RN's weigh in!

[ErinsJuneBug]

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[Papai]

I think you lost her response somehow?

[momongeon]

Originally Posted by ErinsJuneBug

Hi girls (and boys!) - I’ve had this ongoing conversation with a girlfriend about circ and why, even though a lot of medical personnel hate doing them, it continues to happen.

Here is her latest e-mail to me (which is in response to what I wrote to her).

She has some great points and I’d love to get some other perspectives.

Hey Erin, Great questions!!!

I am a nurse in the mother/baby unit as well as L&D I refuse to have anything to do with a circ. I will defer checking the site post circ, I will not help perform them, I will not clean up after them (in most cases), I will not lie to parents and tell them the baby didn't cry but I do try to spare their feeling a little bit. I don't sugar coat it with warm fuzzies. If I am asked about it I am honest. Here is a tipical conversation between me and a pt:
Pt: "I just don't know anything about circumcision. I want it done but I just don't know much"
Me: "It is great that you are taking the time to understand it better. This is a decision that is life long.... These days the AAP does not recommend routine infact circ. There has been some evidence that there could be some potential benefits but not enough to recommend that all newborns be circ'd. The foreskin has protective functions as well as sexual functions for both himself and his partner. During the circ the baby is given a pacifier with a sweet solution dripped on it to somewhat sedate he and keep him calm despite being stressed. They use a numbing solution at the base of the penis to numb it as best they can..."
(I don't go into anymore detail b/c otherwise I would cry in front of the pt but if she asks specifically what happens I will tell her as I cringe)
Pt: " will he feel anything?"
Me: "there really is no way to completely take away all the baby's feeling of the procedure but they do their best to make sure he is as comfortable as possible. We suggest a familiar person go in with him so he can have additional soothing from the familiar voice. But I will warn you it is not easy to watch. It is not uncommon for them to look like they are sleeping through it nor is it uncommon for them to cry through the entire procedure."
Pt: "What type of things could go wrong?"
Me: "The thing I see the most is bleeding after the procedure. Sometimes they require pressure on the surgical site and if that doesn't help we put a piece of material on it that helps form a clot. If that doesn't work we have the docs come back and they will sometimes place a few stitches where it is bleeding. Babies can get an infection or have too much or too little skin removed. Death is the rarest complication."

That is about how it goes. I can only do so much. Sometimes it doesn't help but I will not go down without a fight. I do not offer this info unless they ask b/c Most people are firm about their decision and I would be wasting my breath as well as messing up my rapport with that pt.

[Fellow Traveler]

Originally Posted by momongeon

Hey Erin, Great questions!!!

I am a nurse in the mother/baby unit as well as L&D I refuse to have

I am courious, do you offer up that you don't participate in the procedure for ethical reasons? If so is there any reaction to that?

[Fellow Traveler]

Erin, I wanted to also ask that with other staffers against the procedure has there been any movement within the group to subtly change the information presented? Have the Doctors or Nurses reached out to NOCIRC or Doc at all? If not why? That's what I'd like to know.

[momongeon]

Originally Posted by jwhispers

I am courious, do you offer up that you don't participate in the procedure for ethical reasons? If so is there any reaction to that?

The thing is that when I am in the newborn nursery the only one that knows I won't assist with a circ is the doc that wants to schedule one and or the nurse who has to take my place. When I am a floor nurse and they require circ checks for the first 2 hrs. I ask them to bring the baby to the newborn nursery and I tell them I don't do them. I think some people think I just don't know how but if they are curious about why I don't do the checks I tell them I don't agree with circumcision. One time I brought a baby and his dad down for a check and I asked the nursery nurse to do it for me b/c I don't do them and the nurse asked me if I had gone through the process of becoming a conscientious objector. I said no and she told me that I could only object if I had filled out the paperwork. I said that's fine but I still wasn't do it. The father must have thought I was a B!+@# but I didn't care. I won't sell out b/c of how my decisions make people feel. Most people are understanding of my choices. Families don't react negatively to these choices but I think it makes them think about their decision and they wonder why I feel that way. Others don't care.

[Fellow Traveler]

Originally Posted by momongeon

The thing is that when ... Families don't react negatively to these choices but I think it makes them think about their decision and they wonder why I feel that way. Others don't care.

Interesting, I was courious more along the lines if, when discussing it with a parent, and they asked about it you might say, "I don't know because I am ethically opposed and don't participate." Like do you ever mention that directly to the parents when the circumstances might allow such a statement.

[momongeon]

Originally Posted by jwhispers

Interesting, I was courious more along the lines if, when discussing it with a parent, and they asked about it you might say, "I don't know because I am ethically opposed and don't participate." Like do you ever mention that directly to the parents when the circumstances might allow such a statement.

When I say things like "I don't believe in circumcision" or "I don't agree with circumcision" it indicates that I have an ethical dilemma with the procedure. I don't have to say "I ethically oppose" to get that point across. It is implied. I try to be tactful while being honest.