The Circumcision Discussion - page 58

I know this can be a HUGE debate, and I'm not looking to start any arguments. I was just wondering as you are OB nurses. I'm expecting a boy in July and not sure if we should circ. or not. My... Read More

  1. by   Spidey's mom
    Quote from crissrn27
    The hospital I left a few months ago did sweet ease immediately prior. Thats it. I did notice screaming during and after (especially with pee). No Tylenol, no nothing. Wait, we did have one doc that did EMLA 1 hour pre.

    We did jelly gauze until 1st diaper change, then jelly in diaper only. I did notice that the gauze would sometimes stick, so I tried to get to the gauze before the doc, and really load it up for them, and that seemed to work better. Think it is too little jelly that causes the sticking.

    I always have to say (and have gotten in trouble for this) that the AAP no longer recommends routine circs, when asking if they want a circ. That is all I say, cause I catch enough grief even for this, but most of the docs do NO teaching. They ask if they want it, then they put the $$ in their pockets, do the circ and walk away. I would love for a doc to do actual teaching and see if that would change pts minds.

    At my old hospital it was $200 out of pocket. I work with Arwen now. How much is where we are Arwen? I can't remember what I was told, something like $600-700. Doc don't want circs to go away, they are making big money on this. All that cash for a 5-10 min (hopefully) procedure.
    I had a handout with questions to ask the doc . .. .with the AAP info and pain questions. I always gave it to the parents.

    Surprisingly, most parents still opted FOR circumcision.

    But at least they had the info.

    steph
  2. by   ElvishDNP
    Quote from crissrn27
    At my old hospital it was $200 out of pocket. I work with Arwen now. How much is where we are Arwen? I can't remember what I was told, something like $600-700. Medicaid and lots of insurances are not covering this now. Docs don't want circs to go away, they are making big money on this.
    Hey Criss!
    Where we are it is $673 if you're paying out of pocket. It amazes me how many people can't find $30 for a carseat but still want that little boy's foreskin cut off. If I were on the fence, that would make up my mind right there!

    I have seen only 2 docs at our facility who actually educate new moms on circ. And one of them is anti, which is (I think) why he in particular does such a thorough job.

    And you know steph, I'm with you. I give parents the info, whether anyone above me likes it or not (actually, my immediate supe is anti, so she's ok with it). And even if they decide for circ, I obviously don't agree with it but I'm much better about them making up their minds with more than just "yeah, I guess we oughta do it".
    Last edit by ElvishDNP on Nov 15, '07
  3. by   crissrn27
    Hi Arwen


    Arwen, I will say that most of the residents do a 30 second spiel along these lines, right after birth, when they get the do the form for you guys. It goes like this.

    Doc: Do you want me to circ your son?
    Mom: Yes, are you going to do it right now? (lol, most really do say this)
    Doc: No, we will do it later. There is a less than 1% chance of infection or bleeding. Are you sure you want it?
    Mom: yes

    That is about it, haven't heard anything but that, not even a description of the procedure, but to be honest the moms don't ask.

    That is a lot of $$ for a circ. It was $150, then changed to $200 right before I left the other place. I have had pts ask to see SW for help with a carseat, formula, etc, but they usually find some way to get the money for the circ. Most of the docs there would actually take the money and put it in their pockets too. Literally, mom hands doc the cash. Only a couple require that it be paid in the office.
  4. by   ElvishDNP
    Quote from crissrn27
    That is about it, haven't heard anything but that, not even a description of the procedure, but to be honest the moms don't ask.
    No, when I go to Mom's room to have the consent signed, that's when they have the million questions! I don't mind answering them but always offer to have the doc come in & answer as well.
  5. by   Spidey's mom
    Quote from Arwen_U
    No, when I go to Mom's room to have the consent signed, that's when they have the million questions! I don't mind answering them but always offer to have the doc come in & answer as well.
    That is when I do it too . . . the info is on the clipboard with the consent.

    steph
  6. by   ElvishDNP
    sounds like a good plan, steph. will take all the written info when I go do consents! up til now, all the info has been verbal (apart from the booklet everybody gets on admission). thanks!
    Last edit by ElvishDNP on Nov 15, '07
  7. by   crissrn27
    At THE OTHER PLACE (lol), we had no written info at all. No booklet, nada. We had a one line instruction on the general discharge instructions, that gave post care info.
  8. by   2curlygirls
    We had a baby the other day in the NICU with RDS, hypoglycemia, basically a r/o sepsis. One of the relatives asked the father if the baby had been circ'ed yet. When he answered no, the relative grabbed the nurse and said "You guys delay circ's???" (this baby was <24 hours old)

    Um, duh. Let's get our priorities straight here people. First, let's make sure he can breathe without assistance and maintain his blood glucose!

