Say you are the personnel director of a large community hospital (publicly funded) that serves a very low income population.

You hire a nurse who is highly qualified and has many years of experience.

A few months later, she is written up by her supervisor for refusing to participate in a blood transfusion. You ask her why? She says because her religion doesn't allow it. However, the patient will die without this transfusion.

Who's rights are right? (in other words, who gets what they want.) We are assuming that this patient is in the care of this nurse for her shift, and to transfer the patient to another nurse would overburden that nurse or in another way make care difficult (like an actual hospital situation.)

As a nurse, I would have to say both rights are important. I would have to assume working on med/surg floors that there are other competent nurses that can give the blood while the nurse that feels it is against her religious practices can be useful elsewhere. No one has to be overburdened or the patient not given proper care. It is a matter of promptly shifting the duties of the shift is all.
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09-10-02, 12:24 AM
displacedNYer
I was saying that the patient could not be reassigned because I was hoping to see which one people would choose. You are right, in reality they would just reassign the patient.

09-10-02, 04:08 AM
MrSensitive
If the nurse refuses, the nurse refuses. She has that right. Either the patient will die or someone will pick up the slack.

But what the hell is the woman doing, working as a nurse, when transfusions are part of the job? I'd fire her and recommend she find an industry more suited to her religious limitations.
One might as well hire a muslim to be a bacon-taster.


Mr(relgiously qualified)Sensitive

09-10-02, 10:13 AM
displacedNYer
Can't fire someone on the basis of their religion. Its against the law.

09-10-02, 11:00 AM
Prothero
But you can fire them for failing to perform an acceptable and by all standards, reasonable expectation of their job.
Though her nursing skills may have use somewhere else, it is your obligation as an administrator of a hospital to insure the staff cares for the patient above all other considerations.

09-10-02, 11:08 AM
displacedNYer
Actually, you can't. You cannot fire someone for refusing to perform job duties that are against their religion. (see why this is sticky issue?)

09-10-02, 11:18 AM
Texan-In-Exile
If her duties are against her religion, shouldn't she find another profession?
She's only hurting the people she professes to want to help!

09-10-02, 12:14 PM
Z281980
Now why the hell would the woman want to be a nurse knowing she's going to have to deal with this at some point. Her fault for being stupid !

She's refusing to do a specific duty of her job, therefore, she should be fired for insubordination. Religion shouldn't even have to be an issue in this one.

I don't get people.... I'm not a cop because I don't feel I could shoot someone.... I'm not a fireman (firewoman) because I'm scared of fire. I wouldn't join the fire department and then tell them I'm scared of fire and can't do my job and they'll just have to deal with it....

roll eyes

09-10-02, 12:28 PM
Prothero
Sorry, but you absolutely can fire someone who cannot perform the basic expectations of the job. If the demand is a reasonable, accepted part of the profession, there is not yet a court (except maybe the 9th circuit) that would rule against you in the scenario provided.
If the requirement is not, in normal operations, an accepted aspect of performance, then you are right - the job is protected - but not in the case you offered.
There are other solutions I believe are viable, but you've already suggested you aren't seeking sensible alternatives.
Since the premise of the question is a stretched, I will change direction if you are adding another twist to the question.

The only way this situation could involve protection is if she was assigned to a ward where she was either contractually exempt or, again by reasonable standards, would not be expected to perform the duty (in a hospital this might be hard for her to establish.)

So, question is, are you just talking ethics, or law?

09-10-02, 03:45 PM
displacedNYer
I agree that this woman should not have been a nurse in the first place. However, you can't stop people from becoming what they want to become.

And actually, Prothero, you can't fire her. I know this because this actually happened. When I worked as a medical secretary in a hospital in Upstate NY, we had a nurse call in sick one night. Another nurse was floated from the ER to our floor. She refused to give a blood transfusion.

They couldn't fire her because her religion was the basis of her actions, and you can't fire someone because of their religion. Also, her day to day job duties did not require her to transfuse blood (its not usually something you do everyday, from what I've seen - I think more in some fields than others but not in just General Med.)

So I agree, she should not have worked in that field. She would have been more suited to teach or to work in a doctor's office. But current law forbids asking the person's religion. So until they are hired and a situation like this comes up, you don't know.

09-10-02, 04:01 PM
Prothero
Okay, now I have the additional information. It was careless of the hospital and they pay the price.
Most applications for employment ask if there is anything you are aware of that would prevent you performing the duties of the job - if they had that she could have been fired for failure to list her limitation (she knows her faith, she has been educated in the field, she should know.)
Even with that they may have been reacting to other forces - she is still a valuable employee in a shortage field, risking a lawsuit where there is no need.

I might still put the patient first though and risk the lawsuit later. Imagine the lawsuit of the family if the patient had died.

And of course you can stop people from being something "just" because they want to. Not all jobs, not even the majority, but there are jobs that have requirements that must be met (I'll overlook your nurse if transfusions are that rare - not a logical expectation of performance.)

09-10-02, 05:39 PM
displacedNYer
The position she applied for, ER nurse, does not perform transfusions. There was no reason for her to mention that on her application.

09-11-02, 01:35 AM
Wildflower63
Any reasonably experienced RN knows that giving transfusions are part of the job in an acute care hospital. You are taught the protocol in nursing school. It is also commonly known in the profession that if you do not have the emergency facilities to back you up, they are transferred to a hospital to get the transfusion.

I have given many transfusions in an acute care hospital. Since leaving for different type of nursing opportunities, I have never given one since. There are many areas of nursing to go to if you don't feel that transfusions are for you. Shop elsewhere for a job. Most places don't give them at all, only acute care hospitals.

By the way, I made less money and had higher stress working in acute care hospitals. I'm glad I got out of there!

09-11-02, 04:20 AM
Pin~Jinx
....which religion disallows the transfusion of blood anyways?

roll eyes Pin~Jinx /anarchist

09-11-02, 06:40 AM
Elexina
The nurse has the right to refuse to participate.

That said, this is an impossible situation for all of the reasons already stated (this woman should not have become a nurse, the hospital should not have hired her, the patient would just be transferred, etc. etc. etc.). Also, I do not know of a religion which prohibits this. I know that certain religions, such as Jehovah's Witnesses, I believe, that refuse to ACCEPT blood transfusions or have blood drawn or saliva swabbed or that sort of thing, but that does not include the taking of blood from others.
Now, if she were the only person in the world with blood compatible to the patient's and he would die WITHOUT HER BLOOD, there would be a moral dilemma, but she could still not be compelled to give it.

09-11-02, 02:43 PM
displacedNYer
The nurse in question when this happened was a Witness, and she said that she could not participate in the tranfer of blood products. Wild - you are absolutely right - that's what we all said too! Even a nurse in a doctor's office, or with an insurance company, or even with Hospice!

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