January, 2012 Archive

July 31, 2016, 5:42 pm

Augmentin 375mg Pills $109.00

Augmentin 375mg pills $109.00 Sorry, augmentin 375mg pills $109.00 no.

Augmentin 375mg pills $109.00 This is the problem.

Augmentin 375mg pills $109.00 There is a huge injustice being perpetrated against a nurse right this moment.

Augmentin 375mg pills $109.00 It’s getting worse.

Augmentin 375mg pills $109.00 And the ones who got the party started aren’t happy that it isn’t quiet.

Augmentin 375mg pills $109.00 That their moves, augmentin 375mg pills $109.00 and their motives, augmentin 375mg pills $109.00 are under public scrutiny.

Augmentin 375mg pills $109.00 That nurses are talking.

Augmentin 375mg pills $109.00 Because if you are quiet, augmentin 375mg pills $109.00 it means they’ve got you frightened.

Augmentin 375mg pills $109.00 If you are quiet, augmentin 375mg pills $109.00 it’s harder for the next nurse to speak out.

Augmentin 375mg pills $109.00 If you are quiet, augmentin 375mg pills $109.00 it is easier to intimidate and retaliate against nurses with impunity.


I received a call from the Arizona Board of Nursing this morning. Augmentin 375mg pills $109.00 I am not able to obtain a copy of the Banner Del E. Augmentin 375mg pills $109.00 Webb Medical Center complaint against Amanda Trujillo, augmentin 375mg pills $109.00 RN, augmentin 375mg pills $109.00 MSN.

They are able to tell me that a complaint was filed, augmentin 375mg pills $109.00 and what date it was filed, augmentin 375mg pills $109.00 but the actual content of the complaint is confidential. Augmentin 375mg pills $109.00 A copy goes to the RN involved.

I appreciated the call, augmentin 375mg pills $109.00 they could easily have sent an email.

That doesn’t mean I won’t see a copy of it, augmentin 375mg pills $109.00 it just means I can’t get a copy from the AZBoN.


Well, augmentin 375mg pills $109.00 it gets worse.

Today, augmentin 375mg pills $109.00 ten months after the original complaint was filed, augmentin 375mg pills $109.00 Amanda was advised that the Arizona Board of Nursing had called her university and reported that she is under investigation. Augmentin 375mg pills $109.00 Amanda is studying for her DNP.

Amanda got the email from her university, augmentin 375mg pills $109.00 informing her of what they had been told.


Is it normal for boards of nursing to actively report registered nurses to their universities?

By phone?

While the investigation is still going on?


I talked to a nurse investigator in Nevada, augmentin 375mg pills $109.00 who said absolutely “NO”, augmentin 375mg pills $109.00 they did not report nurses to universities., augmentin 375mg pills $109.00 That until the case is decided, augmentin 375mg pills $109.00 it’s confidential and there is no way of knowing that the nurse was in school or what school she attended.

There has been no disciplinary action against Amanda Trujillo by the Arizona Board of Nursing.

So why are they calling her university?

Why now?


This has gone past a regular investigation of a complaint against the license of a registered nurse and has all the markings of a personal vendetta.

Augmentin 375mg pills $109.00 I’m no Morley Safter or Mike Wallace.

Augmentin 375mg pills $109.00 This blog isn’t 60 Minutes.

Augmentin 375mg pills $109.00 I’m just a blogging staff nurse who is aghast at what she is seeing and I have questions.

Augmentin 375mg pills $109.00 Who has ties to the Arizona Board of Nursing? What pull, augmentin 375mg pills $109.00 if any, augmentin 375mg pills $109.00 does Banner Health have with the AZBoN? What pull, augmentin 375mg pills $109.00 if any does the doctor whose public display of rage set all this in motion, augmentin 375mg pills $109.00 have with the Arizona Board of Nursing?

Augmentin 375mg pills $109.00 What ties does the Arizona Board of Nursing have with Amanda’s university?


And let’s keep in mind why all this is happening.

A patient received education concerning their condition and upcoming procedure, augmentin 375mg pills $109.00 and a referral for a case management consult for hospice placed at the patient’s request.

No patient was harmed. Augmentin 375mg pills $109.00 No patient was killed. Augmentin 375mg pills $109.00 No medication given. Augmentin 375mg pills $109.00 No procedure done.

A patient was given information.



And god help the nurse who had the audacity to facilitate this autonomy, augmentin 375mg pills $109.00 this right.

How can you not be outraged?

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July 31, 2016, 3:03 pm

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Buspar 10mg pills $267.00 I’ve been blogging for 6 1/2 years.

