June 25, 2016, 5:42 pm

Cialis Brand

Cialis brand Sorry, cialis brand no.

Cialis brand This is the problem.

Cialis brand There is a huge injustice being perpetrated against a nurse right this moment.

Cialis brand It’s getting worse.

Cialis brand And the ones who got the party started aren’t happy that it isn’t quiet.

Cialis brand That their moves, cialis brand and their motives, cialis brand are under public scrutiny.

Cialis brand That nurses are talking.

Cialis brand Because if you are quiet, cialis brand it means they’ve got you frightened.

Cialis brand If you are quiet, cialis brand it’s harder for the next nurse to speak out.

Cialis brand If you are quiet, cialis brand it is easier to intimidate and retaliate against nurses with impunity.

*****

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

They are able to tell me that a complaint was filed, cialis brand and what date it was filed, cialis brand but the actual content of the complaint is confidential. Cialis brand A copy goes to the RN involved.

I appreciated the call, cialis brand they could easily have sent an email.

That doesn’t mean I won’t see a copy of it, cialis brand it just means I can’t get a copy from the AZBoN.

*****

Well, cialis brand it gets worse.

Today, cialis brand ten months after the original complaint was filed, cialis brand Amanda was advised that the Arizona Board of Nursing had called her university and reported that she is under investigation. Cialis brand Amanda is studying for her DNP.

Amanda got the email from her university, cialis brand informing her of what they had been told.

WHAT???

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, cialis brand who said absolutely “NO”, cialis brand they did not report nurses to universities., cialis brand That until the case is decided, cialis brand 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.

Cialis brand I’m no Morley Safter or Mike Wallace.

Cialis brand This blog isn’t 60 Minutes.

Cialis brand I’m just a blogging staff nurse who is aghast at what she is seeing and I have questions.

Cialis brand Who has ties to the Arizona Board of Nursing? What pull, cialis brand if any, cialis brand does Banner Health have with the AZBoN? What pull, cialis brand if any does the doctor whose public display of rage set all this in motion, cialis brand have with the Arizona Board of Nursing?

Cialis brand 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, cialis brand and a referral for a case management consult for hospice placed at the patient’s request.

No patient was harmed. Cialis brand No patient was killed. Cialis brand No medication given. Cialis brand No procedure done.

A patient was given information.

Informed.

Empowered.

And god help the nurse who had the audacity to facilitate this autonomy, cialis brand this right.

How can you not be outraged?

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June 25, 2016, 3:03 pm

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Antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00 This week, antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00 we’ve seen nurses band together online to support one of our own, antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00 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, antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00 to find support and encouragement.

They use the internet and social media to gather information; to be able to decide, antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00 in discussions with their healthcare provider, antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00 the best treatment to pursue.

The “patient” is you. Antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00 And me. Antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00 We are all patients.

Knowledge is power. Antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00 Knowledge empowers a us to advocate for ourselves.

But what happens when you are sick, antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00 lying in a hospital bed with new information flying fast and furious, antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00 with no time (or access) to “look it up”. Antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00 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, antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00 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, antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00 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, antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00 either because they have not been informed, antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00 or because they did not understand the information provided, antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00 the nurse has a duty to:

a. Antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00 provide the missing information, antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00 or the needed education and/or

b. Antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00 refer the patient to the appropriate source of information

Antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00 There is no choice.

Antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00 It’s not a case of making a note and hoping the next shift deals with it.

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Antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00 The nurse is mandated by law, antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00 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, antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00 as defined by the American Nurses Association, antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00 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, antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00 RN, antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00 MSN, antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00 an experienced transplant RN, antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00 by Banner Del E. Antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00 Webb Medical Center is so mind-boggling.

She was doing exactly what she was supposed to do as a registered nurse, antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00 for a patient with a knowledge deficit regarding an upcoming transplant.

*****

For the record, antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00 to those who have written to say I don’t have both sides, antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00 Banner Health isn’t talking. Antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00 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, antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00 which should be public record.

I’ll post any response I get from them.

In the meantime, antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00 Amanda’s legal response to the original complaint, antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00 which answers the complaint point-by-point, antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00 can be found at vdutton’s posterous.

I encourage you to read the comments, antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00 as there is some interesting dialog there, antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00 as well

*****

I am not militant.

I rant now and again, antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00 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, antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00 I’d be watching from the sidelines, antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00too.

My gut tells me, antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00 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, antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00 that means “moneymaker”) got angry at an RN, antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00 ergo, antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00 she must be punished.

Most hospitals just fire people, antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00 Banner Health reports them to the Arizona Board of Nurses.

God help the nurses at Banner Health, antidepressants > cymbalta 40mg pills (generic) > 180 pills > $242.00 because I’d be watching my derriere 24/7 if I worked there.

Corporate healthcare at it’s finest.

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June 25, 2016, 12:03 pm

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Pain relief > ibuprofen 400mg pills > 30 pills > $90.00 I apologize for the misunderstanding.)

