problem lies, in my most humble opinion. Nurses are for the good of people, I am betting most will agree on that. So, if we are for the ”good”, what happens when a fellow nurse has formal charges brought against her/him? I have read the the numerous comments on the various blogs that have written about Ms. Trujillo’s experience. For the most part, it seems the majority of ”voices” support her, even though all of the facts are not known. There are some skeptics, but what I find most remarkable, is the silence of the educators and associations that were founded to support nurses.”

http://nursingnotes.posterous.com/whats-missing-in-the-amanda-trujillo-story

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American Nurses Association: Supporting Nurses, Until You Need It, Emergiblog, February 9, 2012:”I have always considered the American Nurses Association my professional organization. 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.”

http://www.emergiblog.com/2012/02/american-nurses-association-supporting-nurses-until-you-need-it.html

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Healthcare Providers Strive For Excellence, February 8th, 2012, By Jennifer Olin, BSN, RN, @JOlin2 :”Hospitals and other healthcare facilities that earn Magnet Recognition are examples of how nurses and nursing care can influence patient outcomes. It is a great honor and it is one healthcare providers spend a lot of time and money to achieve. However, there are only about 400 Magnet hospitals around the world and thousands of fine healthcare institutions employing nurses everywhere you look.”

http://www.rncentral.com/blog/2012/healthcare-providers-strive-for-excellence/

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Why Nurses are Furious about the Amanda Trujillo Case, February 7, 2012, Those Emergency Blues:”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.”

http://torontoemerg.wordpress.com/2012/02/07/why-nurses-are-furious-about-the-amanda-trujillo-case/

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Amanda Trujillo, Whitecoat, Emergency Physicians Monthly, February 6, 2012:”I finally took the time to read some other blogs today. One of the issues that I found disturbing was the case of Amanda Trujillo. There are a lot of bits and pieces out there about what actually happened in this case. This blog post was reportedly an e-mail from Amanda describing the events. A summary of the post follows. Amanda was a registered nurse of six years , specializing in cardiology, geriatrics, and end of life/palliative care. In April 2011, she was caring for a dying patient at Banner Del E. Webb Medical Center who had agreed to a major invasive surgery recommended by a staff surgeon. Amanda used materials from her hospital to educate the patient about the details of the surgery and the aftercare. The patient became upset, stating that the surgeon never explained details of the surgery or what had to be done after the surgery (complex lifetime daily self care). Amanda also discovered that the patient “had no idea” that surgery could be refused or that the patient could enroll in hospice care. She educated the patient on those options as well.” http://www.epmonthly.com/whitecoat/2012/02/amanda-trujillo/

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The Nurse: The Swiss Army Knife of Healthcare, by carol-gino on February 5, 2012:”Okay so, after reading a ton of books trying to find a definition of nursing that matched my experience, I fell asleep with no clear cut answer to my question, ”What is a nurse?” I mean it’s not that I haven’t been pondering that for a very long time, it’s just that nothing so far has satisfied me. I’ve seen brilliant bedside nurses–and I don’t mean nurses who only cared for patients with superb care and compassion– I mean smart, really smart diagnosticians. Nurses who doctors asked, ”What do you think is going on with this patient?” And when they answered, there was true appreciation and respect from the doctor to that nurse. They were colleagues, no question there. I’ve seen ICU nurses, who both doctors and patients trusted to look at a monitor, administer meds — both stat and with standing orders — who saved patients lives time and time again, before a doctor ever could get to the Unit.

http://hopefulhealer.com/the-nurse-the-swiss-army-knife-of-healthcare/

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The Case of Amanda Trujillo, February 2, 2012, By Shawn Kennedy, AJN editor-in-chief:”Amanda Trujillo, MSN, RN, is a nurse who until recently worked at Banner Del Webb Hospital in Sun City, Arizona, until she was fired for, as she claims, just doing what she’s obligated to do as a nurse—specifically, providing a patient information about a surgical procedure in an attempt to support fully informed decision making. (You can read her e-mail detailing her story here. She did not, as she has pointed out in comments, ever attempt to directly obtain informed consent herself.) Amanda Trujillo. Ms. Trujillo says that, when the patient had a change of heart about the surgery, she requested a hospice consult. After a physician complained that Trujillo had overstepped her scope of practice, the hospital filed a complaint with the Arizona Board of Nursing, which has launched an investigation.”

