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Trisha Torrey

Crossing the Line? Or Doing Her Job? Nurse Fired for Educating Her Patient

By February 2, 2012

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Suppose you are very sick - terminally ill.  You've been through the ringer with so many drugs, so many different forms of treatment, difficult side effects, very little quality of life...  now your doctor wants you to have ONE MORE THING - surgery.  If the surgery works, then it will keep you alive longer.

Since you trust your doctor, you make arrangements for the surgery.  You have no idea what to expect. You don't really know anything more than the fact that when you wake up, the surgery will be over.  You're not sure how long you'll be hospitalized, or how long it will take to recover.  But you're excited because you'll live longer!  So your feeling is... you just really want to get it over with.

But wait!

Along comes a nurse who spends some time with you as you lie in your hospital bed.  Since you realize you know next to nothing about your impending surgery and what to expect, you start to ask her some questions....

The more answers she gives you, the more you realize... maybe this surgery isn't what you want after all.  You had no idea what was involved, how debilitating it will be, how much pain you'll be in, how much it will impact any quality of life you have left, even how risky it is - and it IS risky.  You didn't even know you had a choice.

No one told you that you could refuse that surgery! And now that you know that... well, maybe you just don't want this surgery after all.  But what are your options?  What other possibilities are there?

So the nurse helps you understand.  She explains that you can say no, that hospice and palliative care are options.  As you talk it through with her, you realize that you'd rather not suffer the results of that surgery. You'd rather keep any quality of life you still have, even if it's for a shorter amount of time.  At least you know you have to give it some more thought before deciding to have this surgery.

And so, to help you further, the nurse orders a consultation with those who can help you further in the decision-making process - case management.

So for now, surgery is off.  You are relieved.  You go home to figure out what to do next.

But not long afterward, you learn that the nurse who was so helpful, the nurse who answered your questions and walked you through your options, the nurse who was truly your advocate, in your court, has been fired.

Why?

What hospital personnel told the nurse is that she was fired because she did the doctor's job.  Her job was not to educate a patient.  She was there to do what the doctors told her to do, not answer questions about treatment from her patients. And it was against their rules because she ordered a consult from case management.

They say the truth is stranger than fiction.... and in this case.... this is a true story. The nurse is Amanda Trujillo, and the hospital is Banner Del Webb Hospital in Sun City West, Arizona.

And we can make an educated guess that despite what the patient was told about why Amanda was fired, the truth is that she was fired because the patient decided against the surgery. The doctor and hospital had abdicated their responsibilities, therefore, not only had Amanda embarrassed them, but she cost them money.  That surgery would have meant big bucks for them!  But no longer....  and so, Amanda is no longer working for the hospital.

Further, for good measure, the hospital filed a complaint with the Arizona Board of Nursing.  Amanda can't get a job as a nurse anywhere else either.

So what does that mean for us patients?  Well, that depends....

It depends on whether we think nurses should be advocates and educators.  They are trained to be both and most nurses I know are great in both roles.  But clearly Banner Del Webb Hospital doesn't think they should be advocates or educators - and I suspect Banner Del Webb isn't the only hospital that makes nurse do their jobs with one or both arms tied behind their backs.  It would be like telling an auto mechanic he was expected to do everything else but work on engines.  Or telling a teacher she is supposed to teach everything but reading.  Having policies in place that restrict nurses from advocating or educating is a ridiculous notion.

Or - maybe not.  If it was against hospital policy, well, maybe Amanda should have paid attention? Didn't she realize it was against hospital policy for her to order a consult with case management?  Maybe she should not have stuck her nose into that patient's medical business.  Maybe she should have known better about the policies of the hospital and where her boundaries were....

What do you think?  Was Amanda doing her job?  Or did she cross the line?  Please take this poll and share comments below.

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Comments
February 7, 2012 at 11:02 am
(1) Linda W. says:

I don’t believe that any of these questions or answers for Amanda are correct. I am not sure that she should have been fired but I do believe that she should have had counseling. It is unfortunate that a doctor didn’t answer all of those questions prior to the patient being hospitalized for surgery. But, again, unfortunately, that does not chnge the fact that a nurse answered questions that a doctor should have answered. That it not saying either, that the nurse didn’t know the right anwers, but it was not her job to act as a physician.
I think that maybe the correct solution would have been for Amanda to advise the patient to write down a list of questions and consult with her doctor before going any further, and then the patient letting her doctor help her make those choices.

