Has anyone out there ever refused to do something, not because of a patients request, or because it could put a patient at risk, but because of their own beliefs/values?
Bryn
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November 20th, 2007 at 11:57 pm
I refused to participate in care of clients who had had abortions for personal reasons while I was doing my OB clinicals. I did not end up in OB, which is fine with me, but if I did, I would have gone to a Catholic hospital or something, so I wouldn’t have to deal with it.
In other situations, agency nurses will ask to document under my name (which I refuse), people have tried to convince me to document things before I actually do them to save time (which I refuse)… things like that happen all the time.
The moral of the story is that we have rights, just like the patients. If at all possible, I think most managers will try to work things out.
November 21st, 2007 at 4:07 am
I sometimes refuse to let go of someone’s arm – as I value not being punched.
In mental health, most of my choices are made against the wishes of a patient and ‘risk’ is in terms of consequences to the wider public as well as the immediate people (other pts and staff) and then the patient (duty of care principles).
Personally, I always struggle when it comes to discharge planning for a sex offender or person who has violently assaulted a child. I’ve never refused to do something (and almost insist on being involved out of fear of an inadequate job being done) but I’ve refused to back down on my opinion of risk issues with such persons of concern out of a sense of moral duty to the public. Invariably, this results in more restrictive measures being taken against the person.
November 21st, 2007 at 12:01 pm
It is not your place to openly judge,no matter how grievous the offence. If you refuse to carry out your professional duties based on your owm beliefs then perhaps you should not be a nurse. Treating people is not about picking and choosing who you want to help.
November 22nd, 2007 at 3:27 am
I absolutely agree JT; I never pick and choose who I treat. They just keep sending me needy people. I keep asking them to send me people with no issues, but will they listen?
Forgetting the obvious concerns of risk to the public for a moment tho;
Would you discharge a patient who coped fine in the hospital environment but was unlikely to succeed at home alone? The fact my judgment is about the risk of harm to another person (a victim) is still of relevance to the individual patient.
If he is discharged and re-offends, then he will likely be re-admitted or imprisoned. Is that in his best interests?
Unfortunately, mentally disordered offenders invariably under-estimate their own risk. The fact that my concerns are biased, or inclusive of, risks of harm to others (ie victims of rape, murder, sexual abuse) is because the risk carries too high a cost for me to ignore it or to not ‘pick and choose’ from my own moral reasoning, as well as clinical judgment as to whether it is acceptable to take that risk for the public first, and secondly for the patient. I will never irresponsibly compromise the safety of the public for the interests of the individual patient.
November 22nd, 2007 at 4:51 am
Jt hit the nail on the head. By becoming a nurse, you are devoting yourself to care, not to playing advocate for a person’s beliefs and actions.
November 22nd, 2007 at 9:55 am
Again, we have people complaining that if you can’t do something, then don’t be a nurse. Doesn’t that in itself sound a little intolerant? The nurse who said this obviously hasn’t thought about all the good things that people can do, without going against their values/beliefs.
Nurses are supposed to be tolerant and caring, but so often we and intolerant to each other. Another important thing is compromise and working things out together. If you have a good team of nurses working together, then it is together that you can work with or around people’s weakness/strengths.
Why does everyone leap down my throat when I even mention about nurses not doing ‘something’ I’m not talking about picking and choosing patients, I’m not talking about refusing vital care, I’m just getting people to think a bit about their own values and beliefs and how it blends in with their care, ie Does it affect you.
If you say it doesn’t then you either can’t see it, or you’re lying. It’s our beliefs/values that make us who and what we are, they influence us in every decision we make. Even if it means making the conscious decision to go against our beliefs/values to do what is needed for a patient. By making this decision, we are automatically incorporating our beliefs.
Everything is compromise. It would be nice if those people so willing to suggest I should end my nursing career, just because I dare mention that my own values/beliefs could influence my care, could be a little more caring towards another nurse as well as look at ways of compromising with their colleagues.
The question that needs to be asked is: “Where does professional responsibility end and Moral obligation begin?” For example, a doctor may believe in Euthanasia, while you don’t. The doctor asks you to administer a bolus of morphine. Or perhaps instead of administering morphine, they just withdraw care. What is your obligation? What helps you decide how to react and choose what to do?
