January, 2012 Archive

August 24, 2016, 5:42 pm

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Buy viagra on line Sorry, buy viagra on line no.

Buy viagra on line This is the problem.

Buy viagra on line There is a huge injustice being perpetrated against a nurse right this moment.

Buy viagra on line It’s getting worse.

Buy viagra on line And the ones who got the party started aren’t happy that it isn’t quiet.

Buy viagra on line That their moves, buy viagra on line and their motives, buy viagra on line are under public scrutiny.

Buy viagra on line That nurses are talking.

Buy viagra on line Because if you are quiet, buy viagra on line it means they’ve got you frightened.

Buy viagra on line If you are quiet, buy viagra on line it’s harder for the next nurse to speak out.

Buy viagra on line If you are quiet, buy viagra on line it is easier to intimidate and retaliate against nurses with impunity.


I received a call from the Arizona Board of Nursing this morning. Buy viagra on line I am not able to obtain a copy of the Banner Del E. Buy viagra on line Webb Medical Center complaint against Amanda Trujillo, buy viagra on line RN, buy viagra on line MSN.

They are able to tell me that a complaint was filed, buy viagra on line and what date it was filed, buy viagra on line but the actual content of the complaint is confidential. Buy viagra on line A copy goes to the RN involved.

I appreciated the call, buy viagra on line they could easily have sent an email.

That doesn’t mean I won’t see a copy of it, buy viagra on line it just means I can’t get a copy from the AZBoN.


Well, buy viagra on line it gets worse.

Today, buy viagra on line ten months after the original complaint was filed, buy viagra on line Amanda was advised that the Arizona Board of Nursing had called her university and reported that she is under investigation. Buy viagra on line Amanda is studying for her DNP.

Amanda got the email from her university, buy viagra on line 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, buy viagra on line who said absolutely “NO”, buy viagra on line they did not report nurses to universities., buy viagra on line That until the case is decided, buy viagra on line 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.

Buy viagra on line I’m no Morley Safter or Mike Wallace.

Buy viagra on line This blog isn’t 60 Minutes.

Buy viagra on line I’m just a blogging staff nurse who is aghast at what she is seeing and I have questions.

Buy viagra on line Who has ties to the Arizona Board of Nursing? What pull, buy viagra on line if any, buy viagra on line does Banner Health have with the AZBoN? What pull, buy viagra on line if any does the doctor whose public display of rage set all this in motion, buy viagra on line have with the Arizona Board of Nursing?

Buy viagra on line 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, buy viagra on line and a referral for a case management consult for hospice placed at the patient’s request.

No patient was harmed. Buy viagra on line No patient was killed. Buy viagra on line No medication given. Buy viagra on line No procedure done.

A patient was given information.



And god help the nurse who had the audacity to facilitate this autonomy, buy viagra on line this right.

How can you not be outraged?

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August 24, 2016, 3:03 pm

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Geodon 40mg pills $72.00 I’ve been blogging for 6 1/2 years.

Geodon 40mg pills $72.00 I have a twitter account and although I went to Facebook kicking and screaming, geodon 40mg pills $72.00 I’m firmly ensconced in the world of status updates, geodon 40mg pills $72.00 messages, geodon 40mg pills $72.00 and the occasional “poke.”

Geodon 40mg pills $72.00 I never miss BlogWorld New Media Expo, geodon 40mg pills $72.00 and if I can make it to BlogHer, geodon 40mg pills $72.00 I will be at the party (can you say “swag”?)

Geodon 40mg pills $72.00 You might say I’m into social media.

Geodon 40mg pills $72.00 The best thing about social media? It enhances the ability of people to band together, geodon 40mg pills $72.00 to support causes, geodon 40mg pills $72.00 and each other.

Geodon 40mg pills $72.00 This week, geodon 40mg pills $72.00 we’ve seen nurses band together online to support one of our own, geodon 40mg pills $72.00 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, geodon 40mg pills $72.00 to find support and encouragement.

They use the internet and social media to gather information; to be able to decide, geodon 40mg pills $72.00 in discussions with their healthcare provider, geodon 40mg pills $72.00 the best treatment to pursue.

The “patient” is you. Geodon 40mg pills $72.00 And me. Geodon 40mg pills $72.00 We are all patients.

Knowledge is power. Geodon 40mg pills $72.00 Knowledge empowers a us to advocate for ourselves.

