February 9th, 2012
By Jennifer Olin, BSN, RN
Yesterday, February 8, 2012, the American Nurses Association (ANA) finally, sort of, addressed the issue of Arizona nurse Amanda Trujillo and her firing by Banner Health for what they claim was a breach of her nursing scope of practice. This story has taken the nursing social media world by storm in the past few weeks since Trujillo reached outsider her home state for support.
Seeking the help of nurse bloggers across the country was not Trujillo’s initial response. Back in April, 2010, when the whole mess erupted she reached out to the organization she has been paying annual dues to for years and had even very recently donated $100 to for the ANA political fund.
”They never answered any of my emails for help or even acknowledged my emails,” Trujillo said this morning. “They didn’t return my calls either.” She flat out received no response from the national or state office—until yesterday.
So what sparked this sudden appearance of interest from an organization that claims to represent the 3.1 million nurses in this country? Bad press from the blogosphere is my guess.
Here is what the ANA said:
”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.
”ANA appreciates how difficult it is for a nurse to undergo an investigation of his or her practice by the state board of nursing. To be clear, ANA expects the Arizona Board of Nursing to follow its standard procedure, to render an unbiased judgment in this case, and to be fully transparent in its findings.
”ANA is the professional association for the nation’s 3.1 million registered nurses (RNs). Since its inception in 1896, ANA has established, promoted and maintained professional nursing practice through the development of foundational documents such as the Code of Ethics for Nurses and Nursing: Scope and Standards of Practice.
”State nurse practice acts are the laws that define scope of practice with the intent of protecting the public. The laws also establish qualifications for practice as well as what constitutes unprofessional conduct or misconduct and associated disciplinary procedures when a complaint is filed against a nurse. The board of nursing is responsible for ensuring nurses are competent and do not exceed their scope of practice. Therefore, it investigates complaints, holds hearings, and renders findings.
”ANA advises that any nurse who has been alerted by the board of a complaint and an impending investigation retain legal counsel. It is the role of legal counsel to represent the nurse during the process. In addition, ANA cautions nurses and the public not to rush to judgments about complex cases based on social media postings or other media coverage.
”Professional associations, nurse practice acts, and state boards of nursing all play a vital role in protecting the public and the profession. ANA encourages nurses to seek out and apply resources that support them in their professional practice. “
Well, at least they are acknowledging there is a problem. The public, and in particular I mean the 3.1 million of us who are nurses and anyone who ever has been or will go to the hospital, has a right to know about this and they wouldn’t get all their info from “social media or other media coverage” if the ANA had spoken up sooner.
There are some questions that arise from this press release, the least of which is did the ANA really talk to Trujillo’s attorney? He never said so and he was recently let go by Trujillo in order to retain someone with more experience in these kinds of cases. So either the ANA never talked to him, or they did and he kept it to himself, or they tried to and he didn’t work for her anymore so really he couldn’t say anything.
And this is my favorite line, the “ANA encourages nurses to seek out and apply resources that support them in their professional practice.” Isn’t that what Trujillo tried to do by contacting the ANA?
It has now been 10 months since Trujillo lost her job for assessing that a patient, who was going to be worked up for a procedure, did not really understand what they were in for. There was a question in her mind as to whether the patient really had given fully informed consent. She provided the patient with teaching materials and requested a case management consult, including information about hospice care. That requested consult is the supposed breach of scope of practice.
Following her dismissal, Banner Health filed a complaint with the Arizona State Board of Nursing (ASBN) and now Trujillo sits, waiting to find out if she will continue to be a nurse in good standing or lose her license.
In all the months since Trujillo was let go, neither the ASBN nor Banner Health have chosen to comment on the situation except to say she is under investigation and the Banner does not discuss employee issues.
So, is it just sour grapes that she was being ignored that made Trujillo reach out to us, the nurses who write in public forums? I don’t think so and I asked her about it.
”Oh geez, no! I mean if it were about getting even who could hold out this long or have the energy for the campaign my daughter and I have been on for ten months now (she has been a very big part of this fight). And, for that matter who would put up with the number of doors that have been slammed in my face,” Trujillo told me.
”If this were about revenge, I would not have had the sheer determination to endure the challenges of this past year. It’s about lives; nurses and patients. I took an oath to get the RN after my name, and walking away from the battle would mean knowingly turning away from what I know was wrong and damaging to my patients—the lack of information they had and the denial of the very basic right to self determination when they were refused the right to see hospice,” Trujillo continued.
”If I stay silent; if I turn my back; if I ignore what happened and call it a day; collect my paycheck and go home—that is the day I need to walk away from nursing. That will be the day I have placed my own needs, wants, desires, well-being, and protection above those in my charge,” she said.
”We all nurse differently. I respect that and love that about our profession. We all have such amazing things to bring into nursing, and this is what I have to bring to the table; I make no apologies for it. I stand for what I believe is right and just—especially when there is potential harm on the horizon for both my colleagues and patients and our profession as a whole,” she continued.
”If we do not do something now, this is going to keep happening. I mean, it’s happening right now as we speak. I can’t collect a paycheck at the expense of the lives of my patients and their families. I understand the publicity with the Texas nurses was scary. I get the publicity the Nevada pediatric nurses received was even scarier—who would want to report after seeing all of our stories.
”But if nurses like me don’t put their foot down and do the right thing—not the easy thing—then people will get hurt, people will die, and our profession will suffer enormous consequences. It all comes down to one thing: when you consider whether to fight for what is just and what is right, if you are thinking of the moral imperative to do what "is right for the sake of doing right" and nothing else then the solution is easy. You keep talking, you keep knocking on doors, you keep emailing, you keep sending letters, you keep tweeting, you keep trying, and you keep fighting "UNTIL." The choice to act, the decision to stand up and speak loudly only becomes difficult when you allow the interests of "self preservation and protection" into the equation. “
Everything Trujillo says sounds very noble. And unless like me, and select group of others, you have heard it from her directly you may not buy it. What I can say is she is very passionate about what happened to her and could have happened to her patient. And, she deserves to at least be acknowledged by her peers and the organizations she has dutifully belonged to for years.