Jehovah's Witness nurses in the critical care unit?

[asdf88]

Hello

This is my first time posting a thread. I was just wondering if anyone is or knows of a Jehovah's Witness nurse who works in a critical care unit. Also if you dont mind can you tell me at which hospital? The reason I am asking is that I am also one of Jehovah's Witnesses and I just passed my NCLEX. Yay I really want to work in the critical care unit, specifically the CCU. However, when I explained to the supervisor of the ICU/CCU about the issue with the blood transfusion, she said she couldnt hire me on to the critical care unit. Yes, this hospital is offering critical care positions to new grads. I was really devastated because i wanted to really work in the CCU. So I was wondering if it's the same for other hospitals. I explained to the supervisor that I am willing to care for the patient who is receiving the blood transfusion, but that I would need a second nurse(most likely the nurse who would be verifying the blood with me) to spike the blood and press the start button. I do understand why the critical care environment may not want to have a nurse who cannot initiate the blood transfusion. So I was just wondering if I do not have a chance at all in a critical care unit. For now I am orienting in the med-surg floor and I still have lingering feelings for the critical care unit.

Thank You

[cutekittenj]

I don't see why any JW would have a problem simply with "checking off" anything. It's actually spiking the blood that many JWs face a dilemma with.

From my understanding it would be like your supporting blood transfusions. So in turn that would make one a hypocrite. It'll be like "So you won't spike the bag but you'll sign off on it?" See what I'm saying. In order for them to be total against blood transfusion it has to be the whole nine yards. Can't be in between. Like a person who wants people to quit smoking however when a friend ask them to go to the store and buy cigarettes. Now the two individuals know that he is against smoking however people from the outside would be like "what in the world.....i thought he didn't want people to smoke? What kind of example of that"? Even though it is a different situation I believe the same principle applies in that it would make the person seem like a hypocrite. (At least this is how it was explained to me)

[MunoRN, RN]

I agree it's sort of irrelevant whether or not the blood ends up getting hung, because there is a bigger premise here. I think the overall premise that Nurses must be able to separate what they would want done for themselves, religious beliefs, opinions, etc. and their role as patient advocate is too important to allow for such egregious exceptions. As a nurse, you are expected to assess and understand the patient's beliefs and priorities and then advocate for that, if you instead choose to ignore the patient's beliefs and priorities to better accommodate your own, you have no business being a nurse, even if you can find a position where you are not expected to hang blood.

In terms of legal accommodations, I don't know of a case that fits this exact scenario, but courts have not upheld a healthcare workers right to abide by their religious beliefs in a manner that affects patient care, the best example I can think of is that of pharmacists who refused to dispense the morning after pill on religious grounds; the legal conclusion was that they must dispense regardless of personal beleifs, they do have choice in that they can choose another career.

Plan B Pill - Pharmacists can't refuse Plan B pill, appeals court says - Los Angeles Times

[Belle Epoque]

You're talking about a scenario that shouldn't even happen. There should be a system in place so that nurses who are willing to hang blood get the blood hung in an expedient manner. I can't imagine any Witness nurse deliberately interfering with the process at the cost of a patient's life. Witness nurses value the lives of their patients just as much as any other nurses do, and to suggest they don't is offensive and has a whiff of bias.

For that matter, most of the Witness nurses I knew who felt that strongly about the blood issue chose to work in areas where transfusions were a rare event.

Your interpretation is far too "perfect world" to hold much credibility. Sure it would be ideal if blood is always hung in an expedient manner no matter who is working but that just isn't always reality. If a JW's patient needs blood it is HER responsibility to ensure these orders are carried out, not another nurse who happens to be working the same shift. Maybe she'll find someone to help, maybe she won't. But that's irrelevant. As the nurse assigned to care for that patient, she is ultimately accountable and liable for all nursing care provided to that patient. If she cannot provide the care needed, then she shouldn't be the nurse. Period. And that applies to anyone unable to provide appropriate care because of personal or religious reasons. Patient is first. You, the nurse with your own individual ideologies, comes second.

And as for the suggestion that JW's don't value the lives of their patients, that is your mention, not mine.

In case you missed it, the original poster was asking about working in CCU so I highly doubt transfusions would be a rare event.

[cutekittenj]

I agree it's sort of irrelevant whether or not the blood ends up getting hung, because there is a bigger premise here. I think the overall premise that Nurses must be able to separate what they would want done for themselves, religious beliefs, opinions, etc. and their role as patient advocate is too important to allow for such egregious exceptions. As a nurse, you are expected to assess and understand the patient's beliefs and priorities and then advocate for that, if you instead choose to ignore the patient's beliefs and priorities to better accommodate your own, you have no business being a nurse, even if you can find a position where you are not expected to hang blood.

In terms of legal accommodations, I don't know of a case that fits this exact scenario, but courts have not upheld a healthcare workers right to abide by their religious beliefs in a manner that affects patient care, the best example I can think of is that of pharmacists who refused to dispense the morning after pill on religious grounds; the legal conclusion was that they must dispense regardless of personal beleifs, they do have choice in that they can choose another career.

