I have finally have gotten a position in L&D. I had worked towards this position for many years now and somehow during my interview a question was raised and I was blindsided. I was asked if I would have a problem participating in late term terminations.... up to 26wks. How had I not realized this was a very real part of L&D? I worked with OB patients for 5yrs (MD office) and had also done my senior preceptorship in L&D, but somehow this never entered my mind. The interviewer proceeded to go into graphic detail about the procedure and needless to say the obvious reason why we could not comply if the patient requested footprints.
Wow... it's been a few months since and I'm still struggling with this.
I feel compassion for the mother who has to make the heart breaking decision to terminate because of medical/genetic/congenital reasons ect.
I struggle with the elective late termination because I just can not wrap my head around it. In one room I have a mother destroyed at the thought of losing her 25 weeker and in the other another patient as she stated is just "Getting rid of it".
Where is the line between our nursing duties and ethics.
Thanks so much for any response. I know this is a very touchy subject.
If you are uncomfortable with participating you should discuss this with your manager. Thought processes change and you should be respected for that what once didn't bother you now seems to. You are under no obligation to continue doing something because at the time you agreed, it wasn't an issue; nor, should you have to suffer with ethical dilemma you now find yourself in.
I would tell them up front that under absolutely NO circumstance could I ever assist with murder. Period. If they didn't accept that, then I would be looking for a different job. I became a nurse to save people's lives, not end them.
If you can't or won't work with patients that *choose* to terminate for whatever reason, then you should look to a Catholic hospital to work L&D.
Parents who *choose* to end a pregnancy where the child is doomed to die during birth or will be in horrific pain during it's entire life (however long or short that may be) should not be villified and require compassionate, competent care, even if we would have *chosen* differently. The people I knew who had to do this, did not make the decision lightly, that child had a name & a nursery already - and siblings and grandparents. A wanted, loved child, who was not going to live past birth (acephaly).
If you *choose* to be against abortion, then are exercising your right to choose.
Please read more carefully and slowly. The problem is not about the right to choose. This is about a nurse and mother looking for advise on having to handle, as I did, a patient coming in at 24wks to terminate. No medical, congenital, genetic reason ect.... just birth control.
Again, for the third time, I am not judging anyone!
Just wanted a little advise about dealing with a very real aspect of L&D.
Every unit has their moral dilemma. Not judging.
Thank you to all of those who actually gave constructive advise.
Do ELECTIVE terminations really occur in the hospital setting in the absence of defects that are not compatible with life??? We do not do these. We terminate due to defects that would not allow the baby to live and that is all. I have not even seen an abortion due to Down's syndrome and it is my understanding they do offer this to women. I am ok with caring for a pt undergoing a termination due to fatal anomalies but absolutely would not participate in an elective termination.
If you could not participate, I would be honest with them about it...chances are another nurse may trade you patients in that case.
I have found that there are alot of things that I 'personally' disagree with in nursing, but I put my nurse panties on and do it because its not my choice, its the patients.
I can't imagine helping with one myself...there are things that stick in my head for years and I am sure that would be one of them.
Specializes in A little of this & a little of that.
I personally wish that they wouldn't place patients who are not "having babies" in the same units with those who are. I think it's convenience of the doctors. Years ago, I had a second trimester miscarriage that actually turned out to be a molar pregnancy. I grieved for it just the same. I was placed in a 4 bed room with 3 women with babies right next to the newborn nursery!!! After two days, I managed to get moved further from the nursery and next room-mate was a GYN surgery. It was a tragic time I will not forget. Nor will I forget that the nurses on that unit were the most awful I have ever been unfortunate enough to meet. Maybe they were OK with the new moms and their babies, but not for me. I can only imagine how badly they treated women with elective terminations.
I think it would be better all the way around if non-mothers were placed in med-surg.
For those looking to work L&D or OB and can't deal with the terminated pregnancies, definitely seek a religious hospital - there are others besides Catholic that don't perform terminations.
I think that what the OP was subjected to as far as graphic description is unconsciounable. Asking a nurse if she has an objection to participating is one thing but that's outrageous behavior. I think I'd have nightmares. I know it happens and am aware of it what it's like. I don't think any of us needs the graphic descriptions.
