Can't do TOP

GadgetRN71, ASN, RN · May 2, 2008

I was always taught that you can refuse to participate in terminations without repurcussions. I'm not sure I'd have a problem with cleaning up the room afterward-the deed is done at that point, and I look at it as I'm helping to move things along for the rest of the patients that day.

At any rate, nurses, techs etc do have the option to refuse to participate in things they find unethical. I think as long as the patient isn't already in the room and you haven't accepted the assignment, then they can't get you for abandonment. Most likely, there will be other staff willing to go in there for you. I feel the same way about DCA(donation after cardiac death) organ donations.(mainly because the patients are not brain dead at that point, they push propofol and other meds to urge them along. I basically think it's euthanasia) I have made it clear that I will not be part of these procedures and I am in my rights to do so. There are Jehovah's Witness nurses who will not hang blood and they are covered under this as well.

Good luck talking to your manager.

ewattsjt · May 2, 2008

I have not had to be in on TOPs or DCAs and would probably find employment elsewhere before being mandated to do so. Patients have their rights but I also have mine. If my employer would not respect my wishes in issues like that; it only shows you what type of employer they really are. Sorry that I can not give anything dealing with the direct matter as I have not been there. I can offer you some advice on another aspect you indicate in your question which is the possible repercussions.

You have to remember that as far as working goes, there are some “at will” and “right to” work laws in some states. I do not know what yours is off hand if any. It simply means that the “at will” laws means that your employer can fire or you can quit when you or they want (keeping in mind issues like pt. abandonment) and the “right to” means the same but in a lesser degree (Ie. if they fire me they need a reason, it doesn’t have to be a good one but it has to be stated why and keep in mind that they can not discriminate).

In my opinion, I would not want to work for a place that would not respect my ethnics when it comes to controversial matters. If they don’t really respect yours, how much do they really respect the patients? and do you really want to work for such a facility? Within the same token; what would it say about you if you keep doing something you didn’t believe in? Does it say that you place $$$ over your moral conviction? What I see from the brief paragraph is that the facility doesn’t care about your convictions and you need a job so you are willing to sacrifice some of your convictions for the job. If your convictions are strong it will eventually eat you alive (remember that I have no experience on your topic but have in other ethics dilemmas and I can say that things like that eat and eat at me).

Please don’t get me wrong. I am not judging one way or the other. I am just pointing out how I see what it says about your facility and yourself if you both keep doing them but are against it or they know you are against it.

I also have to say that if you are not for or against it and would simply rather not, then that is a different story within itself.

That’s just my 2 cents for what it is worth, hope it makes sense for you.

DNRme · May 3, 2008

I also work in NJ. I have provided written documentation of my refusal to participate in TOPs and DCD harvests. I am pretty sure that once you inform them of your religious objection (I'm also Catholic), any backlash can be considered religious discrimination. If your facility has an ethics hotline it may be worth a phone call.

Scrubby · May 4, 2008

I'm not bothered by TOP's at all but I do respect the fact that others may find it hard to deal with due to religious/personal beliefs. I don't believe that anyone should be forced to work where they feel extremely uncomfortable.

However at the same time you did choose to work in the operating room where pregnancy terminations are performed. Did you discuss your feelings about this when you first started your employment? I do find it a little hard to understand why people choose to work in an area where things are performed every day that is against their religious/personal beliefs. For example people who may be Jehovah's witness who work in an area where blood is given to patients frequently. If every person in the area had these beliefs then it would be hard from a manager/team leaders perspective to find staff willing to work with blood products/TOP's.

Annony RN · May 7, 2008

I don't mean this to be catty, the other ideas mentioned are good food for thought. so in addition- would you be more comfortable in a Catholic hospital? Are there any in your area? I used to work in one and many things like that were just non-issues.