Amanda Trujillo

You can read Amanda’s story in her own words; please, do.  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.

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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:

1. Don’t be afraid to speak up when you see your patients in danger. “If we lose that, we lose the foundational fabric of our profession.” She’s right. Nurses are patient advocates, possibly the last advocate the patient has nearby, often advocating behind the scenes where patients and families do not even see or know. Amanda encourages every nurse to be familiar with the Nursing Code of Ethics, to make it more than a school textbook. Keep it at your side, and use it in daily nursing practice. Amanda admits, “It’s not easy standing up for the patient.” No, no it’s not, especially in light of Amanda’s current situation. Still, it’s our duty and moral obligation to do so.

2. Stop bullying each other. “Nurses have to stop the back-stabbing. When we tear each other down, we diminish our profession.” Without a doubt, it’s the part of nursing culture that is starting to move out of the shadows. It wasn’t until a few years ago when we started talking about bullying within our profession. We must make serious strides toward improvement, and it will take each and every one of us working together to accomplish such an insidious culture shift.

3. One person can make a difference. It happens every day. “It’s the ripple effect,” Amanda pointed out so appropriately (and so inspired this blog series titles). “Sometimes you have to do the scary things to make a difference.” True. Nursing is full of scary moments, few of which I ever thought would be related to educating patients or asking for a case manager to speak to a patient. Still, one person is powerful. It only takes one person – one – to change a patient’s outcome.

Astute suggestions in the face of adversity. I expect nothing less from my nursing colleague. Her words ring in my ears. I hope they linger in yours, as well.

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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.

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You can read Amanda’s story in her own words; please, do. 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.

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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.

No. More.

Amanda paused during our conversation, explaining the waves of support from healthcare colleagues, “This is the nursing profession I’ve been waiting for, that I’ve always wanted.” You and so many of us, Amanda. We are here. There are amazingly great nurses and organizations. We’re finding one another. We’re standing alongside you.

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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.

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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.)

Nightmare?

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.

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