Doctor Asked For A "Kind" Nurse - page 6

Let me preface this thread by stating a few things: 1. I'm not posting this thread to bash certain religions, I'm posting to vent, gain understanding, and get a variety of views. 2. Whatever... Read More

  1. by   zudy
    I worked a trauma once on a 22 yr male, he was a JW, unconcious, his parents refused to let him take any transfusions. I believe he would have died anyway, he had such severe injuries, but it was still an extremely tough situation on everyone concerned. I don't know what the answer is. All I could do was try and put myself in that mothers shoes, and know that I could never do anything to my child if it was in my belief that I would be causing that child to sin. All we can do is what LVRN did, ask questions and try to understand each other.
  2. by   caroladybelle
    Originally posted by fab4fan
    There are many alternatives that are acceptable. Procrit and Epogen are among the newer drugs used, very successfully, for that matter. There are other things that can be done, such as hypothermia, hyberbaric O2, and others. I was glad to see someone mention something that should be obvious, but often gets overlooked: microsampling when labs are needed.

    Thanks for bearing w/ me on this...got a little hot under the collar last night.
    Are volume expanders - Hespan/Dextran - permitted? Just curious.
  3. by   montroyal
    Originally posted by LasVegasRN

    My main point: I'm hoping someone could explain to me, how in the world can you stand by and allow your child to die?

    Harsh question, and I'm sure an age-old question, but I do not and can not understand it. [/B]

    In order to understand a question such as this, you must look at it from the families point of view and not from yours which is predjudiced by your beliefs and upbringing. This can be difficult if not impossible for some people. The most important part of this issue is tolerance. Being able to accept the families beliefs and following their wishes is an important part of nursing. You don't have to agree with those beliefs, just accept them as this families and work within those beliefs. By doing this, we are showing our respect for their ability to choose what they believe is best for the patient while still maintaining our role as caregiver.
    Last edit by montroyal on Mar 25, '03
  4. by   fab4fan
    Originally posted by caroladybelle
    Are volume expanders - Hespan/Dextran - permitted? Just curious.
    Yes
  5. by   sjoe
    fab writes: "sjoe: There are no "other branches" of JW...any people that have separated and formed variations of the faith are considered apostate."

    And these branches consider those who consider them to be apostate to themselves be on the "wrong track," which is exactly what I said in the first place. The same hold true in ALL religions and cults (and political parties, on and on).

    (BTW, I edited a previous post, since Vegas had later advised that this patient was age 18. If that patient had not specified in advance directives that transfusions, etc. were desired, the hospital appropriately, IMHO, followed the desires of the next-of-kin. My previous comments had been addressed regarding the health care of a minor.)
    Last edit by sjoe on Mar 25, '03
  6. by   SmilingBluEyes
    I am not wise.......I have NO great words of wisdom here. I also am not "kind" I guess. Cause I could NOT stand by and watch this as an RN or mom...ever. I would have to refuse that assignment even at the risk of losing a job, if court intervention was either not sought or failed..... I just would. I guess I am simple-minded that way. To me, it is immoral what is happening in that situation.
    Last edit by SmilingBluEyes on Mar 25, '03
  7. by   obillyboy
    The golden rule..........Do to others .. well you know how it goes.
  8. by   LasVegasRN
    So many points to respond to.

    First, Fab, thank you for taking the time and the risk of attempting to shed some light and understanding on this issue. As a parent and a nurse, I would have to agree that I would have to refuse this assignment. I don't think it would make me "un-kind", just that I couldn't participate in the case. I'm fortunate because I'm not directly involved in patient care and don't have to make that decision.

    Second, Hospice is a viable option in this case for the following reasons:
    - Unable to do the EGD for the reason Caroladybelle gave. The GI specialists refuse to touch this case with a Platelet count of 14.
    - Hespan is not going to save this person, nor will the other volume expanders
    - All the Procrit, Reglan, Protonix, etc is not going to save this patient.
    - With hospice, the patient can have comfort measures and all the time needed with her family.

    Pedi-tubes are being used for blood draws.

    My next question and consideration I may have to discuss with the docs on the case today is DNR status and if I should proceed with a Hospice evaluation. It will be a sensitive issue to approach, but I have to consider it the same as with any patient who makes decisions to withdraw or not have life sustaining measures. Thoughts?
  9. by   LasVegasRN
    Originally posted by obillyboy
    The golden rule..........Do to others .. well you know how it goes.
    Not that simple. I would do whatever is necessary to save my child. Period.
  10. by   SmilingBluEyes
    Originally posted by LasVegasRN
    Not that simple. I would do whatever is necessary to save my child. Period.
    I have to agree. It is NOT an issue that can be simplified with such a pat line. WAY too complicated. I am not wise or kind...just a mom and an RN with a strong opinion, like everyone else.
  11. by   Hooligan
    I believe if God gives us the ability to comprehend, understand, and share the limited healing powers He entrusts us with, it is a sin not to use them.

    I could not agree more!!! It reminds me of the joke about the the religious zealot in the flood...this is not to make light of the original post in any way but to further explain my believe... the premise is that there's a man stuck on his roof pleading to God for help during a flood. After a short while along comes his neighbor paddling by in a home built raft and offers help. The man politely refuses and replies "my God will save me" and he continues to pray to God for help. A while later the water has risen even higher and a rescue worker in a power boat offers his assistance and again the man refuses saying "thank you but no, my God will save me!" The rain continues to fall throught the night and the water has risen so high that the man is crouched upon the chimney shivering and wet and still pleading for God to save him. Shortly before dawn, the Coast Guard flies by in a helicopter and sends down a ladder for the man. Once again, he refuses and declares "my God will save me!" Unfortunately the man is overtaken by the flood and dies. Upon entering heaven, he asks God..."Father, why didn't you save me?" To which God rolls his eyes and replies..."For Pete's Sake, what more do you want? I sent you a raft, a power boat, and a *******' helicopter..."

    I personally believe we have acquired our knowlege for a reason and if we werent meant to use it, we wouldn't have it!

    ~Bean
  12. by   ayemmeff
    Originally posted by bean 76
    I personally believe we have acquired our knowlege for a reason and if we werent meant to use it, we wouldn't have it!

    ~Bean
    Are you including our knowledge of the development of WMD etc. in that?
    Not flaming you,just curious?
    It sounds a little to me as if you are implying that humans don't have any choice and any knowledge we have *must * be used.
  13. by   LasVegasRN
    I don't feel comfortable sharing too many details of this case - I don't want to tread on confidentiality issues, but at this time the patient has a new diagnosis and the physicians are discussing transferring the patient to a facility that is used to handling cases such as these. The Hgb is down to 5, petechiae is there, and now questioning intercranial hemorrage in addition to everything else.

    I was involved in the physicians conference and all are extremely frustrated with this, but are handling it professionally (I really have to commend them). We have the house ethics nurse involved and I'll get started researching facilities. :stone

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