ethics lecture rant (sensitive topic)

[Ginyer]

Today our lecture was on ethics and values in nursing care. We were discussing abortions and our teacher was explaining to us that we can refuse to care for a patient if say they are in the hospital because of a serious medical problem due to an abortion. The discussion got a little heated (personally I wouldn't try and refuse to care for anyone unless I felt threatened in some way) but some of the students in my class explained they would never care for a patient who was in the hospital from a problem with an abortion unless obviously no one was available to take over that pt's care. I was surprised a few students felt so strongly about this. I thought a big part of nursing care is to not pass judgement and be as accepting as possible. I realize we're only human but personally I feel that if you have reservations about treating certain pt's because they believe in something you don't...or they have acted in a way that you feel is against your own morals, you're in the wrong profession.

Anyway...a little fired up from the lecture still and wondering how you guys feel about passing a pt on to another nurse and reasons that would make you refuse care to for someone.

(no abortion arguments please)

Ginyer

[RNSuzq1, RN]

I feel very strongly about the oath and pledge we all must take when entering the Medical Field - First and foremost - do no harm!!! When we are faced with a patient in pain, in trouble, etc. - our first duty is not to pass judgement on them and the reason they are in pain, but to help heal them.

I'm not only a Nursing Student, but a devout Roman Catholic, life in any way, shape or form is a precious gift to me. I know I will never take part in ending a life, but also know that I'll be faced with patients that have tried to end their life through attempted suicide, women who are bleeding to death from abortions, etc. My first priority will always be the patient in front of me and what I can do to help them "get well"..

As much as it breaks my heat, It's not my job to judge someone as to why they wanted to end their life or the life of their unborn child. As painful as it is to think about - perhaps they thought that was their only way out or the only option they had. We all know that anyone who is so depressed, stressed out, etc. to go to those extremes is in desperate need of help and that is where we come in - we are here to help them through this and perhaps make a difference in their lives.

[Spidey's mom, ADN, BSN, RN]

I would never participate in the murder of a fetus, so don't ask me to.

I will care for an admission who had complications relating from an abortion because that's a whole other issue to me.

I think there is nothing wrong with reassigning patients we are uncomfortable with, especially if it's a moral issue.

I work with a Jehova Witness who doesn't hang blood. She doesn't mind caring for patients that have received blood, but she won't hang blood. I don't see how asking a nurse to sacrifice his/her moral principles is helping the patient.

This makes perfect sense to me.

steph

[RedSox33RN]

I feel very strongly about the oath and pledge we all must take when entering the Medical Field - First and foremost - do no harm!!! When we are faced with a patient in pain, in trouble, etc. - our first duty is not to pass judgement on them and the reason they are in pain, but to help heal them.

I'm not only a Nursing Student, but a devout Roman Catholic, life in any way, shape or form is a precious gift to me. I know I will never take part in ending a life, but also know that I'll be faced with patients that have tried to end their life through attempted suicide, women who are bleeding to death from abortions, etc. My first priority will always be the patient in front of me and what I can do to help them "get well"..

As much as it breaks my heat, It's not my job to judge someone as to why they wanted to end their life or the life of their unborn child. As painful as it is to think about - perhaps they thought that was their only way out or the only option they had. We all know that anyone who is so depressed, stressed out, etc. to go to those extremes is in desperate need of help and that is where we come in - we are here to help them through this and perhaps make a difference in their lives.

Very well put, Susan!

[Soleilpie]

well thanks soleilpie. i do love my babies. i didn't have nearly as many grey areas when i worked in l&d, but the nicu is much different. what's ethical to one person is completely unethical to someone else and sometimes two opposite scenarios can both be care consistent with keeping a nursing lisence... it's a mess some days! i know those parents have the right to determine their infant's code status and i certainly don't think it's my business to decide for them, but i think a nurse who agrees with the ethics of the treatment will be a much better resource for the family than one who doesn't. sometimes the most ethical thing is admitting our deficits and seeking help if we can't do the best job.

btw, if you are interested in the issue of dehydration and death, you can always google "terminal dehydration". hospice and palliative care is certainly not an area i am well versed in. my only experience was with this one child and the specialist docs came to speak with us about it before that plan of care was instituted.

yes, i can definitely see where there would probably be many more grey areas in nicu and icu etc. i don't advocate forcing anyone to do anything they consider unethical. mostly what i'm trying to say is that all healthcare professionals should be required to do what is clearly ethical without judging a person's personal choices or lifestyle. you shouldn't be required to participate in abortions but should be required to help with any complications as a result of it. if it upsets the nurse to help even with the complications because of inability to put aside their judgment, then it's probably best for them not to work with that patient, but then i question why they would choose to work in the medical field or any field where they will encounter people from all walks of life. if you allow your judgments about a person's lifestyle dictate who you're going to help or not help, then you're supporting the idea that not all people should have access to healthcare. what if everyone felt as you did, what would happen to the patient? but if you consider a certain treatment unethical because it will harm the patient or cause an unreasonable amount of pain and suffering w/out any benefit, then that's a whole different situation. you're advocating for a patient in that situation. i'm not directing this at you fergus51. i clearly see that the decisions you make are because you are an advocate for your patients.

i will definitely do some research on terminal dehydration. i've never heard of it before. if it doesn't cause any pain or suffering, then i'll definitely be for it.

[Soleilpie]

I would never participate in the murder of a fetus, so don't ask me to.

I will care for an admission who had complications relating from an abortion because that's a whole other issue to me.

I think there is nothing wrong with reassigning patients we are uncomfortable with, especially if it's a moral issue.

