Families requesting no male nurses for their baby.

prmenrs, RN · Jul 10, 2010

I'm agreeing w/you based on what you wrote. What would management be saying/doing if a family requested no nurse of (whatever ethnic background) care for their family member.

Sounds like some education is needed for families. IMHO, that's where management's energy should be spent.

theatredork · Jul 10, 2010

My assumption is that if a ethnic nurse request was made that it would be denied. Our unit utilizes primary nurse lists for our babies, and also allows parents to 'fire' a nurse if they don't want the nurse taking care of their child.

The no male nurse request has occurred a few times over the last couple of months. A complaint has been that men are not nurturing enough.

ittybabyRN, RN · Jul 10, 2010

We also have primary nurse lists for our babies...however it is the nurses choice if she wants to start a list for any particular baby, so not every baby has primary nurses. Parents may ask a nurse to be on their childs list if they want but are not allowed to choose who cannot care for their baby. Now as far as the male nurse goes, I did take care of a baby who had a male nurse during the night shift and her mother was outraged saying the baby was not bathed well enough and "how can a man take care of a baby" I think in this situation it was definitely more of a cultural thing where in her culture it is primarily the woman caring for the children. Anyways I think she may have taken it up with the charge nurse and no longer has male nurses for her baby, granted we only have 3 on our 200+ staffed unit, and her baby is over 8 months old so they may be accommodating for her.

I have noticed that management does get involved in some of the "high publicity" cases such as the baby of a local pro hockey player, and a recent set of conjoined twins, making primary lists for those babies before they even hit our floor without the nurses necessarily agreeing with it. Kind of puts out the message that only "certain" nurses can take care of those babies and that not the whole unit is qualified, but just my opinion.

caliotter3 · Jul 11, 2010

Back in my CNA days I was hired by a home health agency. During orientation I was told that if I went to a client's home and they said they didn't want me to work because of my ethnicity, they didn't get that choice. I never found out what would really happen in such a situation. But as a licensed nurse, in home health, I have seen nurses fired all the time and sometimes ethnicity has everything to do with it. But an intelligent person won't tell the employer that ethnicity is the reason. They make up something that sounds plausible. I believe that wishes should be granted to a certain extent, but then what do you do when circumstances do not allow for the parent's wishes to be followed? There are only so many available employees at any given point in time and it is quite possible that the nurse they want may not be available to them. Probably best not to give out "druthers".

llg, PhD, RN · Jul 11, 2010

In many cases, management goes along with these requests to protect the nurse and the hospital from a potential lawsuit. Once the family has made such a request (no matter how unjust that request is), both the hospital and the individual nurse would be at great legal risk should that nurse be assigned to that patient's care. The family would probably be "trigger happy" should anything even slightly undesirable happen to the patient -- and might even sue for emotional distress or even assault for no other reason that the patient was cared for by someone they didn't trust or like.

Whether a jury would side with the patient or with the hospital, you never know ... but regardless of the outcome of the trial, it could result in a long stressful and expensive legal process for all involved. So, many hospitals find it easier just to honor the family's request.

As a nurse, do you really want to risk a lawsuit being filed against you ... or charges filed for assault ... just to make a point?

NicuGal, MSN, RN · Jul 11, 2010

We tell parents that everyone on the staff is capable of taking care of every baby in the unit. We don't let them say who can and cannot take care of that baby unless there is an all out war basically. We are too busy of a unit to get involved in that. We have had no males with some of our Muslim moms due to cultural basis, but that is as far as we take it.

As for a lawsuit, I would have to respectfully disagree there. And I think the hospital would too. There has to be intent to harm.

Bortaz, MSN, RN · Jul 12, 2010

Luckily, that hasn't happened to me yet. And I'm far more nurturing to the babies than nearly any of the female nurses on the unit.

llg, PhD, RN · Jul 12, 2010

As for a lawsuit, I would have to respectfully disagree there. And I think the hospital would too. There has to be intent to harm.

There doesn't "have" to be anything for a person to file a suit. They can file a suit for anything, even trivial things. They might not win the case if it is trivial, but the human and financial cost of defending yourself is still something you want to avoid if possible.

Also, lawsuits can be filed and won for acts that were not intentional. People don't intend to let an IV infiltrate and cause a scar -- but it happens -- and that pain to the baby and the permanent scarring can be the basis of an expensive lawsuit. People don't have to intend to make a med error for it to cause a problem and stimulate a lawsuit.

"Intention" has nothing to do with most lawsuits. Parents may forgive a lot of little things (or even medium mistakes) if they have a good relationship with the staff and believe the staff is doing its best to provide good care. However, they may take a very hard line against the staff/hospital and seek damages for those same mistakes if they feel their wishes have been ignored and that the caregivers are not the right people to be responsible for their child.

One of the standard recommendations on "how to avoid a lawsuit" is to work WITH the family and honor their preferences when it is possible so that they feel they are being listened to and being cared for in a way they believe is appropriate. A lot of hospitals will cave in on some requests that violate our sense of fairness in order to prevent trouble later should there be any little problem with the patient that an already upset family might over-react to. As someone who has spent 14 years in NICU leadership positions in a few different hospitals, I know that to be the case.

ittybabyRN, RN · Jul 12, 2010

now that I think of it, we have had other incidents as well, one I was involved in. I came in to work and was assigned a baby who had been around the bush a few times, he was almost 6 months old (full term) had spent most of his time in the Cardiac ICU, then stepdown, then cards bumped him up to us, his mother was a bit neurotic, when she saw me sitting down to get report she pulled the night shift nurse into the room and made a big fuss, the nurse came out and didnt say anything to me but started giving me report, the mother then marched down to the charge nurse station and interrupted report going off that she now couldnt leave for the day because she didn't know the nurse taking care of him and she saw another nurse she liked come in and wanted to know why he didnt have her (reason being was that that nurse had a primary baby who used to be paired with him but had her room changed), she put up a big fuss and ultimately the charge nurse changed the assignments (which she probably should not have caved to), I honestly didn't mind because I didn't feel like dealing with 12 hours of that :uhoh3:

BittyBabyGrower, MSN, RN · Jul 14, 2010

We don't put up that kind of stuff either. We also have only had females for some of the Muslim families, but usually if they are breastfeeding.

As for the intent to harm, I think she probably means that if they retain a lawyer, they would be hard pressed to find grounds. I have been in management and a charge nurse for lots of years and never heard of or saw a lawsuit from a family about who took care of their baby. Not enough money in it for the lawyers I guess. And IV infiltrates...I would certainly hope not one person intends for that to happen, but those cases are just settled and rarely go to court. I too work for a large unit and we just don't have the time nor staff to play those kind of games. I have also been deposed several times and not once did the "did the parents like you or so and so" come up, and these were on chronic complainy types. Yes, you should try to make the family happy, to a certain extent, but sometimes, you just can't. We did have one family that only wanted black nurses...well that wasn't going to happen and they learned to live with it.

Bottom line...just do your best.

Babynurse20 · Jul 15, 2010

In Labor & Delivery I've heard of patients requesting to not have a male as their nurse, which is understandable. Recently, some families in the NICU have requested that their baby not be cared for by a male nurse, and management has granted this request.
While understandable in L&D, I feel like this is discriminatory based on gender, and shouldn't be supported by management in the NICU setting.
Your thoughts?

I think most managers in the NICU are into kissing the families "you know what". This is not right, IMO. We tend to grant too many parents' wishes when they are not appropriate!