The Case of Amanda Trujillo

By Shawn Kennedy, AJN editor-in-chief

Post updated on January 10, 2013; see final paragraph. Amanda Trujillo, MSN, RN, is a nurse who until recently worked at Banner Del Webb Hospital in Sun City, Arizona, until she was fired for, as she claims, just doing what she’s obligated to do as a nurse—specifically, providing a patient information about a surgical procedure in an attempt to support fully informed decision making. (You can read her e-mail detailing her story here. She did not, as she has pointed out in comments, ever attempt to directly obtain informed consent herself.)

Amanda Trujillo

Ms. Trujillo says that, when the patient had a change of heart about the surgery, she requested a hospice consult. After a physician complained that Trujillo had overstepped her scope of practice, the hospital filed a complaint with the Arizona Board of Nursing, which has launched an investigation.

Ms. Trujillo has gone public with her story, sending e-mails and tweets to editors, public officials, bloggers, and the news media. The nursing blogosphere is full of posts with her story—Emergiblog, vdutton’s posterous (which has her attorney’s response to the complaint), and thenerdynurse, as well as a number of others. On January 31, she was interviewed on local television. She makes a compelling […]

2016-11-21T13:10:49-05:00February 2nd, 2012|nursing perspective|42 Comments
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HCR: Been There, Done That

By Maureen ‘Shawn’ Kennedy, AJN editor in chief

I was doing some research in the AJN archives and came across an editorial written in November 1993 by Virginia Trotter Betts, then-president of the American Nurses Association. “The Best Buy in Health Care” (click through to the PDF option; article will be free until July 18) reads like it was written with the Institute of Medicine’s Future of Nursing report in mind. Here’s an excerpt for those who don’t have access to the AJN archives (a shameless plug: subscribers have full access to ALL the issues of AJN, back to the very first issue in 1900—a treasure trove of nursing history):

“But we must also face the fact that such reform will require significant changes in nursing. Nurses will have to operate with greater autonomy and deliver care to a broader clientele. To foster enhanced roles for nurses as case managers and team leaders, nursing administrators must alert the work environment to offer a continuum of care on site and off site. Nurse educators will need to offer innovative programs, curricula, and clinical placements that prepare nurses for careers characterized by critical thinking and maximum flexibility. Nurse researchers will need to add more health care system, economic and policy studies to their repertoire.”

And another:

“Nurses want to do more in a reformed system to facilitate access at a reasonable cost.  We want to do what we are educated to do – provide […]

2016-11-21T13:14:18-05:00January 18th, 2011|career, health care policy, nursing perspective|0 Comments
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‘Problems Worthy of Attack’: Takeaways from IOM Summit on Nursing’s Future

By Shawn Kennedy, AJN interim editor-in-chief

Last week, I spent two days at the summit convened by the Robert Wood Johnson Foundation to launch the Campaign for Action—the strategic plan to implement the recommendations of the Institute of Medicine’s (IOM) report on the future of nursing.

The days were packed with presentations from key players in health care, who offered their perspectives for implementing the recommendations (plus lots of networking, hallway “sidebars,” animated dinner conversation, and commitments from individuals and organizations to continue the momentum). Here are some quotes and snippets of conversation that stick with me as I work on a more comprehensive report:

IOM president Harvey Fineberg, in his opening remarks: “It’s our turn to act to advance nursing and health.”

Risa Lavizzo-Mourey, president and CEO of the Robert Wood Johnson Foundation, opening the event: “We will remember that we were here on November 30 at the beginning of a new future for nursing.” And cautioning: “scope of practice is the hot button that could blow all this apart.” (A thought echoed by Jack Rowe, an IOM committee member, professor at Columbia University Mailman School of Public Health, and former CEO of Aetna, who used the term “combustible.”) […]

2016-11-21T13:14:45-05:00December 6th, 2010|career, health care policy, nursing perspective|0 Comments
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Turf Wars Aside, How Do NPs and MDs Really Differ?

By Christine Moffa, MS, RN, AJN clinical editor

There’s been a lot of talk lately about turf wars between NP’s and physicians, especially when it comes to the much discussed U.S. shortage of primary care providers. Before going back to school and getting a master’s in nursing education, I batted around the idea of becoming a nurse practitioner. It seemed like the ideal next step for someone who was happy being a clinician but wanted to take on an advanced role.

However, there was something that didn’t sit right with me about becoming an NP—namely, my fear of public perception. I’m not sure most people know exactly what the role of an NP is and how it differs from that of a physician, particularly in primary care. I’ve seen patients call their primary care NP “doctor [insert first name here],” which to me illustrates the confusion.

When people ask me the difference, I myself have a hard time articulating it. How do I respond when someone says something like this: “if entry to medical school and residency is typically more competitive than for advanced degree nursing programs, and if physicians spend a longer time attending tougher programs, how do you justify their doing the same work as NPs?” (For instance, when I was in school we, along with the NP candidates, were only required to take two semesters of pathophysiology!)

Now, I’ve been to an NP as a patient, and I was happy with the care I received. She certainly […]

2016-11-21T13:18:07-05:00April 20th, 2010|career, nursing perspective, students|6 Comments
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Nurses Under Fire: Cleared in Texas, Embattled in California

By Shawn Kennedy, interim editor-in-chief

By now you’ve probably heard that last Thursday Anne Mitchell, the Texas nurse who found herself fired from her job and on trial after reporting a physician for what she felt was poor medical practice (see our report in the October 2009 issue) was found not guilty (her colleague, Vicki Galle, had her case dismissed prior to trial). It only took the jury about an hour to exonerate Mitchell of criminal charges and uphold her right to advocate for patients. (Day-by-day reports from the trial were made available on the Texas Nurses Association  (TNA) Web site.)

The case garnered national attention—at its core was a nurse’s right (duty, really) to safeguard patients in her or his care. It seemed a no-brainer, and almost incredible that the case even came to trial. Last Friday, I spoke with TNA president Susan Sportsman, PhD, RN, who agreed, saying she was surprised the case went forward, especially after the state medical board agreed that what the nurses did was appropriate. Sportsman said, “This is the role of nurses—it’s required that we report what we see to safeguard patients. This nurse was just doing her job, what she was supposed to do.”

Like nurses everywhere, Sportsman was “delighted and ecstatic” about the verdict. Sportsman noted a guilty verdict would have discouraged nurses and others from coming forward about poor care out of fear of losing their jobs and facing prosecution.  Perhaps […]

2016-11-21T13:19:19-05:00February 16th, 2010|Nursing|3 Comments
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