Pts abusing "cultural/religious" practices to manipulate RNs - page 2

This has been bugging me for a while. A few weeks ago, we had a postpartum patient who is Jewish (Orthodox), which means that they won't do "work" on their Sabbath (sundown on Friday until... Read More

  1. by   JeanettePNP
    I want to add that a woman who is >72 hours PP is considered "dangerously ill" according to Jewish law and is allowed to violate Shabbat herself if her health/comfort depends on it and no nurse is available. With my first child I had to be in the hospital over Shabbat and although I was somewhat uncomfortable with it, I did things like adjust the electric bed and turn on warm water for myself (things that are normally forbidden on Shabbat but OK for a sick person.) I wondered whether I had a valid "excuse" to adjust the bed but I decided that it was very important for me to get adequate rest, and I needed to position the bed between feeding and sleeping. And I did keep my baby with me the whole time ... you couldn't drag him away.

    Also, Carol has a good point... if this happened in October it could have been over a holiday.
  2. by   HvnSntRN
    This happened a week prior to Sukkot... I thought maybe you had the explanation I was hoping for, but no.

    I did not even consider the possibility that she may have been exhibiting some early signs of PPD, though. Even so, the fact that she was verbalizing her wishes in a cultural/religious context, kind of sent us on a wild goose chase. Unless we become extremely well versed in all the subtle nuances of all the various cultural and religious groups we encounter, how would we know (without becoming mind-readers) that when an Orthodox Jewish woman says "Can you bottle feed my baby overnight in the nursery because it's Shabbat and I am not permitted to work on Shabbat" really means "I'm exhausted and overwhelmed and bordering on postpartum depression"??

    There are some cultural groups (Asian and Somali locally) who do not breastfeed until the milk comes in. Instead the babies are bottle fed for the first few days. At night, they want to sleep, so they ask their support person or the nurses to do the feedings for them. As part of supporting their cultural practices, we become part of the support network that does what their culture dictates needs to be done postpartum.

    In my opinion we do a great job of trying to give these women a culturally sensitive birth experience. But as I said in my first post, I feel some resentment when someone exploits our lack of knowledge about their cultural practices to get us to do something that we would gladly do for them anyway if they just told us the truth about being exhausted from clusterfeeding their baby and wanting to give a bottle for a couple of feeds so they can sleep a bit before going home to the rest of their family. We aren't in the business of judging people's choices - but that shouldn't be a license for them to manipulate us and be deceptive in order to ensure that they get their way.
    Last edit by HvnSntRN on Dec 4, '06
  3. by   caroladybelle
    Quote from firstyearstudent
    Huh? Are there degrees of Jewishness?

    Many secular Jews consider themselves as Jewish as religious Jews (and Mel Gibson would probably agree). And many practicing Jews from other branches of Judaism consider themselves as Jewish and as religious as those who observe in a different way.

    I regret that you misunderstood. I am sure there is a more clear word than "nominally". I will try to explain, but it may not help much.

    There are differences in Jewishness, in the same way that there are of Christianity, or in Republicanism, or or any ism/religion/belief system/culture. There will be some that adhere to the strictest law of hard line religious/cultural law or belief. There will be those that are more relaxed with these practices. There will even be separate groups that regard one tenet and interpret that tenet in completely contradictory ways.

    Two groups of different Christians may call themselves both Christians, but practice the religion very differently and sometimes may not even consider each other Christians.

    They are still Christians, but they do things differently. And some are stricter and others more "relaxed" in their practices.

    This means while many people remember the rules regarding Sabbath, Yom Kippur, Channukah, Passover -they maybe less familiar with Sukkot, less familiar with sects that require more extensive accomodations of tradition.

    Sukkot is shortly after the High Holy Days - perhaps the hospitalization fell then. Rosh Hashanah is 1 Tishrei, Holy days up to Yom Kippur (10 Tishrei ). Sukkot is 15 Tishrei, then lasting a week.

    Chaya/someone can check me on this - there are more Holy Days than this in Tishrei, but 7 days in which there are restrictions on work, during Tishrei.

    My most recent Orthodox patient did hit the call light when he had a bleed occur, because of the permit when life is threatened.
    Last edit by caroladybelle on Dec 4, '06 : Reason: additional info.
  4. by   firstyearstudent

    I guess I'm just a little sensitive. It irks me that some Jews do not consider others to be as authentic. Of course this occurs in Christianity as well...
    Last edit by firstyearstudent on Dec 4, '06 : Reason: clarity
  5. by   phoenix72
    I don't have anything constructive to add but just had to chime in. I cannot understand someone misrepresenting their religious beliefs period but to do it to get time away from their newborn is alien to me. When I had my babies, even their father couldn't pry them out of my arms with a crowbar for the first month. I understand exhaustion but jeez...
  6. by   caroladybelle
    Quote from phoenix72
    I don't have anything constructive to add but just had to chime in. I cannot understand someone misrepresenting their religious beliefs period but to do it to get time away from their newborn is alien to me. When I had my babies, even their father couldn't pry them out of my arms with a crowbar for the first month. I understand exhaustion but jeez...
    How many children do you have?

    One of my cousins has 14.
  7. by   phoenix72
    Quote from caroladybelle
    How many children do you have?