Buspar 10mg pills $267.00 I have a twitter account and although I went to Facebook kicking and screaming, buspar 10mg pills $267.00 I’m firmly ensconced in the world of status updates, buspar 10mg pills $267.00 messages, buspar 10mg pills $267.00 and the occasional “poke.”

Buspar 10mg pills $267.00 I never miss BlogWorld New Media Expo, buspar 10mg pills $267.00 and if I can make it to BlogHer, buspar 10mg pills $267.00 I will be at the party (can you say “swag”?)

Buspar 10mg pills $267.00 You might say I’m into social media.

Buspar 10mg pills $267.00 The best thing about social media? It enhances the ability of people to band together, buspar 10mg pills $267.00 to support causes, buspar 10mg pills $267.00 and each other.

Buspar 10mg pills $267.00 This week, buspar 10mg pills $267.00 we’ve seen nurses band together online to support one of our own, buspar 10mg pills $267.00 fired and in danger of losing her license for acting as a patient advocate and providing patient education.


Patients use social media to band together with others who share the same challenges, buspar 10mg pills $267.00 to find support and encouragement.

They use the internet and social media to gather information; to be able to decide, buspar 10mg pills $267.00 in discussions with their healthcare provider, buspar 10mg pills $267.00 the best treatment to pursue.

The “patient” is you. Buspar 10mg pills $267.00 And me. Buspar 10mg pills $267.00 We are all patients.

Knowledge is power. Buspar 10mg pills $267.00 Knowledge empowers a us to advocate for ourselves.

But what happens when you are sick, buspar 10mg pills $267.00 lying in a hospital bed with new information flying fast and furious, buspar 10mg pills $267.00 with no time (or access) to “look it up”. Buspar 10mg pills $267.00 No time to find an “online support group”.

What if the quality of the rest of your life depends on the decision you make with the information you get, buspar 10mg pills $267.00 now.

Who advocates for you/us then?


The entire healthcare team advocates for you.

Nurses and physicians advocate for you.

They advocate for you by making sure you have all the information you need to make an informed decision on any plan of care.

They advocate for you by telling you all of the options open to you, buspar 10mg pills $267.00 including no treatment.

They advocate for you by making sure you understand all of the information and education provided.

They advocate for you by respecting the fact that you are able to advocate for yourself and respecting the decisions you make.

Doing all these things is the right thing to do.

It’s also the law.


When a nurse assesses that a patient does not have the information needed to make an informed decision about their care, buspar 10mg pills $267.00 either because they have not been informed, buspar 10mg pills $267.00 or because they did not understand the information provided, buspar 10mg pills $267.00 the nurse has a duty to:

a. Buspar 10mg pills $267.00 provide the missing information, buspar 10mg pills $267.00 or the needed education and/or

b. Buspar 10mg pills $267.00 refer the patient to the appropriate source of information

Buspar 10mg pills $267.00 There is no choice.

Buspar 10mg pills $267.00 It’s not a case of making a note and hoping the next shift deals with it.

Buspar 10mg pills $267.00 It’s not a case of thinking, buspar 10mg pills $267.00 “oh well, buspar 10mg pills $267.00 they need this surgery/procedure anyway.”

Buspar 10mg pills $267.00 The nurse is mandated by law, buspar 10mg pills $267.00 and obligated ethically to act if they discover a patient does not have the information they need to make an informed decision about their care.


Here’s the ethical principle in operation here, buspar 10mg pills $267.00 as defined by the American Nurses Association, buspar 10mg pills $267.00 who have a great website on nursing ethics:

Autonomy: agreement to respect another’s right to self-determine a course of action; support of independent decision making.

This is why the firing of Amanda Trujillo, buspar 10mg pills $267.00 RN, buspar 10mg pills $267.00 MSN, buspar 10mg pills $267.00 an experienced transplant RN, buspar 10mg pills $267.00 by Banner Del E. Buspar 10mg pills $267.00 Webb Medical Center is so mind-boggling.

She was doing exactly what she was supposed to do as a registered nurse, buspar 10mg pills $267.00 for a patient with a knowledge deficit regarding an upcoming transplant.


For the record, buspar 10mg pills $267.00 to those who have written to say I don’t have both sides, buspar 10mg pills $267.00 Banner Health isn’t talking. Buspar 10mg pills $267.00 They made a statement on their Facebook page to that effect.

I have written to the Arizona Board of Nursing for a copy of the original complaint, buspar 10mg pills $267.00 which should be public record.

I’ll post any response I get from them.

In the meantime, buspar 10mg pills $267.00 Amanda’s legal response to the original complaint, buspar 10mg pills $267.00 which answers the complaint point-by-point, buspar 10mg pills $267.00 can be found at vdutton’s posterous.