http://ajnoffthecharts.com/2012/02/02/the-case-of-amanda-trujillo/

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#NurseUp and Educate On!! Support Each Other! ER Nurses Care, Thursday, February 2, 2012:”Nurses all over the US are upset and simply can’t understand how on earth a nurse could be fired for being a patient advocate, educating her patient on all aspects of their care and explaining in detail treatment plans, which led to a greater understanding by her patient and subsequent change in plans. Amanda Trujillo is an advocate for her patients, she did what we all do every shift that we work, make sure our patients understand what is wrong with them, the plan of care, which includes educating them on any treatments, procedures, medications, surgeries, activities or anything else the patient or family asks of us. http://ernursescare.blogspot.com/2012/02/nurseup-and-educate-on-support-each.html

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Tsunami: A Conversation with Amanda Trujillo (Part 3 of 3), by Nursetopia on February 2, 2012:”Amanda nailed this situation during our call when she said, ”This is bigger than me.” She explained her actions – reaching out to colleagues via emails and social media – is not about revenge or getting even with any organization. She understands the Arizona Board of Nursing must investigate her because she was reported, however, the reason she was reported – a case management consult construed as a medical order – is the bothersome part. ”We all make mistakes, realize them, use them to change, give thanks for them, and move on. If I had done something wrong, I could take it. If I had done something wrong.” Amanda’s story is a ripple culminating in a tsunami of change and ideas and discussions. When asked what she’d like other nurses to know, she provided three thoughts:” http://nursetopia.net/2012/02/02/tsunami-a-conversation-with-amanda-trujillo-part-3-of-3/

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A Letter From the Arizona Nurses Association,February 1, 2012, Author: Mother Jones, RN, @motherjonesrn:”I wrote a letter to the Arizona Nurses Association when I learned that the association was not coming to the aid of Amanda Trujillo. If you haven’t heard, Amanda was fired from Banner Del E. Webb Medical Center after she educated one of her patients about their upcoming liver transplant. I wrote about it here and here. I couldn’t understand why the association was twiddling its thumbs until I learned that Teri Hill, the president of AzNA is also the Director of Professional Practice at Banner Del E. Webb Medical Center. This is what I wrote: ”I’ve been a registered nurse for 35 years and I had thought I had seen everything until I read about the persecution of Amanda Trujillo. I wondered why the Arizona Nurses Association wasn’t backing her until I learned that you are affiliated with the hospital that fired Ms. Trujillo. Shame on you for throwing a nurse under the bus just to appease a doctor that obviously has an anger management issue. Sorry the hospital lost out on a billable procedure, but the patient had a right to know about all of their treatment options. I hope your membership throws you all out of office for not backing Ms. Trujillo. You are a disgrace to the nursing profession.””

http://www.nurseratchedsplace.com/2012/02/a-letter-from-the-arizona-nurses-association/

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Waves: A Conversation with Amanda Trujillo (Part 2 of 3), by Nursetopia on February 1, 2012:”Nurses throughout the U.S. and Canada are standing beside Amanda Trujillo, RN, MSN. We’re talking about this everywhere – in blogs, social media, our offices, you name it. Admittedly, Amanda is a shy person; she’s not accustomed to this attention. Yet, she says, ”For the first time, I feel safe; for the first time, I don’t feel alone.” Why does Amanda’s story resonate with so many of us? Because the majority of us have faced a sliver of Amanda’s story. We’ve each felt alone in our careers – in certain situations – at one point or another, and we don’t think anyone should have to do that. Despite what most believe, there is a strong cohort of nurses who don’t eat our profession’s young; rather, we take them under our wings and mentor them. It’s unfortunate so many nurses do not get to see this amazing group of nurses because they typically find one another, encourage one another, and make their organizations great. The same is true for the bullies – those nurses that really should never provide care for people because they are constantly tearing down everyone they meet. They find one another, too, creating hostile and toxic environments, driving nurses away from the profession and making them think they are failures.”

http://nursetopia.net/2012/02/01/waves-a-conversation-with-amanda-trujillo-part-2-of-3/

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An Update on AZ Nurse Amanda Trujillo Case, Submitted by Mech on Wednesday, 1 February 2012:”Amanda Trujillo, a registered nurse in Arizona, has been scuffling with her case on patient advocacy for several months already. On January 24, 2012, her case was supposedly to be heard. But unfortunately, it has been postponed and rescheduled on March. And what is reason for delaying it? The AZ BON don’t like Amanda’s online activity and feel she threatened a former boss. Thus, they are requiring her to undergo first a psychiatric evaluation. With the popularity that Amanda Trujillo’s case is receiving online, it made me realized then how important social media is in healthcare industry. They are not only beneficial in promoting health awareness but also allow people in nursing scrubs to share their experiences. Additionally, social media makes it possible for nurses to extend their support to fellow professionals in nursing scrubs like AZ nurse Amanda Trujillo who is currently in a dilemma.

