Patient refuses blood products. How does your hospital ensure their wishes are followed?

nimtzmary · Jan 17, 2015

No one would ever have forced the albumin on the patient. It was in error. The patients family did not know what is was until after the fact. The nurse knew the patient was jw but the albumin didn't click. It comes from pharmacy and not blood bank. I'm finding out it is a common mistake with blood by products and just trying to find a way to keep it from ever happening again. The physician who ordered it felt badly. But you are right, the buck stops with the nurse.

eroc · Jan 17, 2015

Just educate your patient to their own religion. Albumin is acceptable for JW, unless they just are refusing to be refusing. Many have no idea what the "Society"

(name for their governing body) really approves of and disapproves of.

Heck share this article with them from their "official" website. Jehovah's Witnesses The Surgical/Ethical Challenge - Jehovah's Witnesses Official Web Site[search_id]=e1d16ca9-38d1-4f52-a5b4-0409dc4b5542&insight[search_result_index]=0

Part our job as nurses is to educate not only the patient, but ourselves.

MunoRN, RN · Jan 17, 2015

Most blood products require a consent. Albumin does not -- it's just hung and documented like any other IV med.
I worked in one facility that had a white band with the circle "no" sign and said "NO BLOOD" on it; we'd put it on the patient next to the ID and allergy bands. I liked that idea so much, that when my new facility didn't have this, I made them for any JW pts I had (after clarifying with them first -- some JW's will take blood! You should always ask and not assume). I'd either use a red band or turn it inside out, and just write NO BLOOD really big on it. That, and as someone else said, the lack of a type and screen band, should make it clear enough, especially if there's an emergency and the pt can't speak for themselves.

There are some potential problems with that idea. When we give blood products to a JW who wants them, we typically move them down to a procedural area where visitors aren't allowed and make sure no visitors know where they are so they can go looking, because they do try. If it's an ICU patient and needs to stay on the unit then we bring a bunch of equipment that isn't being used into the room so we can tell everyone that nobody can go in during the procedure. If we just say they can't visit for the next four hours they figure it out pretty quick.

If there were "No Blood" signs as a general rule then the patient's JW visitors would likely notice if the sign wasn't present, making even JW patients who do want blood feel obligated to have the sign up (and refuse blood). So by using the sign system you're either advertising to the visiting JW's that the patient has agreed to have blood, despite this being something that they almost always want kept secret, or you're potentially overriding the patient's true wishes by not allowing them to make the choice without other JW's knowing.