Do i have the right to be excused from being present during circumcision?

  1. Hello everybody, I'm looking for advice, so please be understanding and i want to warn before hand that i am not here to start a debate.
    here is my problem: I found out that during our nursing classes we will be working in neonatal unit and part of the learning will be being present during circumcision.
    I want to ask my instructors to be excused from that, but i'm afraid i will get a "no".
    circumcision is very traumatic for me emotionally, especially after learning everything that i know about it. I can deal with death, i can deal with pain for a good cause, but there is nothing i can change about the way i feel about cirumcision.
    I never impose my views on anyone, i just don't want to see it again, because the last time i saw it i was upset for months and to this day i can not for get it - it's been 3 years.
    For those who can not understand my position - picture yourself training to be a nurse in Africa were FGM is a common practice in some cultures.
    Well, enough said.
    Please, advice me what is the best way i can bring up this issue during my upcoming interview with a nursing staff member and if someone knows anything about NY laws, i would greatly appreciate your advice.

    thanks. Nat
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  2. 26 Comments

  3. by   MollyJ
    Nat, you need to have a discussion ahead of time and perhaps LOTS of extra support when/if the time comes and time process your past experience and any future experiences.

    Technically, circumcision is a procedure that you may well see ONLY in your clinical rotations and then never again BUT I might anticipate that you will have a similar reaction TO ANY coercive or difficult procedure. These could include:
    Procedures on children where they have to be restrained--putting in IV's, sutured, etc;
    urinary catheter insertion in a young child;
    Rape exam on a child or young teen;
    Supporting a young teen through a first pelvic exam;
    Supporting a mentally retarded adult through invasive exams;
    Any procedure where the person is not fully alert and doesn't understand the procedure or the necessity for the procedure and maybe struggles or calls out.
    While all of these exams can be skillfully done by skillful practitioners OCCASIONALLY they end up being difficult procedures for patient and staff alike.

    So avoiding circumcision may not let you entirely avoid the distress you experienced at watching a painful and invasive procedure done on a weak or unpowerful person. I would judge that to be a central concern for you. Do talk to your teachers and be candid with them. Good luck.
  4. by   PCT_Nat
    Molly, thank you so much for responding.
    I guess there is no easy way out of it.
    i thought many times about what u are descriving about IVs in babies, rape, etc.
    I've been through so much personally and I have seen so much from working in inhumane conditions in a hospital in russia. I watched my own baby being stiched, I witnessed/experienced plenty of suffering from medical procedures, but when a patient being treated for a desease or a medical condition it is a totally different story in my eyes, but i'm sure very few share my understanding of circumcision.
    I know what u mean though - i can;t run away from it. I just hope there is something i can do.
    The hospital where i work and will practice does not do abortions because of their religious point of view, which is one other thing i'm glad i won't have to look at.
    I'm hoping that (even though my position on circ has no religious background) they will understand me.
    thanks for your help
  5. by   P_RN
    Nat,

    I have been reprimanded and almost suspended for refusing to participate in an abortion. It made it to the state board of nursing who upheld my right of conscience.

    The nurse manager knew beforehand of my position, in fact we were in the same class in nursing school. That didn't matter, she told me I had to do it and I told her I would NOT do it.

    If you stand your ground, you may get grief from people, but you will know in your heart what is right FOR YOU.

    P
  6. by   Agnus
    Speak from the heart to you nursing insutructor. Tell her why you don't want to do this. Seeing a circ. is not a critical issue. You can be a great nurse without experiencing this. Tell her of the inhuman experience you have had in Russia. It may be a cultural education for her, and I believe will win her compasion.
  7. by   MollyJ
    Nat,
    For people who don't understand what FGM stands for--it is Female Genital Mutation. This is female circumcision and is part of religious tradition in some cultures. I believe it was the NACOG journal that had an excellent series on this a few years back. Reading about it is horrific and a challenge to all trans-cultural nurses is deal with your own feelings about it so that you are not expressing your revulsion in a way that alienates the patient or the family.

    Culturally, it is a problem that causes nurses to pause and say, "How is this different from circumcision on little boys? How is it alike?"

    Frankly it sounds like you have some background that lets you know that sometimes health care involves difficult situations for all. Proceed forth, but I would still find someone I could process this issue with.

    Good luck.
  8. by   Shevalove
    Hi there,
    I do sympathize with you. Like the other posters said, have a good talk with your instructor. Our instructor was wonderful and she tried to get us to be a part of all different experiences, but never forced us to endure anything we did not feel comfortable with. I wish you luck.
  9. by   mattsmom81
    Part of being a nurse involves projecting a nonjudgmental attitude towards people who we may not agree with on a moral or religious level. You will encounter many situations that will test your tolerance....but that is the life of a nurse.