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Pain relief > ibuprofen 400mg pills > 30 pills > $90.00 I should tell those stories; they happened long ago. Pain relief > ibuprofen 400mg pills > 30 pills > $90.00 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, pain relief > ibuprofen 400mg pills > 30 pills > $90.00 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, pain relief > ibuprofen 400mg pills > 30 pills > $90.00 based on information that has been made public or is in the public record, pain relief > ibuprofen 400mg pills > 30 pills > $90.00 three things occurred or nearly occurred (In hospital terminology, pain relief > ibuprofen 400mg pills > 30 pills > $90.00 we call those “near-misses.”)

This should make everyone of us queasy.

1. Pain relief > ibuprofen 400mg pills > 30 pills > $90.00 A PATIENT WOULD HAVE HAD SURGERY WITHOUT INFORMED CONSENT.

A patient scheduled for surgery, pain relief > ibuprofen 400mg pills > 30 pills > $90.00 in this case a major, pain relief > ibuprofen 400mg pills > 30 pills > $90.00 life-altering surgery, pain relief > ibuprofen 400mg pills > 30 pills > $90.00 did not know (a) the extent of the surgery, pain relief > ibuprofen 400mg pills > 30 pills > $90.00 (b) the ramifications of the surgery – this being complex lifetime care, pain relief > ibuprofen 400mg pills > 30 pills > $90.00 or (c) options other than surgery.

All of the above, pain relief > ibuprofen 400mg pills > 30 pills > $90.00 along with the risks and benefits of the surgery, pain relief > ibuprofen 400mg pills > 30 pills > $90.00 constitute “informed consent.” Before any surgery consent can be signed, pain relief > ibuprofen 400mg pills > 30 pills > $90.00 all of the above must be addressed.

Before the discussion with the nurse, pain relief > ibuprofen 400mg pills > 30 pills > $90.00 the patient did not know this information.

2. Pain relief > ibuprofen 400mg pills > 30 pills > $90.00 A PATIENT’S DECISION WAS NOT SUPPORTED BY THE MD, pain relief > ibuprofen 400mg pills > 30 pills > $90.00 OR THE HOSPITAL

Granted, pain relief > ibuprofen 400mg pills > 30 pills > $90.00 the surgery did not happen. Pain relief > ibuprofen 400mg pills > 30 pills > $90.00 But instead of supporting the patient’s decision as being the patient’s decision after the patient had been fully informed, pain relief > ibuprofen 400mg pills > 30 pills > $90.00 as was their right by law, pain relief > ibuprofen 400mg pills > 30 pills > $90.00 there was anger and recrimination from the physician and the facility.

Why?

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

I’m speculating, pain relief > ibuprofen 400mg pills > 30 pills > $90.00 but I wonder – how much of that anger did the patient hear, pain relief > ibuprofen 400mg pills > 30 pills > $90.00 or sense?

3. Pain relief > ibuprofen 400mg pills > 30 pills > $90.00 A PHYSICIAN DISPLAYED DISRUPTIVE BEHAVIOR AT THE NURSES STATION.

Well, pain relief > ibuprofen 400mg pills > 30 pills > $90.00 this has been going on from time immemorial, pain relief > ibuprofen 400mg pills > 30 pills > $90.00 but it is no longer tolerated.

Now, pain relief > ibuprofen 400mg pills > 30 pills > $90.00 concern over a patient is not disruptive behavior. Pain relief > ibuprofen 400mg pills > 30 pills > $90.00 Anger is not a disruptive behavior. Pain relief > ibuprofen 400mg pills > 30 pills > $90.00 (If it was, pain relief > ibuprofen 400mg pills > 30 pills > $90.00 I’d be in trouble.) Screaming and throwing a temper-tantrum at a nursing station is, pain relief > ibuprofen 400mg pills > 30 pills > $90.00 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, pain relief > ibuprofen 400mg pills > 30 pills > $90.00 the facility? The nurses?

*****

Two of these, pain relief > ibuprofen 400mg pills > 30 pills > $90.00 the informed consent and the disruptive behavior are issues that are covered by licensing bodies. Pain relief > ibuprofen 400mg pills > 30 pills > $90.00 Joint Commission has looked at the impact of disruptive behavior by physicians and other members of the health care team. Pain relief > ibuprofen 400mg pills > 30 pills > $90.00 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. Pain relief > ibuprofen 400mg pills > 30 pills > $90.00 Webb Medical Center was not innocuous.

If not for the actions of a registered nurse, pain relief > ibuprofen 400mg pills > 30 pills > $90.00 doing exactly what she was educated to do, pain relief > ibuprofen 400mg pills > 30 pills > $90.00 and bound by the Arizona Nurse Practice Act (and her ethical duty) to do, pain relief > ibuprofen 400mg pills > 30 pills > $90.00 a patient would have had a surgery they were not prepared for, pain relief > ibuprofen 400mg pills > 30 pills > $90.00 and would not have wanted had they known what was happening.

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

Pain relief > ibuprofen 400mg pills > 30 pills > $90.00 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.

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Pain relief > ibuprofen 400mg pills > 30 pills > $90.00 Now I want to see exactly what Banner Health, pain relief > ibuprofen 400mg pills > 30 pills > $90.00 and the Arizona Board of Nurses, pain relief > ibuprofen 400mg pills > 30 pills > $90.00 are going to do to rectify this situation.

Pain relief > ibuprofen 400mg pills > 30 pills > $90.00 This has huge implications for nurses, pain relief > ibuprofen 400mg pills > 30 pills > $90.00 and patients.

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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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