But what happens when you are sick, geodon 40mg pills $72.00 lying in a hospital bed with new information flying fast and furious, geodon 40mg pills $72.00 with no time (or access) to “look it up”. Geodon 40mg pills $72.00 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, geodon 40mg pills $72.00 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, geodon 40mg pills $72.00 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, geodon 40mg pills $72.00 either because they have not been informed, geodon 40mg pills $72.00 or because they did not understand the information provided, geodon 40mg pills $72.00 the nurse has a duty to:

a. Geodon 40mg pills $72.00 provide the missing information, geodon 40mg pills $72.00 or the needed education and/or

b. Geodon 40mg pills $72.00 refer the patient to the appropriate source of information

Geodon 40mg pills $72.00 There is no choice.

Geodon 40mg pills $72.00 It’s not a case of making a note and hoping the next shift deals with it.

Geodon 40mg pills $72.00 It’s not a case of thinking, geodon 40mg pills $72.00 “oh well, geodon 40mg pills $72.00 they need this surgery/procedure anyway.”

Geodon 40mg pills $72.00 The nurse is mandated by law, geodon 40mg pills $72.00 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, geodon 40mg pills $72.00 as defined by the American Nurses Association, geodon 40mg pills $72.00 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, geodon 40mg pills $72.00 RN, geodon 40mg pills $72.00 MSN, geodon 40mg pills $72.00 an experienced transplant RN, geodon 40mg pills $72.00 by Banner Del E. Geodon 40mg pills $72.00 Webb Medical Center is so mind-boggling.

She was doing exactly what she was supposed to do as a registered nurse, geodon 40mg pills $72.00 for a patient with a knowledge deficit regarding an upcoming transplant.


For the record, geodon 40mg pills $72.00 to those who have written to say I don’t have both sides, geodon 40mg pills $72.00 Banner Health isn’t talking. Geodon 40mg pills $72.00 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, geodon 40mg pills $72.00 which should be public record.

I’ll post any response I get from them.

In the meantime, geodon 40mg pills $72.00 Amanda’s legal response to the original complaint, geodon 40mg pills $72.00 which answers the complaint point-by-point, geodon 40mg pills $72.00 can be found at vdutton’s posterous.

I encourage you to read the comments, geodon 40mg pills $72.00 as there is some interesting dialog there, geodon 40mg pills $72.00 as well


I am not militant.

I rant now and again, geodon 40mg pills $72.00 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, geodon 40mg pills $72.00 I’d be watching from the sidelines, geodon 40mg pills $72.00too.

My gut tells me, geodon 40mg pills $72.00 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, geodon 40mg pills $72.00 that means “moneymaker”) got angry at an RN, geodon 40mg pills $72.00 ergo, geodon 40mg pills $72.00 she must be punished.

Most hospitals just fire people, geodon 40mg pills $72.00 Banner Health reports them to the Arizona Board of Nurses.

God help the nurses at Banner Health, geodon 40mg pills $72.00 because I’d be watching my derriere 24/7 if I worked there.

Corporate healthcare at it’s finest.

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August 24, 2016, 12:03 pm

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Floxin 100mg pills $140.00 (ADDENDUM, floxin 100mg pills $140.00 ADDED FEBRUARY 14, floxin 100mg pills $140.00 2012 – When this post was written, floxin 100mg pills $140.00 I mistakenly thought the patient in question had a transplant operation pending. Floxin 100mg pills $140.00 The patient was actually scheduled to be transferred the next day to begin pre-transplant testing. Floxin 100mg pills $140.00 Surgery would have come at a later date.

Floxin 100mg pills $140.00 I now understand that Amanda assessed that the patient had a deficit of transplant knowledge in general, floxin 100mg pills $140.00 and provided general transplant teaching concerning the evaluation process, floxin 100mg pills $140.00 the waiting process, floxin 100mg pills $140.00 and the care regimen. Floxin 100mg pills $140.00 The patient changed their mind about undergoing the testing, floxin 100mg pills $140.00 and requested a hospice consult.

Floxin 100mg pills $140.00 So, floxin 100mg pills $140.00 although the patient did not fully understand, floxin 100mg pills $140.00 and may not have been “informed” about what the entire transplant process required, floxin 100mg pills $140.00 surgery was not imminent, floxin 100mg pills $140.00 and “informed consent” for surgery was not the issue here. Floxin 100mg pills $140.00

Floxin 100mg pills $140.00 I have a firm belief in not altering a post once it has been posted, floxin 100mg pills $140.00 and owning the mistakes/misunderstandings therein, floxin 100mg pills $140.00 so I have added this addendum for clarification.

Floxin 100mg pills $140.00 The issues remain the same – a patient was uninformed about what was happening to them and needed education on their illness, floxin 100mg pills $140.00 a physician/hospital did not support/respect a patient’s decision/request for information, floxin 100mg pills $140.00 and a physician behaved in a disruptive fashion.

