This cannot be ethical!

[sweetcheekers]

I was recently told during NRP training that a nurse was instructed at some point to always use the opportunity to practice intubation if a stillborn babe was available. I said, "Are you kidding me?" She said no and that she had the opportunity three times but just was unable to do it. I said that I felt that was extremely unethical and that using a patient's body (dead or alive) for learning purposes without proper consent was just plain WRONG! I don't care how great the learning opportunity, I would NEVER use another human to further my education without knowledge and consent of the patient or parents. Am I overreacting! This does not seem like a gray area to me.

[student4ever]

I was recently told during NRP training that a nurse was instructed at some point to always use the opportunity to practice intubation if a stillborn babe was available. I said, "Are you kidding me?" She said no and that she had the opportunity three times but just was unable to do it. I said that I felt that was extremely unethical and that using a patient's body (dead or alive) for learning purposes without proper consent was just plain WRONG! I don't care how great the learning opportunity, I would NEVER use another human to further my education without knowledge and consent of the patient or parents. Am I overreacting! This does not seem like a gray area to me.

I am in total agreement with you! Proper knowledge and consent should be obtained from the parents before doing any "practice" on the stillborn child. Unless doing so to try and resuscitate the child, (obviously not the case here) a practice intubation should not be performed, IMO.

[Jolie, BSN]

No, I don't think you are over-reacting.

But I worked in one hospital where this was done, and I'm sure it happens in other places as well.

Perhaps you could use this opportunity to bring the issue to the ethics board of your facility. That is something I was not assertive enough to do. There were so many things wrong with the facility where I worked, that I just left.

Thank you for being so compassionate to these precious babies and their loved ones.

[soliant12]

I was recently told during NRP training that a nurse was instructed at some point to always use the opportunity to practice intubation if a stillborn babe was available. I said, "Are you kidding me?" She said no and that she had the opportunity three times but just was unable to do it. I said that I felt that was extremely unethical and that using a patient's body (dead or alive) for learning purposes without proper consent was just plain WRONG! I don't care how great the learning opportunity, I would NEVER use another human to further my education without knowledge and consent of the patient or parents. Am I overreacting! This does not seem like a gray area to me.

Practicing an intubation on someone who is deceased is done quite frequently. It would be a lot different if it were practicing a central line or something in that realm. When the patient is deceased the is more time to focus on landmarks and take the time to study the anatomy and visualize the vocal cords and a loss less chance of breaking any teeth. And I can honestly say in the number of times I have done this or seen it done not once did the patient complain.

[BKRN]

And I can honestly say in the number of times I have done this or seen it done not once did the patient complain.

Not funny. I would be upset to find out this was practiced on my stillborn infant-especially without my permission.

[Jolie, BSN]

Practicing an intubation on someone who is deceased is done quite frequently. It would be a lot different if it were practicing a central line or something in that realm. When the patient is deceased the is more time to focus on landmarks and take the time to study the anatomy and visualize the vocal cords and a loss less chance of breaking any teeth. And I can honestly say in the number of times I have done this or seen it done not once did the patient complain.

I doubt that anyone would argue the educational benefit of this practice. But morally and ethically, many believe it to be wrong to manipulate a human body like a practice manequin (sp?) without the consent of the next of kin. Your patient wouldn't complain if you removed his/her organs for donation, either. But doing so without consent is clearly wrong. This is similar in many people's minds, just perhaps to a lesser degree.

With the parents' consent, I see no problem.

[mom23RN]

As someone who has lost a child (not to stillbirth but very young) I would be horrified if someone did that to my child.

I'm not sue crazy, but had I EVER found out that someone had done that I would sue them. That is my child in life and death and NO ONE has the right to treat them/practice on them without MY consent.:angryfire

If I ever SAW this being done I would also report it to the ethics commitee at my facility.

[Undecided7]

I am assuming that these "practice" cases are done when the family is not there. In that case, what's the harm? You're not taking organs or cutting open the body or anything like that- it would not alter to final appearance of the body and let's face reality- the body is dead- the soul- left for better places. In nursing school our instructors (especially in ICU) would come get us if someone expired or was about to expire so we could check different reflexes and see what happens to people. Of course if the family arrived, it was important to show sensitivity to their loss and grieving needs. As long as the family is gone- I don't see a problem.....

It would be interesting to know what posters have worked in NICU or ICU settings for several years and which ones are new- only because I think it may affect how you approach some of these emotionally charged issues, especially the concept of mortality

[sweetcheekers]

The harm is that nurses are suppose to have a code of ethics. We are suppose to handle ourselves in a way that makes us deserving of the trust that our patients and their families place in us. We are not suppose to deceive people for our own gain, regardless of wether our gain is knowledge or something else. We are required to show honor and respect to the human body wether living or dead. Is nothing sacred? I firmly believe in providing dignity for all my patients, child, adult, living, or dead. I will not betray someone by using them for experimentation without specific consent from the appropriate party. I would be outraged if someone did this to someone I love. Do we want to create an environment in which families feel they must protect the deceased remains from the very people who are suppose to care for the patient? What happened to the psycho-social side of nursing and caring for more than just the physical needs of our patient. We are suppose to value the psychological needs equally and that includes the family of the deceased. Even if not in agreement with this theory, I would think that anyone who believes that nursing is a profession would choose to conduct themselves in a professional manner and put the feelings of the patient/family before their own desire for a learning experience. Patients should not lose their rights because they die. Professionalism means that we have a code of conduct which includes honoring the rights of patients wether we agree with the patient or not. Patients should never become a "commodity" that we see as convenient for our own use regardless of the circumstances.

[linfull]

"And I can honestly say in the number of times I have done this or seen it done not once did the patient complain.

You're a cold person. What a cruel, hurtful thing to say. :angryfire :angryfire :angryfire

[bagladyrn, RN]

As an OB nurse who handle demises much more often than I wish I did, there is NO way this would happen in my presence - unless they wanted to try and move my very solid body out of the way!

When dealing with a stillborn child or a neonatal demise, I wash, dress, wrap and handle these babies exactly as I would if they were still breathing, with the same respect and in a way that I would feel perfectly comfortable if a family member wished to watch or participate in the care.

If you would not feel comfortable doing the procedure with the parent right there you have no business doing it without their express permission!

[babynurselsa, RN]

This happens very very often. I used to work in a teaching facility. Whenever we lost a baby our Neo would INSIST that all of the residents attempt to do this. I was never comfortable with this practice. I can see the logical train of thought, but I still found it very upsetting.

My understanding is that many procedures are practiced on expired patients.