Judgements about big families

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We had an incident today at work that engendered quite alot of discussion. A mom was having her sixth c-section and seventh child. Throughout the case the anesthiesiologist was making comments to the mom about how this was plenty of kids and no one should want to have more than this, how it would be irresponsible of her to have more children (note he was not referring to the fact that she had so many c-sections and more pregnancies could be dangerous.

The nurse in the case talked to him afterwards saying she thought it was inappropriate for him to be making these judgemental statements to a patient. He responded that there was nothing wrong in giving his opinion to the patient. I asked if people thought it was okay to make judgemental statements to patients who had abortions. Everyone in the room immediately gasped no!! The opinions on the statements regarding the number of children were split about 50/50.. Why is it okay to make judgements about family size but abortion is taboo??? I personally think they both are off limits!!

Specializes in Utilization Management.
1. the guy is a trained physician who has a lot more expereince than a nurse he might have been an OB at some point you have no clue.

2. what's your point

3. So you only talk to patients when they ask you specific questions.

1. Training does not entitle one to say whatever is on his/her mind.

2. Proper training for any healthcare professional puts the patient's needs first. If he was ever an OB at some point and stepped down to do anesthesia, that might be considered a good thing, considering his gauche, inappropriate remarks.

3. I can only gather from your answer that you are not a doctor, nor a nurse, nor a parent.

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The MD was out of line discussing his opinions with the woman while she was paralyzed and being cut open. It is a misuse of power and authority to confront someone when he or she is at such a disadvantage. He would have been out of line discussing his opinions about large families anyway because, as someone said, he wasn't the OB, he was the anesthesiologist. Having an opinion about large families has no relevance to the job at hand.

Ok, now I'm going to play devil's advocate....:devil:

Is it possible to adequately provide supervision and a high level of parental involvement when there are 6, 8, 10 kids in a family? Do the kids suffer because they don't have enough attention/involvement from a parent?

The world is very overpopulated, and while one person isn't responsible for that fact, the whole group of people who have a lot of kids is responsible.

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1. the guy is a trained physician who has a lot more expereince than a nurse he might have been an OB at some point you have no clue.

2. what's your point

3. So you only talk to patients when they ask you specific questions.

1. Being "a trained physician" doesn't mean he has carte blanche to comment on anything he chooses. He was there to provide anesthesia, not counsel her on family planning. Even, in the unlikely event, he had ever been an OB, he wasn't HER OB so he had no business advising her in that capacity.

2. You don't see anything wrong with forcing a medically vulnerable person to listen to personal opinions? Not to mention the fact that she probably would have preferred to concentrate on the birth of her child.

3. While I might make small talk or ask superficial questions to put a patient at ease, I do not give unsolicited medical advice in an area that is not my specialty while a patient has her belly sliced open and is about to hear her baby's first cry.

I'd like to give you the benefit of the doubt that you are just yanking my chain with your responses. If, by chance, you're actually playing it straight . . . .ah, never mind. I won't go there.

Miranda

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1. the guy is a trained physician who has a lot more expereince than a nurse he might have been an OB at some point you have no clue.

2. what's your point

3. So you only talk to patients when they ask you specific questions.

I hope there's more compassion there than there seems to be.....

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The MD was out of line discussing his opinions with the woman while she was paralyzed and being cut open. It is a misuse of power and authority to confront someone when he or she is at such a disadvantage. He would have been out of line discussing his opinions about large families anyway because, as someone said, he wasn't the OB, he was the anesthesiologist. Having an opinion about large families has no relevance to the job at hand.

Ok, now I'm going to play devil's advocate....:devil:

Is it possible to adequately provide supervision and a high level of parental involvement when there are 6, 8, 10 kids in a family? Do the kids suffer because they don't have enough attention/involvement from a parent?

The world is very overpopulated, and while one person isn't responsible for that fact, the whole group of people who have a lot of kids is responsible.

Yes it is possible to provide supervision and a high level of parental involvement when there are 6, 8, 10 kids in a family. No kids don't have to suffer simply because they are part of a big family. Size doesn't equal quality of parenting. Parents with one child can be neglectful, abusive, etc.

Take a look at RNin 2007's post . . . . a very loving family has their own bio kids and adopts other kids with special needs who would have ended up in an orphanage - instead they are part of a loving family that works well.

The world is not overpopulated - certain areas are of course but we have plenty of room - the land area of Texas is 262,000 square miles, and the world's population is about 6 billion. By converting square miles to square feet and dividing by the world's population, one readily finds that there are more than 1,217 square feet per capita. The entire world's population could fit into Texas.

steph

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1. Being "a trained physician" doesn't mean he has carte blanche to comment on anything he chooses. He was there to provide anesthesia, not counsel her on family planning. Even, in the unlikely event, he had ever been an OB, he wasn't HER OB so he had no business advising her in that capacity.

2. You don't see anything wrong with forcing a medically vulnerable person to listen to personal opinions? Not to mention the fact that she probably would have preferred to concentrate on the birth of her child.

3. While I might make small talk or ask superficial questions to put a patient at ease, I do not give unsolicited medical advice in an area that is not my specialty while a patient has her belly sliced open and is about to hear her baby's first cry.

I'd like to give you the benefit of the doubt that you are just yanking my chain with your responses. If, by chance, you're actually playing it straight . . . .ah, never mind. I won't go there.

