WhiteCoat

Amanda Trujillo Update

I haven’t dropped the mission with Amanda.

There have been a few technical problems, though.

Amanda is in the process of creating a timeline of events that have occurred since the incident. I have been piecing together responses from organizations that have responded to the issue and will add those to the timeline. Thus far, I am disappointed in some of the responses from the Arizona Board of Nursing. If you have more information about Amanda’s case, e-mail it to me.

I have also done some research on several of the people involved in the firing and investigation. I can’t post their names here, though.

I have also received multiple documents from several sources that I will also post.

The problem is that I have been asked not to post the material on this blog. There were several reasons for this request, and I agree with the reasons and have agreed not to post the material here as a result. One reason that was raised was that the problems that Amanda is facing do not involve emergency medicine physicians and do not involve emergency medicine in general. This was a problem that occurred with inpatient medicine and surgical informed consent. Emergency Physician’s Monthly magazine has a focus on emergency physicians. I agree with that.

I think that the issues involved in Amanda’s case cut across all aspects of medical care.

If a patient hasn’t received informed consent or doesn’t understand the informed consent, to me, that’s not a “floor medicine” issue, that is an issue that affects patients in every aspect of medical care – including emergency medicine.

If a staff physician had a temper tantrum in front of patients and staff and is otherwise disruptive, to me, that is not just a floor medicine issue. Disruptive physicians affect every aspect of medical care. They make other staff afraid to do their jobs for fear of the next tantrum or … of losing their jobs. If physicians are disruptive on the medical floors, they will be disruptive in the operating rooms and disruptive in the emergency departments as well. Most hospitals have a code of conduct that must be followed. That code must be followed everywhere, including the emergency department. This is a team sport.

If a nurse has gone outside the scope of her nursing license, that isn’t a floor medicine issue, to me, that is another issue that affects every aspect of medical care – including emergency medicine.

If a hospital trumps up charges against a medical provider due to political pressures, that tendency doesn’t stop with floor nursing, with nursing in general, or even with physicians. Inappropriate administrators should be investigated just as much as inappropriate medical staff.

If a state nursing board has to hide its review of a nurse’s actions and has to threaten a nurse’s licensure for disclosing facts about the investigation, to me, that is facially suspect and flirts with constitutional due process violations. The same issues could happen just as easily to an emergency medicine nurse and I have first hand knowledge of similar things happen to emergency medicine physicians.

So, yes, Amanda is a floor nurse and this issue did not happen in the emergency department. However, the underlying procedures involved with this case transcend specialties. When medical professionals stop questioning the process, we lose as a profession, not as a specialty and not as a class or providers. When we stop investigating the potential for nepotism and conflicts of interest to assure that any disciplinary process is fair, everyone loses.

I still don’t have enough information to conclude one way or another whether what Amanda did was correct. But the fact that the parties investigating her actions won’t release any information and have allegedly threatened Amanda in order to prevent her from disclosing the allegations against her and the investigations involved makes me wonder what those parties are hiding.

In order to pursue this issue and to help other bloggers in the process, I am starting another independent blog. I’m not leaving EP Monthly, but I am going to independently publish information on this other blog about Amanda’s case. I’m also going to provide an open platform to other medical bloggers who want to blog – either anonymously or in their own name. We’ll compile our stories and write about random unidentifiable patient scenarios so that there can be no claims of “HIPAA violations” by administrators, lawyers, or anyone else. De-identified information is not and has never been subject to HIPAA laws [see 45 CFR 164.502(d)].

Want to blog? Drop me an e-mail at whitecoatrants (at) Google’s e-mail service dot com and I’ll sign you up.

I have paid for the domain and hosting and am just waiting for the hosting service to confirm everything. And after the SOPA fiasco, I’m not using GoDaddy, either.

UPDATE:

Medbloggers.org is registered and will soon be live.

 

 

16 Responses to “Amanda Trujillo Update”

  1. kathie says:

    Not only a man of words, but a man of action. You are awesome!

  2. SeaSpray says:

    I will be following.

    *If* there is nothing to hide ..then it should all be open for review.

    I would want my nurse to do exactly what she did if I didn’t understand. I’d like to read everything from the beginning again as I’ve just gotten bits and pieces here and there. I read Kim’s post today (emergiblog) and can’t believe all they are trying to do to Amanda. really does seem they are trying to silence – wear her out and intimidate her. It would only make me fight HARDER. Glad to see you and others being advocates on her behalf. It’s awful that she has lost her job and all the other things, but that her reputation ..her name is tarnished …what price do you put on that?

