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:
The OP asked the question about the Nurse refusing to preform a direct order from the pt's Dr, in this case a blood transfusion. Can a Nurse refuse to follow an order due to religious beliefs? Again, yes, they can, however, the Nurse most definately should take the matter up with her direct manager. As this was a problem that was not an everyday occurance, a call to the manager by the pt's Nurse at the time of recieving the order, should have been made and not left to the OP to deal with. While I know many JW's who are wonderful, hardworking people, I have also encountered those who use thier religion as an excuse to avoid work. This does not deminish the rest of the religion, just those who will have to face thier God and explain to Him why they chose to use Him in such a way.
Specializes in Pediatric Intensive Care, Urgent Care.
The simple matter is that a nurse can refuse to do something based on their religion period. It's a right fought hard for in the Courts. Suggesting that they shouldn't be a nurse is obsurd! We will never be able to walk into a patients room completely seperated from our beliefs, in fact nursing education encourages you to bring those with you in order to provide a unique perspective to the care you provide. JWs have been refused care by physicians and nurses and entire hospitals because they didn't want to recieve blood! So they know all too well what prejudice feels like. The fact that a JW nurse holds it against their belief to spike the blood and hang it has nothing to do with you, if you don't agree. Their faith has no reflection on yours...it is not about your faith at that point, it's about theirs. So arguments about your faith not being any less because you don't oppose to blood are moot! You don't have the problem with it...they do. We make accomodations everyday for our co-workers...i personally would never (although ironically i wont be able to avoid this) want to work with someone who is not accomodating for a JW coworker...because today they are not accomodating for the JW and tomorrow they won't be accomodating for me...
On a side note...I'm sure they also put up with our "office" christmas spirit, halloween spirit, valentine day spirit, etc...and they don't walk around bashing us for our beliefs. And before you continue the same argument that has no teeth that the previously mentioned doesn't endanger lives...the fact is that neither does their belief. On any given minute there are several nurses on ANY floor in the hospital. Isn't that what they teach us novice nurses when we start that a dozen nurses are a yell away...in an emergency situation?!?!? So in an "emergency" where blood needs to be hanged...there will always be several nurses to do this. The key to this is preplanning...as long as the JW is proactive about their situation...there should never be a problem with this in a hospital...
Not everyone is agreeable to work with someone with unfamiliar beliefs, customs, backgrounds; and look for valid reasons to avoid having to deal with them. To say "itiswrongor unfair to get someone else to provide one form of medical treatment for a patient because of a particular conflict with the nurse's beliefs", and at the same time say "I don't want to work with someone whose beliefs are different from mine" is being a bit hypocritical in my opinion. If we are to be accepting, kind and supportive of our patients regardless of creed, color, religion, social status, and so forth, then we should feel the same toward someone we work side by side with.
Point taken, who says about Not wanting to work with someone different from their belief.. The Original thread is concerned about a Nurse doing what she should have done to the patient and setting aside her belief putting the Patient needs FIRST.. We are accepting... But likewise, it's just an option to take.. No matter what area you put a nurse whether a non TOXIC we cant help but expect an unexpected event... Just like what the case that had been stated, the patient is for BT.. If she was the only nurse there and NO ONE ELSE to do it, obviously she will stick with her belief and put the patient NEEDS aside? then well, what's the use of the Oath you have took as a nurse..
The simple matter is that a nurse can refuse to do something based on their religion period. It's a right fought hard for in the Courts.
It's not a right and has been fought hard for in the courts. It was decreed by executive order last fall.
Where's the line?
Can a pharmacist refuse to dispense prescribed birth control for pregnancy prevention?
Can a pharmacist refuse to dispense prescribed birth control, prescribed for a medical condition?
Can a pharmacist refuse to dispense legal over-the-counter without a prescription emergency contraception, assuming it's in stock?
Can a physician refuse to prescribe or even refer birth control pills for the purpose of contraception to a patient inquiring about it?
Can a physician refuse to treat or even refer a patient with a medical condition necessitating birth control pill therapy per established guidelines of care?
