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.
My question is even if you believe you are in a monogamous union sometimes women will have STDs and not know. Its not like all men are honest in relationships or even the woman who is delivering. I have heard and seen it all being a nurse. Why tempt fate ?, it can lead to the baby going blind. I dont understand some people that want to go so natural they refuse all medical interventions. Dont they get the fact that the vitamin K is for blood clotting and babies have immature livers . They think they know more than the health care providers. I think that is half the problem in our healthcare system. I think its good they have to sign a waiver that way their idiocy is on them. Though their babies have no say in the matter of whether they want treatment or not.. Just my 2 cents......
The hospital should have a clearly written policy on how to proceed in such situations -- and if any staff member can't live with that policy, then he/she can look for a job elsewhere.
My question is even if you believe you are in a monogamous union sometimes women will have STDs and not know. Its not like all men are honest in relationships or even the woman who is delivering. I have heard and seen it all being a nurse. Why tempt fate ?, it can lead to the baby going blind. I dont understand some people that want to go so natural they refuse all medical interventions. Dont they get the fact that the vitamin K is for blood clotting and babies have immature livers . They think they know more than the health care providers. I think that is half the problem in our healthcare system. I think its good they have to sign a waiver that way their idiocy is on them. Though their babies have no say in the matter of whether they want treatment or not.. Just my 2 cents......
women have a complete std screening prior to birth, or at least here they do. i did, and every other mother i know.
vitamin k is given to babies for the very rare chance (1 in 10,000) that they have a vit k deficiency. to each their own- humans made it all the way to the 1960s without receiving vit k injections at birth. it is nobody's business but the family's.
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
The hospital should have a clearly written policy on how to proceed in such situations -- and if any staff member can't live with that policy, then he/she can look for a job elsewhere.
Although I agree with vaccinating our children........I also have a little nagging fear that we will vaccinate ourselves into glass houses. There is something to say for natural immunity and having co-existing auto-immune disorders my self which has me quite disabled (multiple sclerosis and dermatomyositis)......I wonder what "modern medicine" miracle has had to do with my damaged immune system. I am of the DES daughter age,small pox vaccines and live polio immunizations.
I believe that the parents should be given informed consents and refusals.......but they have the right to refuse on personal,legal,religious,or whatever reason they wish. This is a free country and we do not live in a policed state. I have vaccinated my children. But I really did not want them to have the varacella, at the time, mostly because no one could tell me what the length of immunity would be and that if they would have to be re-vaccinated when they got older when complications from varacella was more common AND serious......turned out I was right....It wouldn't last long and would need more vaccines......they recieved their re-vaccination last year. I still have not given my daughter HPV....and I probably will not......saftey,effecacy, and side effects deter me roght now.
I believe in informed consent and informed refusal. Although as medical professionals we give interventions "against" patients will....ie: confused combative patient a chemical restraint, restraining a patient before they jump out the window but... patients that are able to make decisions have the right to refuse.....whether or not I agree with them.
To force them IS Assault and Battery.....At least that is what I have always been told. You can make whatever policy you want....... but if it is in conflict with the Patients Rights, Nurse Practice Act,or state and federal laws...You can be prosecuted and/or sued. Just my 2cents
I think that if you are at a facility for medical care by professionals, then you should take what they recommend. If not, dont go.. People want to pick and chose what treatments they will and will not get, its rediculous. Its a state law, what on earth is the harm in putting eye cream on? rediculous.
also, the people who are going in for major life saving surgery who do not want any bood products administered. are you kidd ing me? you are going to have a major surgery performed, to save your life, and if you need a stinking unit of blood, you refuse it? so all the hours a whole team in the or worked to save your life , you are willing to die for such a petty reason?
we had a liver transplant patient who refused blood products. ummmmm doesnt an ORGAN supercede BLOOD? you will accept and ORGAN from someone else, but not blood ? this should not be alowed. its rediculous. taking an organ when so many other people are on a list for the same, who will be willing to accept whatever treatment the PROFESSIONALS deem necessary, and here comes some bozo, who will take the organ but refuse a simple unit of blood or ffp,making that entire transplant a waste? when someone else could have had that organ? this really ticks me off......
women have a complete std screening prior to birth, or at least here they do. i did, and every other mother i know.
vitamin k is given to babies for the very rare chance (1 in 10,000) that they have a vit k deficiency. to each their own- humans made it all the way to the 1960s without receiving vit k injections at birth. it is nobody's business but the family's.