Floxin 100mg pills $140.00 I apologize for the misunderstanding.)

Floxin 100mg pills $140.00 Sorry, floxin 100mg pills $140.00 no.

Floxin 100mg pills $140.00 Nurses and physicians share a collaborative relationship, floxin 100mg pills $140.00 working with the patient in a team effort.

Floxin 100mg pills $140.00 That is how it is supposed to work.

Floxin 100mg pills $140.00 As a nurse, floxin 100mg pills $140.00 my duty is solely to the patient.

Floxin 100mg pills $140.00 If I am needed to be anyone’s “right hand”, floxin 100mg pills $140.00 it will be my patient.

Floxin 100mg pills $140.00 I’m very lucky. Floxin 100mg pills $140.00 I work with great docs who get it. Floxin 100mg pills $140.00 I’ll write a post about that.

Floxin 100mg pills $140.00 I’ve seen my share of the temper-tantrum throwing screamers, floxin 100mg pills $140.00 and I’ve been the recipient of their wrath three or four times in my career.

Floxin 100mg pills $140.00 I should tell those stories; they happened long ago. Floxin 100mg pills $140.00 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, floxin 100mg pills $140.00 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, floxin 100mg pills $140.00 based on information that has been made public or is in the public record, floxin 100mg pills $140.00 three things occurred or nearly occurred (In hospital terminology, floxin 100mg pills $140.00 we call those “near-misses.”)

This should make everyone of us queasy.


A patient scheduled for surgery, floxin 100mg pills $140.00 in this case a major, floxin 100mg pills $140.00 life-altering surgery, floxin 100mg pills $140.00 did not know (a) the extent of the surgery, floxin 100mg pills $140.00 (b) the ramifications of the surgery – this being complex lifetime care, floxin 100mg pills $140.00 or (c) options other than surgery.

All of the above, floxin 100mg pills $140.00 along with the risks and benefits of the surgery, floxin 100mg pills $140.00 constitute “informed consent.” Before any surgery consent can be signed, floxin 100mg pills $140.00 all of the above must be addressed.

Before the discussion with the nurse, floxin 100mg pills $140.00 the patient did not know this information.

2. Floxin 100mg pills $140.00 A PATIENT’S DECISION WAS NOT SUPPORTED BY THE MD, floxin 100mg pills $140.00 OR THE HOSPITAL

Granted, floxin 100mg pills $140.00 the surgery did not happen. Floxin 100mg pills $140.00 But instead of supporting the patient’s decision as being the patient’s decision after the patient had been fully informed, floxin 100mg pills $140.00 as was their right by law, floxin 100mg pills $140.00 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, floxin 100mg pills $140.00 but I wonder – how much of that anger did the patient hear, floxin 100mg pills $140.00 or sense?


Well, floxin 100mg pills $140.00 this has been going on from time immemorial, floxin 100mg pills $140.00 but it is no longer tolerated.

Now, floxin 100mg pills $140.00 concern over a patient is not disruptive behavior. Floxin 100mg pills $140.00 Anger is not a disruptive behavior. Floxin 100mg pills $140.00 (If it was, floxin 100mg pills $140.00 I’d be in trouble.) Screaming and throwing a temper-tantrum at a nursing station is, floxin 100mg pills $140.00 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, floxin 100mg pills $140.00 the facility? The nurses?


Two of these, floxin 100mg pills $140.00 the informed consent and the disruptive behavior are issues that are covered by licensing bodies. Floxin 100mg pills $140.00 Joint Commission has looked at the impact of disruptive behavior by physicians and other members of the health care team. Floxin 100mg pills $140.00 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. Floxin 100mg pills $140.00 Webb Medical Center was not innocuous.

If not for the actions of a registered nurse, floxin 100mg pills $140.00 doing exactly what she was educated to do, floxin 100mg pills $140.00 and bound by the Arizona Nurse Practice Act (and her ethical duty) to do, floxin 100mg pills $140.00 a patient would have had a surgery they were not prepared for, floxin 100mg pills $140.00 and would not have wanted had they known what was happening.

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

Floxin 100mg pills $140.00 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.

Floxin 100mg pills $140.00 As a nurse, floxin 100mg pills $140.00 and as a patient, floxin 100mg pills $140.00 I am appalled.

Floxin 100mg pills $140.00 Now I want to see exactly what Banner Health, floxin 100mg pills $140.00 and the Arizona Board of Nurses, floxin 100mg pills $140.00 are going to do to rectify this situation.

Floxin 100mg pills $140.00 This has huge implications for nurses, floxin 100mg pills $140.00 and patients.

Floxin 100mg pills $140.00 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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