February 7, 2012 at 11:10 am
(2) karen says:

oh course she should not have been fired or prevented from getting another nursing job.
she did what the doctors should have done- and since they dont have the time, or inclination to be truthful with the patient and explain the pros and cons of the surgery, this nurse was doing the best for the patient.
unfortunately we still think of doctors as gods, and medicine is big business– we-the public have to try and get as much med info as we can- the doctors already think they know what is best for us- sometimes their motive is unethical.its one thing when u are a doctor who treats his patients as if they are unable to make any dicisions about their own bodies,lives- but we deserve the right to be educated about the treatments they are planning -atleastgive us the choice!e, i think it is disguesting to have treated this nurse in such an unprofessional and corporate big business manner.
but then again, that is how medicine /docotrs are these days,not all, but most- its disgusting-many get hurt,go thru uneccessary pain and die because of this callous approach -
iis infuriates me!!!!!!!!!!!!!!!!!!!! it is so wrong..so mean..and very counterproductive!
karen

February 7, 2012 at 11:22 am
(3) Martin says:

Most doctors I know never discuss all the options. If I were that nurse, I would sue the doctor and hospital for wrongful firing. I would love it if a nurse could open up like that one did. I do not have any medical issues yet that could require surgery, but it appears that hospital is trying to put fear into the other nurses in the hospital so they keep their mouth shut and not to really care about the patients very much.

February 7, 2012 at 12:27 pm
(4) Steve says:

Unfortunately its not that simple. The nurse’s fiduciary responsibility is to the hospital. If she violates their policy they can fire her. The question of whether she did the “right” thing is a separate issue.

This is the reason that hospital personnel including patient advocates are not authorized to act/educate in the best interest of the patient. They work for the hospital. The best way to get all the information is to engage an outside advocate to educate you who is not beholding to the system. Get a second opinion from another doctor who won’t make money on the surgery.

Another approach the nurse might have taken is to arrange for the doctor to meet with the patient so that the doctor could answer the questions. The doctor however is “selling” surgery so often doctors bias these discussions in favor of what “they” the expert, want to do. Why should those stupid patients have any say? On the other hand the doctor might provide excellent education and help the patient decide not to have surgery. Keep in mind the doctor doesn’t get paid for education. S/he gets paid to do surgery. Inherent conflict of interest.

So even if the doctor is included and “sells” the patient on surgery through misinformation/irrelevant information should the nurse speak up and offer other options? Only if s/he is willing to be fired. That’s how the system works.

Its a sad system. The system is broken. Most of the people aren’t.

February 7, 2012 at 1:54 pm
(5) michelle says:

I am an R.N. who has been completely blinded with naivety when starting this career. I thought nurses could assist people in their darkest hour, when your standing by their bedside and they look in your eyes and ask you about the surgery. I was wrong. I thought that by doing the right thing for the patient, you were advocating and objectively allowing the patient to make their own choice. The living will has been amended 6 times and probably won’t stop there. If this patient had her wishes spelled out for the doctor as she was terminally ill, this could have all been prevented. The doctor or case managemnet, should have inquired what her wishes were and how she felt about surgery. He was negligent to not have her wishes be known to him. Doctors do not realize how much power they have,especially with the elderly. They need to go back and remember why they worked so hard through medical school to become doctors’ in the first place ,QUALITY OF LIFE, not how much money can we make from this.Let’s stop blaming the nurses because it’s an easy way out and put the blame where it belongs, whomever it belongs to. What a broken, shameful system.

