February 11, 2012, 2:26 am

Hush, Hush…Keep It Down Now, Voices Carry

Back in the days before budget cuts, and long before the rise of the Internet, the California Board of Registered Nurses would publish a regular newsletter/report.

Every registered nurse in the state received a copy.

In the back, they would list the names of the nurses who had received a disciplinary decision on their license.

I used to read that, seeing if I recognized anyone I knew.

I never did.

But I would look and see just what it took to get dinged by the BRN.

Felonies and/or drug associated activities were about 99.9% of the cases.

It takes pretty serious stuff for the CA BRN to hit your license.


The thing that bothers me most about the Amanda Trujillo case; the thing that makes me furious when I stop and think of everything surrounding it, is this belief that a nurse accused is required to, pardon my bluntness, keep their mouth shut.

Now, let me try and work this out…

Anyone can place a complaint with a Board of Nursing.


For any reason, any motive. In this case it was Banner Del E. Webb Medical Center who filed the complaint with the Arizona Board of Nursing.

This complaint is public record. The fact that you have a complaint on file with the Arizona BON, and the date it is filed is public record.

But…ask the Arizona Board of Nursing for a copy, and you are told you cannot disclose what the complaint says. Can’t fax it. Can’t copy it. Can’t quote it.

Keep your mouth shut.


So, ten months pass, during which the nurse investigator assigned to the case tells you your charting, care plan, nursing diagnosis, and nursing care are above and beyond the call of duty and recommends that your case be dismissed as this is no danger to the public.

The Board says no, and proceeds to investigate/interrogate your entire career up to that point, with a fine tooth comb.

They don’t find anything.

So, this nurse reaches out to an author she admires (Echo Heron) and the story makes the Internet via the nursing blogs and all hell supposedly breaks loose.

Keep your mouth shut!

The Board isn’t happy she is speaking out.

She posts her response to the complaint with the patient information redacted.

Her attorney is mad! She’s a bad nurse! Bad, bad nurse!

Keep your mouth SHUT!

You are accused. We will tell you if you are relevant. We will tell you when and if you may speak.

Stand back and shut up, for you are the accused.


When you speak up, or have others speak up on your behalf, you are considered to be “retaliating“.

This buys you a psychiatric evaluation, courtesy of the Board.

For that, they want releases from every single physician you have seen for the past six years.

All your HIPAA stuff? They’ll own it.

Now step back and think of everything you have asked your physician about in the last six years. You comfortable with that in the hands of a state Board of Nursing, with ties to national nursing organizations and a member who works for Banner Health? You comfortable with that in the hands of a Board appointed psychiatrist?

That’s what you get for not keeping your mouth shut.

And to top it off, after ten months, someone on the Board will call your university directly and inform them you are under investigation.

Keep your mouth shut.


Even nursing colleagues have doubts.

“She must have done something else.”

“No one gets fired for just one thing.”

“We don’t know all the facts.”

“There’s two sides to every story.”


“She ought to keep her mouth shut.”

Does anyone even think for one minute how gutsy it was to go public…

and NOT keep your mouth shut?


That’s the problem.

Nurses do keep their mouths shut. All the time.

Because they are afraid. Isolated.

Fear of retribution by their employers. Doctors. Corporations who wave HIPAA like it’s the national flag.

And I’m sorry, but hospital corporations like Banner Health and state Boards of Nursing do NOT work in secrecy and isolation.

A nurse was FIRED and her LICENSE put up for investigation by an employer. THIS IS HUGE, PEOPLE. To fire a nurse for allegedly not following your policy is one thing. To go after her license is quite another.

You say you want the whole story?

The only way you are going to get the whole story is to get it out of the secrecy of corporate hallways and state boardrooms and start talking about it.

Stop keeping your mouth shut.


  • Hush, Hush?Keep It Down Now, Voices Carry
    Hush, Hush?Keep It Down Now, Voices Carry

    February 11, 2012 at 4:32 am

    […] Hush, Hush…Keep It Down Now, Voices Carry […]

  • Greg Mercer, MSN
    Greg Mercer, MSN

    February 11, 2012 at 12:52 pm

    It may well be prudent to make no public comment in a case of civil or criminal litigation, or to let your attorney handle that. It is sad beyond measure that in a situation like this, Nurses with responsibility to their profession and the public has handled this case so poorly – are we to assume it reasonable to publicly acknowledge a case against an identified RN, to notify her school, while taking a year or more to produce any further result? Can anyone really see such a prolonged professional exile as proportionate to the accusations made? The only arguments I have seen have been entirely circular: we must trust BONs because they are the people we must trust to handle such matters. Nonsense – it is that kind of reasoning, that lack of transparency and accountability, that leads to unfettered corruption. Except for the Supreme Court, even judges lack that kind of autonomy – there are public records, public access to hearings, and layers of appeals. The public and the profession of Nursing deserve evidence that such an important process is being handled properly, not vague reassurance and the message that all such matters should be trusted implicitly to the officials in place, involved in a partially political process, as they perform governmental functions.