http://www.scrubpoint.com/2012/02/01/an-update-on-az-nurse-amanda-trujillo-case/

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Ripples: A Conversation with Amanda Trujillo (Part 1 of 3), by Nursetopia on January 31, 2012:”I know there are people who have read and read and read about Amanda Trujillo. In fact, there are so many great posts, I don’t know who to link to so you can see them all. Be sure to check out The Nerdy Nurse, Those Emergency Blues, Emergiblog, iCoachNurses, Nurse Ratched’s Place, and Vern Dutton’s page. There are a plethora of links between those fabulous blogs. Still, there are many who have no idea what is happening in Arizona. You can read Amanda’s story in her own words; please, do. I spoke with Amanda via telephone for over an hour, listening to her tell her story and asking questions. The many subsequent posts are for Amanda as well as inspired by her. I thank her for sharing her time and story with me so I can share it with you in hopes you will share it with others. This must stop.”

http://nursetopia.net/2012/01/31/ripples-a-conversation-with-amanda-trujillo-part-1-of-3/

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A Conversation with Amanda Trujillo (Part 1 of 3), by Nursetopia on January 31, 2012:”I know there are people who have read and read and read about Amanda Trujillo. In fact, there are so many great posts, I don’t know who to link to so you can see them all. Be sure to check out The Nerdy Nurse, Those Emergency Blues, Emergiblog, iCoachNurses, Nurse Ratched’s Place, and Vern Dutton’s page. There are a plethora of links between those fabulous blogs. Still, there are many who have no idea what is happening in Arizona. You can read Amanda’s story in her own words; please, do. I spoke with Amanda via telephone for over an hour, listening to her tell her story and asking questions. The many subsequent posts are for Amanda as well as inspired by her. I thank her for sharing her time and story with me so I can share it with you in hopes you will share it with others. This must stop.

http://nursetopia.net/2012/01/31/ripples-a-conversation-with-amanda-trujillo-part-1-of-3/

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Amanda Trujillo – Nurse fired for being a patient advocate, Pat Iyer, January 30, 2012:”The story of Amanda Trujillo is a horrifying one. Briefly, she is a single mom who fought to get off welfare and fulfilled her dream of becoming a nurse. Not only did she become a nurse, she earned a masters degree in nursing. One night while working a Banner Health in Arizona, she took care of a patient who was being asked to undergo a liver transplant. In talking to the patient, Amanda learned that the patient did not fully understand what was going to occur. Amanda educated the patient. She explained the option of hospice instead. The patient decided against the transplant. Then the physician came in, had a well- witnessed tantrum at the hospital when he found out his patient had decided against surgery, and Amanda was fired by the hospital. Her case came up for review by the Arizona Board of Nursing. The summary of her case written by the attorney representing her is below. Amanda has been devastated in terms of her career and her finances. She is back on welfare, her dream of being a nurse shattered.”

http://www.avoidmedicalerrors.com/2012/01/amanda-trujillo-nurse-fired-for-being-a-patient-advocate/

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Here’s the plan: Lets make the powers WANT to help Amanda T, Greg Mercer, January 29, 2012:”I have a plan, and much evidence suggests it could work. Forget “support,” forget “standing by,” forget sympathy and empathy and outrage, for a moment. We now have achieved plenty of all of those things. I think we should offer more – ensure Amanda retains her license, her good name, and her career. I surely can’t offer certainty, but I can offer a fair shot of success, without asking more than many Nurse are already offering. My last posts have been lengthy, so here’s a short version – I suggest the full ones if you can find the time, worth it, please trust me on that. My plan makes more sense if you know a bit more about the history and successes of Social Media advocacy outside of Nursing. The short version: initially tiny groups of plain old average powerless people, with much less credibility and wherewithal than that of the average Nurse, have repeatedly used Social Media to organize. Using these tools they have defeated the following in some way – all real well-documented examples, I give my word and reputation on it. These examples are more fully describes in other posts”

http://grchealthcareblog.com/2012/01/29/heres-the-plan-lets-make-the-powers-want-to-help-amanda-t/

