Picture this: your pt shows up with a birthing plan that includes "no vaccines for baby, including Vitamin K" but you know that VitK is a state requirement. Period. Aside from it being hospital policy to administer it to every baby born, it is a state policy. You could actually leave yourself open to losing your license if you *didn't* give it. You are breaking the law by *not* giving it.
(nice, right?)
This policy and it's legal ramifications are on file in the nursing admin office (you know this because you called them ASAP!). As much as it stinks to get off on the wrong foot with your pt right off the bat, you inform the pt of the policy and the position you are in.
The family then whips out a letter supposedly written by a lawyer stating that they will sue if their baby gets Vitamin K.
(nice, right? I love it when patients show up to the hospital so incredibly prepared.)
NOW WHAT??
(tell me what you'd do and I'll tell you what happened )
This is sounding like a case of heavy-handed legislation written and passed by people with no medical knowledge or consideration of scientific evidence. (Huge surprise there, right?)
There is absolutely no medical or scientific reason to mandate that vitamin K be given within the first hour of life. And anyone with experience in L&D or a birthing center can attest that this is the very time frame during which its administration(and erythromycin ointment, for that matter) is likely to interfere with bonding.
How horrific no wonder the parents came in with the heavy mob- I am surprised that this has not been challenged in the courts - after all USA is meant to be the land of the free- but it appears not free choice.
I'm in New York State where Vitamin K is mandated, unlike vaccines which can be refused. Seems that the law was based on this study (the link is to an abstract. There's a pdf file with the actual article on site).
OK, I read these links, including the article which summarizes New York State's "research" on hemorrhagic disease in the newborn, and "justifies" the policy of forcing vitamin K on all newborn infants, regardless of parental consent. It is downright scary! This "research" includes infants with DIC and intraventricular hemorrhage as examples of disease processes which "justify" this mandate. Do these researchers not know or not care that these infants were likely critically-ill premature infants who received vitamin K, and developed life-threatening complications of prematurity completely unrelated to their vitamin K status? They also included babies who experienced hemorrhage whose vitamin K status could not be determined. Isn't that convenient to their agenda?
The link on eye prophylaxis states that it is to be administered immediately upon delivery, and advocates the use of silver nitrate! Just how out-dated and barbaric is that?
I seriously question the qualifications, experience and mind-set of Mary Applegate, MD PhD Medical Director of the Bureau of Women's Health, and Frederick J Heigel, Director Bureau of Hospital and Primary Care Services.
It all crazy out of controll its like big brother gone wrong- one case of child with cancer with a vage link to vit K - whose parents were forced to give it to the child would blow this mandate out of the water.
When I read your initial post, I was certain that you were either being misled by your hospital leadership about the state law on vitamin K (and eye prophylaxis), or you were misunderstanding it. I now know better.
As to your initial question about what would we do in your scenario: My answer is nothing. Although there is clearly a state mandate regarding these treatments, I would defer to hospital administration, and not touch the baby, the vit K syringe, or the erythromycin ointment with a 10-foot pole!
What a mess we make when we turn healthcare over to lawmakers!
Where I am, if mom doesn't want baby to get VitK, Emycin, or HepB, we just document that she declined and move on. Some nurses get their knickers in a bigger wad than others, but I personally have WAAAAY bigger fish to fry. And really, the human race obviously didn't die out before we started doing all this stuff to these babies.
Well, i would first use good ol' Google to look up and see if it is truly a state requirement.
Then, i would have them sign a ama/refusal of treatment form. State requirement or not, we cannot do anything to them against their will. So I wouldn't do it. If you do it against their will, its assault.
i'm in new york state where vitamin k is mandated, unlike vaccines which can be refused. seems that the law was based on this study (the link is to an abstract. there's a pdf file with the actual article on site). at the time of the incident, nursing admin came to the unit brandishing copies of both the hospital policy and the state law. it's in ny state public health codes. peds did speak to the parents then literally washed her hands of it, refusing to even document that she had discussed the issue with them.
(that's fine. it was documented that she spoke with them elsewhere)
quote]
and people wonder why parents come armed with lawyers letters and get all antsy about stuff...unbelievable...so would i......:uhoh21::uhoh21::uhoh21::uhoh21::uhoh21:
OK, I read these links, including the article which summarizes New York State's "research" on hemorrhagic disease in the newborn, and "justifies" the policy of forcing vitamin K on all newborn infants, regardless of parental consent. It is downright scary! This "research" includes infants with DIC and intraventricular hemorrhage as examples of disease processes which "justify" this mandate. Do these researchers not know or not care that these infants were likely critically-ill premature infants who received vitamin K, and developed life-threatening complications of prematurity completely unrelated to their vitamin K status? They also included babies who experienced hemorrhage whose vitamin K status could not be determined. Isn't that convenient to their agenda?
The link on eye prophylaxis states that it is to be administered immediately upon delivery, and advocates the use of silver nitrate! Just how out-dated and barbaric is that?
I seriously question the qualifications, experience and mind-set of Mary Applegate, MD PhD Medical Director of the Bureau of Women's Health, and Frederick J Heigel, Director Bureau of Hospital and Primary Care Services.
Like I said earlier- a load of crappola! Despite all the vitamin k in the world some kids will get bleeding disorders- research my ar**e!!!! This stuff makes me wanna puke........and its those parents who refuse this, because they've informed themselves with "real" research and facts;that are then treated like criminals. Far out...anyone got Dr Applegates email addy - we could email and ask for clarification....oops...the study is that old shes probably dead!!!!
Treating normal labors as though they were complicated can become a self-fulfilling prophecy.(Rooks)
Oh I agree, and I don't go in with that thought, I'm a pp nurse so I have nothing to do with the labors but this is what I've learned from the nurses around me.
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Jolie, BSN
6,375 Posts
OK. I didn't read the link yet.
This is sounding like a case of heavy-handed legislation written and passed by people with no medical knowledge or consideration of scientific evidence. (Huge surprise there, right?)
There is absolutely no medical or scientific reason to mandate that vitamin K be given within the first hour of life. And anyone with experience in L&D or a birthing center can attest that this is the very time frame during which its administration(and erythromycin ointment, for that matter) is likely to interfere with bonding.
What boneheaded legislation.
I'm beginning to see the parents' point!