March 16th, 2012
By Jennifer Olin, BSN, RN
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.
For her troubles, she seemingly angered a physician by disrupting his plans, he pursued having her fired, and her hospital did not stand up for her practice. She was fired and her license marked “Active: Under Investigation.” That’s as good as a “do not hire” sticky note.
It’s been dirty pool ever since.
For many months Trujillo sought the support of the nursing organizations to which she belonged. They did not respond in any way—no emails, no phone calls, no smoke signals…nothing. At least, they didn’t respond until she sought the support of one nurse writer (Echo Heron) and, from there, the blogosphere exploded.
Ten months after losing her job the American Nurses Association (ANA) finally responded to her situation. But, it wasn’t much of a response from the support perspective. The American Nurses Association is closely monitoring the case of Amanda Trujillo, MSN, RN, and has been in contact with her attorney. ANA strongly supports nurses and their right and responsibility to engage in patient education and advocacy,” they wrote.
”ANA appreciates how difficult it is for a nurse to undergo an investigation of his or her practice by the state board of nursing. To be clear, ANA expects the Arizona Board of Nursing to follow its standard procedure, to render an unbiased judgment in this case, and to be fully transparent in its findings.”
Last time I wrote about this my favorite part was when the ANA encouraged “nurses to seek out and apply resources that support them in their professional practice.” That’s what I thought she did when Trujillo kept contacting them. Now I have a new favorite part.
It’s part of that first sentence, where the ANA says they will be closely “monitoring” the case. To monitor means to observe and check the progress or quality of (something) over a period of time; keep under systematic review. Now, it seems the ANA has confused “monitoring” with censorship.
Yesterday, fellow nurse and blogger, Vernon Dutton, RN (aka Nursing Pins on Twitter and Facebook) posted a comment in support of Trujillo on the Iowa Nurses Association Facebook wall. Dutton has been posting supportive comments and sharing supportive blogs on many websites as part of the campaign to help Trujillo.
”I post everywhere,” Dutton told me on the phone this morning. “I don’t even remember what I posted exactly. I post about Amanda on most nursing association pages. I do know it wasn’t off color, no accusations.”
What followed was very interesting. Dutton received a direct message asking him to call the INA office. “I called and talked to a lady who started asking me all kinds of questions. ‘Is this Nursing Pins?’ Then she says, “what is your motivation for posting this on our Facebook page,” he paraphrased. Dutton asked if she was aware of Trujillo’s story and then asked why did they need his “motivation” for posting?
Again paraphrasing, Dutton tells me the woman responds with “We have to find the motivation of everybody who posts on our page. That’s the policy of the INA.” Then, Dutton says, she tells him the INA was directed by the ANA not to allow his posts.
Wow! Really! That sounds like more than monitoring. Since then Dutton’s initial post has disappeared from the INA Facebook page. Responses to his sharing this interaction with other nurses and writers have appeared on the INA wall and are not being erased.
The blogger who writes under the name Nurse Ratched’s Place quickly responded. “This type of censorship is unacceptable. On the other hand, the INA didn’t have to give Vernon an explanation for their actions,” she writes. “Maybe they wanted Vernon to know about the ANA’s censorship campaign. The ANA is truly ‘monitoring the situation.’ Big Brother is proud of you.”
Now, people, organizations, have every right to determine what information appears under their name on a social media platform. And, yes, the INA is a state representative of the ANA. But this is pretty heavy handed. To have the mother ship tell the independent organization what to post and what not to sure sounds like censorship, not monitoring.
There have been other seemingly unfair salvos in Trujillo’s unpleasant journey. The Arizona State Board of Nursing demanded Trujillo have a psych evaluation. Somehow they think it’s crazy she went looking for help outside Arizona when no one at home would even acknowledge her.
Trujillo is a graduate level nursing student. Someone advised her university that she was under investigation, which threatened her being able to continue her education. When many of the nurses who have been following this case reached out to their own state BONs to find out if this was a common practice, every other BON responded by saying they would never do such a thing and how would they even know where someone went to school? Did I mention there is an AZ BON member who is also faculty at Trujillo’s university? Dirty pool!
So, on Monday and Tuesday the Arizona State Board of Nursing has its quarterly meeting and it is expected that decisions about Amanda Trujillo’s future will be discussed. This has been a long road for this nurse who was only trying to do the right thing for her patient, with practices within her scope of practice. She has been unsupported by the agencies she thought were there to help her; she has been maligned personally and academically. I hope they get it right this time and let her go about her business—being a nurse who advocates for her patient’s best interests.