“Why are you sticking up for Amanda Trujillo?” nurses have asked me.
My first response was, “She fought back with the courage of her beliefs.”
But the truth is that I believe she could be any one of us. Whether we find out she did some foolish things, or her judgment wasn’t always perfect, doesn’t mean to me that we should throw out all the other truths that her case has uncovered.
One truth is, that while there are organizations to protect patients, we have no organizations to protect nurses. While our nursing organizations can make policy to tell us what they expect of us, we can’t count on them to support us if we follow even our own Code of Ethics which they’ve developed.
Through Amanda’s case, I learned the Nursing Boards are there not to protect nurses, but to protect patients from nurses. Nurses are taught to advocate for patients. Against whom? I am now questioning the conflicts of interest between the hospital that fired Amanda and the members on the Arizona board of Nursing.
I’m intensely grateful that Amanda’s case brought all of the real issues for nurses forward. The fear and intimidation has become so much more obvious. Instead of joining together, we as nurses began to fight among ourselves – much less threatening than fighting the system. Exposing the defects of any system is uncomfortable but ultimately necessary for any system to change.
I don’t like all the greed I see in our society because of the new transparency laws that the government has imposed on the business of healthcare, pharmaceutical houses and financial institutions, but I understand that there’s no way to fix it without that knowledge.
I’d like to believe that everyone who runs our country and our corporations is there because they want to be shining heroes to make life better for all of us, but the fact is that greed is one part of human nature and apathy is another.
I was really surprised to find out that we, as nurses, are pretty much on our own if we’re working in a hospital. God knows what kind of targets we are as we go into expanded practice as primary caregivers because doctors are no longer willing to accept the treatment that we have been willing to for so long. Now, though I’m a big believer in education, I’m forced to ask what the benefit is to getting a better education if there’s no organization that’s going to cover our backs, and no legal team to help defend our right to practice?
We all got so used to “Groupthink” as nurses, and are so fearful that we don’t want to change the status quo. What I’m grateful to Amanda for is she put herself out there, whatever her agenda was. I can’t know that, so I take her at her word. It worked for me because I was able to see what kind of a system we really had, who was there for us, and what our resources were if we made mistakes.
I haven’t determined who’s right or wrong. I know a lot of the situations that Amanda was accused of, I’ve encountered over my own years in nursing. They are truth to me because of my own experience. Therefore, I owe it to myself to give Amanda the benefit of the doubt – as I would any nurse – because I know how many times I was falsely accused. All of what any of us think is only projection unless we know the real truth, which even the law doesn’t reveal.
All I know is that if I look at the difference in the power positions of doctors and nurses, I can see the potential for abuse. Once you have doctors bringing money into a corporation, and nurses as part of a hospital budget, that hospital can cut at their discretion, there’s no way it can be fair to nurses or patients.
The fact that we don’t know what resources are available or what steps to take if we as nurses get into trouble if we follow our organizations suggestion to get a higher education, and also our own Code of Ethics to advocate for patients, leaves me with only one conclusion.
Healthcare has to change, and we have to find it within ourselves to help implement that change. Knowledge is power. And we – as nurses – have the knowledge. Now we need to stand together so that tomorrow’s nurses can be all they can be.
We managed to get rid of our caps, but what did we replace them with?
Thanks for the fine piece. Social Media gives me hope: while it is difficult and perhaps professionally hazardous to advocate for each other and for our patients against abuse and errors locally, with Social Media we can transcend geography and gather numbers in ways never before possible.