Please read more carefully and slowly. The problem is not about the right to choose. This is about a nurse and mother looking for advise on having to handle, as I did, a patient coming in at 24wks to terminate. No medical, congenital, genetic reason ect.... just birth control.
Again, for the third time, I am not judging anyone!
Just wanted a little advise about dealing with a very real aspect of L&D.
Every unit has their moral dilemma. Not judging.
Thank you to all of those who actually gave constructive advise.
So you are looking for advice on how to handle these situations? We don't need to read more slowly and carefully to understand what you are trying to convey. Treat that patient like any other patient. That's how you handle that situation. Don't forget women terminate abortions in cases of rape also, it's not just about congenital defects.
Specializes in A little of this & a little of that.
OK, so I'm confused. This was the original post I was replying to. Are you saying you took this job and are routinely being faced with this issue? This callously ("getting rid of it")? I've never had to deal with patients with late-term abortions for non-medical reasons. The ones I've dealt with that were far enough along to need a procedure were quite serious and thoughtful about their decision and sincerely in need of compassion and empathy. There's no "line" between our duties and ethics. We provide compassionate care to all. If there is a conflict with personal morality, that's a personal not professional issue that can be resolved by requesting a different assignment or working someplace that doesn't do the procedure.
I have finally have gotten a position in L&D. I had worked towards this position for many years now and somehow during my interview a question was raised and I was blindsided. I was asked if I would have a problem participating in late term terminations.... up to 26wks. How had I not realized this was a very real part of L&D? I worked with OB patients for 5yrs (MD office) and had also done my senior preceptorship in L&D, but somehow this never entered my mind. The interviewer proceeded to go into graphic detail about the procedure and needless to say the obvious reason why we could not comply if the patient requested footprints.
Wow... it's been a few months since and I'm still struggling with this.
I feel compassion for the mother who has to make the heart breaking decision to terminate because of medical/genetic/congenital reasons ect.
I struggle with the elective late termination because I just can not wrap my head around it. In one room I have a mother destroyed at the thought of losing her 25 weeker and in the other another patient as she stated is just "Getting rid of it".
Where is the line between our nursing duties and ethics.
Thanks so much for any response. I know this is a very touchy subject.
Even nurses have ethics and morals. It is up to us as professionals to determine if we can participate in the procedures that the unit or hospital provide. We need to do this BEFORE we accept employment.
To the original poster - I sincerely hope that if you are so torn up by this, that you look for another position. Our careers aren't worth losing our morals and/or ethics.
Specializes in Nursing Ed, Ob/GYN, AD, LTC, Rehab.
I think that if a nurse has an ethical problem with procedures done in a place of employment it is that nurses responsibility to leave the job and find work that is morally agreeable. My reasoning is that when a patient enters a care facility to get legally sanctioned procedures that patient has a right to staff that supports those choices. If one nurse there didnt and always was passing these patient off to other nurses it would create a stresful work environment and lets be honest at some point you would have to care for them in on capacity or another. I feel the nurse is responisble to find a facility that shares their morals. If you find you can not care for these patients or have difficulty I would suggest you find a better work environment for your own comfort and piece of mind. You also have the right to work somewhere comfortable for you. If you really want to find a way to care for these patients and work past this issue try to find the positives in the situation and focus on the women and not the fetus. Try to remember (as you have stated) that no matter how a persons life looks on paper (3 late term abortions etc) you have absolutly no idea what lead to those decisions and how people may act in such a difficult decision may not how they act in life with others. Nurses see people usually at their worse in these situations. A caring understand perspective I find is best. I too work with many VTOP and SAB etc I try to remember every story is different and every situation is different. I am happy and supportive that all these women in these situations at least had options available wether I agree or not, they made the right choice for them. Hope that helped!
loricatus
1,446 Posts
If you are uncomfortable with participating you should discuss this with your manager. Thought processes change and you should be respected for that what once didn't bother you now seems to. You are under no obligation to continue doing something because at the time you agreed, it wasn't an issue; nor, should you have to suffer with ethical dilemma you now find yourself in.