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Here’s how you can REALLY help Amanda T and other Nurses, Greg Mercer, RN, @gregmercer1, January 28, 2012:”I have a few more ideas to offer about Amanda Trujillo’s situation, about Social Media, about powers Nurses already have, and those we COULD have and soon, IF we decide to make it so. It wouldn’t require much from most individual Nurses, really, not much at all: for most of us, a few minutes here and there, perhaps a few dollars occasionally. Very little in comparison to the hard work we put in every day. What do Nurses need most? What do Nurses like Amanda need most? They need more power, plain and simple. Everything else is details. Here’s a thought: what about sending peanuts? Whoa, where did that come from? This, my friends, is a teaser: a preview of one of the real success stories later on in this post. Ordinary little people got mad, and instead of complaining and waiting for someone else to save them, they got organized, they sent lots and lots of peanuts. By so doing they quickly, cheaply, and rather easily forced a large Corporation to change its ways against its will. TRUE STORY, people. Check it out: unless you want Nursing to stay as is or get worse.”

http://grchealthcareblog.com/2012/01/28/heres-how-you-can-really-help-amanda-t-and-other-nurses/

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The Trujillo case, the truth, and BONs, January 28, 2012, Greg Mercer:”I have recently been exploring the controversy around AZ RN Amanda Trujillo, like so many others well before me – thanks to so many conscientious Nurses for raising awareness that finally got past my innate philosophical skepticism. You see, I’m very cautious: I try not to assume the truth of most ANYTHING before some careful scrutiny, especially anything from our various public media. Less but solid information is a far better foundation than lots of questionable data: inconvenient and tedious at times, but sound practice. And as cognitive science proves, we humans frequently fool ourselves: we confuse the plausible and/or vivid with the factual – a tremendous source of erroneous belief and thus misguided action. So, there it is – my skepticism slows me down but hopefully keeps me optimally within the bounds of truth. Reality is universally more complex, nuanced, and tedious than our pictures of it.”

http://grchealthcareblog.com/2012/01/28/the-trujillo-case-the-truth-and-bons/

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RN Amanda Trujillo Becomes a Call to Arms, By Jennifer Olin, BSN, RN, January 28th, 2012:”It has been a call to arms. The story of Amanda Trujillo, RN, is sweeping the nursing blogosphere in just a matter of days. From the initial story released via Vernon Dutton, RN to the many followup blogs, a national petition and a support group seemingly grown out of nowhere, nurses are banding together to help one of their own. When Trujillo was first fired she reached out for support to nursing organizations in her home state of Arizona. That support was not forthcoming. As the months passed and her hearing in front of the Arizona State Board of Nursing was put off Trujillo decided to take matters into her own hands and look for support elsewhere. Long a fan of nurse/author Echo Heron, Trujillo sent her an email about her troubles. Heron forwarded that email to Dutton. I recently spoke with Trujillo about her decision to seek help from strangers.” http://www.rncentral.com/blog/2012/rn-amanda-trujillo-becomes-a-call-to-arms/

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Stop the Bullying Now — Stand up for Nurses and Patients, Kathy Quan RN BSN, The Nursing Site, January 26, 2012:”photo from Flickr Have you heard about the plight of Amanda Trujillo, an RN who was fired by Banner health in Arizona for educating a patient in the process of obtaining informed consent? The physician threw a well documented tantrum because the patient decided against the procedure after being educated. The physician demanded the nurse be fired and he has filed a complaint against the RN with the AZ Board of Nursing. This keeps her from being hired anywhere else in AZ. Listen to this interview and read more about this case. You can also sign a petition for the AZ BRN to remove the ”under investigation” status from Amanda’s license. Follow this situation on FACEBOOK.”

http://www.thenursingsiteblog.com/2012/01/stop-bullying-now-stand-up-for-nurses.html

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The Nurse Stands Alone… @Emergiblog, January 24, 2012, #nurseup #AmandaTrujillo #nursefriendly:”Nurses talk a great game. In the Halls of Academia and the Ivory Towers of Those Who Claim to Advance The Profession, it’s all “Nursing Is An Independent Profession” and we tirelessly “Fight For Our Right To Practice To The Full Extent Of Our Education And Training”. Unless you’re down in the trenches doing patient care every day and someone gets angry that you have dared to advocate. And if that Someone is a Doctor, well, the bigwigs scatter to the four corners of the ring. Musn’t create controversy. Hell, they aren’t even standing on your side of the arena.”

