January 28th, 2012
By Jennifer Olin, BSN, RN
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.
Why did you reach out through Echo Heron to the world of social media to get help with your situation?
"Echo Heron was a heroine to me early on in my life. Some of us nurses have known all our lives that this is to be our life's work. I read her books and she was who I wanted to be someday–like kids dream of being batman or such things, I wanted to be what Echo was to patients and to the profession. Straight up honest, and powerful in her values and beliefs and her desire to do the right thing.
"As I advanced in my education, I thought more about her, remembered her independence and autonomy and free spirit; her no bull attitude. She held on to who she wanted to be in this profession, not what anyone else expected her to be. With Echo what you see is what you get—and in many ways, during my early career she inspired me to always be myself no matter the pressure to be who I was not. In the corporate world everyone is conditioned to think and act and believe a certain way to succeed. I've never been that person, I don't change in order to get leadership roles and I don't step on my colleagues or make them look bad to get ahead. Like Echo, I am who I am and I make no apologies for it. Of course I make mistakes, and have made them as a nurse, but I'm not immune to the human condition. We live, we make mistakes, we learn from them, we give thanks for them, and we move forward—hopefully, a better practitioner.
"That being said, I've refused to sacrifice my ideals, morals, values, or the ethical tenets of our profession simply to go with the flow. I'm not there to be liked I'm there to take care of people first and foremost. If my colleagues are in trouble, I will be loud. If my patients are in trouble, I will be loud. Echo did it. She stayed true to herself. She found her place in the profession and so would I. But it would not be at the sacrificing of who I was, authentically, as a nurse and as a person. It would not be at the expense of a patient's safety or their life.
"When this situation happened, it was only natural for me to reach out to Echo, because I had no doubt that the strong heroine I remembered when I was younger would be the one to "nurse me" and "support me" through this. If she had this effect on me, surely there were other nurses out there who looked up to her too. If anyone had the power and the voice and the influence to get my story out there, "our story" as nurses—it was Echo."
Are you surprised at the response you have gotten from the nurse/bloggers?
"Oh my gosh, yes. I've been working at this for months. I assumed when the Arizona Nurses Association told me they couldn't support me, and the American Nurses Association remained silent that I was some defective nurse undeserving of support from my peers.
"When Echo and Vernon got a hold of this everything happened so fast. I was surprised at how quickly things began to roll. This whole situation has evolved into something so big that I wasn't expecting. I was hoping and praying for support from my state, instead I was blessed with the support of my peers around the country and around the world. What do you do with that? How does one begin to wrap their head around the magnitude of this? I found my answer. I just keep remembering that at the whole center of this, where this all started, was with the need of my patient. Period. So I guess you could say this is a pleasant, albeit overwhelming, response. This is, after all, what I dreamed of being a part of. This is the profession I envisioned for so many years; a solid one, a proud one, a hopeful one. The response has given me such hope that I do belong in this profession; that I do have a future, that I do have the very real capability of making a healthy difference in the lives of people, their quality of life, how they transition to another life. And, for the first time in a while I feel that I have future of our profession. I had almost given up—and and everyone has given me renewed strength and hope and faith in nursing.
Andrew Lopez, RN – nursefriendly.com
"We ran with Amanda's situation because it hits close to home, help was requested and because we could.
"We can relate to Amanda as a nurse. Each of us has been intimidated on the job, dealt with it and got through it. Few of us have our livelihoods threatened – that aspect is unacceptable.
"This is an opportunity to show Amanda, and ourselves that we are not helpless.
"When her situation came to our attention, Anna, Keith, & Kevin brought me into the discussion. I agreed that we could actually do something about it. Could use our social media reach, our blogs, our networks to help her.
"Our initial contact was Echo Heron (Amanda wrote her), whom I've followed for quite some time and was requesting help through Vernon Dutton.
"Perhaps we can give other nurses in similar situations some hope, some tips on how to improve their circumstances.
"Personally, I've been itching to see how effective social media can be as a tool for nurses. This is a perfect test case."
Brittney Wilson, RN, BSN – thenerdynurse.com
I had tweeted a new blog post: 10 Tips for Nurses on the Night Shift , and she replied with her tip: @*TheNerdyNurse*
”The link told her story. I just skimmed it initially, because I didn't have the time to read it fully until the weekend. When I read the story I was just taken aback by what appear to be a severely dysfunctional healthcare system that punishes nurses for advocating for patients and rewards doctors for throwing temper tantrums.
”It made the think about the times that I've educated my patients on procedures, labs, treatments, their care, and their conditions and how I would feel if a doctor threatened my patient's rights or my license and livelihood because he had already convinced a patient to get a procedure, especially went he patient was obviously not fully informed of all the details and other choices.
”I saw in Amanda's story what I see in so many good nurses who just want to do the right thing and are often silenced and pushed out of the profession. I saw bullying from a healthcare system and a physician.
”I saw other nurses who were not supportive of their coworker and who essentially threw her under the buss when she advocated for a patient. I saw a woman who is the American dream. She lifted herself from poverty, raised her child as as single parent, has a master education, and is a doctoral candidate.
”I saw the nurse I want to take care of me and my loved ones and I just couldn't sit by and keep quiet when I felt that someone deeply wrong was being done to her.”
Anna Morrison, BSN, RN – icoachnurses.com
"Amanda’s case is really not about her at all. While it does tragically affect her individual life and the life of the patient she intervened for, this case represents so much more.
