TAB's?

[jrring1019]

At the hospitals you work for, are you allowed to refuse to take care of pts who are having TAB's? During an interview I was told that nurses cannot refuse to care for these pts. The hospital I am at now does allow nurses to decide if they will care for these pts. I was surprised that this was part of the interview, but I guess if this is against religious beliefs etc... then people would not take the job.

I don't want a debate on ABs and I won't even say where I stand, but I think that nurses should have the right to not participate without the risk of being reprimanded. I learned from another nurse that she was told the same thing in her interview at a different hospital. Just wondering how it works in other places

[fergus51]

There is a difference between participating in the actual procedure and caring for the patient before and after. Most facilities will allow nurses to avoid the procedure, but the after care is not something that is against anyone's religious beliefs so the same allowances are not made.

[Fiona59]

I worked float in a hospital that did second trimester abortions for fetal anomolies. The actual abortion was done in an OR, the patient returned to the Gyne. unit for care.

The interview asked a lot of questions before asking how you would care for a woman who was in for an abortion. It's pretty clear to the manager what your attitudes are and that's how the hiring decision was made. Apparently a few years back under a different manager an RN had been hired who was antiabortion and left a few of her patients with a lecture and a leaflet outlining what terrible human beings they were for "murdering".

It's simple, if you can't accept the procedure, Womens Health is not the unit to go to.

Most women don't undertake having an abortion lightly. They need care, compassion and respect, before, during, and after the procedure.

[palesarah]

Nurses on my floor absolutely can refuse to participate in TABs (we occassionally have them on the floor as second-trimester induction). Those who feel it is immoral for them to assist, have a little piece of paper they can put their names on (very small percentage of staff). The rest of us don't mind. We're all crosstrained to eveything so there's always somebody else who can do it, and we would all rather see these patients who (thank you Fiona!) need caring, compassion, respect and understanding get it from someone who means it, from someone who does stand in judgment against them

[SweetieRN]

I think it is a nurse's right to refuse to participate/assist in the actual procedure itself, if she has moral/ethical/religious beliefs that prevent her from doing so - HOWEVER - if she was told prior to employment that this particular facility performs these procedures and they specifically asked her if she had a problem with that and she said "yes", and then accepted employment there regardless, then she should have refused the employment offer and gone elsewhere to work. I feel that refusing to take care of a patient who has had an abortion is WRONG. What's done is done, and that patient needs nursing care - refusing to care after-the-fact is being JUDGEMENTAL in my opinion. It doesn't matter if your pro-life, pro-choice or whatever you should provide compassionate care to a woman post-abortion and leave your personal "baggage" out of it. If you can't do that - then move on - to another facility who does not perform such procedures.

[SmilingBluEyes]

Before seeking employment in any OB situation be sure you ask if TABs are performed there and if refusal is truly not only allowed but possible. In one Catholic hospital I worked, NO TABs were performed, obviously. This could work for you---if you find a hospital that simply won't do them.

Also, If you are that vehemently opposed, make it clear from the outset. But know, sometimes, emergent situations happen where this is not always in your control. OB is dynamic and staffing, tricky, at best. you sometimes have to take the first patient that comes up when it's very busy. Be sure you are working w/folks who support and will respect your ideals and will switch assignments to accomodate them.

GOOD LUCK!!!

[imenid37]

I did work for a few months in a place that did TAB's. It was not a good time in my life any way. I did not participate in the procedure BUT did take care of people afterwards. Whatever your opinion on this topic, in a position where the facility performs TAB's, you are not in this setting to evangelize or put your opinions on your patients. You are there to give kind and compassionate care. I feel that I never mistreated any of my TAB pt's. I felt incredibly sad for them and felt that even though I didn't "participate" in the actual procedure that my being there facilitated something with which I didn't agree. In an odd way, I am glad I got to see "the other side" of this issue. It is not black and white. It is a very grey area. I also know I wouldn't accept a position in this type of facility again. As for the pamphlet passer. I think that is horrible. If a patient has this procedure, they deserve to feel safe and cared for by the staff, not under attack. People who care for these patients, if they choose to, should be able to do so non-judgementally. I guess what I am saying is that even if you do not participate in the AB itself, it will still be in your face as you provide care for the patient before and after.

[psalm, RN]

...I would not knowlingly prepare a pt. for an abortion, but I would not have any problem with aftercare. And I could do it without being judgmental or holier-than-thou.

[imenid37]

Often the aftercare involves the nurse delivering the fetus. This is very difficult. It is in some ways harder and more unpleasant than the "procedure" itself. I am referring to second trimester AB's. Even people who were okay w/ the "procedure" itself grew weary of taking care of some of the women afterward. It can be emotionally draining. Many nurses were quite terse to some of these patients. If you do them at your facility, I can see that some would not want to have to care for the AB pt's all of the time. It is hard work. It often includes a run (at least where i was) to the OR for retained placenta. I went into it not feeling okay w/ AB's and left not feeling any different. I did feel terrible for the women. IMHO and it is just my opinion, many were there because men in their life were pressuring them to be. I often felt like there had to be something better we could do for these women, but I can't tell you what. Very few were being performed for anomalies. I guess my point is, if you work w/ TAB pt's, know what you are in for. Where I work now we do cytotec on occasion for those w/ lethal anomalies. I feel sad for the patients, but I have no conflicts. For me, it is a different situation than terminating a healthy fetus in the second trimester.

[RNnL&D]

In one Catholic hospital I worked, NO TABs were performed, obviously. This could work for you---if you find a hospital that simply won't do them.

Exactly. I work in a Catholic hospital where there is no such thing as a therapeutic abortion. Keeps me from having to worry about how I would respond.

[DutchgirlRN, ASN, RN]

Exactly. I work in a Catholic hospital where there is no such thing as a therapeutic abortion. Keeps me from having to worry about how I would respond.

I think a women should be able to make any decision that she feels that she can live with. I personally don't believe in AB. I have worked with patients who have misscarried live babies and that was extremely tough on me there is "no" way I would put myself through this, taking care of someone who chose to do this to themselves and their child. This is only my opinion. I still think abortion should be legal.

[LandDRN]

It IS a grey area. I had, what I prefer to call a pregnancy termination, at 22 weeks gestation. This was a baby we had tried to conceive, planned for and even bought and did the nursey after I passed 16 weeks and AFP was normal. Our baby had the most severe form of Tetrology of Fallot, completed renal agenesis ( total absence of both kidneys), complete absence on internal urinary system, bilateral lung dysplasia. All three of these were lethal anomalies. We terminated based on our perinatologists suggestion ( I was a cardiac nurse at the time and completely understood the cardiac implications but was fairly ignorant of OB issues.) SInce our baby had no urinary system, I had no amniotic fluid. Since I had no fluid it was explained that if there was any tear/breaking of the amniotic sack and we decided to attmpt to carry to term, I would not know until an infection set in which I was told could possibly impact our ability to conceive and have future children. I was also told because of this factor, I risked higher odds of going into DIC. We agreed on the termination. I didn't decide on my baby's death, it was already decided for me. I felt like we just had to opt for WHEN. Thank goodness for the completely compassionate nurses I had who held our hands and cried with us. I always agree to take these patients. They need such compassionate care and empathy. I would have done ANYTHING to keep that first baby but as awful as it was our nursing care helped us so much with healing.