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

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