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Discussion

Refusal of Blood

Hi...Still a new nurse under a year. Finally experience my 1st patient who refused to have a blood transufion even though her H/H came back with panic levels. Because of her refusal, the doctors are basically treating her with iron and oxygen. I did give one dose of Procrit 10,000 units sq. The family has threatened to call the head of the hospital, etc. because they feel that the docotors aren't doing enough. The hematologist is the one that ordered the iron and oxygen, and stated it would be a long process before her H/H would come up. What more can be done? Thanks...everyday is a learning experience.

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unfortunately it is a patient's right to refuse treatment.

  • Author

I understand that and do respect their decision. My question is what are the other alternatives that can be done.

Don't you just love these folks, when the patient refuses the treatment that fixes the problem, but yet the family is freaking out because the Doctor's can't pull out Miracle Plan B.

Have them sign the refusal of blood products form, and just do what you can do! We have a situation currently where a trauma pt was bleeding to death and family refused blood for religious reasons (we suspected the pt would not agree with them). She's still alive, continues to be critically ill with low H&H, but not able to communicate her wishes.

Nothing can really be done in this situation except to continue providing the patient with oxygen and preventing anything that will consume a lot of it such as fever, shivering, anxiety, etc...

I had a JW patient before that was a trauma and the family refused blood for the patient. H/H was 4/16....I think....at any rate patient is alive and well.....

  • Experts
the doctors are basically treating her with iron and oxygen. I did give one dose of Procrit 10,000 units sq.

Vitamin C can greatly enhance the absorption of FeSO4.

If the bone marrow is able to do it's job you'd be amazed how fast it can work.

I went from the LOW end of normal for women to the HIGH end of normal for men in 2 weeks taking FeSO4 325 & Vit C 500mg TID.

Don't you just love these folks, when the patient refuses the treatment that fixes the problem, but yet the family is freaking out because the Doctor's can't pull out Miracle Plan B.

Really all the patient has refused (assuming normal bone marrow function) is the quick fix. Family needs reassurance that all of the measures to promote RBC production are in place and referred BACK to the patient with their complaints.

If you're well enough to direct your care you're well enough to deal with your family regarding your choices.

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