Pts abusing "cultural/religious" practices to manipulate RNs

[HvnSntRN]

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 sundown on Saturday). No problem. The nurse looking after her planned with her to check in every hour to see if she needed something.

I later found out that the patient sent the baby to the nursery to be bottle fed by the staff overnight, even though she was breastfeeding.

I also found out that not only did she do this on Friday-Saturday, but also Saturday-Sunday, and Sunday-Monday. She had a different RN working with her each shift and pulled the "no work on the Sabbath" routine, expecting that the nurse wouldn't be familiar with the differences between the Christian and Jewish observances of the Sabbath.

I guess I just have a hard time respecting people who misinform regarding their beliefs and cultural practices with the aim of getting what they want from other people. I mean, why not just say (like other people do) "I'm really tired from breastfeeding and I'd rather let you give the baby a bottle overnight", instead of trying to manipulate us with phony information about religious beliefs and practices? I'm pretty sure that Jewish people eat on the Sabbath; do they plan to not feed their babies on the Sabbath once they're discharged from the hospital? If that's the case, then we should be calling CPS, right?

I'm all for being culturally sensitive and respecting other peoples' belief systems. What I don't appreciate is when my colleagues get manipulated on that basis by people being deceptive about their beliefs and practices - it shows a distinct lack of respect for us and an abuse of our efforts at being culturally sensitive.

How do other RNs handle situations like this?

[purplemania, BSN, RN]

and who is feeding the baby now that they are home???????????

[dragonflyRN]

??? I just went from one hospital experience to another. I wanted to be the l&d nurse at one time. I don't see it in my future. I loved my ld nurse when i had my first. Now? they don't seem to care about the child or me....so what's the point

[GardenDove]

Yes, some have made that very point. 29 years ago, when I was pregnant with my first son, the hospital in Albuquerque NM had a rule that they took the babe for the first hour of life. Then they let you have it if they decided it was okay. You had to attend a childbirth class with your husband, so he could attend the delivery. I balked at this controlling attitude and had my first homebirth, and never looked back.

Now, it sounds to me like OB is still a bunch of control freaks, only they've taken an about face. Now they're ready to report you to CPS if you don't 'bond' to their expectations with your babe. They critisize you if your husband isn't staying the night, if you dare put your baby on it's stomach you are viewed as an ignorant nutcase.

The only consistancy here is that OB nurses want to boss around their pts, and limit their choices. They know best and their pts are 'noncompliant' airheads if they want a different choice. They are not there to meet their pts' needs on the pt's agenda, respecting different philosophies and approaches, but the nurse knows best (even if medicine decides 20 years later that, whoops, we were doing it wrong all along, and comes up with some new way that they want to impose on the hapless moms).

My point with this rant is, Respect your pts wishes whenever possible. If you don't have the staff to watch their baby safely, explain that instead of putting them on a guilt trip for wanting sleep. Give them choices, give them options, and tolerate them when those choices differ from your own. Ease their way gently, don't intimidate, and respect their rights to take what they want from the healthcare system on their own terms.

[SmilingBluEyes]

This is room in the middle for what is best. Extremes on either end, never work. I am through with this thread. Carry on.

[babyktchr, BSN, RN]

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Oh my. I, too, have learned so much from reading this thread. There are so many different cultural nuances, it is hard to keep up. It is good to know there are so many resources (you as nurses) on the Jewish faith. Thank you for your input.

[2curlygirls]

Sorry to butt in but I find it interesting how some posters are stereotyping L&D nurses as judgemental. How on earth can you lump ALL the nurses in a specialty into one category. Granted, I'm not an L&D nurse, but as a NICU nurse and mother of two, I sure as heck know a lot of them. I'm sure some are judgemental, as are some lawyers, priests and midwives, but that's not a generalization that comes to mind about the whole profession!

And it's difficult to respect everyone's wishes especially when you might not know where they are stemming from. Lots of us work in very culturally diverse hospitals. We cannot possibly be well versed in every tradition. Do you know the birthing practices of the Hmong community? How about the Uygurs? Do you speak fluent Urdu?

I'm confused about being committed to BF'ing and wanting a good night's sleep. Even the sleepiest newborns usually only go three hours between feeds. So I don't think you can be a mega BF supported and say that mom should be entitled to a night of solid sleep when she is trying to establish a supply. I know that's not what an LC would say.

I don't have much input on the OP, sorry. I do think it might warrant further investigation but isn't necessarily pathologic behavior. I too am thankful for the information about the Orthodox traditions/practices. The cultural aspect of nursing is fascinating.

[peds4now, RN]

You never actually state in your post that the mother was saying she could not breastfeed her baby on the Sabbath. You also never actually say why she sent her child to the nursery. You said she refused to do work. I have a feeling you are bending the truth a bit to be honest. Your post was just incendiary enough without actually giving good detail, which in my experience is one of the telltale signs of a fake post.

Lots of mothers of all religions/ethnicities send their babies to the nursery at night even though they say they are breastfeeding. That may be stupid and misguided, or maybe they are just exhausted and rest is the one and only thing they need at that moment regardless of what it does to the breastfeeding relationship. As a paying customer she has a right to send her baby to the nursery if she wants.

Also, even if this woman were to have her own version of Orthodox Judaism that does not match anyone else's, it's none of your business really. Nothing she did resulted in poor care for her infant, so I think the posts about calling in authorities are stupid.

[JeanettePNP, MSN, RN, NP]

You never actually state in your post that the mother was saying she could not breastfeed her baby on the Sabbath. You also never actually say why she sent her child to the nursery. You said she refused to do work. I have a feeling you are bending the truth a bit to be honest. Your post was just incendiary enough without actually giving good detail, which in my experience is one of the telltale signs of a fake post.

We already clarified that the mother was hospitalized over Yom Kippur, which would explain why she told the nurse "no work" for two days in a row. It is not clear from the original post that the patient believed that nursing or caring for baby overnight was included in "not doing work". I think the two situations are unrelated to each other.

[Melilem]

I haven't read all the threads, just the first few pages. Quite frankly I'm shocked at some of the solutions people are suggesting. I am only a student, but I think what would be in the best interest of both mother and child is some support and education. Whoever suggested child welfare should retire. Child welfare will take you seriously, and assume they are dealing with a neglectful/abusive mother because you, a medical professional, said so. All because you don't like the way she manipulates staff? Thats not in the childs best interest- whats in that childs best interest is getting off your duff and doing some teaching/intervention. sorry... i just had to vent... this goes against everything Ive learned so far. i feel better now.

[BabyRN2Be]

Maybe this would be an instance in which a good PP doula would be of service. I can't remember if it was stated that this was her first child or not, but maybe she was scared of what was ahead and she thought that the only nights she could sleep was when she was hospitalized PP. If she knew that this was a possible resource in her community, maybe she would have relaxed a little knowing that help on the outside was/is possible.

Maybe even better, a PP doula who happened to be of her faith. This person could have explained what was allowed on the Sabbath and what was not, all the while she would have support at home.