"From my perspective, Amanda Trujillo’s case represents a direct threat to the following things:
Keith Carlson, RN – nursekeith.com
"I first heard of Amanda's situation this past Monday just before going on the air with Kevin and Anna for our radio show. I did some quick research, read what I could, and then heard Amanda's story when she called in to our program.
"Amanda's story touches a nerve with nurses around the country due to the fact that this sort of retaliatory situation could indeed happen to any of us. Physicians hold great power in our society, and even though nurses are consistently the most trusted professionals in poll after poll, doctors still wield enormous power over us in many circumstances.
"This situation belies many fiscal and systemic realities that undermine medical care in the United States in the 21st century. It also demonstrates that any nurse who acts within the scope of his or her practice is still potentially a target for retaliatory behavior if his or her actions go against the financial and clinical aspirations of a physician.
"Amanda's case is a test of the ability of nurses to stand up as a united community against unfair practices that undermine our profession."
Carol Gino RN, BS, MA – RN/Author
"I'll have your license for this, young lady," was screamed at me more times than I can count, but I counted at least three times when I wrote the book, "The Nurse's Story." It became a big best seller and I got to tour 21 cities but in each city whenever I did media, and the hosts invited other nurses to join, they refused. They were too frightened of losing their jobs, of being ostracized by other nurses and punished by supervisors, etc.
"Amanda's plight resonates because I know it's the truth. I don't care about the details. I recognize abuses of power when I see them, and I, and many of my nursing friends, have been in the same position. We're smart enough to know when our patients are not being told the whole truth and we're educated enough to advocate for them. But in order to do that, we have to be willing to sacrifice ourselves and that's a lousy position to be put in.
"I hope our support helps Amanda, and at least it let's her trust herself and her nursing judgement. Even more, I hope it can be the catalyst for moving nursing forward, forcing our organizations to grow with us instead of just making it harder for us to do what we're called to do. I know she hopes that too. Yes, she is passionate, but I was passionate, and many of my patients got well because I fought for them. I picked this issue because now I feel it's time.
"I've been fighting for nurses rights to advocate for patients since I wrote "The Nurse's Story" 30 years ago. And I've even gotten past all the issues that forced me onto You Tube to show how little things have changed in all that time. I'm hoping life will be kind to Amanda, but even more, I hope now nurses have grown enough to fight for Amanda and for themselves because a "defenseless defender" is no good to anyone. We have to own our power because patients are our end game."
Mother Jones, RN – Nurse Ratched's Place
" For me, it's because I've seen thing like this before and it has to stop. What make this case so egregious is the fact that the injustice is being perpetrated by so called 'nursing leaders.' Members of the Arizona Nursing Association and the Arizona Board of Nursing advocate for a collegial relationship among nurses and physicians, but yet they have no problem destroying one of their own when a physician throws a temper tantrum. I weep for my profession. I hate it when nurses are catty, and this is just another example of why our profession is in a mess."
Kim Mcallister, RN – Emergiblog.com
"I actually first heard about it this week, from another nurse on FB who asked if I had seen it and sent me the link to Brittney's Nerdy Nurse site.
"I posted at first because I was angry. Angry that a physician could set in motion a chain of events that would threaten a nurse's license, when she was acting totally within her scope of practice. Angry that providing information and empowering a patient to make an informed decision would lead to a nurse being fired.
"Angry that a board of nursing could not resolve this after nearly a year.
"Angry that no nursing organizations were stepping up to support Amanda.
"Angry that she was going through this with no support.
"Then I became resolute.
"This wrong needed to be righted, and this needed to be made very, very public so that the next physician, hospital and corporation would think twice before engaging in this practice of professional retaliation and abuse.
"And that is why I jumped in.
"If we don't, the next nurse could be any one of us."
Kevin Ross, RN, BSN – innovativenurse.com
"After reading her open comments, and the case notes, I quickly formulated my opinion that she was within her scope and her right as a nurse to advocate for her patient.
"My primary role over the last four years has been to advocate for patients who are intellectually and developmentally disabled. They too have the right to quality care, and it requires a tremendous amount of effort to provide education and support to both the patients and the families to ensure that they are making an informed decision.
"Recently, I organized a collaborative platform with Anna and Keith to give a shot in the arm of this profession, and to really support nurses in being able to work their full potential. We are extremely passionate about being nurses, and our cause to elevate this profession. When Amanda's story came to light, I felt as if the integrity of being a nurse was being challenged. I truly felt as if our profession was sucker punched as this blow to Amanda was both unfair and unethical. I thought, how can we lose another nurse on the front lines when it is a vital role that we have to educate our patients and our numbers are already limited? My responsibility as an advocate immediately shifted to a fellow nurse in need. This became an opportunity for me to pay it forward to our profession, to thank Amanda publicly, show my support for her as a nurse, and raise awareness for our profession. I wanted to ignite my online podium and reach out to all nurses letting them know I am firmly planted in our cause to provide safe and ethical patient care, and that as long as we are united, then our voices will be heard."
Coach Perg – The Nurses Coach
"What caught my immediate attention in this case was the intimidation, unfair and harsh treatment of Amanda. This probably stood out due to the fact that as a nurse I've been on the receiving end of it myself.
"Next was the fact that it was over providing a patient information that pertained to them."