Plan B Pill - Pharmacists can't refuse Plan B pill, appeals court says - Los Angeles Times

This is definitely a sensitive topic because of all the different views and you bring out good points. However it really is a shame to say that JW's can't be nurses b/c they are great nurses. I honestly don't agree with a lot of the comments saying they need to choice a different profession because nursing isn't all about blood transfusions. I love people really do care about their patients but I'm sure a JW would too they just don't want to transfuse blood. It really isn't that big of a deal to find someone else(especially in a CCU) to help out with that. The reason I say this because CCU is all about team work or at least on my floor. We help each other out. Hasn't been a problem on our floor with the JW not administering blood. Since we are all aware of that we make adjustments. We help her out and when we need something she helps us out. I do understand how you feel but I understand where the person who came up with this thread is coming from.

[carolmaccas66, BSN, RN]

The topic was working was a JW in a critical care unit; not your personal beefs with the religion.

Yes but JWs and other religious people are bringing their religious beliefs into the work situation. This is becoming more and more of an issue at people's work, and one I don't think is being addressed by nursing management, or the nursing community in general. And it's a very intersesting, and thought provoking discussion.

Some people see their religion as a separate thing from work, others don't. I was only telling some personal stories to give people information re JWs. If you don't want to read the information, that is your choice. My choice was to post this info for everyone so they can try to keep an open mind. Many people post personal stories on here, so no, I'm not the only one.

Not all JWs are bad, or evil or fanatical. I was only telling you my personal interaction with them. And yes I do know re JWs and critical care units. If someone is in an ICU for example and needed blood, the WHOLE JW community - family, friends, elders, lawyers will become involved - it is not just about one person wanting to work or becoming a patient in an ICU. You as a nurse will have to become involved with the whole JW community and family, and that can be very difficult, especially when u have family members in the JWs as well.

I was just trying to give people a bit more of a dose of reality re JWs and MY ACTUAL experiences with them, critical care or otherwise.

[DoGoodThenGo]

I agree it's sort of irrelevant whether or not the blood ends up getting hung, because there is a bigger premise here. I think the overall premise that Nurses must be able to separate what they would want done for themselves, religious beliefs, opinions, etc. and their role as patient advocate is too important to allow for such egregious exceptions. As a nurse, you are expected to assess and understand the patient's beliefs and priorities and then advocate for that, if you instead choose to ignore the patient's beliefs and priorities to better accommodate your own, you have no business being a nurse, even if you can find a position where you are not expected to hang blood.

In terms of legal accommodations, I don't know of a case that fits this exact scenario, but courts have not upheld a healthcare workers right to abide by their religious beliefs in a manner that affects patient care, the best example I can think of is that of pharmacists who refused to dispense the morning after pill on religious grounds; the legal conclusion was that they must dispense regardless of personal beleifs, they do have choice in that they can choose another career.

Plan B Pill - Pharmacists can't refuse Plan B pill, appeals court says - Los Angeles Times

Will give you that, things are going to vary on the ground according to what type and or sort of healthcare "worker" or provider we are speaking about.

Pharmacists running their own stores are not the same as nurses or doctors for that matter, employed by a facility/hospital.

A hospital's first and foremost duty is to the patient and his/her safety. Refusing a direct order to provide care under one's scope of practice can open you up to anything from being written up for insurbordination, and or termination. Each of these choices can also expose the nurse in question to legal action (patient and or facility), and perhaps a report to the state BON.

The nurse in the above cited example seemed to want her cake and eat it as well. After refusing to participate in providing nursing services she deemed equal to abortion (against her religous values), she then refused a transfer to a NIC unit because amoung other reasons it may have required her to prolong a life that clearly (in her view) was ending/ended. This nurse wanted to remain on her current critical care unit, but expected the hospital to go out of it's way to make sure her religious views would not ever be compromised. After enough going back and forth with their employee, the hospital simply the nurse. After all the legal dust was settled the courts ruled that an effort at *reasonable accomodation* of nursing staff (at least in this instance), was met, and that nurses (again at least this situation), do not have the rights to make a hospital jump through hoops to suit their values.

It is not an closed secret that many Phillipine nurses with strong RC values prefer to work at Catholic hospitals here in the USA, where there is little to nil chance of them being called upon to participate in anything remotely like abortion. This includes the frequent and often made request by women undergoing C-sections to have their "tubes tied" at the same time.

As the landscape of healthcare/hospitals in the United States shakes out via mergers and take overs, look for the issue of religous beliefs and healthcare workers to move more to the forefront. You have RC/religous hospital systems taking over secular ones and vice versa. Each time this happens there can be a culture shock, especially for doctors and nurses who normally have the most direct patient care contact.

[Belle Epoque]

Will give you that, things are going to vary on the ground according to what type and or sort of healthcare "worker" or provider we are speaking about.

