Doctor Asked For A "Kind" Nurse - page 11

1. 
   Mar 26, '03

   Originally posted by fab4fan
   3rd Shift Guy: A JW who takes a blood transfusion can be disfellowshipped. Any family members who are JW would not have contact with that individual unless absolutely necessary. Disfellowshipping is a very serious measure; it's not done lightly.
   
   It is not, however, a permanent state. Someone who has been disfellowshipped for, say drug addiction for example, may be reinstated if he/she feels remorse and makes the appropriate changes. Disfellowshipping indicates that not only was the person aware that he/she had committed a grave sin, but also does not have a repentant attitude (similar to "willful misconduct").
   
   A transfusion that is forced on a JW does not result in a disfellowshipping if the JW or family did their utmost to prevent it. This isn't meant to be used as a loophole by the JW or medical staff, however. An e.g. would be a Witness who was having surgery, told the doc no blood, has a signed "No Blood Transfusion" card, has the advanced directive indicating no blood, and writes on the op permit and anesthesia permit "No Blood."
   This person has made it plain that he does not want blood. During surgery, a complication arises and the doc goes ahead and has the pt transfused. The pt should not be held accountable for that; he did his utmost to prevent it.

   Thanks for clearing that up, and for supplying the word "disfellowshipped" that escaped me.
   
   This has been a great thread, but I'll stop adding my one cent now.
2. 
   Mar 26, '03

   Just my humble little opinion, but.....
   
   The bible was written in simple times by simple people who could not possibly have fathomed the idea that we would be using blood as a viable medical treatment in this day and age. The interpretation of it is a modern (and wrong, in my opinion) one.
   
   This is off topic, but,my sister in law is a staunch JW, and it has caused many conflicts in our family, medical and other. She is the only JW in the family and feels it proper to inflict her beliefs on others. She refused to attend many weddings and funerals.
   
   And Fab4...a question for you....how do you, as an RN, handle transfusing blood products into your patients? Is this not an ethical dilemma for you?
   
   Thanks.
3. 
   Mar 26, '03

   Originally posted by LasVegasRN
   Oh no. Have no regrets for being the lady that you are. Hopefully people will learn what it is to be one from your example.

   you know what? I consider myself to be a fine lady. I am entitled to my opionion. I dont deserved to be "bashed" by you.
4. 
   Mar 26, '03

   As far as JW who are medical personnel and the use of blood products in the clinical setting: This is a matter that is left up to the individual's conscience. There are some that feel it would violate their conscience to administer blood; these individuals usually will work in an area where transfusions are not given to avoid conflict in the workplace (e.g. I know someone who is a JW and an RN; she has chosen to work in psych to avoid the blood issue).
   
   There are others who will administer the transfusion; on a personal note, I fall into this category. Just as I feel that no one should impose his/her values on me, I feel that I cannot impose mine on a pt. I am not saying that I feel my view is more correct...it is a matter of conscience. The only official position there is on this is that there should be no criticism from others in the congregation for whatever choice that person makes (in other words, MYOB).
   
   NS: Perhaps the conflicts in your family r/t your sister being a JW have more to do with her personality than the religion. My parents and I are the only JW in our family, and we have managed to get along peacefully.
   
   Comments like that, IMO, have nothing to do with the main issue and come across to me as denigration.
5. 
   Mar 26, '03

   
   NS: Perhaps the conflicts in your family r/t your sister being a JW have more to do with her personality than the religion. My parents and I are the only JW in our family, and we have managed to get along peacefully.
   
   Comments like that, IMO, have nothing to do with the main issue and come across to me as denigration. [/B]

   Thanks for replying. I have no doubt it has more to do with her personality than anything else.
6. 
   Mar 26, '03

   I have been following this thread closely. It is evident. from reading this bulletin board, of the difficult decisions/ethical dilemmas nurses face regarding patient's deaths -- possibly due to not accepting blood products. I have seen such wonderful results for both elective and emergent surgery. With educated staff, proactive nursing, and physicians dedicated to bloodless medicine and surgery, much can be done to help patients receive excellent health care with very positive results. A small example -- just think that the AVERAGE ICU patient loses about 1 liter of blood each week on blood draws!!!! Judicious bloodwork & pedi tubes can help make a difference.
   
   I am fortunate to work in a large hospital which has an outstanding Center for Bloodless Medicine and Bloodless Surgery (CBMS). Upon admission, each patient is asked if they would be willing to take blood products in an emergent situation. Every JW I have encountered is extremely well educated regarding bloodless medicine, carries an identification card, etc. -- I have found their families to be extremely supportive. Immediately, we beep the director of CBMS -- we have outstanding resources. I strive to primary every JW on my floor. I have done extensive research regarding JW & bloodless medicine. I continue to be supportive of their religious/cultural beliefs -- their beliefs are not mine (I'm Catholic) -- but that is not the point. I'm talking about competent, informed patients with the right to make decisions. A difficult/ethical dilemma at times for nursing -- absolutely.
   
   Positive things can come out of this thread. What policies/protocals does your facility have regarding bloodless medicine? How can you support your patients? Perhaps the doctor should not have used the term "kind" nurse -- rather, he should have used the terms "a nurse who is familiar with bloodless medicine." As a fellow nurse, I'm not judging another nurse regarding this issue -- (student nurses -- this is an EXCELLENT research topic for a cultural presentation!) Peace to all.

   Last edit by susanmary on Mar 26, '03
7. 
   Mar 26, '03

   NS:
8. 
   Mar 26, '03

   Thank-you, Susanmary for an excellant post. I did not even KNOW that a Center for Bloodless Med and Surgery even existed.While we all have our differances sometimes, if never fails to amaze me what I learn on this board. Also, thanks to Fab4 for the education on JW and your beliefs.
   One great thing about nursing, always more to learn and explore.
9. 
   Mar 26, '03

   Check out Nursing Spectrum's magazine articles. Go to the Northeast section -- March 10, 2003 -- article on bloodless medicine and surgery is outstanding. This is so much information out there -- and it's vital to get correct information. Again, hopefully some positive things will come out of this post -- what are your facility's policies/protocals regarding bloodless medicine? Peace to all.
   
   This is SUCH an important and exceptional post.

   Last edit by susanmary on Mar 26, '03
10. 
    Mar 26, '03

    Well, Hgb is down to 4 today, platelets at 7. Starting TPN. We got an accepting physician at a teaching facility with the assistance of our JW liason.
    
    I've been on hold with the patient's insurance company now for over 11 minutes. This is just to get to a live person to talk to. ~sigh~
11. 
    Mar 26, '03

    Originally posted by LasVegasRN
    Well, Hgb is down to 4 today, platelets at 7. Starting TPN. We got an accepting physician at a teaching facility with the assistance of our JW liason.
    
    

    Is she still actively bleeding??
12. 
    Mar 26, '03

    Originally posted by NS_RN
    Is she still actively bleeding??

    Yep.
13. 
    Mar 26, '03

    Fab,
    
    I am just curious so please do not take this as a slamming or anything of that manner.
    
    But as a JW and a nurse do you have any issues with administering blood products to your patients? Just wondering...

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