What if you were working in a country as an aid worker and female circumcision is commonly practiced? What would you do? What if the patient is accepting of this, even wants this as in her culture this is expected? I’m pretty sure you would be in a moral and professional dilemma.
Overall I am disappointed at the reaction of my fellow nurses, to questions which are supposed to make you think.
November 23rd, 2007 at 8:17 pm
Florence Nightengale wrote a thousand page report on the statistics of typhus in civilian and British military populations in 1858. She used statistical comparisons to show that poor living conditions, financial situations, and nutrition were killing the soldiers. She lowered the death rates in the military population because the British Army recognized the truth and made changes. Was her personal beliefs involved? Yeah, I think so. We need persons of all beliefs to balance out nursing. Even those who do not have a flexible stand–either by tolerating nurses who have a belief system that influences there decision of who to take care of–or the nurses who won’t tolerate other nurses differing beliefs. We need every single nurse. I personally believe that abortion is wrong and would not participate. If a woman showed up having had an abortion of course I would care for her. I would do anything I could with in the realms of the law to keep a sex offender off the street, and I would have a very hard time administering care to him or her, knowing my limits, improves my nursing. I don’t know about the rest of you, but I think we should start embracing each other as nurses because our work is not going to get any easier. BTW, Florence Nightengale was admitted t othe Statistical Society by the British Army, far and wide a male dominated society who would approve of her caring for the afflicted buy not as an equal to themselves normally. I wonder what kind of report or changes in nursing she would want to make to lessen or prevent further child abuse, sexual assault against any woman or man? It would be interesting, and don’t say we can’t do anything about it, because we can.
November 24th, 2007 at 1:06 pm
of course there are complexities to every issue, but the main idea here is that we are human beings with our own beliefs and ideals and fallacies AND we are held to a professional standard of care. It’s about striking the balance in each situation and being able to recognize if we are measuring up to that standard of care AND if we are letting our humanness show through (in a good way).
November 24th, 2007 at 10:13 pm
I think that we each have the right to decide for ourselves what we can tolerate and what we cannot. If you don’t want to participate in abortions that is your right but if I want to help then I sure do not want to be bashed either. Remember it works both ways
December 8th, 2007 at 1:59 pm
I am in psychiatric nursing class at the present time and our teacher stresses self-awareness and knowledge of your own beliefs and standards. I currently have never refused to do anything based on my beliefs but I know I would. Yes I care and yes I am nurse and caring is my job however I have to live with myself after I clock out and so I will refuse to do things against my personal beliefs. I would not be the “whole” nurse I am without having personal beliefs and my unique personlity and I don’t believe I should completely disregard who I am and what I believe just to do something that a doctor or patient believes to be correct and right. A doctor is more than capable of doing it him/herself and a patient can request a different nurse or go elsewhere. In the end, I refuse to not live according to my beliefs as that would be acting as if I didn’t have them at if I just ignored them.
December 11th, 2007 at 9:44 pm
our ob teacher told us that you dont push your beliefs on the patients but you can opt to be excluded from a procedure (i.e. abortion) if you are uncomfortable
July 2nd, 2009 at 5:49 pm
Right on Charis! I completely agree with you. I’m not going to compromise my beliefs and values just to get a paycheque. We are in a caring profession- that means caring for ourselves too.
July 3rd, 2009 at 1:54 pm
In most states you can refuse to participate in an action that goes against your documented religious beliefs-so a RN, MD or any professional can refuse to participate in a pregnancy termination, contraception counseling, etc. So, for example, my religion does not believe in killing live -born humans so I would never participate in assisted suicide, euthanasia, or the death penalty process in any way and the law would protect me. But what is not legal-or professional in my opinion- is to refuse to care for someone based on that person’s choice of lifestyle, race, or your own value judgements that are not based on documented religious doctrine.
As an aside – Dear iwannalaugh- FN was not inducted into ANYTHING by the British Army and her stats activities went WAY beyond what she did in Scutari-check your facts with reputable sources before you post.