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.
Specializes in Nurse Leader specializing in Labor & Delivery.
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..
Well, that kind of goes against one of the main principles that guide nursing practice - autonomy. WTH is wrong with informed pts (or agents of pts) "picking and choosing" what medical procedures they want and do not want? What you wrote above feels so wrong to me that I have a hard time putting it into words. It's NOT "rediculous" (sic). What would be "rediculous" is if the government or the doctors were allowed to force any and all procedures on patients as if we lived in Nazi Germany or Communist Russia.
And "what is the harm of putting eye cream on"...well, how about unnecessary use of antibiotics? How about the fact that some babies have a bad reaction to the eye ointment and end up with red, swollen eyes for a few days? How about just the plain fact that the parents have the right to decline an unnecessary procedure or medication for their infant? That itself should be adequate reason enough.
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.
I had a complete STD screening at the beginning of both of my pregnancies.. the doc did them on the first visit. I'm assuming this is the norm? And if so, partners aren't always faithful throughout a pregnancy.. lets face it.. we'd like to think all is well in the world but the reality is there is a lot of cheating going on out there and just because mom tested negative in the beginning doesn't mean she will be in the end.
It seems to me if it isn't harmful to the child, there is absolutely no reason not to err on the side of caution.
Specializes in Nurse Leader specializing in Labor & Delivery.
I had a complete STD screening at the beginning of both of my pregnancies.. the doc did them on the first visit. I'm assuming this is the norm? And if so, partners aren't always faithful throughout a pregnancy.. lets face it.. we'd like to think all is well in the world but the reality is there is a lot of cheating going on out there and just because mom tested negative in the beginning doesn't mean she will be in the end.
It seems to me if it isn't harmful to the child, there is absolutely no reason not to err on the side of caution.
And where would you draw the line? Should we refuse to allow any new mom to breastfeed unless she undergoes another Hep B and HIV test, just in case her partner has cheated on her and exposed her to those STIs?
And where would you draw the line? Should we refuse to allow any new mom to breastfeed unless she undergoes another Hep B and HIV test, just in case her partner has cheated on her and exposed her to those STIs?
You draw the line wherever you want to. I don't disagree that it should be up to the parent (unless they truly are refusing life-saving treatment for their child)- I'm just saying that personally, I am all about doing everything and anything that will help protect my child. The Vit K shot and eye ointment, weren't even a concern of mine. Personal choice.
Edited to remove home birth discussion.. I agree it's taking the topic in a different direction.
Specializes in Nurse Leader specializing in Labor & Delivery.
You draw the line wherever you want to. I don't disagree that it should be up to the parent (unless they truly are refusing life-saving treatment for their child)- I'm just saying that personally, I am all about doing everything and anything that will help protect my child. The Vit K shot and eye ointment, weren't even a concern of mine. Personal choice.
That's kind of the point of the thread. These parents are not being given the choice to make healthcare decisions for their child. Especially non-lifesaving healthcare decisions.
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
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......
Interesting......although totally off subject...... it would be ridiculous to have a liver transplant and not have blood products....I would not have thought that the facility would consent to perform the operation. This would be an interesting thread if the poster reposts it!
Specializes in Nurse Leader specializing in Labor & Delivery.
Granted, I know this is less risky than a liver transplant, but we've had JW moms come in for C/S, and of course, refuse blood consent per the dictates of their religion. Thankfully, I work at a large enough facility that we were able to have a cell-saver on standby.
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
LOL! That's kind of exactly my thoughts on circumcision.
I think we need to respect people's beliefs. Educate them, Give them the tools to make the right decision.....but in the end it is their decision!
To administer anything against anyones will is Assault and Battery and YES you can be charged and sued! BUt more than that....it is not our place to judge. We should be embracing each individuals right to believe what they wish and live their lives as they wish.....we are not to judge but to be there to teach, support and guide. Learn someone's point of view....embrace their differences. Acknowledge and respect different cultures and beliefs!
I think if we take the emotion out of it it will help.
The real question is "is it battery to perform a procedure on a patient that they have expressly denied consent for?" I think the answer to that question is pretty easy.
That said, I am not even sure why vaccine questions have entered the discussion, vit K is not a vaccine.
klone, MSN, RN
14,857 Posts
Well, that kind of goes against one of the main principles that guide nursing practice - autonomy. WTH is wrong with informed pts (or agents of pts) "picking and choosing" what medical procedures they want and do not want? What you wrote above feels so wrong to me that I have a hard time putting it into words. It's NOT "rediculous" (sic). What would be "rediculous" is if the government or the doctors were allowed to force any and all procedures on patients as if we lived in Nazi Germany or Communist Russia.
And "what is the harm of putting eye cream on"...well, how about unnecessary use of antibiotics? How about the fact that some babies have a bad reaction to the eye ointment and end up with red, swollen eyes for a few days? How about just the plain fact that the parents have the right to decline an unnecessary procedure or medication for their infant? That itself should be adequate reason enough.