http://www.emergiblog.com/2012/01/the-nurse-stands-alone.html

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Arizona Nurse Has License Threatened By Doctor After Providing Patient Education, January 22, 2012 By The Nerdy Nurse:”There are times in my nursing career when I am so very proud of how far we have come in advancing our profession. Unfortunately, there are also times where I am reminded that this is still very much an uphill climb we must make in order to legitimately participate in truly collaborative healthcare. Today is one of those days in which I am reminded we still have battles to win. The following blog post is related to an email that was originally sent to @EchoHeronAuthor. It was then posted on Vernon Dutton’s Posterous, Amanda Trujillo case will go before the Arizona State Board of Nursing on January 24th, 2012. Her story is one of an archaic medical model in which the doctor’s word is supreme and we are all just nurse maids here to do their bidding. This is an indication that there are many who do not wish to continue to advance toward collaborative healthcare in which we work as a team to provide patients with the best care possible. This is also an example of persons who may not be in medicine for the right reasons.”

http://thenerdynurse.com/2012/01/arizona-nurse-has-license-threatened-by-doctor-after-providing-patient-education.html

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Patricia Iyer, former president of the American Association of Legal Nurse Consultants explains and prepared a video statement:”The story of Amanda Trujillo is a horrifying one. Briefly, she is a single mom who fought to get off welfare and fulfilled her dream of becoming a nurse. Not only did she become a nurse, she earned a masters degree in nursing. One night while working at Banner Health in Arizona, she took care of a patient who was being asked to undergo a liver transplant. In talking to the patient, Amanda learned that the patient did not fully understand what was going to occur.”

http://nurseup.com/wordpress/2012/02/amanda-trujillo-rn-fired-for-being-a-patient-advocate-pat-iyer-com-patiyer-nurseup-nursefriendly-amandatrujillo/

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Banner Health, Arizona Board of @Nursing: A Personal Vendetta? Emergiblog:”Sorry, no. 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.”

http://www.emergiblog.com/2012/01/banner-health-arizona-board-of-nursing-a-personal-vendetta.html

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Nurses associations, my very own arcade claw machine by Kevin Ross, January 29, 2012:”It seems that there isn’t any shortage of things to write about here at Innovative Nurse when it comes to fellow nurse Amanda Trujillo. Search Twitter for #NurseUp, and all of the amazing nurse bloggers out there (links below), that have kept you somewhat up to speed on the case of Amanda. So, I was on Tweetchat this past Sunday with some of these amazing nurse bloggers, leaders, and entrepreneurs out there and the support is just off the hook (save that hook reference for a sec). I know we’re here for a bigger cause than Amanda. I just can’t believe it took something like this to bring us together. We’re here for the nursing profession, and in support of our ability to work collaboratively and to advocate for our patients. There are nursing professionals I’ve never even met that are pouring themselves into this cause with great vigor. Watch out because the energy behind this is unstoppable.”

http://innovativenurse.com/nurses-association-arcade-claw-machine/

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Innovative Nurse: Why did you choose to publicly support Amanda Trujillo, RN? by Kevin On January 28, 2012:”Jennifer Olin, BSN, RN from RN Central reached out about the Amanda Trujillo story to ask, “How did you pick up this story, and why did you decide to run with it?” My comment below just touches on what this really means to me, and everything that we’ve already done as a core group at the #NurseUp movement is just the beginning. You can read the article posted on RN Central from the slide show below to hear from a number of nurse bloggers out there who have helped with this tremendous cause.”

http://innovativenurse.com/innovative-nurse-amanda-trujillo/

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Voices For Amanda Trujillo, Jay Doe, Those Emergency Blues, January 28, 2012:”Each of them eloquently speaks to the heart of what we do as nurses — and why nurses find how Amanda Trujillo was fired and subsequently reported to the Arizona State Board of Nursing so troubling. (Via The Innovative Nurse.)”
Facebook: http://www.facebook.com/people/Jay-Doe/100000771416457
Twitter: http://twitter.com/#!/TorontoEmerg

http://torontoemerg.wordpress.com/2012/01/28/voices-for-amanda-trujillo/

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Amanda Trujillo: Exposing the Truth, By Jessica Ellis | January 26th, 2012:”For those followers of this blog that are not yet aware of what has recently come to the attention of the nursing community, I wanted to make sure to promote awareness of the landmark case out of Arizona concerning Amanda Trujillo. This nurse has taken her case to the public nursing community in order to gain support for herself, and our profession as a whole. The truth has been exposed. We who have been in the nursing profession know it, and now it is time to take the truth to the public. FACT: Nurses and the core of our profession–patient care–are at the mercy of the medical and political powers-that-be when we interfere with the revenue of hospitals, doctors, and the government, including the boards of nursing that govern our practice in each state.”