February 7, 2012 at 3:09 pm
(6) Weena says:

My husband, a physician, has lost privileges numerous times for doing what this nurse did–speaking up on behalf of patients, not the hospital’s financial interests. He has successfully sued each institution, each time, and had privileges restored (often with an apology). But it burned him out and he made some career changes. His response to this nurse’s case was, “Poor thing–she’s a trouble-maker.” Nobody wants troublemakers in the health-care INDUSTRY. In the profession, her behavior was laudable–indeed, it was professional! But in the INDUSTRY? No. She cost the hospital money & embarrassment and exposed a problem. Yeah. She’s OUT.
Don’t forget: It’s an INDUSTRY.
My 2c worth–that patient, or the patient’s family, should sue the doctor for failure to do what the nurse did. It was negligence, pure and simple.

February 8, 2012 at 2:57 am
(7) Patricia B. Arthur says:

Having been on both sides of the fence in my career path, my take on this scenario are twofold:

1). If it had been a janitor who discussed medical issues with this patient, I can see where their job would be in jeopardy;

2). The nurse who gave the comfort and suggestions did the right thing in speaking with the patient. If she had then contacted the Nursing Supervisor to discuss the issue, the Supervisor would then have the authority to either call Social Service, or speak with the Patients’ doctor to get his ideas.

3). By doing it this way, the nurse is not negligent, and the Supervisor can follow up with the correct protocol.

4). This kind- hearted nurse should turn herself into a Patient Advocate. She doesn’t need a nursing license to be compassionate to the people in need!

approached the patients’
Physician to share with him the concern she had with the issues raised

February 8, 2012 at 10:57 am
(8) Lynne says:

Crazy, educating patients is part of a nurses job. The nurse obviously needed to make all of the patient’s doctors aware of the patients indecision. The consult maybe should have been written by a physician. If the nurse is unable to write for the consults due to policy, she should have been reprimanded, but not fired, she still had the patients best interest in mind. The patient should have asked for more information from the surgeon, if he does not have time to answer questions, maybe the patient should have gotten a second opinion. Unless the correct direction is apparent, always get a second opinion. Where was the patient’s primary physician to help him sort out what he wanted to have done? The nurse could have helped the patient to make a list of questions for the doctor.

February 8, 2012 at 8:26 pm
(9) laurie curtis says:

This is not the first or the last time Banner Del Webb has manipulated and fabricated events and policies to force out nurses who are about putting the patients needs above all else. This nurse did nothing wrong and should have been commended. As to the policy regarding case management consult, if a patient is to have a transplant or be transferred case management along with social services should have been already involed since the nurse is not the one who discusses these issues with the patients. The shame is on Banner Del Webb, and not the whole world can see what type of healthcare system is taking over the valley.
Where is the support of the Arizona Nurses Association? Ask senior administration member of Banner Del Webb,Teri Wicker? I see a complete conflict of interest when a member of administration for a large healthcare organization sits in control of a organization that is to support the nurses of this state.
I am proud to be a Registered Nurse and will continue to provide safe patient care and education.

February 10, 2012 at 6:00 pm
(10) Jean says:

She can work at Cancer Treatment Centers of America. They encourage patients to make up their own minds and be educated participants in their care. The case managers, physicians and nurses work closely together to help them make these decisions. CTCA encourages nurses to be there for the patients, like this nurse was for this patient.

February 11, 2012 at 11:45 pm
(11) Amanda Trujillo MSN, RN says:

Hello everyone—I just want to make it clear that I did not explain the risks or benefits of anything. It wasnt my job to get consent or take any piece of paper into that room for a signature. Part of my learning assessment is to ask the patient if they understand the plan of care and if they can verbalize it to me. thats all i did. those consent issues are out of my scope. I keep explaining this but no one seems to see it because were still having the consent talk……….
PS–I never stated to any journalist that I explained the risks, this is where media is able to put their own spin.
I wish I could wave a magic wand and show the world the chart, and then people would see the truth, be we both know i cant do that. Alas I cant, at least “in this particular situation,” gain legal access to the chart to exonerate me. When I went to nursing school I never dreamed it would be so easy for someone to do this kind of thing, I did all I could–had my reference book of all banners policies, did my learning assessment, nursing diagnoses, care plan, notified my manager of my concerns, got my plan of care approved, alerted the next RN to page the doc asap, showed her my documentation- and STILL here I am.

