Ok, not sure where to put this question, so please bear with me if it is in the wrong section. I just kinda want to see everyones opinion about this situation. I am not in Nursing School yet but I am finishing up my pre-reqs for that and will have my CNA soon.
I have been wondering about moral issue with nurses and patients. For example say a patient is on life support and the family wants you, or maybe even the patient requests the "plug" be pulled. Say, you as the nurse believe that is suicide for them to not want to do everything possible to stay alive. I know I obviously could not force my morals on others, or do something against the patients wishes, but do you think that asking another RN to "pull the plug" would be appropriate or do you think the RN who was asked to do it would accept that? Maybe someone with different beliefs could answer. How would you feel if you were asked to do that for another RN? Has anyone ever been in this position before?:uhoh21:
I don't mean to stir the pot, just this question has been on my mind for awhile and I wanted to know what all of you thought about this. I just need to know if morally there are alternatives for me, instead of compromising my faith as well as letting the patient have thier wishes too.
I forget that NICU abbr have different meanings in different specialties (what.....the world doesn't revolve around the NICU????)
Bronchopulmonary dysplasia, a common disease of the lungs in severely premature infants, much like chronic obstructive pulmonary disease in the elderly.
I think there are a couple important facts to remember: Cardiac cells have automaticity. They do not need brain function to continue to fire and contract. They just need O2 and perfusion to keep going. It is blind contraction by cells, not controlled by any higher part of the mind.QUOTE]
I can testify to this personally. Had a very cachectic and elderly cancer patient brought in from home whom the doctor didn't write DNR orders on. She was still talking to the daughters about it when then patient died. So,,, I started CPR, popped ribs loose, etc. One doctor walked in, saw the condition of the patient and refused to run the code, instead he immediately called HER doctor from the room to yell "Do you know what is going on here?" ER doc that arrived, gave one of each drug so we could say we had run the code. She was gone.
After I moved her body to another room, her heart started beating again because the drugs pooled there and kicked off the automatic contractions. It only lasted about 5 minutes, but there was no doubt at all that she was dead.
Removing "life support" is not killing the patient. I too believe miracles can happen, but too often that isn't how God answers prayers. My dh, also a preacher, died in my arms of cancer while still on the vent. When someone comes off the machines, we are not killing them. We are only turning off machines. Yes, someone else can do that for you, but I respect the person enough to do it for them. Personal choice.
It is good to work through things before you are confronted with the reality of them, being prepared.
PW to help more w/your OP,..I worked w/a nurse who was a Jehovah's Witness,..although she had total respect for her pts right to believe differently,.she had a real hard time giving blood,...not a problem,.we all knew her moral delima,.we hung the blood for her,.no big deal,.she had no problem w/caring for the pt,.just didn't want to actually administer the blood,...hope that helps
PW to help more w/your OP,..I worked w/a nurse who was a Jehovah's Witness,..although she had total respect for her pts right to believe differently,.she had a real hard time giving blood,...not a problem,.we all knew her moral delima,.we hung the blood for her,.no big deal,.she had no problem w/caring for the pt,.just didn't want to actually administer the blood,...hope that helps
I think that all try to spare our coworkers the patients with issues that might unduly distress them due to personal beliefs. I know of a very good nurse (on Ortho) that cannot handle postmortem care. We do that for her and she covers other issues for us.
But a thing to think about....when you pick your nursing specialty, you do need to choose what youcan handle adequately with your cultural and spiritual restrictions.
As someone who does not believe in abortion, I work strictly in specialties where that is generally not an issue - BMT/Oncology, occasional ID. It would be completely irresponsible for me to work in a family planning clinic that provides abortions...and then cry off, siting moral objections. Yes, people can sue on these issues, but as a person of moral ideals it would be very wrong.
Thus, when you consider specialization, please keep in mind the requirements of that department and your moral restrictions. If you do not work in ICUs/NeuroTrauma, you probably won't ever deal with "pulling the plug", as those are the units that have the "plugs". If you work those units, or ER, you will likely have these issues come up.
I have an acquaintance that is JW. She works on Onco, but generally with the solid tumors, as Leuks/liquid cancers generally require lots more blood products.
Also, please examine your feelings regarding morphine drips, discontinuing tube feeds. Thus you will be better prepared to choose a department where you will not have your moral convictions tested unduly or find yourself in a spiritual quandary regarding care of patients that may contradict your beliefs.
As someone who does not believe in abortion, I work strictly in specialties where that is generally not an issue - BMT/Oncology, occasional ID. It would be completely irresponsible for me to work in a family planning clinic that provides abortions...and then cry off, siting moral objections.
Wow Carol! If there were a "kudos" button here, I'd triple click it! Your whole post was great-but this really stood out to me (I work ob). That, IMO, is very big of you.
This whole thread has been very interesting for me to read, and thank you espescially to Carol, RN-Cardiac, and Tazzi (& others). As I mentioned above, I work OB, and so *never* deal with transplants. Besides the scant amount we learned in nsg. school, all the information I have is from watching ER and John Q (lol) so you can imagine how much I've learned here.
