Eyes & Thighs - is this an act of battery?

[33-weeker]

I work as a nursery nurse in Texas. Here, the erythromycin eye ointment after birth is mandated by state law.

Twice in the last month, we have had parents refuse it. The second time, risk management told us to stand right there and give it even if the parents were adamantly refusing. The comment was also made that if a nurse was unwilling to give it under such circumstances, then she didn't need to be working there.

I'm sorry, but I have a problem with this. I would rather err on the side of not committing an act of battery.

I am an employee of the hospital, true, but I feel it is the state's place to enforce it's laws, not mine. (ex. We can't stop them when babies leave without a car seat, and that is also law here.) I have no problem calling CPS (child protective services) about the refusal of eye ointment and letting them deal with it (- not vindictively, of course - just to follow procedure, which is what the procedure has been in the past).

As a side note, CPS came in this case, interviewed the parents and did nothing.

I feel that forcing medical treatment --especially that which is not critical, i.e. not life-saving-- on people is a very slippery slope.

Would I be committing an act of battery if I gave the 'eyes' in spite of parent refusal?

PS - Before you go off on parents like this, keep in mind that I am one. I gave birth at home to all my children, and -- although we did give the eye ointment, which wasn't necessary for our monogamous marriage, if you get my drift -- we refused vitamin K for the ones who didn't have risk factors indicating need. I also don't vaccinate, and I believe strongly in a patient's / parent's right to refuse medical treatment.

[AwayWeGo]

If the parent refuses Vit K or Erythromycin it is required in our hospital to have the parent sign a refusal form and we must call the pediatrician and inform them of this. They usually just say "um,ok, thanks."

[mentalhealthRN]

Well a couple of thought here...... I had a family who wanted to refuse the eye ointment and Vit K shot for their newborn when I worked in L&D and though they were a tough crowd after some education (a lot) they let me do it. If I had had no luck I would have called the neonatal doc and had him make a stop before the birth to have him to some education about the reason we give them. I suppose everyone has the right to refuse treatment but its absolutely vital that they do so educated with ALL the correct info of the risks and benefits so they are able to make a truly informed decision. I am in NY state and it is a state law here as well.

The next thing I must say, on an aside is just my own personal opinon. I personally think not vaccinating children is not right. I feel like they are putting other kids at risk and also risking having diseases that we have erraticated return to the population. Diseases that took a lot of lives. We were able to get rid of a lot of aweful diseases due to these vaccines and I think we need to used them. Now here in NY all kids are required to have them for school.

I also am not a fan of home births having seen many, many instances where mom and/or baby would have died had they not had emergency critical care during the labor/birth process--and they had a low-risk, normal pregnancy....so honesty that is just really scary and risky to me. I know there are a lot of people who will disagree with me and say women delivered babies at home with their grandma delivering for hundreds of years......but we also didn't used to use car seats. And docs didn't used to wash their hands either. Just my 2 cents.

As far as the car seats and the law--here in NY it is very enforced and new babies are not allowed to leave the hospital without a corificeat. They make the parents bring the corificeat in so staff car be sure they have it and that it is the right one and assure that they know how to use it (rear facing, etc) They contact social work is the family is unable to provide one with a program where financially challenged families are able to get a free corificeat......a staff person slso goes out to the car with the couple to help and assure the baby is in the corificeat and in properly. I saw this as a nurse and as a patient when I had my two kids. So they do totally enforce that law and absolutely will not discharge a baby without a corificeat--they will hold the baby on grounds of not having a proper discharge plan--until a corificeat is available. But, like I said there are programs here for couples who can't afford one.

[hoppermom3]

I have had many parents refuse eyes and/or thighs. We simply have them sign a refusal.

I always let the parents know what I am going to be doing when babe comes and ask them if they are ok with it. Some nurses don't talk to the parents about it at all.

The parents I have had refuse it have all been parents who researched and prepared for their birth experience.

What is really funny is the nurses who will run to get the "baby meds" when a precip delivery is occuring. Okay, do you honestly think having eye abx and vit k on hand is going to affect initial recovery?

[Elvish, BSN, DNP, RN, NP]

I also live in a state where shots and drops are mandated by state law. If parents decline them, we have them sign a refusal form stating they understand the purpose of the meds, the risks of not getting them, and that they assume responsibility for their decision. And we let the peds know on next rounds; we don't call them right then and notify them (I work nights). Refusal of shots and drops isn't something I get my panties in a wad about, and in the OP's situation I too would rather err on the side of not doing it.

[AtHomeRN]

I work in L&D/Postpartum as well, and we have patients that refuse eyes and thighs all the time. The parents have the right to do that, and I dont get too worked up about it.....UNLESS....the mother is known to have positive hep status (baby needs to get hep b and hbig) or mother is positive for gonorrhea and delivered lady partslly (then the baby needs the erythromycin oint). Also, if the parents refuse vitamin K for infant boys, I let them know that the pediatrician will not be able to circ the baby in the hospital (if that is their plan).

99.9% of the time, none of these situations are the case when the parents refuse, and we simply dont do it. Not a big deal.

[33-weeker]

FYI - RE: vaccine refusal... Although we weren't going to vaccinate anyway, later two of my three kids turned up with autism. Now we have a letter from their doctor stating that vaccines are contraindicated for them.

[tencat]

I would think it would be battery if you went ahead and did those things to the baby and the parents said no. I wouldn't refuse it, but if someone went ahead and did something to my kiddo after I'd said no, they would be in BIG trouble. Patients, or their decision makers, have the right to refuse treatment. As long as you get it in writing that it was refused, then I would think you are covered. And I'd point out to risk management that a lawsuit for battery is really something they don't want to mess with......

[Coffee Nurse, BSN, RN]

FYI - RE: vaccine refusal... Although we weren't going to vaccinate anyway, later two of my three kids turned up with autism. Now we have a letter from their doctor stating that vaccines are contraindicated for them.

Contraindicated on what grounds, exactly?

[lifelearningrn, BSN, RN]

Contraindicated on what grounds, exactly?

That parents may sue him over Wakefield's bogus and unethical studies that are still being backed up by parents who need to grasp some kind of reason their child has autism.

[Elvish, BSN, DNP, RN, NP]

Moderator note:

Respectfully asking that we keep the discussion to the original topic/question, which is NOT (although mentioned in the OP but only as a side note) vaccines/autism. It is about vitamin K/erythromycin being given or not given per parents' request.

This has the potential to be a good discussion. Let's please not derail the topic by making it about the very heated vaccine debate.

[33-weeker]

Moderator note:

Respectfully asking that we keep the discussion to the original topic/question, which is NOT (although mentioned in the OP but only as a side note) vaccines/autism. It is about vitamin K/erythromycin being given or not given per parents' request.

This has the potential to be a good discussion. Let's please not derail the topic by making it about the very heated vaccine debate.

Yes, thank you. I agree.

Respectfully, I've discussed the vaccine issue at length in another thread. Feel free to do a search.