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 case that she was advocating for the patient’s right to information, and one wonders why she was fired and is under investigation.

As we have been for 112 years, AJN is all for coming out in support of nurses. Do we believe a nurse’s first duty is to the patient? You bet. We’re also all about accuracy and facts, and in this case, it’s been tough getting information from all sides. While certain assertions have been repeated in most of the supportive blog posts we’ve read, the undertone is that there is more to this case than the obvious.

Here’s what we’ve learned so far from the other parties: According to Joey Ridenour, MN, RN, FAAN, executive director of the Arizona Board of Nursing, “While the investigation is ongoing, information is kept private to protect the nurse should the complaint be unfounded.” She noted that while Ms. Trujillo can go public with details, the Board cannot. She did verify that Banner Del Webb Hospital filed a complaint about Ms. Trujillo’s practice on April 26, 2011, for “non-compliance with Federal, State or contractural arrangements.”

Ridenour also verified that at the January 24 Board meeting, the Board reviewed the case, voted to continue the investigation, and requested a psychological evaluation of Ms. Trujillo. When I asked if this was unusual, she said that in general, if the board feels that there is a lack of understanding in complex cases, the Board will ask for “expert opinion.” The Board will reconvene in March to review the findings and rule on the complaint. In the interim, Ms. Trujillo’s license remains active and without restrictions.

I spoke with Arizona Nurses Association executive director Robin Schaeffer, MSN, RN, CNE. The Board has been criticized for not supporting Trujillo. Schaeffer says the association is “right there to advocate for nurses,” but it must wait for the Board investigation to be completed. Until then, it will monitor the situation. It’s the association’s policy not to comment on the specifics of any ongoing investigation and the association supports the Board’s obligation to regulate the profession. I asked Schaeffer about any conflicts of interest that might prevent the AzNA from supporting Ms. Trujillo’s position, and she said that, contrary to what’s been purported on some Web sites, she is NOT an employee of Banner Health.

I haven’t had any response to phone calls to Banner Health, but on its Twitter page they have noted that “Banner Health, like most companies, does not publicly discuss employee matters.” No surprise there.

It’s regretful that any nurse has to go through what Ms. Trujillo has gone through, and we hope all will work out well for her. We’re following the story and will update you when we have more facts.

Our follow-up post: “Boards of Nursing and the Amanda Trujillo Case”

Also of interest: this post from nurse/blogger Not Nurse Ratched giving a link to the official Arizona Board of Nursing Notice of Charges in the case.

Addendum: January 10, 2013: The eventual outcome of this case can be seen in the “consent agreement” that Amanda Trujillo has signed with the Arizona Board of Nursing, which states that she “admits the Board’s Findings of Fact and Conclusions of Law” and agrees to fairly onerous terms for continuing to practice as an RN on probation. Thanks to blogger Not Nurse Ratched for providing a link to this document in her recent post about the case and its unfortunate history on the Web.
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