  • […] Kim, over at Emergiblog, is writing about nurses that have accusations against them should not be required to keep their mouth shut. […]

  • Barefootnurse

    February 12, 2012 at 6:14 am

    It seems that she is damned either way. Keeping quiet and not defending herself appears to be some sort of admission of guilt, yet speaking up and advocating for yourself and you are retaliating. I don’t get it. It scares me because it could happen to any nurse any where.

  • The Nerdy Nurse
    The Nerdy Nurse

    February 12, 2012 at 8:45 pm

    My first nurse manager told me I should just keep quiet about being bullied and “let it roll off.” Just how much are are we, as nurses, supposed to let roll off?

  • OrfynRN

    February 13, 2012 at 3:24 am

    Nurses out there are surprised by all this? State Boards only exist to keep nurses in their place…as caretaker to the hospital and the physicians. And hospitals? They only want things back the way they were before the seventies when they owned nurses in a quasi serfdom. AND NURSES HAVE ALWAYS LET THEM GET AWAY WITH IT!Wake up and smell the coffee!

  • Caryl J Carver, RN, BSN
    Caryl J Carver, RN, BSN

    February 14, 2012 at 9:52 pm

    I was a victim of physician bullying as well as lateral violence for the past 2 1/2 years and the HR rep at the hospital where I work told me to “suck it up”. Yeah, Nurses need to speak up, no, wait, we need to SHOUT from the mountain tops!! Victims no more!!

  • Nurse K
    Nurse K

    February 16, 2012 at 7:30 am

    I told her it was career suicide to be blowing up the Internet to this degree, and it is. Her response was that she was never going to work for anyone else again and was going to open up her own business and teach. Um okay.

    Good luck, Amanda. Do you have any people calling you for paid positions to “advocate” for anyone or anything with all this media attention? Nursing teaching positions for MSNs really are pretty borderline; most want a doctorate these days, similar to teaching positions for all other professions. MSN is kind of a throwaway degree now anyway now that the world is moving to the DNP and such.

    Meanwhile, she’s a single mom on welfare. Sorry, but eating food and paying your mortgage is just more important than “making a point”.

    It’s easy to say “shout it from the rooftops, sistah”, but she’s still on welfare and should have protected herself. It’s hard enough getting a job after a termination, let alone a termination with this huge Google fingerprint.

    I’m just saying, if you happen to get fired for a stupid reason, it’s a bad idea to blow up the ‘net.

  • Kim

    February 16, 2012 at 7:50 am

    Hi K –

    Amanda is in school for her DNP right now. Just wanted to clarify that.

  • Nurse K
    Nurse K

    February 16, 2012 at 8:19 am

    Yeah, but she’s on welfare and in school for her DNP. Also, a school is an employer just like anyone else, and they’d be more critical of someone’s Internet footprint than even a regular hospital/employer, I think. They need to pass quite a bit of scrutiny to get a teaching position, and never having worked in your field as a DNP outside of staff nursing is, in and of itself, a huge negative, especially since she is publicly refusing to work in clinical practice ever again (despite a degree titled Doctor of Nursing Practice).

    I wouldn’t want a professor teaching me in a DNP program whose only nursing experience was floor nursing and school clinicals. Just sayin’. I’d want someone who used that degree a little bit out in the community.

    Even if she said, yeah, but something has to be done, her writings about her termination and Board stuff look and sound very unpolished. No paragraph delineations, etc. Her attorney probably told her to not write these things, but she did anyway. She could have went to the media and said things with her attorney’s advice in a more controlled manner.

    All I’m saying is be realistic and protect yourself in case of a stupid termination. Listen to your lawyer. Go through the process. Let the process work. She hasn’t even went through the process yet. Talk to a trusted mentor. If you truly did nothing wrong and can prove it to the nth degree like Amanda claims, it would be a rare case where you had any ding on your record as you implied.

    I mean, one of my nursing mentors got fired the day after she came back from cancer treatment. Like they weren’t even trying to hide the fact they were firing her because she was ill.

    Everyone told her to run straight to the media and sue like there was no tomorrow, but she chose to just apply for and obtain a new job. It’s all in what you want to do. She got wronged, but just wanted to work, so she let it go, and she probably maintained her sanity better this way.