http://www.nursesnetwork.com/2012/01/26/amanda-trujillo-exposing-the-truth/

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The power of social media #NurseUp, By Kevin On January 25, 2012:”If you’ve been following Innovative Nurse, and the other nurse bloggers and innovators out there, then you’ve probably gotten a dose of how powerful social media can be. Just a few short days ago, I heard about Amanda Trujillo’s story and decided to plant my feet firmly on the ground, my fingers firmly on my keyboard, and I took a stance. Drafting an open letter to the Arizona Board of Nursing on Amanda’s behalf just seemed like the least I could do for her. She didn’t reach out to me, I’ve never met her in person, and yet, it’s as if I actually know her. The connection is unbreakable. She’s a nurse. I know what that means. I take a lot of pride in who I am, and everything I’ve done as a nurse. I’m sure you know where I’m coming from if you too are a nurse. We are on the front lines, we are the armor, and together we’re impenetrable.” http://innovativenurse.com/power-social-media-nurseup/

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Arizona Nurse Has License Threatened By Doctor After Providing Patient Education January 22, 2012 By The Nerdy Nurse:”There are times in my nursing career when I am so very proud of how far we have come in advancing our profession. Unfortunately, there are also times where I am reminded that this is still very much an uphill climb we must make in order to legitimately participate in truly collaborative healthcare. Today is one of those days in which I am reminded we still have battles to win. The following blog post is related to an email that was originally sent to @EchoHeronAuthor. It was then posted on Vernon Dutton’s Posterous, Amanda Trujillo case will go before the Arizona State Board of Nursing on January 24th, 2012. Her story is one of an archaic medical model in which the doctor’s word is supreme and we are all just nurse maids here to do their bidding. This is an indication that there are many who do not wish to continue to advance toward collaborative healthcare in which we work as a team to provide patients with the best care possible. This is also an example of persons who may not be in medicine for the right reasons.”

http://thenerdynurse.com/2012/01/arizona-nurse-has-license-threatened-by-doctor-after-providing-patient-education.html

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Advocating for a fellow Nurse: Amanda Trujillo, MSN, RN, DNSc-NP(s), Kevin Ross, January 22, 2012, #RN, @innovativenurse #nurseup #nursefriendly:”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. http://innovativenurse.com/advocating-fellow-nurse/

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Del E. Webb Medical Center, Sun City Arizona AKA Banner Health Nurse Incident @BannerHealth, January 15, 2012:”This is the original post which prompted us to mobilize and form the ”Nurseup” movement. It reprints an email Amanda Trujillo, RN sent to Echo Heron, RN http://www.echoheron.com/ We are deeply grateful to Vernon Dutton, RN @nursingpins for bringing this issue to our attention and continuing to support it tirelessly.”

http://nurseup.com/wordpress/2012/02/del-e-webb-medical-center-sun-city-arizona-aka-banner-health-nurse-incident-bannerhealth-vduttons-posterous/

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Are You On Fire? January 2nd, 2012 by Amanda Trujillo, RN, MSN:”A forest fire is destructive and dangerous, it wipes out all that is good and healthy and beautiful. It exerts its power and overwhelms everything in its path. In nursing many of us come to a point in our career where the fire has overwhelmed our soul and we haven’t realized it or stopped to take a moment to appreciate the toxicity of the smoke surrounding us. We may fail to do the important growth work that is so integral to how we care for others. We forget to periodically evaluate our own forest—to look for the old and the brittle, the dry bushes, the dry earth, the lack of flora.”

http://nursetalksite.com/2012/01/02/are-you-on-fire/

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Being A Naive Nurse Will Get You Thrown To The Wolves, @jaydoe, 11/07/10. #Nurseup:”In matters related to practice, errors, or sentinel events, are nurses far too naïve when it comes to dealing with their employers, regulatory bodies, or police? Nurses falsely assume that all of these authorities will act in, or at least be mindful of, their best interests. The thought that any of them might act solely in their own self-interest (at best) or in bad faith (at worst), is probably beyond most of us. The fact is none of them have a nurse’s interest as their top priority, if in fact they consider it all. Aside from a duty to ensure patient safety, hospitals have a legal, fiduciary obligation to protect themselves from liability issues and legal action.” http://nurseup.com/wordpress/2012/03/being-a-naive-nurse-will-get-you-thrown-to-the-wolves/