    The fact that this procedure is troubling you so much suggests to me you may have trouble accepting other's belief systems if they differ from your own....we really can't do that and be an effective nurse and I hope that you take this to heart and explore your feeling thoroughly...as other posters have also suggested. Best wishes to you, I hope you work through this.
  10. by   hapeewendy
    there are definitely these "rough patches" and unpleasant things in nursing.
    Personally I'm not morally opposed to many things but I too have had hard times and been subjected to things I really didnt want to observe
    you have gotten some great advice here an I would just echo it by saying that its very good that you know that something is bothersome to you and take the time to acknowledge it and not just fall to the expectation that you will readily if not eagerly partake in all aspects of nursing.

    it doesnt matter what we all feel about circumcision, youre right, its not a debate, your uncomfortable and thats whats important
    talk to your instructor, talk to other instructors ,just get it out there for discussion

    I remember doing my OB rotation , and a lady had had a prescheduled termination of pregnancy for genetic reasons (IE- baby's malformations would be incompatable with life etc)
    and while I didnt want to be anywhere around to see the procedure, the instructor agreed with us that probably it wasnt a good idea to subject us to this before we had proper teaching on the subject (at this point we were 2nd year students)
    so we all felt comforted and happy that we could escape it, cept we couldnt, because they had placed the fetus in the supply room by the sink of all places, thats where the nurse was planning to examine the fetus , weigh it etc, but we werent told
    so sure enough three of us go in giggling, joking about something stupid and see the fetus layin there by the sink *nurse had stepped out to stamp up the paperwork* it was horrific and traumatizing
    the goal is to avoid that feeling if you can

    on the other hand , during my pregrad I worked on a gen surg/gi/gyne onc floor that did genetic terminations , and they handled it well, very supportive to the patients, social work and pastoral care involved etc......like night and day from my first experience
    good luck!
  11. by   PCT_Nat
    hey guys!
    A bit of news - I found out that a girl who will be taking the same classes with me at the same time also is uncomfortable with viewing the procedure for the same reasons I have. I think it might be easier if i'm not alone.

    Happewendy - can completely relate to your experience with the fetus. The first time i saw an abortus in hospital environment i was only 9 years old. Like i said - I've experienced more than an everage person needs to know before they reach maturity. The second time it was my own, a victim of nature's caprice.

    Molly and Mattsmom - I mentioned earlier that I do not impose my views on anyone. and if this is what I do, then views of others should not be imposed on mine. Just because american society considers circumcision to be a social norm, it doesn't mean that I must accept it and go along with it. I now this is a difficult subject to discuss and I appreciate your input.

    Mattsmom, i understand what u are saying when u wrote:

    "The fact that this procedure is troubling you so much suggests to me you may have trouble accepting other's belief systems if they differ from your own....we really can't do that and be an effective nurse "

    But I am just curious if you would have trouble accepting a little girl being circumcised in front of you and if you would, would u feel that your reaction would prevent you from being an effective healthcare professional?

    I enjoy exchanging messages with all of you, it is a good experience , thank you again for visiting this thread
  12. by   Agnus
    You might be interested in knowing that Under current professional standards, performing circumcision without approprate anesthesai is unethical.

    The American Society of Pain Management Nurses recognizes that neonatal circumcision is a painful procedure and opposes
    the participation of nurses and other health care pofessionals in the performance of male neonatale circumcision without an anesthetic to treat the pain inherent in the procedure"

    A local anestetic is used. There fore I am sure that if a doctor refused to use such an anestitic she will support you in your refusual to participate or observe.
    IF she fails to support you, the issue should be brought up before both the school and hospital ethics committee.

    P. S. FGM in anyform is also considered unethical and ILLEGAL in this country and is not performed by any ETHICAL physican or hospital.
    Yes there are times when it is requested to put a woman's "mutilitation" back as it was after she delivers a child. This presents a ethical delimia. Especially if the woman is insisting on it herself.
    I do not Know what the ethical standard is on this particular situation in this country, but I would guess it is to not do the proceedure. Yes, some doctors will do it.

    The difference with female mutilitation is that is routinely causes seriously health and medical problems. Aside from the basic cruelty involved. Im males ther are basic 2 problems. Infection immediately after the procedure and decreased sexual sensation as the head of the penis becomes a little sensitized due to constant over stimulation from friction on clothing. The problems with females are much more extensive and serious. (both proceedures reamain contraversial
    Last edit by Agnus on Apr 13, '02
  13. by   NannaNurse
    To me, this would almost be a 'religious' matter and I would cite it as such.
    Regarding the nurse who had to take her views all the way to the Board of Nursing about viewing an abortion......I would NOT, under any circumstance be part of that. Not now, not ever!
    I would not let ANYBODY attempt to tell me that I did. I would find another profession if I had to.
    Nat, stand firm in your belief!! I'm behind you all the way.
  14. by   mattsmom81
    I am not here to argue with you, Nat. To answer your question, I would not practice nursing in a country that practices female genital mutilation. The fact that circumcision is a religious practice in this country comes under 'respect for another's religious beliefs'.. I may not agree with it, but I must respect it.

    Application of topical anesthesia should eliminate discomfort for the infant so I cannot justify refusing to assist and care for a post circ infant since it is a basic nursing function in newborn nursery....

    The fact you were irritated by Molly's and my post may suggest you need to look further into your feelings and possibly control issues. Are you in nursing school with a personal agenda to effect another human being's value judgments? To stand up and protest another's very personal decision? Do you truly wish to help others, even if you don't agree with what is happening in all cases, and can you respect another's choice if it is not your own?
    My reasons for asking are not argumentative:

    1) You may find nursing to be quite stressful for you if you can't deal with situations you disagree with morally or ethically.

    2) You will not be a helping presence if your judgmentalism is displayed to your patients and coworkers.

    You need not answer me, Nat, but I do hope you ask yourself . Good luck to you in any case...I wish you well.

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Do i have the right to be excused from being present during circumcision?