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| No. 80 | 
Feb 21, 2008, 09:12 AM
 Re: Caring for Jehovah's witnesses
<TABLE id=HB_Mail_Container height="100%" cellSpacing=0 cellPadding=0 width="100%" border=0 UNSELECTABLE="on"><TBODY><TR height="100%" UNSELECTABLE="on" width="100%"><TD id=HB_Focus_Element vAlign=top width="100%" background="" height=250 UNSELECTABLE="off">This is probably gonna get some heated comments, but here goes. I have taken care of numerous JW, and it truly represents a challenge for health care workers. The Jehovahs, I have cared for tho, truly need PRBC's, not albumin, hespan, etc. Typically they have been GIB's, This last lady, nearly died H & H 5 and 17 BP's low, truly attempting to continue to perfuse her brain and her kidneys, of course she developed ATN and had to be treated for this as well. She ended up with a colectomy 2/2 her GIB, trached, you know the works. Her family steadfastly refused blood, and while I respect that right, It puts those of us who are not JW's and are nurses/doctors in a horrible position. You are constantly chasing your tail, and making little headway. I think she ended up in a acute-care vent facility. The other guy did die, He actually had a CV surgeon perform a MVR, and triple vessel cabg. He just bled out, during the code, the CCP drew the code blood femorally, and it was like water. No RBC's, just plasma. This is going to sound a bit prejudiced, but it is not meant that way at all. I really think that JW's should be treated by JW's, docs, nurses, etc. There should be a facility that treats only witnesses. That way it would be completely understood, and you all could still get the care you may need, the way you want it. If you can refuse to hang blood, based on your beliefs, shouldn't those of us who aren't JW's reserve the right to not be put into the position of caring for someone who wants care, and wants to be a full code, yet we can't do the one thing that could help save you? Ethically, it can really back us in a corner of wanting to do the right thing (medically), yet unable to because of religious beliefs.
Please if anyone has an answer or input please divulge. And for those that are JW's, truly no offense, this is just my dillemma, and my 
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 | | Advertisement Sponsored Links | | | | No. 81 |
Feb 21, 2008, 09:47 AM
Re: Caring for Jehovah's witnesses Originally Posted by lorilou22RN  <TABLE id=HB_Mail_Container height="100%" cellSpacing=0 cellPadding=0 width="100%" border=0 UNSELECTABLE="on"><TBODY><TR height="100%" UNSELECTABLE="on" width="100%"><TD id=HB_Focus_Element vAlign=top width="100%" background="" height=250 UNSELECTABLE="off">This is probably gonna get some heated comments, but here goes. I have taken care of numerous JW, and it truly represents a challenge for health care workers. The Jehovahs, I have cared for tho, truly need PRBC's, not albumin, hespan, etc. Typically they have been GIB's, This last lady, nearly died H & H 5 and 17 BP's low, truly attempting to continue to perfuse her brain and her kidneys, of course she developed ATN and had to be treated for this as well. She ended up with a colectomy 2/2 her GIB, trached, you know the works. Her family steadfastly refused blood, and while I respect that right, It puts those of us who are not JW's and are nurses/doctors in a horrible position. You are constantly chasing your tail, and making little headway. I think she ended up in a acute-care vent facility. The other guy did die, He actually had a CV surgeon perform a MVR, and triple vessel cabg. He just bled out, during the code, the CCP drew the code blood femorally, and it was like water. No RBC's, just plasma. This is going to sound a bit prejudiced, but it is not meant that way at all. I really think that JW's should be treated by JW's, docs, nurses, etc. There should be a facility that treats only witnesses. That way it would be completely understood, and you all could still get the care you may need, the way you want it. If you can refuse to hang blood, based on your beliefs, shouldn't those of us who aren't JW's reserve the right to not be put into the position of caring for someone who wants care, and wants to be a full code, yet we can't do the one thing that could help save you? Ethically, it can really back us in a corner of wanting to do the right thing (medically), yet unable to because of religious beliefs.
