In case you don’t frequent twitter, the nursing blogosphere, Facebook or other online nursing communities, Amanda Trujillo is a nurse in Arizona who is under investigation by the State Board of Nursing there. In short (you can read her account here) Amanda relates that when she became aware that a patient awaiting a liver transplant had considerable misunderstanding about the procedure and the lifelong aftercare that would be required, she spent time with the patient discussing related issues and ordered a hospice/case management consult at the patients request so the patient could explore his/her options, something that was within her scope of practice and not against her employer’s policies.
The patient’s surgeon, when he found out about this, became irate and demanded that she be fired and her license taken from her. Amanda was then fired by her employer Banner Del E Webb and reported to the state board. Much of the nursing community is enraged about the situation while some nurses are reserving judgment, wanting more information or waiting to see how things unfold. There are also some who doubt the validity of her story and believe she is simply seeking publicity after getting fired. But regardless of what actually happened between Amanda, her patient, the physician and her employer, there are many troubling facts in the case – things that all nurses should be concerned about.
Regardless of your thoughts about/knowledge of the actual events leading up to Amanda’s dismissal, the case has evolved into something much bigger. Yes, Amanda’s license, livelihood and reputation are on the line and she deserves our support. If given the choice, I’d much prefer to err on the side of supporting her than on the side of doubting her. But what’s even more disturbing is how Amanda is being treated in the course of the investigation.
Reports are that the board notified Amanda’s university (she is an NP student) that she was under investigation even though other insider sources say that should/would never be done while any investigation is underway. What could have been the board’s motivation to do that other than to possibly negatively influence her university against her before the investigation is completed?
Even worse, Amanda has been required by the board to have a psych consult, allegedly because she brought the case to the media and is “speaking out.” Some might say that there is a witch-hunt going on – that the powers-that-be are searching deep and wide for anything they can use to make their case. Just for argument sake, even if there were communication, chain of command, or policy issues in question (I’m not suggesting that there are), how does that warrant the type of humiliation and violation of privacy issues that she is being subjected to? And then – what if they still find nothing? What lengths might the board go to, to prove a point or ruin her career?
The case is pivotal not only because of what is happening to Amanda but also because if it happens to her, what’s to prevent something similar from happening to any other nurse in any state? Didn’t we take an oath, public or private, to advocate for our patients, educate them, and operate in their best interests? I’m sure a case can be made for either side on this issue depending on your title, whom you work for, or what your credentials are. But the bottom line is that a fellow nurse is under attack in the course of doing her job to the best of her ability.
Let’s join forces and give Amanda our support and the benefit of the doubt. But beyond that, let’s speak up for fair and equitable treatment for all nurses and the allowance of due process. Remember, anyone can report a nurse for any reason to their state board. It’s then up to the board to determine if there was wrongdoing of any sort or not. It can easily turn into a David and Goliath situation when a board holds enormous power over an individual nurse and her license and exerts undue influence in the state.