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Do SRNA/CRNAs have to participate in elective abortions and sterilizations?

SRNA   (1,371 Views 12 Comments)
by udmgraduate udmgraduate (New Member) New Member

456 Visitors; 2 Posts

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Hi all,

I'm not trying to spark any debate, because I'm not looking for one. However, I have an interview next week for CRNA school and I was wondering...

Do SRNA/CRNAs have to participate in elective abortions and sterilizations?

I'm a devout Catholic and my interview is at a Catholic university (which doesn't mean much these days, religiously speaking). I just want to know if it's possible for me to be a CRNA. The political climate of medicine is increasingly liberal and intolerant of religious exemptions and beliefs. Again, I'm not looking for a religious debate or your opinion on what you think SHOULD happen. I'm looking for your professional opinions on whether or not exemptions ARE made for this type of thing. Thanks in advance to everyone who answers :)

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DreameRN has 10 years experience as a BSN.

8 Likes; 3,568 Visitors; 83 Posts

I actually don't know because I haven't started clinicals yet. I assume yes. this is a forum that discusses it several places, this is just one thread. I'm apprehensive about this myself.

WWW.NURSE-ANESTHESIA.ORG

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6 Likes; 1 Follower; 12,584 Visitors; 678 Posts

Abortion - not likely.

Health care providers refusing to provide care to certain patients is a relatively recent phenomenon. I've been a nurse since 1982 and I never heard of this issue until the late 90's. So medicine is not becoming more liberal-intolerant is a different issue.

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Shanimal has 6 years experience and works as a Nurse Anesthesia Student, Critical Care RN.

5,008 Visitors; 184 Posts

Hi all,

Do SRNA/CRNAs have to participate in elective abortions and sterilizations?

I'm a devout Catholic and my interview is at a Catholic university (which doesn't mean much these days, religiously speaking). I just want to know if it's possible for me to be a CRNA. The political climate of medicine is increasingly liberal and intolerant of religious exemptions and beliefs. Again, I'm not looking for a religious debate or your opinion on what you think SHOULD happen. I'm looking for your professional opinions on whether or not exemptions ARE made for this type of thing. Thanks in advance to everyone who answers :)

The climate of medicine is certainly NOT more liberal. As noted above, intolerance is a completely different issue. The more recent cases that I believe you're referring to (i.e., a medical professional is prosecuted for refusing to provide care in abortion cases) have more to do with a provider refusing to provide care for emergent cases (and NOT elective ones) when there is an obligation to provide care and no other providers are available to do so.

I see no reason why you would be "forced" to provide anesthetic care for elective abortions and sterilizations during school--you will not be the only provider present. Also understand that the vast majority of elective abortions are performed with local anesthesia or with moderate sedation, which typically do not require an anesthesia provider. But if it's something that concerns you, then why not ask about it during your school interview? Good luck.

Edited by Shanimal

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1,547 Visitors; 28 Posts

No one has ever come out and asked me if I'm ok with doing a certain procedure but I would imagine that if you spoke up and said something that they couldn't force you to do it. That being said, I don't think that medicine is becoming "increasingly liberal," but just that as healthcare providers we care for patients of all different backgrounds, whether we agree with it or not. It is not our place to judge. If you have strong feelings about certain things, maybe this isn't the career for you.

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PaSSiNGaS has 10 years experience and works as a CRNA.

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There are times that you may be in a room that has a D&C for early termination. If it is something you are not comfortable doing just tell your CRNA or MDA you're with that day and they can reassign you. It has been talked about and there are people who are just not comfortable doing those cases and they shouldn't hold it against you.

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FurBabyMom has 7 years experience as a BSN, RN and works as a Registered Nurse.

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Is it possible you will be assigned to the same room one of those procedures occurs in? Yes. As others have mentioned, it MAY be possible to be reassigned for part or all of the day, especially as a student. You will likely have less flexibility as a licensed practicing provider. For what it's worth, and it may be our level of specialization, but in our periop ORs - it is more common that we do diagnostic D&Cs for abnormal bleeding or a biopsy than terminations.