Can a nurse refuse to hang prescribed and necessary blood product on a patient in every and all scenarios? No "there might be backups"...what is the answer to this moral dilemma?
Can a nurse refuse to treat a patient with prescribed and necessary insulin, heparin, or any other potentially porcine-derived product due to religious conflict?
Can a nurse refuse to accept assignment on a patient who has received valvular surgery involving porcine components due to religious conflict?
Can a physician refuse to prescribe or even refer necessary blood, insulin, heparin, etc. due a to a religious conflict?
Can a nurse ignore all physican's orders on a patient due to a disbelief in the efficacy of modern medicine brought upon by their religion?
----
I ask, because under the "right of conscience" rule, all of the above scenarios are potentially deemed okay.
The far-reaching regulation cuts off federal funding for any state or local government, hospital, health plan, clinic or other entity that does not accommodate doctors, nurses, pharmacists and other employees who refuse to participate in care they find ethically, morally or religiously objectionable. It was sought by conservative groups, abortion opponents and others to safeguard workers from being fired, disciplined or penalized in other ways.
I find it ethically and morally objectionable to keep 80+ year olds who've coded 5 times today already and suffer from multiple mets alive on a vent with max pressor support. Can I refuse to care for such patients?
A line must be drawn between accommodation and reckless abandon.
Talking about the physiological immediate need of the patient to survive is one thing. A JW nurse should make sure that a facility knows his or her beliefs, then it is up to the facility to hire or assign appropriately. I do not like at all the idea that we as nurses have nothing to contribute to a patient-nurse situation than a desire to fulfill a patient's wants, no matter what our deeply held religious beliefs are. That is not nursing. Nursing involves mutually agreed on goals, remember that from nursing school? I am not a JW, but some things I will not do, ever, no matter what my patient may want.
Specializes in Pediatric Intensive Care, Urgent Care.
It's not a right and has been fought hard for in the courts. It was decreed by executive order last fall.
Where's the line?
Can a pharmacist refuse to dispense prescribed birth control for pregnancy prevention?
Can a pharmacist refuse to dispense prescribed birth control, prescribed for a medical condition?
Can a pharmacist refuse to dispense legal over-the-counter without a prescription emergency contraception, assuming it's in stock?
Can a physician refuse to prescribe or even refer birth control pills for the purpose of contraception to a patient inquiring about it?
Can a physician refuse to treat or even refer a patient with a medical condition necessitating birth control pill therapy per established guidelines of care?
Can a nurse refuse to hang prescribed and necessary blood product on a patient in every and all scenarios? No "there might be backups"...what is the answer to this moral dilemma?
Can a nurse refuse to treat a patient with prescribed and necessary insulin, heparin, or any other potentially porcine-derived product due to religious conflict?
Can a nurse refuse to accept assignment on a patient who has received valvular surgery involving porcine components due to religious conflict?
Can a physician refuse to prescribe or even refer necessary blood, insulin, heparin, etc. due a to a religious conflict?
Can a nurse ignore all physican's orders on a patient due to a disbelief in the efficacy of modern medicine brought upon by their religion?
----
I ask, because under the "right of conscience" rule, all of the above scenarios are potentially deemed okay.
I find it ethically and morally objectionable to keep 80+ year olds who've coded 5 times today already and suffer from multiple mets alive on a vent with max pressor support. Can I refuse to care for such patients?
A line must be drawn between accommodation and reckless abandon.
There is no line and never will be one...sorry. We don't live in a world with nice neat lines drawn to show us the way...it is what it is.
There is no line and never will be one...sorry. We don't live in a world with nice neat lines drawn to show us the way...it is what it is.
Mex
That is why prior communication and a we-can-work-this-out attitude are so important for both the nurse and management. Trying to come up with a one-size-fits-all policy that covers every eventuality is an exercise in futility. The goal should be to find a solution that works for those involved. Policy should state some basic principles. Procedure should arise out of those principles and the individual situation. What succeeds on one floor or shift or work setting may need adaptation in other circumstances.
