I got this from the Arizona Nurses Association in response to my e-mail about Amanda:

Amanda Trujillo, RN, is a member of the Arizona Nurses Association (AzNA).  The Arizona State Board of Nursing is currently investigating Ms.Trujillo’s Registered Nurse license per its regulatory mandate. The Arizona Nurses Association understands that it is difficult for a nurse to undergo an investigation of his or her practice by the board of nursing.  However, we support the Board’s authority and obligation to regulate the profession in the state including investigating complaints. Therefore, AzNA does not get involved in complaints of nurses submitted to the board nor does the association comment on the specifics of any investigation. Ms. Trujillo has chosen to share the details of her case publicly and to imply that the AzNA has taken a position about her case. The fact is that AzNA is neutral and does not get involved in matters before the board of nursing. As of January 24, the state board’s investigation of Ms.Trujillo remained open.  No disciplinary action has been taken against Ms. Trujillo’s license at this time, which remains active and unrestricted during the investigation. Further questions about this case should be directed to the Arizona State Board of Nursing.  

Good to know that they're supporting her so much.
I was so very disappointed to hear about Amanda Turjilo from those emergency blues ( http://torontoemerg.wordpress.com/). Here is what happened in her words:

My name is Amanda Trujillo. I’m a registered nurse of six years , specializing in cardiology, geriatrics, and end of life/palliative care. Back in April of this year I was caring for a dying patient whom I had discovered had no clue about what they were about to participate in when they agreed to get a major invasive surgery. When I properly educated the patient using the allowed materials by my employer they became upset that the physician never explained details of the surgery or what had to be done after the surgery (complex lifetime daily self care). The patient also had no idea that they had a choice about whether they had to get the surgery or not or that there were other options. They asked about hospice and comfort care and I educated the patient within my nursing license and the nursing code of ethics. The patient requested a case management consult to visit with hospice to explore this option further in order to make a better decision for their course of care. I documented extensively for the doctor to read the next day and I also passed the info on to the next nurse taking over, emphasizing the importance of speaking with the doctor about the gross misunderstanding they had about the surgery. The doctor became enraged, threw a well witnessed tantrum in the nursing station, refused to let the patient visit with hospice, and insisted I be fired and my license taken. He was successful on all counts. 

 I was shocked and dismayed to see how she was treated. I would like to say she did what any nurse did, but she did not. She went above and beyond the call to advocate for her patient's right to die in a dignified manor. I cannot speak for the scope of practice in Arizona, but everywhere I have nursed, asking for a case manager is NOT a medical order, it is a nursing order. I thought that nursing had moved past "doctor's tell, nurses do" . We are supposed to be an age of multi disciplinary care teams, where everyone's voice is heard; including the patients. Clearly this patient was not having their voice heard, and as nurses are supposed to do, Amanda made sure this patient had a strong advocate in her. The Arizona state board should be supporting Amanda, not punishing her. The most important, integral part of nursing is to be a patient advocate, and that is what this young lady is. To punish her is telling every nurse in the world that Arizona does not value nurses, and certainly does not see them as equal to doctors.  It flies in the face of all the advances we as nurses have made over the years. 
Shame on you Arizona. People you should e-mail if you feel the same as I do:

The Banner Del E Webb Medical Center, where Amanda worked.  http://www.bannerhealth.com/_Contact+Us/_feedback.htm?s=comment

Executive Direct of the Arizona State Board of Nursing, Joey Ridenour jridenour@azbn.gov

President of the Arizona Nurses Associate (also the nursing direct at Banner Del. E Webb medical centre) Robin Schaeffer robin@aznurse.org

Twitter Feed:

When I was a nursing student, I had to wear navy blue scrubs. Navy blue was not the worst colour I’ve seen by far. Since I graduated, I haven’t worn a single piece of navy blue scrubs. This is common among universities in order for instructors to know who their students are, and for nurses to recognize students.  I see two problems with that piece of logic:
Instructors should know what their students look like. Seriously.
Nurses know who students are. We don’t need them to wear the same scrubs. They pretty much have a gigantic sign saying “STUDENT”.  They are the ones who look terrified and excited. They all have the same nervous smile. They are the ones with the exact same worksheet as their fellow students. That will change quickly after graduation.  They are the ones who take ten minutes to do what RNs can do in two. They are the ones who know every piece of inane facts about their patients and know every single irregular lab value, even if they don’t know why it’s important.  Students don't need to wear the same colour, we all know who you are. 

My Value as a nurse
 One of my favourite nurse bloggers at Those Emergency Blues, challenged nurses to make their own nurse as to what value we have as nurses. Nurses often talk about how hard their job is, and that’s why they get paid. How the job is physically demanding and pretty gross sometimes. But I could teach a high school student to do the physical aspects of my job. Anyone can take a blood pressure, turn a patient, or wipe an ass. My value is in knowing why. This is what I know

·         The signs and symptoms of hypoglycaemia

·         The difference between delirium and dementia

·         Why one antibiotic a is being used instead of antibiotic b

·         When it a pt with a C2 spinal cord injury is diaphoretic, has a headache, anxious with a BP of 120/90 that is a medical emergency

·         Why the nurses are waking you up to ask you where you are, and want you to hold your hands out while you count to ten.

·         I know how many calories a burn patient needs to heal

·         What medications cannot be given while a tube feed is running (more than you would think)

·         I know how to place an NG (despite the administration telling me nurses don’t)

·         What to do when you start seizing. And what to do when you think you’re seizing.

·         When an SBP of 200 is okay, and when an SBP of 90 is okay.

·         I know how to explain the treatment to you and your family so you understand it.

·         I know how to keep families in the loop

·         What words to use to make the doctor get their asses to the ward.

·         The difference between types of chest pain, and what to do for them.

·         Why your shoulder hurts when your gallbladder is inflamed.

·         Why your suddenly confused elderly family member most likely has a UTI

·         When an SpO2 of 88% is okay, and when an SpO2 of 100% is dangerous

·         Why the prescription bottle tells you to take it on an empty stomach

·         Why a stroke patient can’t have a sling for their paralyzed arm

·         Why bed rest means BED REST. No you cannot get up to go to the bathroom; no you cannot sit up to eat.

·         Which dressing will give your wound the best chance of healing
·         I know how to hold someone’s hand while the die, and how to make that process peaceful and dignified.


And probably more that I have currently forgotten.  So my value in as a nurse? has nothing to do with what I know how to do, and everything to do with why and when I know to do it. 

What's your value as a nurse?