    One of my cousins has 14.
    Wow! I am humbled...I only have 4. I have three boys, ages 13, 10, and 8. My baby girl is turning two on the 27th. I'd have more but hubby put his foot down and got a vasectomy. It's a sickness, I think (lol).
  8. by   TrudyRN
    Quote from SmilingBluEyes
    I think evaluation by social services/child welfare personnel is in order.
    Right off the bat? Without even exploring the PPD aspect and just talking with the woman?
  9. by   TrudyRN
    Quote from firstyearstudent

    I guess I'm just a little sensitive. It irks me that some Jews do not consider others to be as authentic. Of course this occurs in Christianity as well...

    There are Reform, Conservative, Orthodox, and Hasidic (a branch of Orthodox) Jews.

    There are Jews from places around the Mediterranean, like Greece, Spain. These Jews are Sephardic. Other Jews are from Germany, Russia, Poland, and Eastern Europe. They are Ashkenazi. The difference is in some customs.

    Not all Jews believe in Heaven and Hell, some are even atheists and if you understand that you are doing better than I. And I am Jewish. A Jew can be a Buddhist, a Hindu, or whatever other religion and still be accepted as a Jew. The only thing a Jew can never be and still be accepted by fellow Jews is a Jew for Jesus, a Christian. Of course, there have always been some Jews who followed Jesus and there are lots of Hebrew Christians, Jewish believers in Jesus today.

    I grew up Conservative, which meant Mom kept kosher at home but we ate the public school lunches and in restaurants. We went to Sunday school and my brothers were Bar Mitzvah but Dad told me I didn't have to do that, even though I wanted to, as he would pray for me while I was young and my husband would do that when I was married. I felt like Yentl. I wanted to learn the Hebrew. Dad worked on Sabbath. He said this was America and God understood (the necessity of working Saturdays to support his family). Oy. It was all pretty confusing. :uhoh21:

    But still, when one is born a Jew, one will die a Jew, no matter what one believes. I just hope this woman can get the help I think she needs. I would not be so quick to be angry with her. She was probably in pain and exhausted and just wanted to rest but was ashamed or scared to ask for help. I can't be certain, not being in her head, but that's my guess.
  10. by   Yuliya3
    I am jewish orthodox and a former OB floor nurse. We feed kids (I have 3 ) on Shabbos. In fact, I think this is one day a week they probably over eat. I am also very much into breastfeeding, my 6 month old never even had a bottle once. I also had two of my kids delivered in a hospital over Shabbos, breastfed both. There is no problem with
    breastfeeding on Shabbos. The Jewish Orthodox community is so into breastfeeding, I would safely estimate 90-95% are nursing longer than a month and probably 99% at least try. However, just because the patient is orthodox does not mean she 1) has to breastfeed 2) cannot request formula given to the baby over night so she can sleep. In fact in NY and NJ there are few recuperating facilities for PP jewish women, people go there for few days, and there as far as I know most of the women chose to sleep through the night, while their babies are bottlefed ( this is for first few days PP). I personally think it interferes with milk supply, least people are breastfeeding. In the hospital I used to work at,on the other hand, LC used to beg mothers to give breastfeeding a chance, but very few tried. It was also very common for mothers to request for babies to be kept in our nursery over night and no excuse was ever given or asked for. I do not understand why your pt would use Shabbos as an excuse, sort of stupid. You should have asked her about it. May be she felt like she needs to justify her self, and this was all she could come up with. It is hard to be in the hospital over Shabbos. I am sure everyone would prefer to deliver on other days of the week, and spend Shabbos home. You cannot use electricity, canot use phone, cannot use call bell .It is also harder on a nurse taking care of that patient. But life is hard in general. Still, it is especially annoying when you are trying hard to help, only to feel you are being manipulated, I feel for you OP.
    I just wanted to respond to posters who want to involve child protective servises, ha? For what? Because the patient provied a lame excuse and wanted to sleep through the night? If on assessment nurse would notice some signs of PPD, no bonding, concerns re: ability to provide child care, etc, perhaps SW ref. would be appropriate. I would reserve Social Servises for my drug test positive patients, patients whose breath reeks of alcohol on admission to delivery, patient who refuse to see her baby during the entire hospital stay, and a 13 year old ( whose mother was getting guardianship), who refused to change diaper of her baby becase it was "ewww".
  11. by   GardenDove
    Uh, wouldn't the Jewish people have died out a long time ago if women weren't allowed to breastfeed on the Sabbath??? Obviously, this woman has some problems that have nothing to do with religion.
    Her thinking is convoluted. Don't women already have a right to ask nursing staff to take their babies so they can rest? I wonder why the OP resents this, and why the mother felt she had to trick the nursing staff into taking the baby?
    Something isn't adding up here.
  12. by   cheshirecat
    Yes, in an ideal world mum would have said "please take baby for the night, I am exhausted". Maybe she felt guilty and thought she would be judged on this, i don't know. Life is hard, new motherhood is hard. Please give this new mum a break.

    After I had my baby by c/s, she spent 3 nights in the nursery. Why? Because as a midwife with a husband in the military and family hundreds of miles away, I knew the next time I would get a decent nights sleep would probably be years away.

    We do not know what support she will get at home.
  13. by   GardenDove
    ---I agree, it's a little perturbing that folks here want to call CPS because this woman was trying to trick the nursing staff into taking her baby for the night. For some reason she felt like she couldn't be honest. I float to OB to help out and if someone wants to sleep here, we take the bassinet to the nurses station quite gladly.
    ---Wasn't it back in the old days that all babies were kept in the nursery? Women who wanted their babies at their sides had to fight for that right. I had my 6 children all homebirths so I would avoid dealing with domineering hospital staff. Maybe this woman didn't want to deal with it, so thought to use her religion as an excuse, thinking that the nursing staff wouldn't know too much about her religion.