February 11, 2012 at 11:45 pm
(12) Amanda Trujillo MSN, RN says:

No one needs permission or a certification of less than six months to live to MAKE CONTACT with hospice education. Signing on for hospice, however, does require that piece from the physician. A patient may self refer from their hospital room, ask a family member or friend to make contact, or let their nurse of physician know of their wish to visit with someone who can provide that expert teaching.
medicare or not, hospice does not turn anyone away for whether or not they can pay or whether or not they are under a specific insurance. due to the unexpected trajectory of diseases such as chf or copd there are multiple recertification periods because hospice organizations have all agreed that it is extremely difficult for even a doc to determine who has less than six months to live. often patients live beyond that. hence the development of programs that encourage early entry into palliative/hospice care that transitions “with” the patient and their illness up to the point they require end of life care. the key to remember here, is that the patient was denied the right to visit with hospice despite having requested to have their questions and concerns addressed.

February 11, 2012 at 11:46 pm
(13) Amanda Trujillo MSN, RN says:

I didnt sign up the patient for hospice, nor did i call in a hospice company, I didnt write discharge orders, nor did I attempt to make any statement pertaining to the certification of life expectancy…..
I understand why nurses do not remain at the bedside. Ive gotten so many letters from around the world–nurses telling me their stories and why they left the bedside. They are all the same. .I dont think Johnson and Johnson have any clue about the reality.
….all we hear about in those commercials is “the promise of nursing…” Yeah. Its a promise alright. After Texas, Nevada, Maryland, New York, California, and now me in AZ–who would want to go all these years to school if its this easy to lose it all for doing it by the book? The publicity of our cases will most certainly make people think twice.
That being said…at the time I was fired I was doing quite a bit of mentoring of new nurses….I will never step foot in another hospital again knowing that I am ex[ected to be a CORPORATE NURSE first and put my patients second. I can be successful as a nurse and a person in other ways…and I intent to explore that because I will not allow Banner to destroy my dreams of being a great provider nor will I allow them or the State Board nullify all the years of hard work to get my degrees. I will be starting my own patient advocate business.
Hope that answers some questions– Thank you everyone for your feedback and interest :) Just remember to tell this story because it isnt just here in AZ–NURSE RETALIATION is everywhere and nurses will not speak up to protect you if it means putting their own lives on the line—its happening all the time now, we need healthcare consumers to step up and say ENOUGH. Until you all speak up and demand more, and demand that nurses be protected by law, its your lives on the line…………

February 11, 2012 at 11:52 pm
(14) Amanda Trujillo MSN, RN says:

Theres a saying we nurses have: “You can get into a hospital with a doctor, but you will not get out of one–alive–without nurses…”

February 13, 2012 at 11:16 am
(15) Tammy RN, BSN says:

Amanda,

I am truly sorry about the situation you have found yourself to be in. I have been a Registered Nurse for 21 years. I know that being a patient advocate is to provide patient education at the bedside. In fact, it is a requirement by JCAHO to do so! So, good job for you providing the opportunity for your patient to make educated decisions about their own healthcare. If indeed, that was the main reason for the hospital terminating your employment, I would tell you go find yourself a good lawyer and let them pay your retirement.

Unfortunately, reading the details of this article, the real reason they terminated your employment, was that you were practicing medicine by writing a doctor’s order. After all of your experience, you know that you cannot write an doctor’s order without first talking to the physician (unless it is a standing protocol at the facility to consult CM for these cases – in which event, I’d say get the lawyer involved). The hospital cannot take the risk of having a nurse writing physician orders without the physician’s knowledge of the such.

Again, I am sorry that this happened to you! I pray for you and your future as a patient advocate. I strongly feel that that is where your heart is and God bless you for that.

Good luck in your future! ~ Tammy

February 13, 2012 at 1:45 pm
(16) David Sandhu says:

Dr Berns, MD, PhD, studies human motivation and decision making by focusing on neuroeconomics, the science of how indiviual and groups make decisions. According to Dr. Berns, very few decision are truly individual decisions. They are often influenced by context of social contact. It is also known that when experts speak, people tend to shut down the critical part of the brain that does the decision making.

