Can a nurse refuse to participate in a code?

[wooh]

I'm sure many of us have had patients that we felt it was just torture to code the person, but for whatever reason, the patient wasn't DNR.

We can refuse to hang blood for religious reasons.

We can refuse to participate in an abortion for ethical/religious reasons.

Can we similarly refuse to participate in a code?

ETA: Without getting fired/violating our nurse practice act/getting in some sort of trouble...

[MunoRN, RN]

In the scenario given in the OP, she states specifically that the patient is NOT a DNR, but the nurse has a personal opinion that running a code would be "torture." I maintain that if a patient is NOT a DNR, and the nurse takes it upon herself to decide that it is inappropriate, she may very well be fired. That's a world away from what you just described.

I think I read the original post differently, the OP referred to participating in a code where a patient was not a DNR "for a variety of reasons". What the specific reason is makes a big difference.

Until we 'cracked down' on this, we would occasionally have MD's make a patient a full code due to family demands after the patient was no longer to express their wishes, even though when they were able to express their wishes a DNR order was written. We had at least 2 situations where Nurses refused to code a patient who was not DNR, they refused for ethical reasons. Luckily the law, hospital policy, and prevailing ethical standards were on the Nurse's side, so getting fired was unlikely, and actually in one of those situations the MD was suspended from inpatient practice.

[SusanRN82]

Are you sure you can refuse to administer blood? I would recommend reading your nurse practice act. (The state nurse practice act supercedes any facility policy).

[MunoRN, RN]

Are you sure you can refuse to administer blood? I would recommend reading your nurse practice act. (The state nurse practice act supercedes any facility policy).

I don't know of any practice act that gets that specific, like most things it all depends on a BON interprets the practice acts in particular situations. I have worked at a facility where there was a large JH population and there were very specific policies regarding what JH staff could refuse (which was essentially nothing).

[edrnbailey]

I'm not asking if I can say, "We aren't coding this patient." That would be obviously breaking all sorts of rules/regulations/laws/common sense.

Yes, I know the options of ethics committees, etc.

But, I can refuse to give blood if I'm a JW. I can refuse to participate in an abortion.

Can I similarly refuse to participate in a code?

NOT can I block the door and prevent anyone else from doing it or write DNR on a chart when nobody is looking.

You can not refuse treatment to a patient based on your own beliefs. This is no different than making a patient receive treatment against theirs. As nurses we are our patients advocates. It is not our place to pick and choose which treatments or beliefs we will uphold.

[edrnbailey]

Used to work with a JW nurse who would refuse to hang blood, although she would monitor the patient and remove the empty bag/tubing. I asked her directly why she could not give the blood to the patient who WANTED it (and had no religious objections to receiving it). She said that she believed doing this would endanger that patient's soul, and she wanted no part of anyone's "downfall".

So, she didn't want it herself and wouldn't give it to someone else, either. She could monitor the patient's vitals because it was doing nothing more than ensuring the patient was safe at that moment, regardless of what was going on. And she'd gladly remove it, because, well....she was taking it away.

Still, whenever humanly possible, we'd just give her a different patient, or if not possible, she'd pick up the slack caused by someone else's additional workload. Not a big deal, really.

Basically this nurse placed her own religious beliefs onto the patient and refused to render care. How would she feel if the roles were reversed.

[SDALPN]

1. Its part of the job and in our job description.

2. All hospitals require staff to be CPR certified. The nurse shouldn't have a need to learn CPR if its against their beliefs.

3. We are taught to be non-judgmental. We can't push our beliefs on a pt or judge them for their beliefs.

I avoid pork due to religious reasons. But if that is what the pt is eating, that is their choice. I refuse to push my choices on another. We know our beliefs before we go to nursing school and we know the job we will be doing when we get out. So to choose to make a living doing things that are against personal beliefs is ridiculous. I wouldn't go work in a pork factory and then after being hired tell the boss its against my beliefs. That's insane!

[nurseebol]

Lividity plus CPR equals desecration of a corpse to me

[Rocknurse, MSN, APRN, NP]

Why are we resurrecting a 5 year old post? Now THAT'S desecration of a corpse!