Re Amanda Trujillo: Open Letter to The Honorable Janice K. Brewer, Arizona Governor


Please learn more about the important ongoing case of RN Amanda Trujillo, a conscientious Nurse who has been punished strikingly severely for providing routine patient education that inconvenienced and angered a physician who demanded her job and her license.  Her State BON has still not decided her case after a year, and she remains an unemployed single mother.

For a fine summary of the known facts, see ”  thenerdynurse.com/2012/01/arizona-nurse-has-license-threatened-by-doctor-after-providing-patient-education.html  ”  If, as I and many others have after much research and reflection, you find her cause worthy and just, please participate in our advocacy campaign.  It requires little commitment, cost, or effort:

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As part of this effort, I have respectfully submitted the following by e-mail and the preferable snail mail:

“The Honorable Janice K. Brewer, Arizona Governor…

Governor Brewer,

As a concerned citizen and Nurse, I wish to make you aware of a matter that troubles me, and increasingly, many others.

Roughly one year ago, Banner Del E. Webb Medical Center in Arizona terminated RN Amanda Trujillo from her Nursing position there.  The case has been researched and described in detail by many Nursing bloggers: for an example, see http://thenerdynurse.com/2012/01/arizona-nurse-has-license-threatened-by-doctor-after-providing-patient-education.html  There are too many other examples to list here in the time I have available, and countless new mentions arise daily – I have been unable to take them all in myself despite some significant effort – on various Social Media fora.  The circumstances leading to this action have led many to suspect that her rights may not have been respected in this matter, that her termination was a disproportionate and unjust response to proper and professionally required patient education that reportedly inconvenienced and cost potential revenue to a staff physician who was witnessed having a tantrum in open hospital areas, leading to a demand that she lose her job and license to practice.

Additionally, my research into your truly admirable public records – easily navigable and well-organized – has found the following information:

The most recently available data indicate a reported percentage of AZ BON customers (including roughly 35,000 licensees) rating BON service as very good or excellent as 7%.  Thus, 93% offer lower ratings, further details of which I have been unable to find.

On average, the AZ Board of Nursing (BON) takes 7.4 months after a complaint is submitted for it to be presented to the board, although only an average of 17.4 hours of investigation time is spent to bring a case to conclusion.  In contrast, Amanda Trujillo’s case has not yet been resolved nearly 12 full months after the original complaint was filed.  In that time, she has remained unemployed – imagine seeking a professional position with your license in doubt.  Whatever the original allegations, and they seemed rather weak to many, a year of effectively suspended licensure seems unjust.

As part of an ongoing interest in conflicts of interest in American health care, it has come to my attention that the following AZ BON members have troubling connections with Banner, the source of the current complaint by Banner officials against Amanda:

Dr. Kathy Malloch, BON Vice President, is the President of KMLS, a consulting firm whose web site lists two Banner hospitals in Arizona as clients.

Patricia Johnson, Board Member, works at Banner Thunderbird Medical Center in Glendale.

Further, Attorney Kathryn L. Busby’s current firms’ web site reports she currently works as general counsel and in other roles for an unspecified “large health plan.”

I do not mean in any way to attack these individuals’ character or motives.  However, it is my understanding that conflicts of interest are well known to exert an undue influence on the decision-making of those affected, regardless of good intentions:  a universal facet of human nature.  I therefore believe, consistent with ample legal and other precedent from many areas of modern life, that conflicts of interest in all matters of the public welfare including health care should be minimized to absolutely the greatest extent possible, and that such conflicts that remain must be made public whenever possible.  Conflicts of interest greatly contribute to the waste, corruption, and inefficiency that continue to plague America, costing us all money we no longer have.

Judge Louis D. Brandeis once said it best: “Publicity is justly commended as a remedy for social and industrial diseases. Sunlight is said to be the best of disinfectants; electric light the most efficient policeman”.  In that context, I have made all the above information available to any interested parties.

I should note that a growing number of Nurses and others, currently numbered in the thousands and growing rapidly, have become aware of these troubling data.  In addition, multiple Nursing and Medical colleagues experienced with Banner Health have reportedly indicated a suspicion that Banner may routinely file BON and other regulatory board complaints regarding fired employees.  There have been posted suspicions that Banner may abuse these systems to improve their position in any civil suits that might arise, which seems to an admitted non-expert an abuse of limited resources.  If true, such practices may well explain the unfortunate delays (7 months!) and perhaps scant investigation (17 hours!) in processing complaints to BON.  One Nurse, who recently left Nursing work in AZ to return to Massachusetts, felt that allegations against Banner seemed plausible in light of her experiences working (not for Banner) in your fine state.  She felt working conditions were notably less favorable than she had become accustomed to here, and this perception contributed strongly to her decision to leave the state.  I take no position, myself, on the validity of these opinions, although they certainly trouble me.