If you consider the information from this story- you have a doctor who is an expert at his field, he/she convinced this patient to have the surgery. My guess is that he probably spent less time than the nurse in the first place.
It appears from the story that the client wasn’t fully informed or lacked a informed consent.
I truly feel that the nurse acted in the best interest of a client and offered her expertise in making the decision process a little more autonomous.

February 16, 2012 at 4:32 pm
(17) Patient Rights are #1 says:

Amanda, if it is meritted in your case, I do hope you take legal action. Thank you for taking time for this patient to hear and offer your knowledge. I am concerned that our society is tightening down to rules only that force decisions to serve corporate interests, rather than decisions based upon alternatives. Alternatives help humans discover choice, knowledge, alternatives hence more freedom in their treatment and more happiness.

February 20, 2012 at 8:06 pm
(18) Anne, RN says:

I have been a nurse for almost 30 years and worked all but 3 years in a large hospital. I can tell you no good deed will go unpunished. The “employer” wants a nurse to mold into what “the corporate” wants, not what is true and right, a patient advocate for the patient FIRST. No autonomy in nursing these days…just strict adherence to foolish ideals. Nurses accept being treated as though they are in kindergarten, even though they are educated professionals. The corporate interest is THE MOST important decision maker in large business. And when you cross them, they will burn you by termination and difficulty obtaining employment after.

I understand writing the physician order may not follow hospital policy and procedure, but this was in the best interest in the patient, as no harm came to her because of this act. This needs to be the primary thought when deciding on the outcome of the “impropriety”.

Amanda, this is life after being a Banner employee. A good one, too. Keep up the good nursing. The patient depend on us, and one day, I will too. I just hope I get a nurse that will “go above and beyond” for the patient…you are to be commended!

Thank you, again!

February 21, 2012 at 11:03 am
(19) Colleen says:

I am a nurse who left the “corporation”of healthcare. I am pursuing healthcare advocacy and as those above said not only does JAHCO state the nurse is to advocate for the patient so do all schools of nursing.
This so called profession teaches you , licenses you, and puts you to work then when you do all of that they taught right leaves you hanging out to dry. How do fellow nurses allow all of this? I’ll never understand the power of men and these hospital corporations have over nurses. Nurses have all the power they just need to band together.
Amanda you did what you were supposed to do and you are allowed to write a nursing order for education for your patient especially if it pertains to her diagnosis and determined it from a nursing diagnosis. Those above are having trouble distinguishing a medical doctor order from a nursing order.
She did no medication order, testing etc order just a consult for educational purposes.
Nurses and society needs to stand together to protect the right to care for patients the correct and proper way not the corporate according to their cookie cutter get them treated and street them kind of way to make money.

February 21, 2012 at 11:20 am
(20) Karl says:

I have the highest respect for nurses, but discussing the pros and cons of a surgery is outside their job description and they know it. There is good reason for this. Nurses’ knowledge about such matters is highly anecdotal, and they don’t always have their facts straight. I have personally received incorrect advice from nurses on more than one occasion. Yes, some really do know what they’re talking about, but a patient has no way of discerning which nurses do and which don’t, or which subjects they should and shouldn’t be trusted about.

That being said, physician advice is very one-sided. Surgeons usually recommend surgery. It’s in their nature. That’s why a signed consent is required. That should be a red flag to any patient that there might be reasons to refuse consent, but I guess not everyone is as good at advocating for themselves as they should be. Maybe patient advocates should be required to be present at the signing.

February 21, 2012 at 10:52 pm
(21) Kathryn Gohman says:

In the past year, two clients have called and asked me to help them locate attorneys to pursue legal action against the nurses and doctors at one of the “Banner Hospitals”. Banner owns 30 hospitals in Arizona; many of them if you look online have nothing but complaints and sad stories listed in the “Comments” areas of each hospital. In the case of my clients both were seniors who died due to lack of care by doctors & the laziness of the nurses who were assigned to care for them. I was told many stories about the horrible care & atrocities that occurred to Seniors in the state of Arizona by the patients families, and I was shocked. Firing this nurse is just one way to get a diligent Nurse out of their system so that business as usual can continue without concern for established rules and regulations of the medical community they have sworn an oath to care for.
Posted by Kathryn Gohman

February 23, 2012 at 5:57 pm
(22) Amanda Trujillo MSN, RN says:

@Karl: Please read my responses above yours. There was no conversation about the risks or benefits of surgery, nor was any intraoperative surgical jargon discussed—that is out of my scope. Patient Advocates are = Nurses. Having anyone less than a licensed RN at the bedside to advocate for the patient in a situation such as this one places the patient at risk–we have a specific body of knowledge that other disciplines–like social workers–do not….just as they have a specific body of knowledge we do not possess……

@Kathryn: I saw many atrocoties—including MD’s falsifying charts. And yet—here i sit. Fighting for my life. Neato.