I work with a Jehova Witness who doesn't hang blood. She doesn't mind caring for patients that have received blood, but she won't hang blood. I don't see how asking a nurse to sacrifice his/her moral principles is helping the patient.

I agree with you here. No one should be forced to participate in a treatment that's going to go against their religious morals or is considered unethical to them. But if the patient sufferes from any complications from that treatment, then I feel everyone should be obligated to treat them, unless of course the treatment is considered unethical.

[Soleilpie]

I think being a nurse is a choice and I don't think anyone is forced into it. What comes along with being a nurse is having and conveying a non-judgemental approach to ALL of your patients not just the ones whose principles you agree with. I think if someone would refuse to care for a patient who was suffering from complications of an abortion, then they chose the wrong profession. Nurses ARE professionals and are expected to act as such. This sense of professionalism means treating every person as an equal no matter whether they are a homeless alcoholic, an HIV positive patient, or someone's grandmother!

Our job is not to agree with our patients and what they do in their own lives, our job is to provide compassionate, unbiased care to them!!

Grrr...people like this make me mad~~ :angryfire :angryfire

I COMPLETELY agree with you.

[Marie_LPN, RN, LPN, RN]

I work with a Jehova Witness who doesn't hang blood. She doesn't mind caring for patients that have received blood, but she won't hang blood. I don't see how asking a nurse to sacrifice his/her moral principles is helping the patient.

So what if no one else is available to hang the blood, what if no one else is available to take that pt.?

I would never expect my facility or co-workers to conform to my moral principles, nor would i even ask them to. Probably because i wouldn't be at a job where i would be running the risk of that happening.

In other words:

If certain cosmetic procedures were to start being performed at the facility i work at, i would not refuse to participate, i would quit, and i wouldn't wind p in the newspaper for it, because i wouldn't give "my morals" as the reason why i would be leaving. It is not up to that facility to conform to ME, it's not up to that facility to accomodate my morals, and i'd never even ask them to. This is what i took into consideration before i applied for the job.

JMO

[bluesky, BSN, RN]

You know you'd be surprised what you're capable of if you challenge yourself. I always thought that with the experience I have had with domestic abuse in my life, that I could never take care of an abuser. Well recently I've been taking care of a quad neck stabbing victim who was stabbed by his stepson for repeatedly abusing his wife. I knew the story but all I could see was the pain and vulnerability of the man laying in front of me. Beleive it or not, it wasn't even a difficult thing to do, it comes automatically with the turf, ya know ? :)

[grentea]

Wow Ginyer...that's something else. Even from your classmates' own perspective of being pro-life what they're saying makes no sense. As nurses and future nurses, we're called to care for the patient not judge whether or not the cause of their medical problems is something we personally condone. By your classmates' logic, practically no one "deserves" medical care. If doctors and nurses chose not to treat every injury, disease, and medical problem that was the result of a decision that they personally would not agree with, there wouldn't be much of a health-care system. Really, think about it! What if you broke your arm doing something stupid like playing tackle football and the doctor wouldn't treat you because he thought it was a dangerous game and you shouldn't have even been playing it. More compassion, less judging! :redpinkhe

[fergus51]

So what if no one else is available to hang the blood, what if no one else is available to take that pt.?

In my experience no nurse will refuse to do something if they are the only one able to do it. I have done things that go against my personal morals and ethics because I knew there was no one else who could do the care better since NO ONE on the unit thought what we were doing was ethical.

Are people against helping their coworkers avoid such situations if there is no real problem? For instance, if your coworker is a JW who doesn't want to hang blood and you have no objections to hanging blood, is it really that big of a deal if the charge nurse assigns the transfusion patient to you and not the JW? If your coworker was molested and has emotional issues looking after a child molester and you don't, why not help her out? If my coworker is Jewish and feels uncomfortable looking after the patient with the swastika tattoo, I don't mind taking him. I'm not suggesting we bend over backwards, but if it isn't difficult to help them out, I think it's just a part of teamwork and caring for our colleagues.

[Spidey's mom, ADN, BSN, RN]

In my experience no nurse will refuse to do something if they are the only one able to do it. I have done things that go against my personal morals and ethics because I knew there was no one else who could do the care better since NO ONE on the unit thought what we were doing was ethical.

Are people against helping their coworkers avoid such situations if there is no real problem? For instance, if your coworker is a JW who doesn't want to hang blood and you have no objections to hanging blood, is it really that big of a deal if the charge nurse assigns the transfusion patient to you and not the JW? If your coworker was molested and has emotional issues looking after a child molester and you don't, why not help her out? If my coworker is Jewish and feels uncomfortable looking after the patient with the swastika tattoo, I don't mind taking him. I'm not suggesting we bend over backwards, but if it isn't difficult to help them out, I think it's just a part of teamwork and caring for our colleagues.

We help each other out like this . . . sometimes a nurse will work 3 days in a row with a particularly frustrating patient and another nurse will offer to take the patient. It is called teamwork.

steph

[CarVsTree]

I think your instructor is WAY OFF. I will not take care of someone during an abortion procedure, but I don't believe that I have the right to refuse to care for them after. I would not be taking part in the abortion or condoning it, just taking care of my patient's needs.

If you can refuse to take care of someone s/p abortion can I refuse to care for a GSW or Stabbing 'cause he was in a fight or killed someone. What about prisoners, should I refuse to care for them because I found out they're a rapist or pedophile. It is not our place to judge and decide who gets care based on our own moral code. It is our place to care for anyone that walks through the doors of the hospital.