As with all new tools, we have seen eager early-adopters, and also critics who see little beyond the risks: how can we know our facts well enough to take a position? How can we know who to trust on line? Cynics have had their hands full: so many people who must, they assure us, all have ill intentions, hidden agendas, and nothing good to offer. We have seen such in Amanda’s case, as we do with all issues that achieve any prominence: some take genuine positions, some latch on for some spin, and some merely to point out how the issue is nobody’s business, except perhaps for themselves. Cynics choose to take no position except to disapprove of everyone else. Most people take no position, which of course provides strong tacit approval for the status quo. Social media change none of these responses, as no technology changes basic human nature. We remain imperfect in our reasoning and choices, and we still need to do our best regardless. Nurses are bound professionally and ethically to advocate, not just when its easy or painless of safe, but whenever they see a need. Amanda put herself in a tremendously uncomfortable position, and whatever else others’ think of her, they should give credit where it’s due. How many of us have seen Nursing under siege in som many ways, the entire health care system falling prey to profiteers and abusers, and yet done nothing but gripe in private, taking no chances and bitterly critical of anyone who does more? We deserve better from each other, and the public deserves more form Nursing. We can improve our place in the world and make a positive contribution, but it won’t happen until we decide to contribute some time and effort and take some risks, upset some people. Hopefully we can find ways with these new tools to better inform, support, and protect those who take these duties to heart and take action. Personally, my focus on Arizona has partly been a test case: can Nurses attract enough attention to a State treating its Nurses badly to make a difference? We need to find ways to do just that, and then apply what we learn elsewhere. At their best, Nurses don’t just see problems: we deal with them and address them. Let’s get to it!
This is becoming a critical issue. One that is insidious and quiet. What we are seeing is the quiet marginalizing of the very leaders that have been mitigating the corporate mentality in patient care, the nurse executives. These nurses have been on the front lines of corporate meetings advocating for nursing and what nurses need to administer patient care. As corporate healthcare continues to get bigger and bigger, the nurse executive is watching their input into care being marginalized and set aside in the corporate structure moves into survival mode. Their voices are being silenced.
We have to move. We have to support these nurses and remind them their input is vital, vital to patient outcomes. They need our support and not marginalized by peers because they are not delivering direct patient care. Patient care is reliant on the job the CNO is doing. They are caught in a strange world being marginalized both by business and by nursing. But they continue to advocate for patients. Because they are nurses.
Thank you for following Amanda’s case, here is the latest:
Red Flags & Questions I See in the Amanda Trujillo, ARNP Case, April 25, 2012 By Beth Boynton:”Amanda Trujillo is an ARNP yet was practicing as an RN. Now maybe there is a perfectly good explanation for this. Third shift is typically tough to staff and given our economy and the financial needs and family commitments, perhaps this was a perfect job opportunity for Amanda. But, honestly, I wonder why she wasn’t practicing as an ARNP rather than an RN? Scope of practice is an important issue in the case and quite different for RNs and ARNPs. Banner health could face serious liability issues if their RNs on duty are practicing out of scope.”
http://?www.confidentvoices.com/2012/?04/25/?red-flags-questions-i-see-in-th?e-amanda-trujillo-arnp-case/
What disturbs me most is that I know what Amanda faced. I worked with Banner and after 8 months in a unit I loved, I had a new manager take over. It was very apparent that this manager did not like me. I was given unfair assignments, I was not offered help, and when I would get overwhelmed I was pulled aside and talked to about my “attitude”. I received two write ups in three weeks. At this point I had been with Banner for 3 years and I never even received a verbal warning from them. I documented everything and I went to my director multiple times about this issue. When that didn’t work, I went to human resources. Human resources set up a mediation between me and this manager, where I disclosed personal health information about myself to her. I found several days later she had taken that information and shared it with my co-workers. I went back and forth between my director, human resources and up to corporate human resources all while documenting what had been happening. The last time I went to human resources, the woman looked at my file and said, “It seems that you are very unhappy here. Have you thought about looking for employment elsewhere?” I knew the steps to try and resolve my issue, I knew my resources, and even that wasn’t enough to affect change. I eventually resigned from that position, knowing that if I didn’t, they would have found a way to fire me. It was the worst experience I ever went through, and has left disillusioned with not only nursing, but health care in general, especially as I move forward in my grad program. I am trying to use what happened to me to benefit other nurses. I let people know that they do have options, and while they might always work, they are there. I agree apathy is a problem, and I agree that we as nurses are not supported as we should be. We are overworked, short staffed, and have more responsibilities added every day without any ever being taken away. Nursing needs to change. And we need people out there motivated enough to go forth and enact it.