February 27, 2012 at 12:00 pm
(23) Jane D says:

Amanda have you looked into hiring a lawyer and what has the state board said?

August 31, 2012 at 3:53 pm
(24) Shaddow says:

It is the doctor’s Responsibility to explain the procedure. The nurse may educate, provide options, but definitely alert the dr that the patient has further concerns. Also, a screening, not a consultation can be ordered by the nurse, as only the doctor can order consultations. Even in a screening, the case management personnel will evaluate the patient, then obtain an order for further action. But she, nor any other nurse should be fired without first attempting counseling, education, and training/retraining. Their aggressive pursuit against her license is sickening, and if I were the patient, I would aggressively pursue recompense in her favor, regarding their money-seeking behaviors, and disregard for patient autonomy.

September 23, 2012 at 12:01 am
(25) Paula Hill says:

I speak as a retired social worker and a senior who has responsibility for a senior. While working I went to a training program that promoted interdepartmental meetings re: patients : Dr., nurse, PT, social work, etc. I have never seen it in action! Recently my husband was in hospital for 3 days following a fall and serious head wound. A nurse/case manager advised me that if he was admitted for a medical reason he could go to rehab for two weeks for PT and cognitive rehab. We both agreed. Two days later I was told he waas being discharged and papers haad been sent to his doctor. I never even met the doctor! He now will receive home care BUT this is a repeat from a fall a year ago when the home care team felt he needed more care. We willmanage. But I definitely felt that the hospital was putting the hospital’s needs ahead of the patient’s..

October 26, 2012 at 3:22 am
(26) Taylor says:

No she should still have a job. It Is well within her right to educate A patient about the diagnosis. We are taught that in nursing school . she cannot be the first one to discuss the diagnosis with the patient but she can talk about the options with the patient once the physician has told the pt about the diagnosis. Rns are not physician extenders. for the record I am an RN. we are licensed professionals that do require an education. We do have to have a scientific background

November 19, 2012 at 2:15 pm
(27) Sherry BSN RN says:

I find this crazy to think that a nurse was fired for being a patient advocate – who was by the way “doing her job” It it against the law for a patient to sign a consent for a procedure withouth the doctor going over the information and answering the patients questions. At least I thought this was the case until I read this article. Why didn’t this doctor have some type of legal action against him and why didn’t she sue the pants off this hospital? I think the case manager consult was pretty insignificant compared to the lack of ethics and total disregard for the patients informed consent. I find this absolutely horrendous and this doctor should have some type of repercussion against them.

November 26, 2012 at 1:16 pm
(28) Claudia Kim Nichols says:

As a private patient advocate, I’m keenly aware that nurses need to be empowered so they are no longer scapegoated, a dynamic that’s been demonstrably proved. Please see:

http://well.blogs.nytimes.com/2010/02/08/nurse-on-trial-after-reporting-doctor/

http://www.nytimes.com/2011/05/08/opinion/08Brown.html

http://well.blogs.nytimes.com/2011/05/09/belittling-the-nurse/

http://www.nytimes.com/2011/05/17/opinion/lweb17nurse.html

Clearly the patients’ interests are superseded by a toxic method of medical practice. Only health care consumers can be the impetus for positive change – and it will be a tough war.

Amanda Trujillo placed the patient’s interests above her own — and is now threatened with the prospect of never working as a nurse again. Why has she been persecuted? As another reader indicates, the President of the Arizona Nurse’s Association, Teri Wicker, is also the Director of Professional Practice at Banner Del E Webb Medical Center – the same hospital where Trujillo was censured. And yes, the hospital faced a loss of revenue from the patient’s reconsideration.

