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:
I don't think what the nurse did was right but that is the new selfishness today, not just in nursing but in society. Her beliefs and values trump everything else even when others do not share her beliefs. It is the same as those who refuse to care for those who have abortions. .
...I'm just throwing this out there for conversation sake.
I would think that there would be a difference in caring for someone post-procedure vs during procedure.
I could never assist a physician in a late term abortion, however, I would have no issue taking care of the woman afterwards.
To me, I am wondering if the JW nurse had a point in not helping with the administration, but she would not have post-transfusion.
I do agree that acute care where decisions have to be made on a dime, may not be the place for her.
I am thankful to live in a place where we do have the right to refuse. With that being said, prior arrangements must be made.
I think of the example of female circumcision done in some cultures. I understand that in those cultures, the procedure is considered a way to keep the girl pure and "godly." It is not meant to be harmful or cruel. Switch places. What if our mainstream culture was the one that believed in this and you, the nurse, did not. (Personally I object extremely to this procedure.) Wouldn't you be thankful that you had the right to refuse to perform the procedure or assist with it? I realize this is an extreme example, but I am glad that I live in a place that gives me the freedom to choose what my beliefs are and gives me the choice to perform or not. As long as other arrangements are made in advance so as not to affect patient care.
I may not agree with the beliefs of others, but I will defend thier right to have those choices.
Female or male genital mutilation, (most) abortion, and feeding patients porkchops are not in the same category as hanging blood. The above procedures are elective and are not medically indicated measures.
Hanging blood, pushing insulin, etc. are potentially life-saving medically indicated measures. In a similar vein, birth control is often prescribed as treatment for a multitude of gynecological illness and refusing to provide birth control pills in such an instance, as some pharmacists are doing under the recent executive order, is essentially denying treatment for patients.
My take on it is that you have every right to object to elective and tangential procedures, but if you choose to object over medical and nursing standards of care for treatment, you need to find yourself a different specialty or profession.
There was a recent case where a Muslim grocery store clerk was fired and then sued his former employer for wrongful termination and religious discrimination. He was fired because he refused to scan and checkout any pork products.
At what point do we draw the line between accommodation and expecting someone to do the job they willingly trained and signed up for?
I myself am not a JW but my family is. Please do not speak in absolute terms regarding things you are not fully aware of. Saying this person is NOT following her own religion is not true. As i understand it from my family, as far as hanging and watching the blood as well as performing all of the "patient care" regarding the blood each individual is left to "their Conscience" regarding those issues. Some JWs do not have a problem with this as they are not the ones who 'ordered' the blood for the patient and they are not accepting it for themselves...but others may have an objection to this therefore it is up to each individual to make a determination for themselves on that matter. Whatever the case it is up to the JW nurse to clearly inform her charge nurse way before this issue even comes up that this is the case. It also helps to not work in a setting where this is going to be a problem if they infact object to the patient care side of blood transfusions.
Mex
Mex,
You are very correct in stating that how far the JW will go with administering the blood transfusion depends on her/his conscience. I think that most JW's have no problem monitoring the patient but would not want to hang the blood. This can usually be anticipated so that the assignment can be made appropriately. Sometimes there needs to be a reminder or a switch in assignment, and the JW being a team player helps. I think my being one of Jehovah's Witnesses is an asset in that I am very culturally sensitive. Hospitals benefit from diversity.
Being a nursing student and a Jehovah Witness i can address this issue. Here is an article from our Watchtower Publication that will help you to reason on a nurses or any other medical workers position regarding blood transfusions or any other blood by product. If you have any questions please feel free to ask.***w754/1pp.215-216AreYouGuidedbyaSensitiveChristianConscience?***
CONSCIENCE
ANDEMPLOYMENT
7 Employment is an area that brings up many problems calling for the exercise of Christian conscience. Some forms of employment, such as making idols, working in a gambling establishment or being employed by a false religious organization, are clearly contrary to the Scriptures. So Christians shun these. (1 John 5:21; Col. 3:5; Rev. 18:2, 4, 5) Not all employment matters, though, are that clear-cut. Certain employment may be in a "gray area," so to speak. And sometimes, while one’s basic work is unobjectionable, one may be asked occasionally to do something questionable. So conscience can be involved.
8 For example, there are employment problems involving blood. The Bible states plainly that God’s servants should not feed on blood. (Gen. 9:3, 4; Acts 15:19, 20) Hence, Jehovah’s Christian witnesses do not eat food containing blood, such as blood sausage, or accept blood transfusions. But what if, on your job you were asked to handle blood or blood products occasionally? Would your conscience permit that? A Witness in Colorado worked in a hospital as the chief medical technician running tests of various types on body tissue and fluid. Among the many things he was expected to test were blood samples. Sometimes it was simply to check a patient’s blood for the level of sugar or cholesterol. But at other times it was to cross match for transfusion purposes. Could he do that?
