Doctor Asked For A "Kind" Nurse

[LasVegasRN]

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 your belief, please respect the beliefs of others.

That said, I admit to not understanding how parents can stand by and watch their child bleed to death.

Teenager, throwing up blood for 2 days, H & H 6.1 and 17.0. Platelets 14. WBC 1.0. Pancytopenia. A religion that does not allow blood products or transfusions. Essentially we will be watching this patient die. As the majority of us know, some fresh frozen plasma, units of packed cells, the ability to SAFELY do an EGD and the patient would be discharged home in about 2 days.

Instead, in 4 hours when the next CBC was done, the Hgb was down to 5.8.

I overheard the attending doc asking the charge nurse to assign a "kind" nurse as this was a "difficult" case. I felt that was unnecessary, because as hard as it is for all of us to watch this, we still treat the patient and family with compassion.

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.

[Aussienurse2]

:roll :roll

I am a missionaries kid!! Maybe that is why I feel so strongly that religious beliefs be upheld though. I nurse with empathy, not a widely held belief these days I know because of the problems of transferrance, but I do try to stop for a minute when I nurse someone whos beliefs get a rating on my " What the?" meter and think, well if it was me and I have so little control in these walls and I'm scared to death that I wont enter Heaven what would I want to happen?

[emily_mom]

BTW, thank you for sharing your views with us Fab4. Education is the greatest way to understand.

[montroyal]

Originally posted by 911fltrn

As an 18yr old the patient has the right to make this decision. Its my belief however that if this was a minor the doctor should transfuse the child and involve child health and welfare services.

Everyone is entitled to their own beliefs but should never force those beliefs on others. Religous beliefs are very personal and should never need explaining. The US was formed on the principal of religous freedom and tolerence, and to deny anyone this right only goes to weaken our society.

As far as why bring them to the hospital, how about to make the patient comfortable and to give support to the family. If we begin to question JW's, why not begin to questions families who bring DNR pt's, or smokers, or obese pts. These pt's have a lifestyle which some of us may not agree with or if changed may result in a different medical outcome. At what point do we as a society start or stop making medical decisions for others? Medicine and Nursing are a science which offers options to people. It is up to the individual or parent to choose which option works for them or their loved one. Just because an option is available, does not mean we can force that option on a patient.

[OBNURSEHEATHER]

Originally posted by fab4fan

Wow...I could reply to this, but only if bashing stops. What was said about JW was inaccurate.

Originally posted by Sunnygirl272

what bashing? and please correct the inaccuracies?

I thank you fab for sharing your insight here. But I'll agree with Sunny that I saw no bashing. Pretty gentle comments of a lack of comprehension are all I saw.

To say we don't understand how someone can do something doesn't mean we condemn them entirely. No matter how educated I am on the matter, it will always be something I cannot fathom. Respectfully. :)

[fab4fan]

I won't go into specific posts, but there were some that, if not bashing, were on the verge of it. That's how it came across to me, anyway.

I can appreciate that this is a very emotional issue for some; speaking personally, I would not want someone to violate his/her conscience in order to care for me. If someone felt uncomfortable caring for me or my family, I would prefer that individual not be involved in my care...I don't want anyone doing something he/she feels is wrong.

Perhaps that's what this doctor was trying to convey when he asked for a "kind" nurse...he might have meant someone that wouldn't be uncomf. I don't know what his actual intent was, but it seems like he had the pt. wishes in mind.

BTW, everyone benefits from the advances that have been made in bloodless medicine/surgery. I think most medical professionals agree that there are risks with transfusions, esp. now. Just as we understand the effects of indiscriminate use of abx., blood is now being seen as not the "only" option.

[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.

[caroladybelle, BSN, RN]

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.

[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.

[fab4fan]

Originally posted by caroladybelle

Are volume expanders - Hespan/Dextran - permitted? Just curious.

Yes

[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.)

[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.

[obillyboy]

The golden rule..........Do to others .. well you know how it goes.