As I often teach Student Nurses, new Nursing program graduates, and more experienced Nurses, I am often asked for informal career advice.  What am I to tell those considering work in Arizona?  I wish to request whatever information you may have to offer regarding the quality, supervision, and regulation of Nursing in Arizona.  As I have been an active advocate on Amanda’s behalf recently, I suspect with admittedly a poor grasp of the topic that any direct contact with AZ BON at this point would be counterproductive and improper.  While I in my ignorance would not interfere with their work, I have contacted your office for three reasons: first, if your web resources are any indication, Arizona is a well-governed state with an admirable level of transparency.  Second, matters of public welfare should be open to public scrutiny in any democracy.  Third, having enjoyed visiting Arizona and having a well regard for its residents, I felt you should know of matters potentially damaging it’s reputation in the eyes of a rapidly growing group of individuals.

Thank you for your consideration in these important matters.

I trust your judgement, and eagerly await any advice you might offer.

Sincerely,

Greg Mercer, MSN”

Please note the following contact information, as found in the link that follows:

The Honorable Janice K. Brewer, Arizona Governor
Executive Tower
1700 West Washington Street
Phoenix, AZ 85007

http://www.azgovernor.gov/Contact.asp

Phoenix Office: (602) 542-4331
Tucson Office: (520) 628-6580
Fax Number: (602) 542-1381

Finally, please participate in our advocacy campaign:

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About gregmercer601 (625 Articles)
I am a staff Nurse in Psych, a Hospital Educator and Nursing Professor. I'm also the Founder, President, and one of two volunteer staff of GRC - Golden Rule Care, a Nurse-supporting consulting program offering education, inspiration, technological and organizational tools to help Nurses and other care providers learn how to better build rapport and cooperation with their patients, and waste less time & energy. In this way they have more fun and get more done, with less stress and frustration, and better quality care.

18 Comments on Re Amanda Trujillo: Open Letter to The Honorable Janice K. Brewer, Arizona Governor

  1. The latest on the case:

    Facing a Crossroads, #AmandaTrujillo, MSN, RN & the Arizona State Board of Nursing:”At the heart of Amanda’s case is Patient Advocacy. Her patient was having second thoughts about a Liver Transplant evaluation, and Amanda helped fill in the gaps. The doctor, Dr. Keng-Yu Chuang (Source AZBON public records), who had only offered the liver transplant, went ballistic when the patient asked for Hospice info instead. He demanded the hospital serve Amanda’s head up on a platter and that the Arizona State Board of Nursing be contacted.”

    http://nurseup.com/wordpress/?p=2850

    Like

  2. THANK YOU GREG. For sheding light on the underhanded politics that are the guidelines for the St bon in AZ.
    I have found others that have been wrongly treated to save a hospital.
    Gov Brewer NEEDS to answer. She is ultimately resonsible for the mess at the st bon.
    I was shocked to see the unprofessionalism that exists with the group. ANd Amanda ‘s so called “investigator” NIKKI AUSTIN is a clown. She is clueless , and letting the others tell her what to do. He name is on the recommendations. She need to have a nursing complaint on her ! what a SHAME azbon, ruining careers all the while acting if they are protecting the public.

    Like

    • Thanks so much, Kathy, for your interest and passion for these important issues. Unless we improve health care quality and ethics for everyone, health care reform is doomed to accomplish no more than greater profits for the ruthless.

      Like

  3. It’s a intersting post.Thank you very much for the post.

    Like

  4. Thank you Greg for following Amanda’s case, this is from TruthAboutNursing.org

    Fired for educating a patient? TruthAboutNursing.org, May 2012:”On February 1, the Phoenix CBS affiliate KPHO-TV ran a short but good item by Peter Busch about veteran local nurse Amanda Trujillo, who said she had been fired by Banner Del Webb Hospital and had a complaint filed against her with the state board of nursing because she had educated a patient about the risks of an upcoming surgery and scheduled a consult about hospice. A hospital spokesman reportedly said that “the doctor, ultimately, is the focal point that directs care for patients” and that “company policy” forbids nurses to order a case management consult. The report does not mention other accounts suggesting that these events were set in motion because the patient’s surgeon was displeased that the patient had decided against the surgery.”

    http://www.truthaboutnursing.org/news/2012/may/trujillo.html

    Like

  5. Thank you for following Amanda’s case, this is from her blog.

    The Moment of Impact: April 21, 2010: by #AmandaTrujillo, MSN, RN, #nurseup #nursefriendly #healthcare:”The day my life collided with something greater than I could ever wrap my head around in this lifetime…..I heard a quote recently that conveys the enormity of the year’s events…its message, perfection, but not in the way I would like to envision life perfected, the way I want it, the way I wanted it, the way I thought I had it…..in any case, I like this quote because it encompasses the past, the present, and the future all at once.”

    http://nurseinterupted.wordpress.com/2012/05/09/the-moment-of-impact-april-21-2010/

    The day that changed Amanda’s life forever. To follow her case and others, kindly visit http://www.nurseup.com

