Arizona Nurse's License Threatened by Doctor After Providing pt education - page 12

by lil miss

46,211 Views | 204 Comments

the email and arizona state board of nursing casethis is a (must read) e-mail that was passed to me from echo heron. @echoheronauthor hello ms. heron, my name is amanda trujillo. iím a registered nurse of six years ,... Read More


  1. 0
    I think we should raise some hell about this.
  2. 2
    There is a long, ongoing thread regarding this.
    Not_A_Hat_Person and leslie :-D like this.
  3. 1
    Quote from NDXUFan
    I think we should raise some hell about this.
    I think she went about it wrong. Even so, she might have been written up, but the crap she has had to go through has been ridiculous.
    lindarn likes this.
  4. 1
    she was advocating for the pt .i wish her well.
    lindarn likes this.
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    To Hampter320

    I could have typed your post. I agree with you word for word. It totally stinks that she's getting burned for what she thought was the right thing to do. I think (just my personal opinion) that she probably got caught up in her patient's story and overstepped her bounds. And honestly that bit about she didn't know she couldn't order a case management consult. It's her JOB to know what he scope is in the hospital she works in. If they have stupid policies saying nurses can't order case management consults (which is dumb) then that's what the rule is. And the whole thing about "what's the nurse order check box there for if you can't use it" come on. That's just a cop out. I have one of those on my orders too and it's for when you receive a telephone order AFTER the doctor tells you can put an order in after it's written down and read back. To play dumb like that doesn't help her case. And I don't really think she's that dumb (and I'm NOT calling her dumb so please don't say I'm calling her names) I just don't think that is a wise move to play because they are only going to burn her for it. A patient deciding to cancel a surgery that is hours away is a HUGE deal. Totally the patient's right but I would call a doc and give them a heads up on that one. Even in the night. That is just a good working relationship. If they get mad at you for calling in the middle of the night hey sorry...thought you would want to know about this one since your entire medical plan of care is about to change. Thanks for your post.
    Last edit by tekgrl33 on Feb 20, '12 : Reason: left out name responding to
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    Also..kind of as an aside...it really concerns me the number of people who keep making comments about how she was an MSN, she was an NP she had the right to do x,y,z. Are these really nurses that are asking these questions or what?

    I am an RN and a staff nurse. That is my capacity. I am responsible to know my capacity and work within the stope of my practice. This is basic. When I was in nursing school I worked as a tech. When I passed my boards and became an RN I was moving overseas within 4 months and the hospital I worked at was nice enough to let me continue to work as a tech so I keep my job until I moved. My manager sat me down and had a "talk" with me to remind me that even though I was an RN I was employed at the hospital as a tech. She made it clear that if any of the nurses put me in the situation of asking me to run a med in for them or anything like that I was supposed to tell them that she told me I could not and come to her if it was an issue. I was not employed as an RN, I was not oriented and signed off as an RN and I was not to work in the capacity of an RN. The fact that I had a license was irrelevant as far as inside the walls of that hospital was concerned.

    It scares me that people question this and it makes me wonder if this may not be where lines got gray for her and she accidentally stepped over that line. But seriously do people really not understand working with in your scope/capacity at a facility. Those kind of comments make me think:
    1. People really don't understand that (scary)
    2. People aren't nurses that are making those comments so they truly didn't learn that (I hope it's this one)
    3. People are making any kind of argument just because as another poster said they are sticking up for her because she's a nurse. We don't make our profession credible or stronger if we can't be critical of ourselves.
    Not_A_Hat_Person, lindarn, and kids like this.
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    Quote from tekgrl33
    Also..kind of as an aside...it really concerns me the number of people who keep making comments about how she was an MSN, she was an NP she had the right to do x,y,z. Are these really nurses that are asking these questions or what?

    I am an RN and a staff nurse. That is my capacity. I am responsible to know my capacity and work within the stope of my practice. This is basic. When I was in nursing school I worked as a tech. When I passed my boards and became an RN I was moving overseas within 4 months and the hospital I worked at was nice enough to let me continue to work as a tech so I keep my job until I moved. My manager sat me down and had a "talk" with me to remind me that even though I was an RN I was employed at the hospital as a tech. She made it clear that if any of the nurses put me in the situation of asking me to run a med in for them or anything like that I was supposed to tell them that she told me I could not and come to her if it was an issue. I was not employed as an RN, I was not oriented and signed off as an RN and I was not to work in the capacity of an RN. The fact that I had a license was irrelevant as far as inside the walls of that hospital was concerned.