Did want to point out--and I'm not sure if this varies by state--we did learn that it doesn't matter if you have "Organ Donation" on your DL, it's really up to your HCP/next of kin whether your organs are harvested (should the conditions be optimal). So it is very important that you communicate your desires to the person designated to make decisions for you.
ok, not sure where to put this question, so please bear with me if it is in the wrong section. i just kinda want to see everyones opinion about this situation. i am not in nursing school yet but i am finishing up my pre-reqs for that and will have my cna soon.
i have been wondering about moral issue with nurses and patients. for example say a patient is on life support and the family wants you, or maybe even the patient requests the "plug" be pulled. say, you as the nurse believe that is suicide for them to not want to do everything possible to stay alive. i know i obviously could not force my morals on others, or do something against the patients wishes, but do you think that asking another rn to "pull the plug" would be appropriate or do you think the rn who was asked to do it would accept that? maybe someone with different beliefs could answer. how would you feel if you were asked to do that for another rn? has anyone ever been in this position before?:uhoh21:
i don't mean to stir the pot, just this question has been on my mind for awhile and i wanted to know what all of you thought about this. i just need to know if morally there are alternatives for me, instead of compromising my faith as well as letting the patient have thier wishes too.
any advice, answers or stories are welcome!
the other thing to remember, and you will learn this in nursing school... if there is something you are in conflict with, morally, then you have the ability to ask another nurse (or your charge nurse) to take the patient. you will always have the ability to get out of a situation... however, i think that a large portion of your concerns will be resolved once you actually go through a nursing program and learn more about the pathophys behind the vent, what really happens to the patient at the time of death, etc. and knowing these things may help you deal better with your perceived dilemma.
Great thread, lots to think about. I actually know the story behind all of this; the brain dead vs. vegetative state standard. A man beat his child severely and she was in a pediatric ICU on every machine we had at the time. The father was arrested and charged with assault and battery, and a few more things, not sure of those anymore. Anyway, the doctors felt there was no hope of her recovering and without the ventilator she would die. Well, needless to say the father had absolutely no interest in taking his child off the vent. not because of his overwhelming sorrow or concern for her, but rather he would then be charged with murder. This was the basis on which the determination of brain death and brain damage began. Severe brain damage, permanent vegetative state, indeterminate brain function all are reasons that a family may chose to not withdraw life support. We can not determine what will happen, we have a good idea but the person is not brain dead. Brain dead means something; dead means something. So what happened is that the policy was developed and said that two physicians had to determine brain death status, the child at the center of the case had the vent removed and died. The father was charged and convicted of murder.
I am working toward my Master's in Divinity, and I am Catholic, not sure what that has to do with anything, or with the article, but I have struggled with this for the last 25 years. I became a nurse when I was 20 and was not prepared for the emotional rollercoaster I got on. I worked NICU, PICU, then to various adult ICU's and ER's. I have seen people at their best and their worst and have learned I am not God, and I will never have all the answers. I foolishly told a family that their baby would be leaving the NICU in a couple of weeks, he's doing fine; he was dead three days later. That was the day I found out God was really in charge. There were years I didn't believe in God, then not in faith and then not in religion. Now I believe in the whole package. While you walk the road you learn and for me I believe this is God's greatest gift to me. Many people don't believe in anything, atheists, agnostics, etc...and you know what, I was them too at one time, it's ok, we take care of everyone, no matter what they believe or how they practice that belief. I still think we have the BEST job in the world, we get to learn from everyone we come across as long as we leave ourselves open. So when it comes to brain death, they don't get better, there is no blood to the brain, there is no activity, there is no one there. The person I am, the one God created me to be, won't be there, I will be trapped unless someone lets my body go. When that happens, if my organs can be of use, take them. Let someone else live and grow and enjoy a long life.
And just as a side note, a little P.S. Catholics really don't believe we are the only one's going to Heaven. That was a lie told back in the early days when immigrants were heavily Catholic and many people didn't like them. According to Catholic Dogma, every path to God is to be respected. If someone is a faithful person, no matter the faith, it would be sinful - very sinful, to try to convert them to Catholicism. Mother Theresa cared for the poor and homeless in India, many converted to Catholicism based on our dogma of: they will know us by our works and will follow because of it. We can't tell people they are wrong. We are obligated to care for our fellow man but not allowed to proselytize them. Now if you have an organization as large as the Catholic Church there will be people who don't follow what they are suppose to follow. It doesn't make the church wrong, it makes that person wrong. Take the number of people who identify themselves as Catholic add the fact that it's been around almost 2000 years and you will find a lot of people who do things and say things they shouldn't and the closet will be full of skeletons. On my own personal spiritual journey I had to find this out, I had to learn to separate individuals who may or may not be right from the truth of the church I grew up in and wanted to return to.
As I mentioned above, I work OB, and so *never* deal with transplants. Besides the scant amount we learned in nsg. school, all the information I have is from watching ER and John Q (lol) so you can imagine how much I've learned here.
I hated John Q. I wanted to watch it so bad when it came out but I was so disappointed in the inaccuracies.
Daisy~ I think I will also learn a lot once I get to nursing school! Thanks for your input! That makes me feel better about things. I don't think I will agree with some matters still, but that's ok I can ask a co-worker to help me out.
As far as the suing issue... I tottaly agree Carol! That's insane! I can't believe you can sue over such a dumb thing! Those are some good thoughts to keep in mind too as I pick which unit to specialize in! As of now I am thinking labor and delivery, OB, or Med-Surg. So much to think about and get finished right now to even get into school here is what I have to deal with right now.
It's great to hear of situations that you guys were in too. Maybe once I am in a situation like that I will understand better. I might not agree with it but it will help me to see first hand both sides of the story..since now I am not in nursing school so I have no idea.
I also don't think if God lets a pt live, if a vent is taken out, it is a miracle, I think it is God's will.
Just to clarify I am not a Jehovah's Witness or Catholic. And not that it matters... but I am a New Testament Christian.
***Hope everyone has a great day...well as great a Monday possible after a holiday!*** :rotfl:
LilPeanut, MSN, RN, NP
898 Posts
Bronchopulmonary dysplasia, a common disease of the lungs in severely premature infants, much like chronic obstructive pulmonary disease in the elderly.