? on jehovah witnesses......and blood

[scared'o'needles!]

Hi, I have just joined the forum, I have been qualified 2 years now.

I was wondering if anyone can help me with some insight with the following.

I was working a nightshift with another SN that is a jehovah witness, there was a patient who had been admitted earlier that day with a low HB and needed 3 x RCC transfusion asap. The nurse whom I was working with told me that because of her beliefs she would not check or have anything to do with this duty:o. I had to arrange for the hospital co-ordinator at night to come down to the ward to assist me in setting up and checking the RCC. This caused a delay in the pt treatment as I had to wait till the co-ordinater was free to assist:-{

My question is was she right to put her beliefs and values before patient care. I know that there is issues in connection to JW not wishing transfusions for themselves etc., but surely as a nurse practitionare she should be putting the pt needs first?

I wanted to challenge this but being newly qualified at the time I was a bit unsure of my knowledge in this:uhoh3:. The nurse co-ordinater was also reluctant to do this due to political correctness, I have since researched this and have found nothing that forbids them performing this duty for others. Maybe I am looking in the wrong places for this information.

Thanks in advance for any insight anyone can give:up:

[AnnaSL, BSN, RN]

hmm, but honestly, from what I know JW beliefs was if Blood is to be transfused to them or organ donations or sort. IF the procedure is to be done to THEM.. Never a procedure to be done on someone else.. Yes, it is their belief.. And we respect that, the concern here is the patient.. NOT the NURSE.. You as a nurse has the duty to do what is right IN CONCERN with the PATIENT's belief.

Yes, the nurse has the right to refuse... REFUSE to do a certain procedure that would pose HARM to the patient... STILL, focusing on the patient..

The case said was different from ethical issues such as Abortion..

What are we? NURSE, an advocate for Longevity.. think about that...

[blondy2061h, MSN, RN]

A little off topic, but how low was the hgb? I'm curious, because I want to know what non-BMT nurses consider critically low, and what deemed 3 units was necessary.

[Ruby Vee, BSN]

she has the right to refuse. if a nurse did not believe in abortion, she would have the right to refuse to participate in one. jw's are very firm and inflexible in their religion. there should be a policy in your hospital that addresses this issue of refusal on religious grounds.

or, if she knew she was going to have a problem with participating in blood transfusions, she could have chosen a job where it wouldn't be an issue: home care, school nurse, office nurse, whatever.

i had a serious back injury. if my back was hurting too much to hold a patient on his side, i could at least stuff the pillows behind him. even if this girl had a problem with hanging blood, it seems she could have checked it and let the other nurse hang it. the fact that she couldn't do it would seem to indicate that she was putting her needs above the patient's needs. i hope she learns better.

[1stloveistobeanurse]

I am married into a family of JW and I am not one, and refuse because of these same reasons. However, to remain netrual I think she should have performed to procedure. Why? because just as she has the right to her own belief the patient has the right to his own. I am now in school for my RN and I am also assisting taking care of a family member who is passing away because she will not have a organ transplate. Daily I watch this women loose her life little by little, but I can't force my beliefs on her, I cant say I will not care for her because I do not believe it is in Gods will to refuse medical attention, as a nurse I must exercise her wants and make her feel as comfortable as possible.

Now this is not to say that I do not feel for her because I do, but once the opportunity was presented for me to join this religion I refused because of my own reasons, one, if this ever happen to me or my spouse, I wanted all medical opportunities afforded to us, and only us, now if I could not do this then I would not be a nurse.

[Batman24]

She shouldn't work on a unit where the job duties interfere with her beliefs. And I agree that most JW don't behave in this way. They have their beliefs where their own care is concerned but will do the will of others knowing everyone doesn't share their views.

[feralnostalgia]

first off, I have a huge respect for some JW beliefs. during the nazi years in germany they were some of the only german christians who willingly went to concentration camps rather than become nazi supporters themselves. that's nothing short of heroic, in my mind.

that said - why is she working a job that conflicts with her morals? I don't think that's remotely fair to everyone else...

[soulofme]

I am tired of this dang PC crap. You knew when you went into nursing that ya had to deal with blood at a certain level. Quit! making other people bend to your rules and beliefs. Find another job if you can't do it! There are plenty of people trying to get into nursing willing to do their jobs w/o bs like this.

[rn/writer, RN]

So, no JW should ever go into med-surg or work in a hospital?

I can see ruling out a transplant unit, but closing the door on all of med-surg seems unnecessary. And it doesn't seem likely there are many units in a hospital setting where you can rule out the possibility entirely. Even a postpartum unit like mine will tranfuse a patient now and then. (OB does it more often. Patients are supposed to be stable by the time we get them, but once in a while problems occur after the fact.).

The solution I have heard of most often is that the JW nurse will do everything connected with the transfusion except for the actual administration. Another nurse will connect the blood bag and open the line. The JW nurse will then do the vitals checks and whatever else is necessary to monitor the patient. If additional units are needed, someone other than the JW nurse will hang those as well. The JW nurse usually helps the assisting nurses with things they need, if not on that shift (monitoring transfusions can be quite time-consuming), then certainly at her earliest opportunity.

This seems reasonable to me provided the parameters are spelled out ahead of time. It doesn't seem kosher to come up with exceptions to certain types of care on the spot. In theory, religious restrictions could be cited by any group, and that's just too easy--and too tempting--to abuse.

But if the restrictions are minimal and well-defined, and the nurse is willing to work out alternatives, this should be a manageable situation.

It might not be practical for a JW nurse to work in ICU where transfusions are more common, but the percentage of garden variety med-surg patients who get blood is comparatively small.

A lot depends on the attitude of the JW nurse. If she is looking for excuses or a way to "make a stand," that's much more problematic than if she's looking for fair and practical solutions. People who only want to avoid personal transgression are easier to deal with than those who are using religious doctrine to get out of work or prove a point.

[hypocaffeinemia, BSN, RN]

Unfortunately, since the executive order last November or December, healthcare providers have the "freedom to act their conscience" on such issues.

It's the same thing that is being used to justify pharmacists refusing to fill prescriptions for birth control and many other things.

[BrnEyedGirl, BSN, MSN, RN, APRN]

I've worked with serveral JW's nurses over the years. They would not spike or hang the blood, but would care for the pt while the blood was running and afterward,.really never was a big deal,..just had someone else hang the blood. I think it's the same as nurses not wanting to assist in performing abortions,.but would still care for some one post op.

[scared'o'needles!]

Blondie - I cannot remember what her hb was (it was a long time ago), what I can tell you is it is our docs that monitor the blood values and decide on the action to take regarding this, also they would not transfuse a pt unless there hb was

[chicookie, BSN, RN]

I am a JW and a nurse. That being stated, I don't hang blood for my patients, before you bash my head in though I do want to make something clear just because I don't actually hang the bag doesn't mean I don't check the bag and do all the other things when it comes to a blood transfusion. The nurses on the floor understand this and one of them comes in with me hangs the bag while I do all the other stuff. I still monitor my patients afterward. Just because I don't accept it and it makes me personally uncomfortable to do it doesn't mean I am going to let it interfer with the patients wishes. I respect other peoples wishes, while I do like to teach about my religion I would never force my beliefs onto other people.

But like any other religion there are people that are extermest, and there are people that are just learning about the religion. Then there are the normal people. I do agree though if the lady knew that she doesn't hang blood that she should have discussed this with the manager on the floor and they should have come up with a plan in case this happened.