    Sheesh.

    Thankfully, we have a large population of patients from cultures that don't circ and those that do, usually wait until after dc.
  9. by   rnin02
    Quote from 2curlygirls
    We had a baby the other day in the NICU with RDS, hypoglycemia, basically a r/o sepsis. One of the relatives asked the father if the baby had been circ'ed yet. When he answered no, the relative grabbed the nurse and said "You guys delay circ's???" (this baby was <24 hours old)

    Um, duh. Let's get our priorities straight here people. First, let's make sure he can breathe without assistance and maintain his blood glucose!

    Sheesh.

    Thankfully, we have a large population of patients from cultures that don't circ and those that do, usually wait until after dc.
    Oh, how important is breathing anyway??? Get rid of that foreskin...stat!!
  10. by   crissrn27
    I was truly amazed at how many people asked about circs when there child is critically ill or premature. I've had 24-25 weekers, and one of the first things parents ask about is circ. In a situation like this, I will tell them that circ is not even on the list of important things at this point.
  11. by   ElvishDNP
    Quote from crissrn27
    I was truly amazed at how many people asked about circs when there child is critically ill or premature. I've had 24-25 weekers, and one of the first things parents ask about is circ. In a situation like this, I will tell them that circ is not even on the list of important things at this point.
    I had an antepartum who'd PPROMed at about 30 weeks, and the only thing Daddy could talk about was when the baby (of course a boy) was going to be circumcised. I realize he was probably anxious over the ROM and wanting to concentrate on something 'normal' but geez. I told him point-blank, "We need to get your son here and healthy before we talk about removing any part of his body." This was, of course, after I'd been taking care of them for a couple weeks already and had a rapport.
  12. by   secretspectrum
    As nurses, we have tremendous collective power and influence in the medical field. Every interaction we have affects the outcomes of patient's lives. While nurses do not take the Hippocratic oath, since we are working "under" doctors it applies to us too. I urge you to think deeply about the issue of circumcision and whether you think forced cosmetic surgery should continue to be inflicted on infants, often without anesthesia. Is this a true commitment to "First do no harm"? Please join other nurses in being conscientious objectors to this brutal practice.
    http://nurses.cirp.org/ Was begun by a group of nurses from Santa Fe, New Mexico. There are many other organizations such as http://nocirc.org/ that seek to preserve human rights. Isn't it logical that each person's body belongs to that person? There is legislation currently waiting for sponsership that would make the female genital mutilation act of 1996 gender neutral so that boys will experience the same protections as girls. http://www.mgmbill.org/usmgmbill.htm You can help by writing to your elected officials-congresspeople, president, governor. This cultural practice can only be stopped one person at a time, by practicing the golden rule. Nurses, please nurture and protect the babies in your care, and refuse to take part in this unethical practice any more.
  13. by   Thanet
    Quote from secretspectrum
    As nurses, we have tremendous collective power and influence in the medical field. Every interaction we have affects the outcomes of patient's lives. While nurses do not take the Hippocratic oath, since we are working "under" doctors it applies to us too. I urge you to think deeply about the issue of circumcision and whether you think forced cosmetic surgery should continue to be inflicted on infants, often without anesthesia. Is this a true commitment to "First do no harm"? Please join other nurses in being conscientious objectors to this brutal practice.
    http://nurses.cirp.org/ Was begun by a group of nurses from Santa Fe, New Mexico. There are many other organizations such as http://nocirc.org/ that seek to preserve human rights. Isn't it logical that each person's body belongs to that person? There is legislation currently waiting for sponsership that would make the female genital mutilation act of 1996 gender neutral so that boys will experience the same protections as girls. http://www.mgmbill.org/usmgmbill.htm You can help by writing to your elected officials-congresspeople, president, governor. This cultural practice can only be stopped one person at a time, by practicing the golden rule. Nurses, please nurture and protect the babies in your care, and refuse to take part in this unethical practice any more.

    I wish you all success

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