needing a little encouragement

oh my, that is terrible what reason was there for not giving anaesthesia?? how is it even legal?

: : : : omg I should'nt have read this, that is horrible

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I agree, and I can't understand how this can be legal.

I don't have a lot of advice or experience but I'm so sorry you have to endure this at work. Our circs are done in the newborn nursery with the assistance of the nursery nurses. I only work ante-partum and post partum and refuse to float to nursery solely because of circs.
The only thing I can suggest is maybe talking to your nurse manager and saying you are a conscientious objector to circs and would like to stop assisting with them. Let her know you're willing to do other work for other nurses if they assist circs in your place. I don't know how they care fire you over an ethical matter, but they might try to make your job difficult if the manager doesn't agree. Hopefully not.
At the very least I don't see why you couldn't discuss w/ both your dept. mngr. and the hospital ethics committee that doing circs w/o anesthesia is ethically wrong and against AAP recommended guidelines. I don't know why at the very least topical anesthetic use can't not be required as part of policy on every circ unless contraindicated (and if the baby isn't healthy enough for the shot than why is he healthy enough for the circ?). OR - if no anesthetic will be used then the policy could state the parents must be made aware of this (because often I think they are unaware).

Maybe also talk to your hospital childbirth educator and see if you can get some pamphlets from NoCirc or the AAP that addresses foreskin function or intact care that can be placed in the folders for those taking childbirth classes.

Again, hugs to you. I don't think I could have handled myself as gracefully as you did. I think when the MD said "they baby wouldn't remember it" I would have said "and I wouldn't remember being assaulted while under general anesthesia but it would still be a violation of my body and not something I would ever want to happen".
I seriously never get the whole "he'll never remember argument". I don't remember a thing before age 4, yet I'm still glad my parents did kind things towards me, ykwim?

I am an RN working in a newborn nursery. The docs do not use nurses to assist, however, I will not participate in any aspect of it - set up, clean up, getting them a pacifier or whatever. Occasionally I get caught being the only one in the nursery when they need to get some lidocaine out of the Pyxis [computerized med drawer], and I have been put in the awkward situation of having to refuse or just getting it for them. I did get in a fight with a doctor once who asked me to get a safety pin for him for the procedure [it's sometimes used to hold the two flaps of the foreskin together after the dorsal slit and the placement of the bell]. I refused as politely as I could, but he wouldn't back off and kept harrassing me, instead of just going to find someone else to help, and we ended up shouting at each other, because I was NOT going to help him, and he wasn't going to take no for an answer. He reported me to my manager, and I got written up for inappropriate behavior.

There are federal laws out there in support of health care workers who have conscientious objections to say assisting with an abortion, or turning off a ventilator on someone who is in a persistent vegetative state . You would certainly have a leg to stand on if you explained your ethical objection. I am sure there must be something in the nursing ethics literature in support of nurses who take an ethical stance on not participating in certain procedures.

Do read up on the Nurses of St. Vincent (Santa Fe NM) and how they negotiated to allow for nurse conscientious objectors to circumcision to officially have the right not to have to assist in a circumcision. Their Memorandum of Understanding that they negotiated with the hospital is on-line and spells out the agreement and the stipulations. You could refer to this as a precedent or a template for an agreement of some kind.

As for lack of anesthesia, this came up in my hospital too. Most of the docs use dorsal penile nerve block, but I found out that one was not using any anesthesia and I wrote a letter to the Chief Medical Officer, and the Chief Nursing Officer (should have included the various managers in the OB, Nursery Unity) bringing it to their attention, citing the literature on what is now well known about infant pain capacities (Anand and Hickey NEJM 1987), and citing the AAP recommendation on the use of pain relief for circumcision. I requested that they endorse and enforce the AAP's recommendations. This started a huge brouhaha among the pediatricians out of which came a somewhat improved consent form that mentioned the AAP's recommendation, and suggested that parent's talk to their physician about the use of pain relief for circumcision. Still not what I'd hoped for (besides them stopping doing circumcisions altogether) - it still left it in the hands of the parents to have to ask the doctor if s/he was going to use anesthesia, rather than require the doc to use it, but at least it was an improvement.

You can do something about both of these things. If you need some more personal support you can PM me your email address so we can correspond more. I can really relate to your situation.

Hugs, Gillian

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I told my husband this story and something like this he said. He almost stopped me from telling him this story then he goes: You are turning me into an intactivist!

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Oh my God. They put the safety pin through the foreskin flaps?

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Unfortunately, yes. It's fairly commonplace.

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Ha ha! Good for you! : The more the merrier! :