Please if anyone has an answer or input please divulge. And for those that are JW's, truly no offense, this is just my dillemma, and my
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I am having a hard time understanding some of the abbreviations, so I dont know if I understood some of what you are saying. I have been both a nurse and an auto mechanic. I have not however been in a situation with caring for a JW. So all I can draw on is my auto mechanic experience. Sometimes, we would recommend to a customer to have repairs done. Repairs we may feel would lead to costlier repairs or possibly endanger the customer. Often times, the customer would refuse. All we could do is document it on the work order.
I think, JW's have given this a lot of thought. If they want to take that risk
And they are adults, not asking one of their children to take the risk, I have no problem with it.
You do raise a good point. I was a seventh day adventist. They own a medical school and hospital, Loma Linda University. I think if they wanted too, JW's, could build their own hospitals, but dont know if the Govt would allow them. I think there would probably be a lot of legal obstacles. I dont know if you can open a hospital and deny non JW's care. Like those that request Blood. What isa GIB anyway?
| | No. 82 |
Feb 21, 2008, 10:01 AM
Re: Caring for Jehovah's witnesses
The Seventh Day Adventist church has a whole system of excellent hospitals and healthcare teaching institutions across the country (and internationally, I believe), but they don't only treat SDAs (they don't even employ only SDAs -- I and plenty of others here have worked for them). They were never intended as a system to provide care for SDAs; they were intended from the beginning as a medical ministry to the world.
Sure, it can be frustrating to treat people with values different from our own (been there!!  ), but that's sorta what we signed up for when we went into healthcare. We live and work in a country and healthcare system that respects (with a few, specific limitations) the individual's right to self-determination. All healthcare clients, not just JWs, always (again, except for a few specific, legally defined situations) have the right to make the final decisions about their care, and refuse any treatment they choose, whether it makes sense to "us" or not, and whether the refusal is based on strong religious convictions, their personal "risk vs. benefit" analysis of the situation, or just something crazy they read in the newspaper last week ...
We don't get to impose our values on those we care for in healthcare settings, just like we wouldn't want to have someone else's values imposed on us. | | No. 83 |
Feb 21, 2008, 11:13 AM
Re: Caring for Jehovah's witnesses
I posted already but it didn't show up. I just wanted to know if anyone knew if CRNA's order/tranfuse blood. And what other JW's thought about persuing a CRNA career.
| | No. 84 |
Feb 21, 2008, 11:19 AM
Re: dealing with blood transfusions as a Jehovah's Witness Originally Posted by LiverpoolJane As a Jehovahs Witness and a RN I do not like having to be involved in administering blood but sometimes there is nobody else to do it. All of my colleagues know I am a Witness and are understanding if I ask them if they would start that transfusion etc. Thankfully I work in Renal and our Consultants are used to correcting anaemia without blood because of the impliations of compromising a patients chances of a kidney transplant if they build up antibodies.
When I am in the situation where I have to be involved in the transfusion I aware of the precident set in the bible in Daniel - I won't go into any further detail as I don't think it is appropriate in a public forum, but just to say that it involves three young men who had to serve food having blood in it although they wouldn't partake themselves.
Likewise in work as long as patients are fully aware of the risks etc - and I believe in the US you have to sign a consent form for a BT - then although it is not something I would want I understand that it is part of my role as a nurse.
Hope this helps
With so many areas in nursing where you probably would never have to give a blood transfusion, why would a JW pick ER or surgery? It does not compute. I dont know If I would be to comfortable doing a transfusion for someone else unless they were going to do part of my assignment in return. That would also mean, I would be at risk for making a med error, on the transfusion. I wouldnt be a happy camper if I lost my job, taking care of someone elses patient.
| | No. 85 |
Feb 21, 2008, 12:00 PM
Re: Caring for Jehovah's witnesses A while back we had a married couple of Jehovah Witnesses. They wanted to have their first child the “old fashion way”, and they did work for it!
<O  ></O > They decided to deliver in their home with a mid-wife present. There were complication and the mother started to bleed.
<O ></O > We received her in the ICU still bleeding. Over several hours of saline and volume expanders, she continued to deteriorate. Her husband was with her most of the time. It was like watching a textbook death as her HGB dropped below 4. First came the arrhythmias, and then the chest pain because of poor perfusion. Her pressure continued to drop and the SOB increased. The cyanosis crept through her body. She became decreasingly coherent.