  • NitroRN

    February 16, 2012 at 10:21 pm

    I think that Amanda has every right to stand up and shout to the mountaintops about her experience. Her mistake was in not waiting until her case was closed before bringing the corruption, and abuse of power to light. By not waiting she opened the door for more retaliation by the BON, and further delays. unfortunately the most likely outcome is an unexplained suspension or revocation that she will have no recourse against.

    The complaint process for nurses is too closed and shrouded in secrecy to be a part of a State agency. Nurses are assumed guilty in most cases, and are forced to abide by whatever sanctions that are placed upon them if they ever want any chance at a career in nursing again.

    The BON should exist as much to protect nurses as it does to restrict and punish them. Board members should be full-time state employees in order to prevent such conflicts of interest as exist in Amanda’s case. BON’s should have as much power to restore the reputation of a nurse that is unjustly treated or fired as they do to set curricula and approve nursing programs throughout the state. Nurses should not fear the BON.
    As far as Banner making a complaint to the BON, I don’t know about other states, but I know that where I live that any termination for cause in nursing practice mandates a report to the board. This was something that shocked me when I first heard of it.

  • Eric Escob
    Eric Escob

    March 16, 2012 at 11:20 pm

    The BON should exist as much to protect nurses as it does to restrict and punish them. Board members should be full-time state employees in order to prevent such conflicts of interest as exist in Amanda?s case.

  • Jordan Schmidt
    Jordan Schmidt

    March 17, 2012 at 4:06 am

    I mean, one of my nursing mentors got fired the day after she came back from cancer treatment. Like they weren?t even trying to hide the fact they were firing her because she was ill.

  • michael Mayer
    michael Mayer

    March 19, 2012 at 8:29 am

    Well, i am glad to “learn” that someoene thinks my MSN that i am working on is a throwaway degree! Does that include the ADN and the BSN i have already?

  • […] Hush, Hush…Keep It Down Now, Voices Carry […]

  • suki

    May 6, 2012 at 6:30 am

    Reading some posts on this matter I see many people writing for nurses to just stay quiet. Get another job. Nurses have done that for so many years. That is called being a doormat. Why is it ok for so many nurses to tell others to continue being the doormat. To take the fall over and over. Why is it ok to not tell the truth? This all reminds me of the way a Domestic Violent victim lives. Stay quiet, put up with the crap. A dysfunctional manner to live is not healthy. Yet, others try to portray nursing as an educated high esteemed field. Not when this behavior continues to exist and so many nurses want the bad behavior to …………shush don’t tell anyone. I just don’t get it.

  • Chris

    May 17, 2012 at 11:50 am

    WoW!! I never knew this was going on. Don’t nurses have a Union? If not someone should start one….

  • ashamed to be a nurse in az
    ashamed to be a nurse in az

    July 10, 2012 at 9:31 pm

    nurses get turned in to state board if they were wronged and threaten law suit against hospital, turned in for trumped up bs. the state board tells them not to talk about the situation. HUH!
    Of course the st board wants everyone to be quiet , so they can do their dirty work and no one know. Just knock them off one at a time. SHAME on all of them!! they should have board complaints ! and the so called investigator, lawyer should be turned in the the bar. ethics violations.

  • Holly, RN, CCRN
    Holly, RN, CCRN

    September 3, 2012 at 12:11 pm

    Wow. What year is this? Are ‘professionalism’ and ’empowerment’ a myth? I’m stunned to read Nurse K’s comment: “she let it go, and she probably maintained her sanity better this way.” I’ve worked with too many nurses who want to keep things the way they used to be: understaffed with nurses subservient to doctors and administrators, accepting mistreatment from patients and supervisors.
    If we ignore abuse we may as well condone it; it doesn’t get better or go away, it just becomes institutionalized. I read reports of cases like Amanda’s and am incredibly thankful I work where I do – a hospital that is nothing like Del E Webb.
    IF Amanda overstepped her scope of practice in requesting the consult, it wouldn’t warrant the extreme response from the hospital and BON she has received. She has a right to speak out about her situation. It’s easy to sit back and critique her methods of going public, but I don’t know how well I would handle it if I were in her position, so I won’t pass judgement.

  • The 30 Best Nursing Blogs
    The 30 Best Nursing Blogs

    February 21, 2013 at 2:09 pm

    […] a comfortable atmosphere for reading her intimate posts on engaging topics. Check out Gina’s Hush, Hush…Keep It Down Now, Voices Carry to read her compelling reflections on the importance of speaking out, despite ongoing pressure to […]

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...

Continue reading »

Find Me On...
Twitter     Technorati

Subscribe to Emergiblog

Office of the National Nurse

Zippy Was Here

Healthcare Blogger Code of Ethics

  • Perspective
  • Confidentiality
  • Disclosure
  • Reliability
  • Courtesy