January 24, 2013 at 10:20 am
(29) Diane says:

It happens all the time. Even if the doctor break the law.

April 6, 2013 at 1:50 pm
(30) Eddie says:

A nurse is an advocate and a teacher. That is what they are trained to do. That is what their job role is….to educate the community and answer questions that arise. However, somehow in this day and age money and greed have taken over and patient’s rights have been pushed to the back burner. I would have answered the questions the patient had, just as I would have expected them answered had I been that patient. I think it is wrong for a dr to experiment on someone without telling them all the facts and letting the patient make an informed consent…that is what nursing is…I disagree with the firing, and definitely disagree with the hold on her license!!!

April 25, 2013 at 3:57 am
(31) Tom says:

I am a social worker for over 30 years and my wife a nurse for the same amount of time.
Just a thought or two: The patients are not the customers of the hospital, the doctors are their customers. Ergo the phrase: “the customers always right”
My wife has often said that “nursing eats their young”. So don’t expect the licensing board to stand up for the right thing. Licensing boards tend to be punitive and unrealistically critical of professionals.
My heart goes out to Amanda. If you ever get past the board issues you would probably do well as a hospice nurse.

May 31, 2013 at 1:41 pm
(32) Karen says:

This is because this is Del Webb hospital. Any banner will file a complaint with the AZBN if they terminate an employee. They are horrible to work for. Del Webb also cleaned house and tries to get rid of any employee who was there when it was Sun Health. They also have a director there that is awful and discriminates. I have a law suit pending about discrimination over tattoos.

July 10, 2013 at 4:16 am
(33) lucia says:

The Nurse has an obligation to ensure that patients are informed about their health status,Care and treatment. Withholding information from patients is a violation of the rights of patients to information.A nurse hAve a Interdependant Function that refers to Co-responsibility . You did the right thing Amanda

July 22, 2013 at 11:34 pm
(34) Nurse Dixie says:

After being an RN for 14 years and an NP/CNS for 10, I have taught as an Associate Clinical Professor to many nursing students. I have had students in the hospital and in the classroom and have always taught them that one of a nurses main roles is to advocate for her patient. I have also taught this important piece of information to many new graduate RNs that have passed through the floor where I worked as the clinical manager. I remember how this was something that was repeatedly drilled into my brain while in school to receive my BSN. I do NOT believe that Amanda acted unprofessionally or anywhere out of her scope of practice. When I was a new RN on the hospital floor of a large teaching hospital connected with a major university, I recall how we were required to provide written documentation that we were providing education to our patients. It is most definitely an element that the JCAHO surveyors scour the charts for as well. Something people are forgetting is that some institutions require that an RN be the one to initiate certain consults if she is aware that the patient is in need of one, and then the RN is also required to enter the order in the computer. This was the case when I was employed by the VA Hospital as a clinical manager on a medical/oncology floor. I don’t believe what Amanda did crossed over into practicing medicine at all and agree with the nurse who believed Amanda entered a nursing order into the chart of the pt. It is truly sad that nurses who provide good care by advocating for their As a nurse who has sometimes been labeled a troublemaker, I am very interested in emailing with Amanda if she is still reading this board.

November 10, 2013 at 6:51 pm
(35) Sindy says:

I have been an RN for almost 25 years. I left the bed side approximately 10 years ago becuase I saw how the corporate business of health care was literally killing good nursing and I wanted nothing to do with it. Amanda was only doing what she was trained to do; first and foremost, she was being a patient advocate as she was trained to do! I often wonder how many patients I could have helped if I would have bit the bullet and stayed on? My decision was like being between a rock and a hard place — I was no longer happy at the bedside yet I know a part of me has been missing out on my true calling. It is such a shame that healthcare is always about money first and the patients come second.

December 10, 2013 at 12:48 pm
(36) besteyrohan says:

I would like to know about the state law is for letting a nursing aides are allowed to stay on there job when they make trouble for any other aide.But she is always in the right never wrong.It is pretty bad when a black can get this one white aide in so much trouble but it isnt her fault. I would like to know what can be done.This is what happened in the State of Pa in Skilled Nurseing place.

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