<O ></O > With each new worsening her husband would go to the phone and call his leader in the church and then come back and tell her the same thing, It is in God’s hands, and they continued the refusal of blood products and intubation. (I firmly believe that since she was the one dying that she would have accepted the blood, but with her husband continuously there she would not.)
<O ></O > The situation continued downhill. We had not seen our MD for and hour or so, he came back in and requested a transfer to a local burn center.
<O ></O > The couple came back about six months later (without infant) to say “Thank You”. What had happened was the burn center had a new hyperbaric chamber. They had used the pressure/oxygen to super-saturate the HGB with oxygen. Shad had stayed in that hospital 3 months. | | No. 86 |
Feb 21, 2008, 12:17 PM
Re: Caring for Jehovah's witnesses Originally Posted by 4fill A while back we had a married couple of Jehovah Witnesses. They wanted to have their first child the “old fashion way”, and they did work for it!
<O ></O > They decided to deliver in their home with a mid-wife present. There were complication and the mother started to bleed.
<O ></O > We received her in the ICU still bleeding. Over several hours of saline and volume expanders, she continued to deteriorate. Her husband was with her most of the time. It was like watching a textbook death as her HGB dropped below 4. First came the arrhythmias, and then the chest pain because of poor perfusion. Her pressure continued to drop and the SOB increased. The cyanosis crept through her body. She became decreasingly coherent.
<O ></O > With each new worsening her husband would go to the phone and call his leader in the church and then come back and tell her the same thing, It is in God’s hands, and they continued the refusal of blood products and intubation. (I firmly believe that since she was the one dying that she would have accepted the blood, but with her husband continuously there she would not.)
<O ></O > The situation continued downhill. We had not seen our MD for and hour or so, he came back in and requested a transfer to a local burn center.
<O ></O > The couple came back about six months later (without infant) to say “Thank You”. What had happened was the burn center had a new hyperbaric chamber. They had used the pressure/oxygen to super-saturate the HGB with oxygen. Shad had stayed in that hospital 3 months.
I guess we can come to our own conclusions. Should all hospitals have hyperbaric chambers? Perhaps. One thing I thought about before..was that necessity forces us to use whatever is at hand to save life. It would seem that life is more important than any dogma. I know, to survive..I would do like the survivors of the andes plane crash, and turn to cannibalism. I think anytime you put dogma before life..you are in danger of doing the absurd. I think, it wont be long, where science will create a suitable blood substitute, just like it was able to create synthetic rubber. I go further, It wont be long when science will create man or woman, ..Which will put all religions in position to reassess their beliefs.
Its hard to discuss such a topic without thinking about religion. As I understand, JW's long term goal is to establish a theocracy here on earth.
I can just see myself waking up in ER, wanting whole blood, and being told..sorry buddy...the JW state does not permit that. Most of the people that think like myself , would probably be in an overcrowded prison..reading Watchtower tracts. I can just see the JW guards, going cell to cell, knocking.
| | No. 87 |
Feb 21, 2008, 12:19 PM
Re: dealing with blood transfusions as a Jehovah's Witness
I don't work in ER or surgery - I work in Renal medicine / dialysis. We work as a team so it is not a case of you do this for me and I'll do that for you. When a transfusion is started two nurses check it but only one needs to spike the bag and attach the blood. When a pt is receiving a BT it is still my responsibility to monitor obs and carry out other care for that pt, you make it sound like I have abandoned my responsibility to that pt? I do give BTs when I have to, but I don't really like it - but there are other things I don't like doing that are part of my job. I'm sure there are things about your job you don't particulary like - but accept? In reality we do not carry out that many BTs and it doesn't fill me with dread if it just so happens someone has to have a BT, it's no big deal, I don't panic and stress about it.
I hope this puts things into perspective for you.
