January 27, 2012, 9:32 am

Banner Health Strikes Blow Against Patient Advocacy, Fires RN


So much of what I do as an ER nurse involves information.

As an RN, I am responsible for providing patients with information about their illness/injury, their medications and their follow up instructions.

Patient education is paramount; I find out what they know, then provide education to fill the gaps.

If they cannot access medications or follow up care, I provide information on how to access those needs.

That is called patient advocacy.

It’s the backbone of nursing, everywhere. Every hospital, every state, every country.


So you can imagine how confused I was to find out an Arizona nurse Amanda Trujillo, RN, MSN had been fired by Banner Health Del E. Webb Medical Center for doing exactly that, advocating for her patient by PROVIDING INFORMATION.

That’s right. Very simply: during a shift, she discovered a patient knew nothing about the details of a major invasive surgery. Not what the surgery entailed or what life would be like after the surgery (“complex lifetime daily care”). They did not know they had the option not have the surgery or that other options were available to them.

The patient requested further information and Ms. Trujillo provided it, including arranging for a case management consult, and documented all of this to the hilt (even the nurse investigator noted this).


The patient changed her mind, didn’t want the surgery. The doctor blew a gasket, threw a tantrum in the nurses station (sound familiar, nurses?), demanded Trujillo be fired, and her license revoked.

Bingo! Instead of supporting their nurse, Banner Health fired her.

For providing information and giving the patient the opportunity to learn more about their condition and their options.

For empowering her patient.

Within her scope of practice.

Within the nursing code of ethics.


As I said in my last post, I’m sputtering angry.

But my anger was turned onto the physician – and that is misplaced anger.

Let the doctor throw his anger all over the place, he will do what he will. If an empowered patient angers him, that’s just sad.

The problem here is Banner Health.

For not supporting patient advocacy.

For not supporting that particular patient’s right to decide.

For not supporting their nurses.

For firing a nurse for doing what she was supposed to be doing.

Her ethical duty.


Next post: this goes viral and how to support registered nurses’ right to advocate for patients.

Because next time, that patient could be you.

January 24, 2012, 12:15 pm

The Nurse Stands Alone…

No funny, vintage picture today.

An Arizona nursing colleague is in danger of losing her license for acting as a patient advocate within her scope of practice.

Her hearing, initially scheduled for today, has been delayed for two months so this registered nurse can undergo a psychiatric evaluation.


Yes, that is correct.

Providing appropriate patient education in the face of a major knowledge deficit, and obtaining information for the patient, at the patient’s request, is now grounds for a sanity check.

Especially if you piss off a doctor.

<Taking a breath. Centering. Doubling up on BP medication>


The nurse is Amanda Trujillo. Her story, Arizona Nurse Has License Threatened By Doctor After Providing Patient Education is at The Nerdy Nurse, complete with original email and brief.

The psych eval is beyond belief. If you can’t bring ’em down on practice issues, intimate that they are mentally ill and delay the process.

Where is the American Nurses Association? What on earth are you there for if not to support the practice of nursing? If this isn’t a hit to the heart of what we do every day, please define what it is we ARE all about!

The Arizona Nurses Association has done nothing, and this has gone on for almost a year (in fact, Amanda notes in a comment that the President of the Arizona association is a Director at the hospital she was fired from!) By the way, hit the link and look at their Mission Statement.

I’m not very proud of my profession right now.

Nurses not only eat their young, but God help you if the almighty Medical Establishment gets ticked off.

Nurses talk a great game. In the Halls of Academia and the Ivory Towers of Those Who Claim to Advance The Profession, it’s all “Nursing Is An Independent Profession” and we tirelessly “Fight For Our Right To Practice To The Full Extent Of Our Education And Training”.

Unless you’re down in the trenches doing patient care every day and someone gets angry that you have dared to advocate. And if that Someone is a Doctor, well, the bigwigs scatter to the four corners of the ring.

Musn’t create controversy.

Hell, they aren’t even standing on your side of the arena.


I guess all that support for the Texas nurses was a fluke.

Hope we enjoyed it while it lasted.

I salute my fellow nurses who are able to blog about this with clear heads and calm words.

I guess I’ve been doing this for too long, seen too much and just cannot believe this is happening in the 21st century.

To realize once and for all, bottom line, that if you are a staff nurse, no one has your back.

Even if you do the right thing by your patient. The right thing by the nurse practice act. The right thing by hospital policy.

One temper-tantrum throwing physician can derail your career!


9:18 am

Grand Rounds is Up…at USATODAY!

Okay, this is exciting!

The host for Grand Rounds this week is none other than USATODAY!

Our very own Dr. Val took 100 (!) posts, representing the best of the medical blogosphere, and will

roll them out in four sections over the course of the day. The theme: patient-centered topics.

The sections are:

1. Health Tips

2. True Stories

3. Mythbusters & Controversies

4. Healthcare Costs

Emergiblog is in the Health Tips section! : )

You can find Grand Rounds here: in the “Your Life” section, in the Healthy Perspective blog!

Many thanks to USATODAY for hosting Grand Rounds and to Dr. Val for a fantastic job!

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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