Nerdy. I apologize for hijacking your blog, but I can’t resist. This can be a teachable moment.
FIRST I have opinions and yes prejudices based upon my history and education.
I don’t know how much of either side of the story is correct. Amanda may be 100% correct and 100% the victim here. But she could be 100% in the wrong. I don’t know and guys and galls, Neither does Andrew or Vern, they have beliefs based upon their prejudices. Yes when I was bored, I enjoyed baiting both of them, trying to get them to say something in public that I can hold against them later. I apologize to the internet for that, and to Nerdy. I’m pretty sure I probably said something bad about her in one of my attempts. I lost my professionalism. The lesson of this is, don’t get angry at people online, when you find that happening, shut the computer off and walk away. Every time they got angry at me, they said something on twitter, that I could have used against them.
This whole episode can be a learning moment. Not the one that Amanda wanted, but a learning moment all the same.
I am NOT a lawyer, I didn’t play one on TV, and I didn’t stay at an Holiday Inn Express last night. What I am, is a nurse, who has been working with lawyers defending RN’s, MD’s and other health care workers in malpractice cases, professional license cases, and even a couple criminal cases. I admit up front that I’m a cynic and I believe that Gregory House, MD was an optimist.
The one thing that Amanda will have going for her is the fact that government attorneys at that level, in general, aren’t Johnny Cochran. They may be good lawyers, but they are busy, underpaid and overworked. As I looked back at my post I realize I had miss typed. I had intended to say that the “factual Allegations” will have to stand up to scrutiny. That is what the hearing is going to be about. Depending on the competence of her legal team, they may have an easy time discounting the whole thing. It is going to be very hard.
I’ve said it many times before. That the “computer let me place the order” isn’t necessarily a solid legal footing. It may be correct, but by itself, it’s not. There has to be a policy and procedure to support it, as well as the appropriate authorization in the nurse practice act. I can’t say to either. I haven’t seen the hospital policy, and I’ve not seen what the AZ nurse practice act allows. Unfortunately for Amanda, it maybe the old “camel’s nose under the tent flap” syndrome. It may not have been “outside scope of practice” but now that the can of worms is open, you can’t put them back. They could rule that Amanda in fact didn’t act outside her scope of practice, and still censure her on “unprofessional conduct”. I won’t begin to predict the AZ BON, or any BON for that matter, no matter how many times I’ve sat in front of them in support of nurses in administrative hearings. Judges and Jury’s are easy to predict, compared to BON’s. Unprofessional conduct is notoriously hard to defend against.
I went back and looked at the letter that Amanda wrote to Echo Heron. The one line
“Back in April of this year I was caring for a dying patient whom I had discovered had no clue about what they were about to participate in when they agreed to get a major invasive surgery. ” and “(complex lifetime daily self care)” Which to me says transplant and not hip surgery but Andrew you are correct. She didn’t say in black and white that the patient was going to be getting a transplant or start transplant workup in the AM.
Of course this line by Amanda’s lawyer pretty much takes the sails out of the response by Andrew’s (NurseFriendly) argument.
“After assessing and communicating with the patient, Ms. Trujillo’s evaluation led her to believe that the patient did not fully understand what (pt) had consented to when (pt) agreed to go forward with an intensive transplant evaluation scheduled to begin at Banner Good Samaritan Medical Center the following day.”
Those are the lines that are being used against Amanda. EVERYONE take this to heart. If you are ever an any situation, even remotely like this. SAY NOTHING to anyone but your LAWYER. Not your pastor, not your BFF, and definitely NOT the internet. Nothing ever goes away on the internet, even if you delete it, it can always be found, and used against you. This is the one area, that TV get’s it right. This is even more so in Administrative law, than in criminal law. So the question has come up, why was she counseling a patient, who was getting orthopedic work, vs a transplant on end of life subjects? It maybe that Amanda just misspoke herself in the letter. But under administrative law, it’s going to be harder for her legal team to get that thrown out. Possible, but difficult. And for what it’s worth, even if the Del Webb version is wrong, it’s going to be hard to stand up to that. The letter could have been written in a couple of different way’s to get the support of a famous nurse author in pursing stronger legislation without giving up her equivalent “right to remain silent”
Del Webb also obviously underestimated Amanda. If they had just fired her, this would probably have gone away 15 months ago. I can imagine the person who decided to turn it into the BON, hitting their head on the desk.
It is common for employers in all states to report nurses who’s employment has been terminated to the BON. I know there is at least one state that requires that. For those of you who are tilting at that windmill, that’s another plank for your platform.
So what do you DO if you find yourself in shoes like Amanda’s. Talk to your lawyer and don’t say anything to anyone without your legal team approving it.
As to the RNGuardian “position statement” which isn’t really a position statement, i have to shake my head. if that’s all it was, I’d say OK, whatever. But again as an educational moment, if you track back their posts, they are advertising a subscription service, to “protect” you from something like this happening to you. It’s about credibility. I personally don’t believe in subscription services like that. But I did a search and the attorney and the actually legal firm behind RNGaurdian, is a real legal entity, and appears to be doing a good job of actually defending health care providers. You’d have to check the local bar association and BBB to find out specifics. But be careful, don’t let fear override your common sense.
A word of hope out of this. If she gets out of this, her career as a nurse doesn’t have to be over. It will be changed beyond what she probable ever imagined. She’ll have a difficult time getting a job in a hospital, but then again, she’s stated that she never wants to work in that environment again. It will be hard, and she’ll have to be creative. But that goes for all of us too. it may not be the job you want, were you want it, but if you find yourself in similar shoes. Take a deep breath and look around with open eyes. There is work out there. Amanda is taking the time to write, if that’s a talent you have, then go for it. You’d have to ask Echo Heron, how much she made as an author vs a critical care nurse, but I’m sure she made some money out of it. It’s possible to make a living blogging. Not as easy as some would have you believe, but it is possible
It may be the motivation to get out of nursing. I’ve seen many posters stating that if they hadn’t invested so much time and money, they would get out. This might be the time.
As long as there is life, there is hope