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Amanda Trujillo: Martyr or Gadfly?

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Kathryn Norcutt can often be found researching and reading about the newest innovations in the health care field. In her free time, she loves to work at perfecting her strength and fluidity in her Vinyasa yoga. Kathryn currently writes and blogs for RNnetwork.

Most of us in the healthcare sector have probably heard of Ms. Trujillo’s name and her impending case and investigation with the Arizona Nursing Board. Unlike many of her nursing brethren who might find themselves in similar situations, (dusting off resumes and crossing fingers while their case is being reviewed) she has found an interesting arena to stand up to her accusers, namely the internet. Ms. Trujillo’s inflammatory blogs have stoked the flames in regards to her purported wrongful firing at the hands of the attending physician who contends that she stepped out of her scope of expertise. The case has spurred incendiary reactions on both sides of the healthcare fence (reopening old battle scars in regards to the age-old division of nurse vs. doctor) all over the blogosphere. Truth be told, in most cases, you’ll encounter a mixed reaction where she is painted either as a hero or thorn in the healthcare system’s side and of course, has become a classic case of he said/she said. But why should we care about the outcome of a nursing investigation? If you ever find yourself either working in a professional capacity (or even as a patient) and thrust into a life/death drama consisting of egos, ethics and at the bottom line; a patient’s bill of rights, you might end up with the same prescription for disaster.

Here is the crux of the issue: patient X, who was hospitalized and prepared for a Liver Transplant Evaluation the following morning, was in Ms. Trujillo’s estimations, unaware of certain risks that would be involved in future treatment that had not been previously discussed, ( i.e. hospice, comfort care and less aggressive treatments). When the patient inquired further, Ms. Trujillo involved a Case Management consult—and this is where the flames start rising—without first speaking with the patient’s doctor. At the end of the day, she was accused of not following proper protocol and when the doctor found out his patient decided to delay his/her impending treatment, he demanded that Ms. Trujillo be promptly fired, which she was. To say this issue has been contentious is a woeful understatement. No doubt everyone involved with the case will have their words properly vetted with either documented evidence or eyewitness accounts throughout the upcoming trial and you can bet there will be a trial, but all this drama begs a bigger question; who ultimately is held responsible in making a decision when a patient’s very life and livelihood is at stake? If nurses are fired by acting as a patient advocate or the physician/nursing lines of communication are broken due to hurt feelings, ego, or whatever the case may be, then the patient will be the one that ultimately pays that very steep price, maybe even with their own life.

Of course, for those of us in within the healthcare sector, we know from experience that there is no perfect world, (who can explain the why’s to a parent who just lost their child following a common medical procedure?) And just as there are no perfect doctors, nurses or people for that matter, how can we expect that a system constructed by imperfection be anything less? But perhaps this is where we should look when thinking about healthcare…or at least consider the possibility that current or traditional wisdoms are not always correct in every situation. At least the seeds for civil dialogue have been sown as seen in discussion boards, but whether we can reap a better healthcare system because of such cases, still waits to be seen.




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