Things you've learned about patient's religions and care?
- 0Apr 19, '11 by Aly529Hi everyone.
Just wondering if any of you have experienced different requests by patients of different religions or declining care due to religion?
- 1Apr 19, '11 by psu_213, BSN, RNHad a pt who was a Jehovah's Witness. Most of us know that those of that faith cannot receive blood products (at least that is the similified view of it...). Anyway, had a pt whose H/H was low. Could not give her blood. With future blood draws the MD ordered that only 'pedi' tubes be used.
- 0Apr 19, '11 by NurseStephRNQuote from psu_213We've also done that on my unit. Pre-op we have started them on Aranesp and PO Iron supplements.Had a pt who was a Jehovah's Witness. Most of us know that those of that faith cannot receive blood products (at least that is the similified view of it...). Anyway, had a pt whose H/H was low. Could not give her blood. With future blood draws the MD ordered that only 'pedi' tubes be used.
- 0Apr 19, '11 by caroladybelleQuote from msjellybeanI can't even imagine that there is a successful induction without being able to transfuse, except maybe M3 (APL). Since epogen and iron would not really be any help, I would think it an extremely risky chance to take.Had a patient on our floor a while back who was Jehovah's Witness & was diagnosed with AML. For some reason, she went ahead with induction chemotherapy. No supportive therapy via PRBCs & platelets and she ended up bleeding out.
- 1Apr 19, '11 by caroladybelleIn our area, we have large numbers of Orthodox Jews. And despite the fact, that the cancer center was part of a donation by Jewish patrons, there are no Sabbath elevators. Trying to remember that the visitors cannot touch buttons on Friday to Saturday night, and they are often reluctant to ask assistance. We have staffers that initially do not realize that the kosher meals need to be heated inside the sealed package - microwaves are not kosher.
As I am Jewish but not Orthodox, I can help explain rules, but usually cannot physically work with them on the Sabbath/ Holy days. Because while I may not feel that it is wrong to help them on the Sabbath and consider it a Mitzvah, they cannot knowingly ask another, even one not as observant as they are, to assist them. And as some are my neighbors, they often know.
Recognizing that many of their Holy days are clustered. Negotiating procedure around the Yom Kippur, Rosh Hashanah, and Sukkat in fall can be complicated.
(some rules may make little sense to outsiders. Once during Yom Kippur, a Rabbi was in my care and desperately ill - needing a CT. As an acutely ill pt, many Sabbath prohibitions are null, permitting the extraordinary care in those circumstances. However, as most acutely ill Orthodox, he was accompanied by a young family member to help translate/ keep watch over his care. The pt needed to go to CT on ground floor and we were on tenth. I explained about the Sabbath elevator in that facility, but he said he was not permitted even to use it on the Yom Kippur evening and instead took the stairs up and down. I would consider that more obvious "work" than the use of elevator, but thus is that sect's rules.)Last edit by caroladybelle on Apr 19, '11
- 0Apr 19, '11 by noahsmamaI had a pt whose parents were Jehovah's witnesses. Brought him into the ED for bloody diarrhea and lethargy. Turned out to have a hemolytic infection and Hgb of 2.x. Parents were almost talked into transfusion despite their religion but balked at the last minute. CPS was called and court order obtained to transfuse him anyway. Parents were cooperative with the court order -- they actually seemed somewhat relieved to have the decision taken out of their hands.
The transfusion raised his Hgb to 7.x. It gradually fell over the course of the next week or so despite daily epogen and ferrous sulfate, but finally turned around after bottoming out at 5.0. Doctors were prepared to transfuse again if his Hgb had fallen below 5.0.
For a child whose family was not Jehovah's Witnesses they would have done another transfusion long before the Hgb got that low, but this number was considered to be the threshold below which the value would be considered life-threatening. I heard some of the docs debating the use of this cutoff value, since of course the real health effects of low Hgb fall on a continuum, but thankfully the pt's Hgb and his general health took a big turn for the better before this became an issue.