Well OB is not my speciality but I remember being screened at first visit and then at about 7 months for group B strep and STDs but I havent had a child in a number of years 22 years to be exact but Vitamin K is a vitamin that helps blood clotting and it is the antidote for Coumadin overdose. Babies many times are jaundiced due to the immature liver and the blood cell turnover after birth and if mother was anemic during pregnancy . My gosh my granddaughter when she was born had immunizations started while in the hospital and she is now almost 4. I mean I maybe need some education because when is this last STD screen done ? You can be infected anytime and I know that with some STDs such as HIV and HEP C and etc. There is a lag time between being infected and it showing up in test results. In the bigger scheme things guess people will make decisions they want but the reason they have newborn guidelines is to protect a newborn's health. I personally am not one to take each drug on the market I dont take any but I think preventative care of any kind is usually good but to each his own.
women have a complete std screening prior to birth, or at least here they do. i did, and every other mother i know.
vitamin k is given to babies for the very rare chance (1 in 10,000) that they have a vit k deficiency. to each their own- humans made it all the way to the 1960s without receiving vit k injections at birth. it is nobody's business but the family's.
Actually things weren't all that great "back in the day" of all home births, no vaccines or vit k, and etc. All you have to do to understand is go to an old cemetery and count the little tombstones. I guess going by this statistic 1 in 10,000 babies "back in the day" had an untreated vit k deficiency..... not a significant statistic unless your baby was that one.
Actually things weren't all that great "back in the day" of all home births, no vaccines or vit k, and etc. All you have to do to understand is go to an old cemetery and count the little tombstones. I guess going by this statistic 1 in 10,000 babies "back in the day" had an untreated vit k deficiency..... not a significant statistic unless your baby was that one.
actually if you review the research, the decrease in newborn death is due to the discovery of microbes and subsequent washing of hands. the netherlands are in the top ten of lowest infant mortality rates, and they have the highest homebirth rate. the united states, as of 2006, had the second worst infant mortality rate in the developed world.
Everyone is screened during an initial OB panel for syphilis, gonorrhea, chlamydia, HepB, and HIV. HepC isn't (at least not in my state) in the routine prenatal labs. Group B strep isn't tested until about 36 weeks (give or take). In my state, HIV is also tested again around 28-30 weeks, as are gonorrhea and chlamydia. Anyone 25 or under, and anyone who's tested positive during the pregnancy, gets another GC/chlamydia upon admit to the hospital.
The risk of hemorrhagic disease of the newborn and/or ophthalmia neonatorum even without the shot/drops is so very very low, there's no good reason to scare parents over it. Our refusal form is a couple pages long and explains in detail the risks/benefits of getting and refusing both medications. As long as parents read this and know what they are signing, I don't lose sleep over it.
Specializes in Education, FP, LNC, Forensics, ED, OB.
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.
Please heed this respectful staff re-direct. Posts after this re-direct that have not been on-topic have been removed. Future posts will also be removed that do not stay on-topic of erythromycin/vitamin K being given or not given per parent's request.
Specializes in Nurse Leader specializing in Labor & Delivery.
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.
This is exactly what I do. As a parent who refused "eyes and thighs" myself, I have ZERO problems with them refusing (the exception to that is if they're planning on circing, or if the baby had lots of birth trauma and bruising).
I think forcing the parents to consent to non-lifesaving treatments for their newborn is so wrong it galls me.
Specializes in Nurse Leader specializing in Labor & Delivery.
vitamin k is given to babies for the very rare chance (1 in 10,000) that they have a vit k deficiency. .
No, that's not why. All newborns have a "vitamin K deficiency" (although I question if it's truly a "deficiency" if every single mammal is born that way). They don't start producing endogenous Vitamin K until they're around a week old (that's about how long it takes for e. coli to colonize in their GI tract - e. coli is what is responsible for Vitamin K synthesis).
I am of the DES daughter age,small pox vaccines and live polio immunizations.
Although as medical professionals we give interventions "against" patients will....ie: confused combative patient a chemical restraint, restraining a patient before they jump out the window but... patients that are able to make decisions have the right to refuse.....whether or not I agree with them. 
Psychtrish39, BSN, RN
290 Posts
My question is even if you believe you are in a monogamous union sometimes women will have STDs and not know. Its not like all men are honest in relationships or even the woman who is delivering. I have heard and seen it all being a nurse. Why tempt fate ?, it can lead to the baby going blind. I dont understand some people that want to go so natural they refuse all medical interventions. Dont they get the fact that the vitamin K is for blood clotting and babies have immature livers . They think they know more than the health care providers. I think that is half the problem in our healthcare system. I think its good they have to sign a waiver that way their idiocy is on them. Though their babies have no say in the matter of whether they want treatment or not.. Just my 2 cents......