Updating the Amanda Trujillo Case

From The Floor

Updating the Amanda Trujillo Case

Cry havoc, part II

By Genevieve M. Clavreul, RN, Ph.D.
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Few things frustrate me more than an interesting story without an ending. Therefore, I decided that for this issue I would revisit the case of Amanda Trujillo and the Arizona Board of Nursing, which I wrote about last summer (Working Nurse, June 2012).

Early Sympathy

First, a quick recap: In April 2011, Amanda Trujillo, RN, a nurse at Banner Del E. Webb Medical Center in Sun City West, Ariz., counseled a patient about liver transplant risks and long-term treatment options and requested a social services case management consult on the patient’s behalf.

According to Trujillo and her supporters, the patient’s physician then angrily demanded Trujillo’s head, leading to her termination and the filing of a complaint with the Arizona State Board of Nursing (AZBN). Thus began a 15-month-long odyssey through the complex and adversarial system of professional review.

Trujillo took her tale of woe to the public through online nursing boards, blogs and even radio and television, presenting herself as a hardworking nurse persecuted for nothing more than attempting to advocate for her patient. Since nearly every nurse has either experienced or witnessed a similar situation, Trujillo’s predicament garnered widespread sympathy. Many nurses leapt to her defense, sending out petitions, letters and other calls for action.

As is customary for state nursing boards, the AZBN was legally required to keep mum about the case until the disciplinary committee formally presented the charges at a public meeting of the board, which gave Trujillo ample time to drum up support for her position. Once the full list of charges against her was released, that support began to erode.  One of Trujillo’s earliest and most ardent allies even went so far as to write a very contrite but firm public retraction of support. Another blogger, known for sarcastic and rather colorful language, dissected the charges and declared that Trujillo’s supporters had been blindly following Trujillo’s word without ever hearing the other side of the story.

Others have continued to defend Trujillo, insisting that the charges against her are bald-faced lies intended to destroy a decent and caring nurse.

After discussing those charges in my original article, I received a profanity-laden email from two of her supporters questioning whether I was even a nurse. Trujillo herself responded with a rambling blog post in which she seemed to take great umbrage at the fact that I hadn’t applauded her moral courage, charging that I was engaging in, in her words, “cyber bullying.”

The Double-Edged Sword

As an old-school activist, I understand only too well that media attention can be a fickle tool. Bright lights aren’t always flattering and once a story is out there, you may not like the way it unfolds, especially if you’ve tried to pick and choose which details to reveal. That’s the risk you take when you choose to bring an issue to the public arena, as Amanda Trujillo did.

Of course, that doesn’t mean that Trujillo doesn’t have the right to present her case or defend herself. As she has made clear, she believed her actions to be in line with Arizona’s Nurse Practice Act and in the best interest of her patient.

On the other hand, after considering the various charges (which involved several different incidents, not just the ones Trujillo decided to publicize) and weighing the facts, both as presented by Trujillo herself and by her accusers, other observers may feel differently. For example, the circumstances of Trujillo’s attempt to educate her patient about liver transplants — in the middle of the night, when the patient, who hadn’t yet received so much as a transplant evaluation, was, according to Trujillo’s own notes, “sad and somber” — left this nurse wondering if Trujillo might not have made a poor choice.

Facing the Music

Despite all the chest-thumping and shouting from the mountaintops that Trujillo would fight these specious charges until she was vindicated, this story ends with a whimper. Shortly before Christmas, Trujillo signed a consent agreement with the AZBN, accepting the board’s findings of fact and conclusions of law and waiving “all rights to a hearing, rehearing, appeal or judicial review” regarding the case.

The AZBN apparently dropped several of the original charges, which are not mentioned in the consent agreement, and the agreement notes Trujillo’s continued denial of several of the charges that are specified. Trujillo still contends that she is innocent of all the allegations, but page 5 of the consent agreement states that her admissions constitute “conclusive evidence of a violation of the Nurse Practice Act” — in essence, a plea of guilty.

The consequences of that plea are 12 months of probation on terms that will in all likelihood take a Herculean effort to complete satisfactorily. Those terms include quarterly self reports, psychotherapy and ethics counseling, as well as some very tough practice requirements.

To complete the terms of her probation, she must work as an RN for no less than 16 hours a week for 12 months, which may be challenging, because if she accepts employment in any job requiring RN licensure or enrolls in a nursing program, she must provide a copy of the entire consent agreement to her employer or school within three business days. The stipulations about acceptable work hours and prohibited work are even more complicated.

“She’s got employment requirements that I can’t really even figure out,” says nurse blogger Notratched, tongue in cheek, “something like she has to work more than one but fewer than three hours per week, but only on Thursday when it’s raining.”

Out Like a Lamb

Only a few bloggers have talked about the consent agreement that brought an end to this convoluted case and Amanda Trujillo wasn’t one of them. Instead, in a recent post on her own blog, she excoriated another blogger for talking about the agreement.  

I can think of many reasons Trujillo might have decided to sign the consent agreement rather than fight it out in court. Drawn-out legal battles can sap every ounce of your mental, physical and emotional strength (not to mention your bank account), and sometimes surrender is the better part of valor. We’ll never know, because after whipping the nursing community into a frenzy over her perceived persecution, Trujillo has said nothing about her final decision.

While she certainly isn’t obligated to explain herself publicly, it would be a courtesy, particularly given the strong support she received. In my view, her decision to let her supporters learn the outcome of her case secondhand does no good to either her cause or the interests of our community. For someone who has painted herself as a courageous and vocal advocate for nurses and end-of-life patients, she has been unconscionably silent on the outcome of her own case.   

You can read the complete consent agreement at www.azbn.gov/ConsentAgreements/1104073.pdf.  

Click here to read the original article from Working Nurse, June 2012.

This article is from workingnurse.com.

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