    It scares me that people question this and it makes me wonder if this may not be where lines got gray for her and she accidentally stepped over that line. But seriously do people really not understand working with in your scope/capacity at a facility. Those kind of comments make me think:
    1. People really don't understand that (scary)
    2. People aren't nurses that are making those comments so they truly didn't learn that (I hope it's this one)
    3. People are making any kind of argument just because as another poster said they are sticking up for her because she's a nurse. We don't make our profession credible or stronger if we can't be critical of ourselves.
    Hmm being critical of, doesn't mean thowing someone under the bus. Docs, at least alledgedly self police. You don't, for the most part see them being critical of their fellows, in public. And, could you please point out to me what she did that was out of her scope? Apolitical,certainly, ?but out of scope?
    tewdles and lindarn like this.
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    This nurse already has an APN- advanced practice degree. That's what the MSN after her name is for and the RN is for after the MSN. If she did not have the advanced pracrice degree, she would be- BSN( that is the generalist degree) RN.
    The DNSc is a student pursuring a doctorate of nursing science. There are 2 general tracks of study for the nursing doctorate according to the AANC:
    1. a Research tract or course of study

    2. a Clinical tract or course of study. Most of the now, currently licensed , real time licensed MSN (APN)- NP's study this tract because in the year 2015, ALL Nurse Practioners - NP's, will be mandated to have their Doctorate of Nursing Science.

    The MSN tracts used to be up to the last year include: (to my knowledge there were no MSN generalists. One has to declare a speciality. It was contradictory to the purpose of a Master's degree which was to gain advanced knowledged and an advanced degree in your chosen area of expertise or interest)

    Adult APN- NP, ( can see patients in an office based practice 11yrs and up;prescriptive priviledges)
    Acute Care ANP- NP,( usually employed in specialists offices and round for thesespecialists in the hospitals, can also be Critical Care Intensivists- admit and manage patients to the critical care units: prescriptive priviledges))
    Pediatric APN- NP, ( enough said: prescriptive priviledges)
    Palliative Care/Oncology APN-NP,( usually employed by oncologists, or oncology treatment facilities, can be also employed by pain managment docs prescriptive priviledges)
    Women's Health/ with or without the Nurse Midwife course of study,( usully employed in OB/GYN practices, do rounds in hospitals also, employed in women's clinics, family planning clinics prescriptive priviledges)
    Psychiatry APN- NP,( has prescriptive priviledges, evaluates and manages medication, can conduct psychotherapy-office and inpatient)
    Public Health NP/Masters in Public Health( usually employed by the health depts on all levels- local, state and federal, can assume the epidemiologist role in all health depts levels, in charge of health dept investigations on all levels)
    Family Nurse Practioner APN-NP ( can see pt's ages 6 months and up prescriptive priviledges)
    Gerontology APN-NP ( usually employed in a family practice and can round in LTC, assisted living, prescriptive priviledges
    Nurse Anestistists- CRNA's( enough said: works under the direction of an Anesthesiologist: can only write med orders in patient not outside the hospital)

    Nursing Informatics,( no prescriptive priviledges)
    Nurse Educator(no prescriptive priviledges)
    Nursing management and Leadership( no prescriptive priviledges)

    These are NOT bedside nurses: RN's, ADN's, or BSN's or online LPN to RN's, wiping butts.

    The Nursing Practice Act in my state and I believe alot of other states, clearly states an RN, a Professional Nurse's, the wee little nurse generalist's (RN, ADN, BSN )responsiblity(not an "it would be nice in a perfect world") is responsible for: patient education, case finding blah, blah blab, blab, any RN is "responsible" to do these 2 activities. That is the wee little RN's scope of practice.
    Maybe Arizona doesn't realize it has APN's- so let's wake up Arizona, re examine your Nurse Practice act. Times have a changed- About 25 years ago. I read Az's Nurse practice act ( really pee poor)and it falls somewhere between a Nurses aid and and LPN role.

    By the way- I am just one of those wee little RN's no MSN, no BSN- and I put in case managment consults all day and every day 5 days a week, 40 hours per week. The only signature I need is for the case manager- also an RN, to get the patient's signature to agree to case manangment services!!! In my state that is my "scope of practice" according to my states Nursing Practice Act- which I take very seriously, and any physican who would report me or any other RN to the hospital or BON would spark hysterical laughter!!!

    I also think it is more than the Arizona BON that needs to re think the Scope of Nursing Practice especially Advanced Practice nursing. I mean the Power that be in the these hospital systmes- If the corporate mogal think theat ann Nurse with the educational backround and capabilities are going to be at the bedside wipping butt and offering clean linen and cleaning bed pans in the hopper- they need to think again. A rude awakening to the financialCZARS and CEO's- should just show the Nursing community how much these MBA's understand or know about the practice of nurse- big fat Zero!! Their Total lack of respect for the nursing profession in general, until one of theirs is in need.
    They want to control the dollar that controls the workforce and ration out care to those they feel are deserving of care- they better first understand the workflow, instead of picking their noses in an office with a big buck salary they have shown poor job performance in earning.
    Last edit by kcmylorn on Feb 20, '12
    lindarn likes this.
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    What hospital did Amanda work in? I bet it's a member of the Arizona Hospital and healthcare Association? All states have a hospital association, they are all politically driven, they are usually comprised of the CEO's from all the hospitals that pay a membership to this association. The polical heavyweights in the state- they beg money(funding from the taxpayers aka the govenor) for thier hospitals causes.
    lindarn likes this.


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