9 This Christian gave careful thought to the matter. It could be seen that it would not be right for a Christian to work exclusively for a blood bank, where everything was devoted to an end that was in violation of God’s law. But that was not his situation; he ran tests of many kinds. Also, if one were a doctor responsible for the decision, one could not order a blood transfusion for a patient, any more than a Christian store owner could order and stock idols or cigarettes. However, this technician realized that in connection with blood he was merely running a test, even as a nurse might have taken the sample, a messenger might have delivered it to the laboratory and someone else might administer a transfusion or other medication on a doctor’s orders. He reflected on the principle at Deuteronomy 14:21. According to that text a Jew finding a carcass of an animal that died of itself could clear it away by selling it to a foreigner who was not under the Law’s restrictions about animal flesh not drained of its blood. So the technician’s conscience at that time allowed him to run blood tests, including those of blood for transfusions to patients who did not care about God’s law on blood.
10 Is that how your conscience would have reacted? If not, for the sake of discussion, ask yourself whether your conscience would permit you as an employee to bring the blood sample to the laboratory for testing. Or, taking yet another step farther away from the actual transfusion, could you as a truck driver deliver the testing equipment to the hospital? Or would your conscience let you make glass from which such equipment might be produced? It is clear that not all these things reasonably can be viewed as direct contributions to violating God’s law on blood. But where does one "draw the line"? Here is where conscience comes into play. While the Christian must avoid things that are unmistakably in conflict with God’s law, he is called upon to use his conscience in settling many matters. Would your conscience serve you well in such situations? Is it sensitive?
11 In this particular case, after many years of running tests, the technician began to be troubled by his conscience. It was not as if someone else should or could tell him that he was doing wrong. Nor was he looking for someone else to make his decisions for him. But he began to think: "Is it consistent to talk of neighbor love, and yet contribute, in part, to my neighbor’s breaking of God’s law?" (Matt. 22:39; Acts 21:25) Appreciating his Christian duty to support his family, he discussed the matter with his wife. (1 Tim. 5:8) Together they agreed that, if his conscience was troubled, it would be better to make a change. He left his $15,000-a-year job and began doing cleaning work, though he started off earning just $3,600 a year.
12 Let us not miss the point of this example. It is not related here to suggest that a Christian cannot be a medical technician; there are Christians who continue to work as medical technicians, nurses, truck drivers, and so forth. This example is given to illustrate that conscience can come into play on matters of employment. In your case the type of job and what you are asked to do may be quite different. But all Christians should give thought to whether they are living as closely as possible in accord with God’s ways and principles. If your conscience trained by God’s Word is pained because of what is asked of you, will you ignore it? Just how important is it to you to have a clear conscience before God and men?—1 Tim. 1:5, 19.
13 Of course, we cannot altogether avoid employment problems, for we are still in this system of things. (1 Cor. 5:9, 10) Thus you likely realize that you may not be able to move your boss to cultivate a Christian conscience. He may choose to disregard certain laws, he may exaggerate the merits of his products or he may stock some items that you would not if you owned the business. Or your fellow workers may lie on their production reports or loaf when the boss is not nearby. Still, you can and should respond to your conscience. So if it does not allow you to do certain things or if you are ridiculed for your hard work, accept that. The apostle Peter wrote: "If someone, because of conscience toward God, bears up under grievous things and suffers unjustly, this is an agreeable thing."—1 Pet. 2:18, 19.
Just a little useful info before you judge: Much research has been done in behalf of Jehovah's Witnesses, and as a result, blood transfusions are not as common place as they used to be. There are alternative methods in blood conservation that many non-Jehovah's Witnesses can take advantage of. These very effective alternatives are also very cost effective and are useful due to the blood shortages. Also, note the new Joint Commission guidelines. As a nurse, it would be good for you to do a little digging before forming opinions.
We use the cell saver for JW patients. Some JW are happy because it is all part of one circuit, otherwise will still refuse because the blood has been outside the body.
If I have a patient who refuses a blood transfusion then that is their right and as a nurse I advocate for this no matter what.
But if I am working with another nurse who won't even check a blood bag because it's against their religion and I have to call another nurse from somewhere else in the hospital to help check it and so on, delaying patient treatment then yes I would have an issue with it. If you choose to work in an area where blood transfusions are a strong possibility then you have to do your job.
