Sunday, April 16, 2006

Can Nurses Refuse to give care?
If you have ever served on an ethics committee or taken an ethics class this question will definitely have been asked and debated.
As a travel nurse can you refuse to give care or treatment? What are the implications if you do? If you accept a contract with a religious based hospital you may be surprised to find they have different ideas about end of life issues. Feeding tubes for example are not routinely stopped (often in defiance of health care directives from the patient) in Catholic based hospitals. The moral arguement is that life is sacred and only god can end life. The withdrawal of fluid and nutrition support is seen as actively causing death.
Courts have ruled that nurses have the right to refuse to give care which they feel violates thier personal values or religious views. The bad news is that courts have ruled that employers have the right to terminate you for doing so.
The crux of the matter seems to be in how you handle it and if the employer can or will assist with modifying your assignment so that another nurse can do the care. In a case where a nurse refused to administer dialysis on a patient who had coded multiple times (often while being dialyzed) and who was terminal the court ruled that because the nurse was the only one available to administer dialysis the employer was justified in terminating her.
Travel nurses are in a tricky situation because they have a very short time to impress the current employer and that employer passes on that evaluation to the travel company. Get too many bad reviews and the company will probably stop using you.
So, the next time you are looking at a contract one thing to keep in mind is if the philosphy of the organization is going to be in direct conflict with your personal values. Of course, it is usually only for 13 weeks and it's not as if you are going to be involved with the ethics committee.
And Happy Easter
Jesse Kesler

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