I agree with the others - most elective terminations are done with sedation which depending on the facility and state regulations may or may not require an anesthesia provider at all. In my facility, most of our tubals are completed in the L&D ORs. Our SRNAs can be assigned up there as well.

I am not a CRNA. But I am an OR nurse in a level 1 trauma center. I've been in several situations where I've care for a patient emergently undergoing a diagnostic laparoscopy to rule or out treat an ectopic pregnancy. I've been in others where the mom was a trauma patient and they spontaneously (despite interventions to prevent) delivered prior to be a viable gestational age. These situations will probably happen and are a little less murky (I'm Catholic) as they are very often "life of the mother" situations where any intervention is aimed to keep the mother alive.

We are allowed to request replacement due to our own religious beliefs, but the caveat is that there has to be an equally qualified individual who can take the assignment in my place. I've only been involved in emergent cases that are similar to these - the diagnostic lap for ruptured ectopic, and a the multi trauma patient who delivered prior to viability. Due to the timing of emergencies, we may or may not have had time to swap staff out due to religious dilemmas. I have been in cases where the patient was pregnant - being pregnant doesn't preclude one from having a bad problem potentially.

I would recommend that you consider the variety of procedures that might occur and what you are able to accept or not. Tubals and possible terminations will not be the only things you may see in clinical practice which is morally murky according to Catholic teachings. People have relatively elective hysterectomies (will you be able to reconcile their rationale having a BRAC positive gene and a higher predisposition to but not having cancer as a viable rationale?). People have those or similar procedures without having those contingencies either. What are your feelings on organ procurements? That may be one to consider. While some of these other procedures may be more likely to occur at a higher level of specialization and care (some things that happen in a trauma center are less likely to occur in a community hospital and almost unheard of in an ambulatory surgery center setting), procurement procedures will occur in almost any non-ASC setting. A facility does not have to have transplant services for a procurement/recovery procedure to occur in their OR space. Sometimes the transplanting facility will work with the organ procurement agency to have their own providers do the recovery - it would be staff, anesthesia (initially) and room time for the smaller non-transplant facility. While we're discussing organ procurement - does your opinion differ whether the donor has been brain death tested or if they do not meet brain death criteria and are a candidate for donation after cardiac death (DCD)?

I applaud you for considering your own ethical and moral feelings and perspectives. I hate to seem like a downer - it is certainly possible to work in this enviornment with your beliefs. May not be as easy as otherwise, but possible, yes.

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6 Likes; 1 Follower; 12,584 Visitors; 678 Posts

Yes, some people don't want to do organ procurement procedures. It gets more and more disruptive. I remember the 'good old days' before all this started.

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34 Likes; 4,210 Visitors; 224 Posts

Many moons ago, while still in nursing school, I worked for a group of anesthesiologists. One of whom was a devout Catholic.

When an abortion or sterilization was "on the books", we just knew not to book John (his name) in that hospital on that day.

Our scheduling staff was small (2 of us) but we managed to make sure he never had those cases.

As for working directly with the hospital, check with them to see if they even allow those types of procedures there. Chances are, they probably do not.

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4 Likes; 5,593 Visitors; 240 Posts

I worked at a Catholic hospital and we did not perform those procedures at all. Only a D&C if the fetus was already dead or an ectopic which places the mother's life at jeopardy. If you work/do clinicals at a place like this you'll be fine.

Another large urban OR did these procedures all the time. They would keep people out of there based on personal belief/ preference if they could but it was understood that a time may come when you're the only one available and you need to care for the patient.

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36 Likes; 8,452 Visitors; 484 Posts

I thought medicine was about providing care for patients regardless of your personal beliefs.

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I would have no problem not assigning a student to scheduled, elective case if they voiced concerns. However, if they were on call with me, and it was the middle of the night, and the case was an emergency, and they refused to do the case, they would be sent home and not allowed back for clinical. And their program would get a huge earful.

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