Pharmacists running their own stores are not the same as nurses or doctors for that matter, employed by a facility/hospital.

A hospital's first and foremost duty is to the patient and his/her safety. Refusing a direct order to provide care under one's scope of practice can open you up to anything from being written up for insurbordination, and or termination. Each of these choices can also expose the nurse in question to legal action (patient and or facility), and perhaps a report to the state BON.

But like nurses, pharmacists are also regulated health professionals and have moral obligations in return for the trust given them by society, regardless of whether they are hospital employees or self employed individuals.

They are still obligated to act in the best interest of and advocate for the patient, observe the law, uphold the dignity of the profession and practice in accordance with ethical principles and their standards of practice. Instead these pharmacists are allowing their own personal biases to interfere with the code of ethics they promised to uphold when they signed up to be a pharmacist in the first place. Refusing to dispense that pill is in the best interest of the pharmacist, NOT necessarily the best interest of the patient. That is just plain wrong, and I hope that ruling is upheld.

[Ruby Vee, BSN]

actually, it's immaterial.

transfusions require the verification of blood by two nurses. your critical care scenario doesn't pass muster because there would be at least one nurse in the scenario who could hang the blood. the one who objected to hanging the blood could still verify the blood.

i'd be interested to see if anyone could come up with an actual case where someone died as a result of a jw nurse not hanging blood on a patient. no hypothetical scenarios, i mean a real case of a patient death.

i am not advocating one way or the other. i am only talking about what i have experienced in my own career. it's certainly not workable if there is not cooperation on all sides. personally, i wouldn't go into areas where transfusions are highly likely if i didn't feel comfortable giving them. there are too many misconceptions out there to have to work around, and it could lead to difficulties with co-workers.

transfusions require verification by two licensed persons: 2 rns, an rn and an np, pa or md all work. in the latter case, the np, pa or md wouldn't be hanging the blood or "pressing the button" because they have other responsibilities. so the nurse had better be prepared to do so.

last night i hung 103 units of products on my patient -- we had two nurses and an md working on her at all times. if one of the nurses had not been willing to spike the blood -- whichever of us was on the side of the bed that had the nearly empty blood bag -- we would have fallen seriously behind. since she was bleeding upwards of a liter an hour, a delay in transfusing would have been critical.

i don't know any jehovah's witness nurses personally, but i can assure you that i have no interest in working with someone who will not hang blood and monitor the transfusion -- for any reason. if you're not willing to do so, you do not belong in a critical care unit.

[Ruby Vee, BSN]

hey thanks for the question. it actually happened to me first hand. they asked if i wanted a blood transfusion and i refused because i hate receiving blood that is not my own. they told me i would die if i didn't get one and i was like you can just use fluids. and when i needed one they gave me fluids to expand my blood it worked out really well because i didn't die like they said i would. now on a sad note i had a cousin who received blood(said he would die without one) and he was allergic to it and died even though he had one.

so i do see your point and understand why people my feel uncomfy about the whole thing but my i think you whatever a person believe in should not go against their religion. i do understand both sides of it and your point but for someone to say that a person will die without one is unreasonable and it is unreasonable for someone not to work at a certain place for what they believe in and for people to encourage them to something contrary to what they believe is right. kinda see where i'm going?(and not knocking what you said in no way because i do see where you are coming from but just having real life experience on the exact opposite on a blood transfusion not working for my cousin has me thinking how good are the blood transfusions really)

come back and talk to us when you have some actual critical care nursing experience. i can guarantee you that if someone is bleeding liters/hour not having a transfusion in a timely matter may cause them to die. your life experience is interesting, but not meaningful to this discussion.

[Ruby Vee, BSN]

this is definitely a sensitive topic because of all the different views and you bring out good points. however it really is a shame to say that jw's can't be nurses b/c they are great nurses. i honestly don't agree with a lot of the comments saying they need to choice a different profession because nursing isn't all about blood transfusions. i love people really do care about their patients but i'm sure a jw would too they just don't want to transfuse blood. it really isn't that big of a deal to find someone else(especially in a ccu) to help out with that. the reason i say this because ccu is all about team work or at least on my floor. we help each other out. hasn't been a problem on our floor with the jw not administering blood. since we are all aware of that we make adjustments. we help her out and when we need something she helps us out. i do understand how you feel but i understand where the person who came up with this thread is coming from.

there are ccus that are actually critical care units, and there are ccus in smaller hospitals who actually don't get that many critical patients. sounds as if you work in the latter. believe me, it would be an issue in the former.

[CrazierThanYou]

I am trying to imagine myself in an emergency situation, where every second counts and in the middle of all the hustle and bustle saying "Oh sorry, I can't spike this bag. You'll have to find someone else". I just cannot imagine it.

[PMFB-RN, RN]

last night i hung 103 units of products on my patient -- we had two nurses and an md working on her at all times.

*** wow, tough night.