I encourage you to read the comments, buspar 10mg pills $267.00 as there is some interesting dialog there, buspar 10mg pills $267.00 as well


I am not militant.

I rant now and again, buspar 10mg pills $267.00 but I am very happy in my corner of the couch with my trusty old MacBookPro.

But I would take to the street for this.

I am that angry.

If I thought for one minute that there was more to this case, buspar 10mg pills $267.00 I’d be watching from the sidelines, buspar 10mg pills $267.00too.

My gut tells me, buspar 10mg pills $267.00 there is not.

My nursing instinct tells me there is not.

My nursing instinct tells me that a hospital corporation got upset because a “rainmaker” (in the legal world, buspar 10mg pills $267.00 that means “moneymaker”) got angry at an RN, buspar 10mg pills $267.00 ergo, buspar 10mg pills $267.00 she must be punished.

Most hospitals just fire people, buspar 10mg pills $267.00 Banner Health reports them to the Arizona Board of Nurses.

God help the nurses at Banner Health, buspar 10mg pills $267.00 because I’d be watching my derriere 24/7 if I worked there.

Corporate healthcare at it’s finest.

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July 31, 2016, 12:03 pm

Voltaren 50mg Pills $169.00

Synthroid 50mcg pills $60.00 (ADDENDUM, synthroid 50mcg pills $60.00 ADDED FEBRUARY 14, synthroid 50mcg pills $60.00 2012 – When this post was written, synthroid 50mcg pills $60.00 I mistakenly thought the patient in question had a transplant operation pending. Synthroid 50mcg pills $60.00 The patient was actually scheduled to be transferred the next day to begin pre-transplant testing. Synthroid 50mcg pills $60.00 Surgery would have come at a later date.

Synthroid 50mcg pills $60.00 I now understand that Amanda assessed that the patient had a deficit of transplant knowledge in general, synthroid 50mcg pills $60.00 and provided general transplant teaching concerning the evaluation process, synthroid 50mcg pills $60.00 the waiting process, synthroid 50mcg pills $60.00 and the care regimen. Synthroid 50mcg pills $60.00 The patient changed their mind about undergoing the testing, synthroid 50mcg pills $60.00 and requested a hospice consult.

Synthroid 50mcg pills $60.00 So, synthroid 50mcg pills $60.00 although the patient did not fully understand, synthroid 50mcg pills $60.00 and may not have been “informed” about what the entire transplant process required, synthroid 50mcg pills $60.00 surgery was not imminent, synthroid 50mcg pills $60.00 and “informed consent” for surgery was not the issue here. Synthroid 50mcg pills $60.00

Synthroid 50mcg pills $60.00 I have a firm belief in not altering a post once it has been posted, synthroid 50mcg pills $60.00 and owning the mistakes/misunderstandings therein, synthroid 50mcg pills $60.00 so I have added this addendum for clarification.

Synthroid 50mcg pills $60.00 The issues remain the same – a patient was uninformed about what was happening to them and needed education on their illness, synthroid 50mcg pills $60.00 a physician/hospital did not support/respect a patient’s decision/request for information, synthroid 50mcg pills $60.00 and a physician behaved in a disruptive fashion.

Synthroid 50mcg pills $60.00 I apologize for the misunderstanding.)

Synthroid 50mcg pills $60.00 Sorry, synthroid 50mcg pills $60.00 no.

Synthroid 50mcg pills $60.00 Nurses and physicians share a collaborative relationship, synthroid 50mcg pills $60.00 working with the patient in a team effort.

Synthroid 50mcg pills $60.00 That is how it is supposed to work.

Synthroid 50mcg pills $60.00 As a nurse, synthroid 50mcg pills $60.00 my duty is solely to the patient.

Synthroid 50mcg pills $60.00 If I am needed to be anyone’s “right hand”, synthroid 50mcg pills $60.00 it will be my patient.

Synthroid 50mcg pills $60.00 I’m very lucky. Synthroid 50mcg pills $60.00 I work with great docs who get it. Synthroid 50mcg pills $60.00 I’ll write a post about that.

Synthroid 50mcg pills $60.00 I’ve seen my share of the temper-tantrum throwing screamers, synthroid 50mcg pills $60.00 and I’ve been the recipient of their wrath three or four times in my career.

Synthroid 50mcg pills $60.00 I should tell those stories; they happened long ago. Synthroid 50mcg pills $60.00 I’ve kept them off the blog because of the emotions that come flooding back when I think about them.


I’ve been blogging on the Amanda Trujillo situation for a few days now, synthroid 50mcg pills $60.00 but lets move away from Amanda being fired by Banner Health and turned in to the Arizona Board of Nursing and look at this from a patient’s point of view.