Toxic Shock: I'm also against animal testing and I"m vegetarian. I'm aware that most of the products we use are extensively tested on animals. I will not wear any lanyard from any medical company, I do not accept their pens and other stuff that nurses all seem to love and I have walked out during inservices where videos are shown of a latest product being tested on an animal.However, I will feed a patient meat if they required it, provide a patient with a product that has been tested or come from an animal because I don't force my beliefs on others as well.
I appreciate your respect for your patients including Jehovah's Witnesses. Any one of us, if we are a patient may need an advocate to help see to it that our wishes are carried out. I have had such a nurse speak up for me on more than one occasion. As for nurses that are Jehovah's Witnesses, I really don't know of many that would not step up to go the extra mile and do other tasks in an effort to share the load. I would guess that the case mentioned is an exception: as regards to the unavailability of another nurse to quickly step in for that one particular task. After all, it takes some time for blood to be ready and available to hang. If she was bleeding out that fast, wouldn't she be transferred to the unit?
Thanx to everyone who posted, its given me a good insight into lots of different opinions.
My despair at the time was this was not a new member of staff, no one knew this was her stance on this matter until the blood was on the ward (she had recently been drafted from a day area where she would not have to do this very often). The restrictions between time blood arrives and is delivered is tight and could lead to an incident form going in if it is breached. I was more than happy to do all the spiking attaching I just needed someone to go through the checks to verify it was the right blood for the right person etc. She indicated she was having nothing to do with it. She was the senior member of staff on shift (7 years exp in different areas within hospital), and I had to do make the phonecalls and worry about time issues etc. to get infusion started. I was only recently qualified and already S******* myself over most things:$
Bestbabynurse - This lady had a chronic bleed, which initually needed 3 tx RCC, but as she was with us for a few weeks she needed more transfusions to keep her hb up:-). Sorry if what I wrote mislead anyone to think it was an acute bleed:-(
Britrene19 - Thank you for posting this, very helpful:-D
Thanks for the question. It gave a fair opportunity to explain, as opposed to you having to come to your own conclusions. I'm sure this nurse had to clarify her position as to what she will or will not do in such instance, since your experience of feeling left in a lurch. She may have forgotten about updating anyone in her new area/shift, as this is not something we think about all the time, believe it or not.
Your thread was a reminder for all nurses to keep everyone informed of anything that could affect our clinical area in regards to what we (Jehovah's Witnesses or anyone else) will or will not do for conscience reasons. (blood transfusions, circumcisions, abortions, ect.)
I hope that those that have further questions about Jehovah's Witnesses working in acute care settings, ask for information like you did. It is how we keep ourselves educated as professionals.
I have to admit I am quite ignorant about JW's and their beliefs (I only have known one, when I was in grade school). Could someone tell me why they cannot accept blood transfusions? I did read the post about ingesting it, and that makes sense to me. But this is not eating it. It is replacing blood back into your veins when you are losing blood. I would just like to try and understand why a nurse would walk away from her duty, her patient. A blood transfusion is not something that can wait, and to me, it seems like she was endangering the patient because of her personal beliefs. I always thought that as a medical professional, you are supposed to put your personal beliefs aside for the patient.
I will try to answer your question the best I can, but if I cannot answer all your questions, there are more resources available to you. One of such is called, the Hospital Liaison Committee (HLC). They are persons assigned to specific regions to facilitate communication and information between the hospital, the patient, and the family in regards to Jehovah's Witnesses and their stand on blood products and non-blood treatments/ alternatives. There are also disciplines that deal with this specific area that many hospitals have in place to provide care to people of any denomination that do not want blood transfusions. There are also websites that have loads of information on non blood treatments due to the demand. There is a DVD that you can obtain from any of Jehovah's Witnesses that is on the subject. So lots of education is available in this area.
With that said, I will attempt to address your points now. First, substances can be injested through different routes. If we are to 'obstain' from something due to a divine prohibition, it would seem reasonable that we not go some alternative route. To illustrate the route concept: You would not give an alcohlic alcohol through an IV.
As far as nurses "walking away from their duty" is concerned, please check back on postings dealing with how this is not the case with the proper measures in place...such as, the clinical managers and charge nurses being aware prior to a situation.
I hope this was helpful, I will try to find a specific Web site for more medical knowlege on the subject.
BabyLady, BSN, RN
2,300 Posts
...I'm just throwing this out there for conversation sake.
I would think that there would be a difference in caring for someone post-procedure vs during procedure.
I could never assist a physician in a late term abortion, however, I would have no issue taking care of the woman afterwards.
To me, I am wondering if the JW nurse had a point in not helping with the administration, but she would not have post-transfusion.
I do agree that acute care where decisions have to be made on a dime, may not be the place for her.