  3. amanda trujillo says:

    ….seaspray….honestly not concerned about the repuation or tarnishing if it means another patient wont be denied their rights or another nurses doesnt have to go through this ever again. Or–if people hear my story and start to advocate more for themselves or their loved ones—reputation or a shiny squeaky clean name means nothing if you dont do something worthwhile and good with it….yes it is frustrating…and shameful…but I do see the bigger picture so its something i will have to come to terms with later….when this is all over.

    • SeaSpray says:

      Hi Amanda – I think you may misunderstand what I meant by that.

      I applaud you for going public and trying to effect change. I think good will come from it.

      **It’s not the going public that is tarnishing your name. Going public – shedding light on the whole situation … will help to clear it*

      The powers that be who caused all of this in the first place have already tarnished your reputation or you wouldn’t be in the position of having to defend and fight for what you did.

      I think it is terrible that they have had no regard for your following protocol, working on behalf of the patient and you HELPED the patient and they have been willing to hang you out to dry. And treating you like you don’t have rights.

      If I am inaccurate with anything I said, then please correct me. I have not read all the comments and may not be up on the latest information.

      I Thoroughly support your bringing this out into the open. I wish you well with this case.

  4. amanda trujillo says:

    Seaspray–i know you didnt mean anything negative :) and I am so appreciative of your supportive words and encouragement–they are a blessing!!! Yes, you are correct about my reputation–I believe there is a blog out there talking about this “unfortunate case of career suicide.” (ouch)Im still smarting from just the title (i havent read the blog) this forum is one of maybe three I come back and interact on. I will have to eventually rebuild our lives….and right now the state board filed more charges so even my future may be threatened….I have yet to see the totality of the damage that has been inflicted on not just my career, but the lives of me and my family members…..I imagine it will take a long time to recover….to be honest I think more of what good can come from this malatov cocktail and when the good stuff is secured….Ill go back and reassess the damage……:( Again—thank you so very much for your support!!!!

  5. This is one of the many reasons why transparency withing healthcare organizations is VITAL.

  6. Green says:

    In the world of nursing, you hardly see a nursing manager willing to stand up for his/her employee when a nurse was not treated fairly. On top of that, so much other harrassments that nurses have to put up with. In Carl T. Hayden VA medical Center, Phoenix, AZ, nurses was notified via email that action would be taken if a nurse call in sick 2 days or more within 2 weeks. This means nurses are not allow to be sick for more than a day required by the a VA hospital run by the Federal government.

  7. Jennifer says:

    Dear Amanda,
    If you’re reading these comments I just wanted to let you know that I really feel for you. I’m an RN too and it seems very clear to me that you absolutely did the best thing for your patient. It’s sad that the nursing board is acting the way it is. I wish that we could transform healthcare so that the patient comes first. Good luck and I hope everything works out well.

  8. Donna says:

    Amanda,
    I am with you, I understand what you did and why. Was faced many times in my career with doctors failing to inform patients or spottily advising them of what they were doing and the risks. I stood for the right and refused to prepare patients for surgery until said doctor did his job. They reacted in anger unfortunately, but did what they needed to do, and I guess I was “fortunate” that their temper tantrums were mild. What good is all the training/education we get if not to advocate for our patients, and to hold everyone accountable who cares for them? And where is the Institute of Medicine (IOM) in all of this? Are they not advocating for nurses to have more training to be on a par with physicians? I am appalled that the nursing powers that be, have not stepped up and wrapped their arms around you, Amanda, to tell the world that you are the kind of nurse they are educating, the kind of nurse we want to care for our sick, elderly, and those who are victims of health inequalities.
    I will get on a soapbox here, so I will just end by saying, I am in your corner and will advocate for you wherever and whenever I can from my little corner of the world.
    52 years of nursing – WA State.

  9. Betsy RN says:

    An issue I have not seen addressed is the waste of health care resources. If this patient had gone on with further evaluations and possibly have received a liver transplant, she would (by her own evaluation) have been overwhelmed with the aftercare. Chances are high that she would have rejected the transplant.

    This would have been a waste of a liver (while so many people die waiting for a liver) and it would have been very expensive. I’m assuming that she has really good insurance.

    It would have cost the patient time with her family as well as costing her the discomfort of having to endure painful and unpleasant procedures.

    Even if the patient hadn’t been approved for a transplant, it would still have cost her valuable time and the healthcare system valuable resources during the evaluation process.

    It is important for nurses to remain on the forefront of patient education and advocacy, because that education and advocacy is a major factor in determining patient outcomes in all fields of medicine.

  10. Lisa says:

    You should have a show on blog talk radio!

  11. Ric says:

    Maybe you would like to see the report from the Arizona Board of Nursing. Sorry, but Ms Trujillo has problems!

    http://www.mediafire.com/view/?x99vxbx2853uzxv

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