As I see it, synthroid 50mcg pills $60.00 based on information that has been made public or is in the public record, synthroid 50mcg pills $60.00 three things occurred or nearly occurred (In hospital terminology, synthroid 50mcg pills $60.00 we call those “near-misses.”)

This should make everyone of us queasy.


A patient scheduled for surgery, synthroid 50mcg pills $60.00 in this case a major, synthroid 50mcg pills $60.00 life-altering surgery, synthroid 50mcg pills $60.00 did not know (a) the extent of the surgery, synthroid 50mcg pills $60.00 (b) the ramifications of the surgery – this being complex lifetime care, synthroid 50mcg pills $60.00 or (c) options other than surgery.

All of the above, synthroid 50mcg pills $60.00 along with the risks and benefits of the surgery, synthroid 50mcg pills $60.00 constitute “informed consent.” Before any surgery consent can be signed, synthroid 50mcg pills $60.00 all of the above must be addressed.

Before the discussion with the nurse, synthroid 50mcg pills $60.00 the patient did not know this information.

2. Synthroid 50mcg pills $60.00 A PATIENT’S DECISION WAS NOT SUPPORTED BY THE MD, synthroid 50mcg pills $60.00 OR THE HOSPITAL

Granted, synthroid 50mcg pills $60.00 the surgery did not happen. Synthroid 50mcg pills $60.00 But instead of supporting the patient’s decision as being the patient’s decision after the patient had been fully informed, synthroid 50mcg pills $60.00 as was their right by law, synthroid 50mcg pills $60.00 there was anger and recrimination from the physician and the facility.


Why did a patient’s decision to not have surgery cause this upheaval? Who lost out here?

I’m speculating, synthroid 50mcg pills $60.00 but I wonder – how much of that anger did the patient hear, synthroid 50mcg pills $60.00 or sense?


Well, synthroid 50mcg pills $60.00 this has been going on from time immemorial, synthroid 50mcg pills $60.00 but it is no longer tolerated.

Now, synthroid 50mcg pills $60.00 concern over a patient is not disruptive behavior. Synthroid 50mcg pills $60.00 Anger is not a disruptive behavior. Synthroid 50mcg pills $60.00 (If it was, synthroid 50mcg pills $60.00 I’d be in trouble.) Screaming and throwing a temper-tantrum at a nursing station is, synthroid 50mcg pills $60.00 no matter what the reason.

How would you feel as a patient if you heard a screaming rant going on at the nurse’s station outside your door?

How would you feel about the doctors, synthroid 50mcg pills $60.00 the facility? The nurses?


Two of these, synthroid 50mcg pills $60.00 the informed consent and the disruptive behavior are issues that are covered by licensing bodies. Synthroid 50mcg pills $60.00 Joint Commission has looked at the impact of disruptive behavior by physicians and other members of the health care team. Synthroid 50mcg pills $60.00 The Centers for Medicaid and Medicare Services are also concerned with the effect of this behavior of patient safety.

What happened at Banner Health Del E. Synthroid 50mcg pills $60.00 Webb Medical Center was not innocuous.

If not for the actions of a registered nurse, synthroid 50mcg pills $60.00 doing exactly what she was educated to do, synthroid 50mcg pills $60.00 and bound by the Arizona Nurse Practice Act (and her ethical duty) to do, synthroid 50mcg pills $60.00 a patient would have had a surgery they were not prepared for, synthroid 50mcg pills $60.00 and would not have wanted had they known what was happening.

That should scare the hell out of every single one of us.

Synthroid 50mcg pills $60.00 Because something like this has a chilling effect on all the other RNs in a facility – and I hope that the other registered nurses at Banner Health have the guts to keep educating their patients without the fear of losing their jobs and their licenses for doing their ethical duty.

Synthroid 50mcg pills $60.00 As a nurse, synthroid 50mcg pills $60.00 and as a patient, synthroid 50mcg pills $60.00 I am appalled.

Synthroid 50mcg pills $60.00 Now I want to see exactly what Banner Health, synthroid 50mcg pills $60.00 and the Arizona Board of Nurses, synthroid 50mcg pills $60.00 are going to do to rectify this situation.

Synthroid 50mcg pills $60.00 This has huge implications for nurses, synthroid 50mcg pills $60.00 and patients.

Synthroid 50mcg pills $60.00 All of us.

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About Me

My name is Kim, and I'm a nurse in the San Francisco Bay area. I've been a nurse for 33 years; I graduated in 1978 with my ADN. My experience is predominately Emergency and Critical Care, and I have also worked in Psychiatry and Pediatrics. I made the decision to be a nurse back in 1966 at the age of nine...

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