Ripples: A Conversation with Amanda Trujillo (Part 1 of 3)

by Nursetopia on January 31, 2012

Amanda Trujillo via Twitter

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.

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Imagine you come in for a “routine” 12-hour night shift. Everyone is stable, and one of your patients is scheduled for a facility transfer in the morning for an organ transplant evaluation. Should be a slow night. When you assess the organ transplant eval patient, though, you find the patient really has no clue what’s happening – doesn’t even understand the disease process, medications, or future plan of care, including what the process is for organ transplant and recovery.

As any prudent nurse would do, you provide education to your patient, including information about hospice. When the patient asks more about hospice, you tell the patient a case manager can help provide more in-depth information about hospice and what all occurs with that process. You then activate a case management consult via a nurse-led order in the electronic medical record system.

Now imagine you come in the following evening, hear about the fit the physician threw when he found out the patient was no longer considering the organ transplant and then speak with your nurse director, only to end in termination – without any previous write-ups or counseling sessions – for going beyond your scope of practice and ordering a medical order. (That’s right – a case management consult.) Not only are you losing your job, but oh, yes, your organization – Banner Del E. Webb Medical Center in Amanda’s case – is reporting you to the Board of Nursing for going beyond your scope of practice. And, through a series of unfortunate events during the Board’s investigation, they decide you need psychoanalysis.

Your state nursing association isn’t interested in advocating for you – maybe because your license is under investigation and there are legal ramifications* or maybe because the board president is a director at your former employer. Maybe a bit of both? (*State Boards of Nursing are, after all, charged with protecting the public and investigating all concerns brought forward to them.)


Except Amanda Trujillo cannot wake up; it’s a very real situation for her. She’s a masters-prepared nurse working on her DNP. She’s knowledgeable, eloquent and passionate about nursing and quality patient care. She “gets” professional nursing, transformational change, and advocacy. I know of many organizations who would clamor to have her as an associate and nurse leader; yet, no one wants to hire her because she’s under investigation…for a case management consult that angered a demanding physician.

Amanda Trujillo’s situation impacted the surface of our profession, making tiny ripples. Tomorrow I’ll discuss those ripples building into waves and more.

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There are numerous ways to support Amanda Trujillo, RN, MSN. Join the Nurse Up Facebook page. Donate to her cause. (Remember, no nursing advocacy organization is currently standing with her.) Share her story with your nursing colleagues and local media outlets.