Miranda

Great post.

How can anyone think that it is anyone else's business how many kids a person has? Unless asked, as someone else said, zip it.

steph

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Specializes in Case Mgmt; Mat/Child, Critical Care.
1. the guy is a trained physician who has a lot more expereince than a nurse he might have been an OB at some point you have no clue.

2. what's your point

3. So you only talk to patients when they ask you specific questions.

1. This statement proves you truly have no clue as to the professional world of medicine...I am ROFLMAO at the "trained physician w/more experience than a nurse" bit! :rotfl: Good one! :icon_roll

2. Hmmmm, gee, I don't know, let's see...why don't we roll you into a cold, sterile room surrounded by strangers, strap you down and slice you open and then let the person responsible for making sure you don't actually feel that happenning start grilling you about the personal choices you've made in your life? I'm sure this wouldn't bother you a bit, now would it??? Or if it were your wife.... :uhoh21:

3. Actually, in the OR, the only thing anesthesia has to concern itself with, is the patients stability, pain level and comfort. I highly doubt grilling someone about their life choices would accomplish that goal! :doh:

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I am number 7 out of 14 children, and I take offense to that MD's words. My parents wanted every single one of us (no accidents). We never used the welfare system, we went to good schools, have good work ethic, and all have turned out to be good, hardworking, caring members of society (3 nurses). Maybe my parents didn't take us to Disney, or big lavish vacations, but we had everything we needed. Just think about all the clothes and toys there were, if you share, you have more than most people. I personally do not want that many children, but now a days with 2 income families it is much harder to have a large family. I am sure this patient was used to the rude comments. Growing up and even still today when I tell people I have 13 brothers and sisters, same mom and dad (I am very proud to talk about it), people still say "haven't your parents ever heard of t.v.?" or "Let me guess, Irish catholic". I tune out those comments, I have been complimented all my life for my level headedness, and my strong work ethic, all of which I attribute to how I was raised and loved.

I am happy that this nurse had enough compassion to speak up, and I hope it doesn't stop her in the future. I guess you can't teach compassion, empathy, or advocacy, but every dog has his day.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Folks: We are never going to agree on "how many is the right number" of children to have. Nor will we agree if the planet is overcrowded or not---it's about a lot more than simply space---- but resources---- you must consider, when deciding if overcrowding *is* an issue or not.

That said, it is certainly not my role as an RN (nor that physician's) to offer unasked-for opinions and editorials, particularly when a patient is so vulnerable! I think that was disgraceful.

Now, I challenge the members here, with one question. If this happened to YOUR patient, and you witnessed it, what would you *do* about it?

Maybe, we could shelve arguments about whether the planet is overpopulated or how "selfish" it is to have that many kids---- or maybe even quit exclaiming how wrong this dr. was? Most of us agree this behavior was wrong on the part of the physician.

For me, anyhow this begs the discussion: how do we BEST advocate for our patient in such delicate situations?

You don't have to answer me; I am being mostly rhetorical---not demanding answers. I just would ask each of us to think about how we would handle this and other similar situations involving our patients. Unethical behaviors surround us all the time. As patient advocates, it is encumbent upon us to ACT--not just exclaim......

Don't we see: this is about a LOT more than "judgements about big families", when we think about it.

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I asked if people thought it was okay to make judgemental statements to patients who had abortions. Everyone in the room immediately gasped no!! The opinions on the statements regarding the number of children were split about 50/50.. Why is it okay to make judgements about family size but abortion is taboo???

Because our society is one full of empty/weak minded people who don't answer truthfully for themselves, but rather turn to the quickest/safest answer, the politically correct one. You are so right about this double standard.

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Specializes in ER, NICU, NSY and some other stuff.

Personally, I would have had no problem stepping and telling this physician that this was obviously this family's choice to have these children. I would also point out that he was upsetting and making this mother uncomfortable and tarnishing her new childs birthday. In private I might have a few other statements to make to him.

Of course, my mouth has never gotten me into trouble before. :rotfl:

Along this vein I was having a discussion with someone yesterday whose family situation is simialr to mine. (children 19, 16, 4, and 9 months)

We were discussing the people who make jusdgement regarding the number of children and the spacing of them, and whether or not we know what causes all thse kids.

For the record Yes, I do know what causes pregnancy.

Whether or not I have lost my mind had no bearing on my decision to have 4 children. (my sanity is a completely seperate issue)

Just because YOU think a complete family is having one or 2 children, doesn't mean I HAVE to think so also.

Each person's priorities are different.

It is funny how people can have even different ethical values about things and just expects others will ahve the same.

As has been mentioned in here numerous times. Many folks would be horrified if someone were to have given this lady a hard time for having 7 abortions, but it is OK to click your tongue at her for having 7 kids??????

That just strikes me as asinine.

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Along this vein I was having a discussion with someone yesterday whose family situation is simialr to mine. (children 19, 16, 4, and 9 months)

We were discussing the people who make jusdgement regarding the number of children and the spacing of them, and whether or not we know what causes all thse kids.

I have four kids, and sometimes I think about having another. I'm appalled by the number of friends (people who would not be impacted in any way) who say, "No, don't; you shouldn't have any more." I can't figure out where they're coming from. What difference could it possibly make to them?

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