Jane Originally Posted by psychnurse1998 With so many areas in nursing where you probably would never have to give a blood transfusion, why would a JW pick ER or surgery? It does not compute. I dont know If I would be to comfortable doing a transfusion for someone else unless they were going to do part of my assignment in return. That would also mean, I would be at risk for making a med error, on the transfusion. I wouldnt be a happy camper if I lost my job, taking care of someone elses patient. | | No. 88 |
Feb 21, 2008, 12:25 PM
Re: dealing with blood transfusions as a Jehovah's Witness Originally Posted by LiverpoolJane I don't work in ER or surgery - I work in Renal medicine / dialysis. We work as a team so it is not a case of you do this for me and I'll do that for you. When a transfusion is started two nurses check it but only one needs to spike the bag and attach the blood. When a pt is receiving a BT it is still my responsibility to monitor obs and carry out other care for that pt, you make it sound like I have abandoned my responsibility to that pt? I do give BTs when I have to, but I don't really like it - but there are other things I don't like doing that are part of my job. I'm sure there are things about your job you don't particulary like - but accept? In reality we do not carry out that many BTs and it doesn't fill me with dread if it just so happens someone has to have a BT, it's no big deal, I don't panic and stress about it.
I hope this puts things into perspective for you.
Jane
Jane , I admire the stand JW's take on war. I was a Seventh day advenstist. We were concientious objectors. We did everything but shoot the gun. JW's would have nothing at all to do with war. I sense an inconsistency..you hand the whole blood, or bullet to someone else to do it for you.
| | No. 89 |
Feb 21, 2008, 12:40 PM
Re: Caring for Jehovah's witnesses
Hi,
I would just like to clarify that I am a JW as well as a RN and I cannot refuse to give a blood transfusion.
I would also like to say that I have seen a few people exsanguinate despite having massive blood transfusions. So is it really possible to say a person died because they didn't have a BT when even those that do still die?
As regards JW only hospitals - a better idea is something that you already have in the US - bloodless hospitals that treat anyone who would would rather not have a BT. I would recommend you have a look at some of the websites as it is really interesting and I'm sure most people if asked would say they would prefare not to have a BT if possible? The technology available these days is enabling all of us to have a safer alternative to blood transfusions.
Several hospitals local to me have accepted equipment donated by JWs that are being used for the benefit of all it's patients and reducing the need for transfusions. The surgeons have been receptive to new techniques and are more confident in treating more and more people without transfusions and now treating JWs is not something they fear. Originally Posted by lorilou22RN <TABLE id=HB_Mail_Container height="100%" cellSpacing=0 cellPadding=0 width="100%" border=0 UNSELECTABLE="on"><TBODY><TR height="100%" width="100%" UNSELECTABLE="on"><TD id=HB_Focus_Element vAlign=top width="100%" background="" height=250 UNSELECTABLE="off">
This is probably gonna get some heated comments, but here goes. I have taken care of numerous JW, and it truly represents a challenge for health care workers. The Jehovahs, I have cared for tho, truly need PRBC's, not albumin, hespan, etc. Typically they have been GIB's, This last lady, nearly died H & H 5 and 17 BP's low, truly attempting to continue to perfuse her brain and her kidneys, of course she developed ATN and had to be treated for this as well. She ended up with a colectomy 2/2 her GIB, trached, you know the works. Her family steadfastly refused blood, and while I respect that right, It puts those of us who are not JW's and are nurses/doctors in a horrible position. You are constantly chasing your tail, and making little headway. I think she ended up in a acute-care vent facility. The other guy did die, He actually had a CV surgeon perform a MVR, and triple vessel cabg. He just bled out, during the code, the CCP drew the code blood femorally, and it was like water. No RBC's, just plasma. This is going to sound a bit prejudiced, but it is not meant that way at all. I really think that JW's should be treated by JW's, docs, nurses, etc. There should be a facility that treats only witnesses. That way it would be completely understood, and you all could still get the care you may need, the way you want it. If you can refuse to hang blood, based on your beliefs, shouldn't those of us who aren't JW's reserve the right to not be put into the position of caring for someone who wants care, and wants to be a full code, yet we can't do the one thing that could help save you? Ethically, it can really back us in a corner of wanting to do the right thing (medically), yet unable to because of religious beliefs.
Please if anyone has an answer or input please divulge. And for those that are JW's, truly no offense, this is just my dillemma, and my
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