Why Nurses Are Where They Are: Amanda Trujillo Story, The Reason For High Burnout Among Nurses, And What Each Individual Nurse Can Do To Change That

by Shahina Lakhani

in Art Of Living Powerfully, Health Care, Holistic Hospice and Palliative Care, Nursing

Why Nurses Are Where They Are: Amanda Trujillo Story, The Reason For High Burnout Among Nurses, And What Each Individual Nurse Can Do To Change That

Shahina Lakhani

This article is inspired by one of Mother Jones' beautifully written article. In the article she explains that since doctors are revenue generators they have much more clout. Where as, nurses are a cost and therefore considered a liability by healthcare corporations. She hits the nail right on the head when it comes to acute care.

Since I have also worked as a hospice nurse, I was surprised to see the results when table are turned. So I want to share my experience with you here to drive home a very important point.

In hospice, CMS (Center For Medicaid and Medicare Services) states that the RN supervision of the care team is integral. Without the RN the companies will not be able to meet the CMS requirements and therefore will not be able to bill and get paid for the services provided. Yes, not an MD (who, until recently, were not even required to make visits at all) but an RN.

So now the RNs become the revenue generating, lead care providers and case managers. Nurses become the face of the company and the care provided. People choose a hospice agency based on the promises by the marketers about the excellence of care, number of RN visits and the care by support staff such as CNAs, SWs and Chaplains.

The medications and tests ordered by a physician are based on an RN’s assessment. Her recommendations are also a key factor in deciding not only the medications a patient receives but also the number of visits by CNAs, therapies approved etc. We can also ask the SWs and Chaplians for more frequent visits if needed.

It sounds like a very empowered role especially because we not only manage all aspect of care but are also the revenue generators. You’d think that in this scenario, nurses would be treated fairly and would reap the benefits of their hard work in better work conditions and more pay. Unfortunately, the opposite is true.

A lot of hospices, including one of the biggest in USA (I worked for them for a few months), take this revenue generating power of the RNs to manage them like work horses. The more patients they see the more money for the company!

This brings me to a very important point. I believe, the current condition of the nurses and the nursing profession is because of a lot of factors including the fact that we have never stood together as a profession to speak up for our own rights.

Because nurses have not been united we have been an easy target for exploitation.

A clear example is how Amanda Trujillo’s case has been given a silent treatment by a lot of nursing organizations and how AZBON has handled it. We got a response from ANA only recently because of the pressure of nurses beginning to rally together.

Unfortunately, the oppressors in nursing are not just the outsiders but also a lot of fellow nurses in leadership positions and those who stand on the sidelines or hide when they see a fellow nurse being treated unfairly.  

Nurses are well positioned to be bold, well informed and fierce advocate for the patients. We are our patients' (and their loved ones') eyes when they are unable see clearly, we are their ears when they can not hear and we are their voice when they can not speak for themselves. That is why Florence Nightingale was the lady with the lamp!

How can we advocate for them if we are in constant fear of retaliation and punishment for speaking up for what is right? It is about time we claim our right to protect and advocate for our patients by being a fierce advocate for oursleves, our profession and our fellow nurses. 

You don't have to do much, just show your support for change in nursing and in your own life and help one more nurse to do the same

For a long time now nurses have been forgetting to put their own oxygen masks first. As a result, we have run out of breath. The high burnout and attrition in nursing is a clear proof of this. It is time to change that.

If we really want to change the work conditions for ourselves, if we really want to be recognized as partners in healthcare, it behooves us to rally together now. Organize events, draft proposals and do everything necessary.

We do not need even a single politician behind us. Our sheer numbers and our unity is enough for everyone to take notice. And, once they take notice, we will have to be very alert to make sure that no agreement is reached unless it is exactly what our profession needs and deserves.

The question is are we ready and committed to rise up to the challenge?

I implore each and every nurse to rise up and take action. Show each other and the world that nurses support and take care of their own. Show your support for yourself, your profession and for Amanda Trujillo by signing the petition below now!

This is just the beginning. It is one of the very first steps, an exercise in coming together. We are going much further from here. But we must do first things first. Let's rally together for Amanda Trujillo who is bold enough to refuse to let her patient suffer and let herself be bullied.

Petition to Arizona Board Of Nursing: remove Amanda Trujillo's Nursing License From Under Investigation Status

A few years from now when the story of nurses' uprising and revolution will be told, will your name be among the ones who stood on the sidelines or will your name be among those who walked the walk and changed the face of nursing forever?

The choice is yours!


Yours in love, peace and gratitude

Shahina Lakhani

Shahina Lakhani RN MSN Author, Poet, Speaker, Expert Holistic Life Change Strategist. She advocates using holistic strategies in personal empowerment, care of the sick, the dying and their loved ones. Shahina Lakhani has been a nurse for more than 25 years. She has worked as an educator, Nurse Practitioner and a Hospice Nurse. Her passion is to empower people to Live Powerfully and experience Wellbeing until their last breath.


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{ 4 comments… read them below or add one }

Diane DP

I don't know this firsthand, but I would guess that part of the burnout factor for nurses is related to the very reason people go into the profession in the first place: they are caretaker personalities. But you can't be a giver all the tiime, that gets mighty exhausting.


Sherry Iqbal

Hi. Shahina your work is commendable. I want to participate as well.
Cares and good luck
Sherry Iqbal


John Kauchick,RN,BSN

You took the words right out of my mouth. I have advocated  billing for nursing services in acute cure for that exact reason. So we are seen as human capital and considered equals. I have written emails to many people of influence. The ones that can turn the tide is the media. Sadly, they write up what MD say or if a nurse has killed a patient. Amanda's case has great potential to rally us and break down barriers. I have also campaigned for nurses legal defense fund. ANA will have none of it.


Shahina Lakhani

Yes John ANA will have none of it for sure and media also is not willing to see nurses as anything of importance. So many medical based dramas hardly ever show nurses making a difference. I admire your desire to make a difference. Lets talk more on this. Please email me and let us talk more.


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