Respecting our patients needs and beliefs is more of a challenge when our own core needs and beliefs are disregarded and diminished (I am not a JW, but I do have other strongly held convictions). In rare cases, that accommodation may be so unrealistic as to make working in a particular environment impractical or unwise (JW nurse working at a blood bank), but that's why communicating before the fact is essential. That is the way a JW nurse--or anyone, for that matter, who may run into a similar conflict--puts her patients first. She anticipates situations that may arise and, with management and co-workers, develops a plan to make sure everyone has what they need.
It helps if the people involved are genuinely invested in finding solutions. Adversarial and judgmental attitudes rarely benefit anyone.
Part of the reason we can easily speak and write about our views today is because of the freedoms that Jehovah’s Witnesses fought to keep. Our laws regarding freedom of speech, freedom of the press and freedom of religion stem from court battles fought and won by Jehovah’s Witnesses. Because of these type freedoms, no one else can dictate where a person can and cannot work, based on their religion. In the not so distant past, Jehovah’s Witnesses endured persecution, including loss of jobs and even expulsion from schools, because of their religious beliefs of remaining neutral during a time of patriotic fervor.
For these reasons, it is hard for me to hear statements that seem to take giant steps backwards in time by suggesting that Jehovah’s Witnesses should not work in hospitals. On even a more personal note; the only job I lost had to do with my beliefs as one of Jehovah’s Witnesses. It was for the Hospital Association of a major city, where I was warned that I “better attend a Christmas party, or else.” I just started working there and it was impossible to prove, so I had no recourse.
We need to think deeply about what we demand of others. To make small accommodations for our co workers is much more humane than to ask them to give up where they work; or worse, who they are.
Part of the reason we can easily speak and write about our views today is because of the freedoms that Jehovah’s Witnesses fought to keep. Our laws regarding freedom of speech, freedom of the press and freedom of religion stem from court battles fought and won by Jehovah’s Witnesses. Because of these type freedoms, no one else can dictate where a person can and cannot work, based on their religion. In the not so distant past, Jehovah’s Witnesses endured persecution, including loss of jobs and even expulsion from schools, because of their religious beliefs of remaining neutral during a time of patriotic fervor.
For these reasons, it is hard for me to hear statements that seem to take giant steps backwards in time by suggesting that Jehovah’s Witnesses should not work in hospitals. On even a more personal note; the only job I lost had to do with my beliefs as one of Jehovah’s Witnesses. It was for the Hospital Association of a major city, where I was warned that I “better attend a Christmas party, or else.” I just started working there and it was impossible to prove, so I had no recourse.
We need to think deeply about what we demand of others. To make small accommodations for our co workers is much more humane than to ask them to give up where they work; or worse, who they are.
Please stop playing the martyr card. For reference, I belong to a demographic, based on national surveys conducted in the years after 9/11, deemed "less trustworthy than Islam" by the American people, so it's not as if I drew the long straw in the religion contest.
This isn't about persecution of Jehova's Witnesses or any other group. It's about finding a palatable answer to the following question:
Is it ethical to delay or deny necessary care and treatment to a patient based on an objection to the care stemming from personal belief?
What conclusions you draw from answering this are up to you, but you can't skirt the question-- it's the heart of the issue.
Like I said: Think deeply. You (in general) can't say people of a whole religious group should not work in a hospital. Religious freedom, Hello? ( Um, I omitted telling about my racial experiences, as that would be off the subject. )
The point is: For many reasons mentioned throughout this thread, Jehovah's Witnesses do work in various departments in the hospitals and they always will for as long as we need hospitals. Get used to it, and even learn to like it if you want to get along with everybody without discriminating.
P.S. It was a bit of history and my personal history I was sharing, for why I care about the subject. Martyrdom has nothing to do with it.
I would rather someone empathize about my feet hurting after a 12 hour shift. That, would be the martyr card I would prefer to play.
:lol2:
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chicookie, BSN, RN
985 Posts