    Like

  6. Thank you Greg for following Amanda’s case, here is the latest:

    The War Against Amanda Trujillo, April 25, 2012, Mother Jones, RN, Nurse Ratched’s Place:”I still support Amanda Trujillo and some people who have read the allegations against Amanda have questioned my judgment. Frankly, I don’t believe these allegations because I personally know two other nurses who have been reported to their nursing boards by their former employers. One of my friends was reported to the BON after she spoke up about unsafe nursing practices at a shady nursing home, and the other was reported after he chastised hospital administration for placing psychiatric patients and staff in an unsafe environment. Their former employers cooked up all kinds of false allegations against my friends who are both stellar nurses. Their former employers crucified their character, but in the end they were both cleared of any wrongdoing by their respective state nursing boards. There is an escalating pattern of abuse as more unscrupulous employers are using nursing boards as the ultimate scare tactic to keep nurses “in their place. ” Amanda is just another victim of this ploy.” http://www.nurseratchedsplace.com/2012/04/the-war-against-amanda-trujillo/

    Like

  7. Thank you Greg 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-the-amanda-trujillo-arnp-case/

    More info: http://www.nurseup.com

    Like

  8. I’ve been a nurse for 30 years and I’ve NEVER had a problem getting work. I live in the D.C area and I’ve had a lot of jobs. But the world has changed with the economic troubles and Michigan has been hard hit. So if you want to make good money as a nurse you’re gonna have to move to the East or West coast. If I were just coming out of nursing school, I would get to the D.C area as quickly as possible. Northern Virginia hospitals have programs for new graduates. My sister-in-law just finished one and now she has 2 years experience and found another job right away. The area is expensive, but you will be able to afford it once you start working. Look online at Washington Hospital Center, Inova Health Care System and George Washington Univ. Medical Center. Don’t listen to the naysayers. The average starting salary for a new nurse in this area is $24-$25 an hr. It only goes UP from there. Good luck to you.

    Like

  9. Greg — Would you kindly share the source of the ‘17.4 hours per investigation’? I would greatly appreciate it.

    Like

    • Amanda Trujillo MSN, RN // February 16, 2012 at 4:01 am // Reply

      (sigh) Some people have to learn the hard way Greg. No worries brother, I got this. :)

      Like

      • I love my job as an RN. I actlaluy work in an ER where I am a supervisor. I have a mixture of management time (2 times a week) and floor time (3 times a week). The work is very satisfying to me. I couldn’t imagine doing anything else. I don’t know what it would be like to be a neonatal nurse but overall I believe nursing is a very rewarding and amazing career. You get to help people everyday. And not all of them thank you for it but it’s still worth it! I have been a nurse for 8 years (a supervisor for 5 of those) and make approx $ 60,000/year. But I live in Iowa which has the one of the lowest Medicare reimbursement rates in the nation which is why we usually have lower salaries! Good luck to you!!!

        Like

  10. FANTASTIC letter!

    Well researched and beautifully written. So eloquent and powerful.

    Like

    • Aw shucks – thanks. I edit better when I’m dealing with Governors and such, I guess…

      Like

      • I have been a nurse for over 35 years and I have never had trouble getting a job either.Many times I have had more than one job.You are thinking inside the box about nursing at the beside because that is what you are familiar with but nurses work in many other settings as well.Community healthresearcheducationambulatory careoccupational healthYou can even go on in a nursing career and get more education and specialize as a clinical nurse specialist or a nurse practitioner.All of these require the advanced education that your degree will provide.Sometimes when jobs are in short supply in one area there are many more jobs in another area. There are regional differences in job opportunities. This is true in both Canada and the US.While the nursing shortage is real and is predicted to go well into the future it does cycle somewhat. About every ten years or so there is a down turn in the number of nursing jobs that are available..Since you are in the first year of a 4 year program it is quite likely that the job market will be different when you graduate. It may be a bit too soon to be fretting about getting a job.When you graduate your real chances of getting a job are good. You may not get one right away and it may not be the exact job you want, and you may have to relocate to get it, but you will get a job.And once you have a job and some experience in nursing it is much easier to get another one. And that is how you build and advance in your nursing career.

        Like

8 Trackbacks & Pingbacks

  1. AzNA applauds the nurses who have spoken out on Amanda Trujillo’s situation. It’s inspiring to see nurses ignited and engaged. | Nurse Up!
  2. Nurseup.com, A Nursing Advocacy Organization | Nurse Up!
  3. Scrubs Magazine: Arizona BON Keeps Trujillo Under Fire | Notes from the Nurses’ Station www.rncentral.com | Nurse Up!
  4. Arizona Right to Fire, #Youtube, LoneProtestor, Another Banner Nurse, Career Almost Destroyed #nurseup #amandatrujillo | Nurse Up!
  5. #Georgia #Nurses, Could This Happen To You? Learn More Today or Risk Your License Tomorrow #nurseup #nursefriendly | Nurse Up!
  6. Alaska Nurses, Could This Happen To You? Learn More Today or Risk Your License Tomorrow #nurseup #nursefriendly #amandatrujillo | Nurse Up!
  7. District of Columbia Nurses, Could This Happen To You? Learn More Today or Risk Your License Tomorrow #nurseup #nursefriendly #amandatrujillo | Nurse Up!
  8. #Nurseup #AmandaTrujillo, #RN, #Blogposts Let us know what is missing! We want them all :) #nursefriendly | Nurse Up!

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