Tag Archives: prematurity

Religious Ethics in the NICU: Balancing Beliefs and Life-Saving Care

The ethical situation that comes to mind this week is religious ethics. This theory focuses on religion, often shaped by a parent’s upbringing and older family members. For example, Jehovah’s Witness parents do not allow blood transfusions. This becomes critical when a baby in the Neonatal Intensive Care Unit (NICU) needs a transfusion. In such cases, the treating neonatologist may need a court order to administer the transfusion. In extreme emergencies, if two doctors sign off that immediate action is necessary, the baby will receive the transfusion while the court order is pending.

As a parent of a premature baby myself, I could not imagine not doing everything possible to save my child. Yet religious ethics prioritize the parents’ beliefs, even when medical decisions are life-saving (Denisco & Barker, 2012).

The parents’ refusal can hinder care, but nurses must promote family-centered care, involving caregivers in decision-making whenever possible (Meadow, Feudtner, Matheny Antommaria, Sommer, & Lantos, 2010).

I recall my experience in a level 3 critical NICU, where many rooms were open due to the infants’ conditions. I watched a baby deteriorate rapidly, and the healthcare team discussed urgent transfusion needs openly. As a parent, it was heartbreaking. As a nurse, I wondered how I would handle such a situation, balancing professional responsibilities with compassion for the parents.

The nurse manager at the time criticized the parents, calling their decisions ignorant. While part of me understood her frustration, the compassionate nurse in me knew these parents faced an agonizing choice. I reminded the manager that, regardless of personal opinions, our role was to support the family, ensure the infant’s safety, and provide care—whether or not the parents agreed. By law and ethical standards, the baby would receive the transfusion if medically necessary, often by court order, but our empathy and guidance were essential for the parents during this crisis.

With religious ethics, we may not agree with the family, but as nurses, we must respect their customs and beliefs as long as the baby’s life is not in immediate danger. Compassion and empathy guide us in navigating these difficult situations.

References:
Denisco, S. M., & Barker, A. M. (2012). Advanced practice nursing: Evolving rules for the transformation of the profession (2nd ed., pp. 569-581). Retrieved from https://campus.capella.edu/web/library/home

Meadow, W., Feudtner, C., & Matheny-Antommaria, A. H. (2010, April 13). A premature infant with necrotizing enterocolitis. Special Articles – Ethics Rounds. http://dx.doi.org/10.1542/peds.2010-0079

 

Judging the Quality of Research Articles

In this study fifteen mothers who had babies born in to the Neonatal Intensive Care Unit (NICU) were evaluated using Spradley’s domain analysis approach.  The purpose of the study was qualitative to show how parents develop an ownership as a mother to the baby in the NICU.  The study was also quantitative because mothers in the NICU dealt with all emotions that they felt throughout different stages in their stay from stress to grief and feeling like they could not take care of their baby (Heerman, Wilson, & Wilhelm, 2005).   The researchers clearly stated their purpose in confirming their suspicion and that is that parents in the NICU do not feel like the baby is theirs until they go home with the baby. This method of study is done interview style and using different stages, meaning parents staying there from at least one week with a 24-34 week gestation baby. The study used middle class mothers that were Caucasian.

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The method of study is a valid one to obtain research, however I may have opted to use mothers of different ages, different races and more than one hospital. The factors that I feel interfered with the integrity of the research study is that the people were all of one socioeconomic class and race.  This does not give a valid study to the rest of the population, because premature birth does not make exceptions to race, economic status, geographic location, famous or not famous, it can affect anyone. A resource that would help would be other studies that used qualitative research as well with a broader subpopulation.

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Although the study only used one socioeconomic class and one race, the study does express the issues that have been mentioned in other studies that talk about what parents feel when they are in the NICU like the study conducted by Dudek-Shriber that showed the stress of parents while in the NICU. The study that Dudek-Shriber utilized was a larger group of mothers and also a diverse population.  In comparison to the current study, Dudek-Shriber’s study was more accurate because there was variety in stages of birth, race, mother’s age and the length of stay in the NICU (Raines, 2013).

There are clear links in the subpopulation collected by the researcher to obtain the conclusion obtained, which is that mothers feel like a visitor instead of a mother when they have their baby in the NICU.  They do not feel that the baby is theirs until they go home.  Now some mothers do feel that they are a part of the baby’s life while they are in the NICU from day one and get involved to the point that they start to act like the staff according to the results.  These moms will use the same language to describe their baby but it is not really identifying them as a mother, they are still referring to the baby the same as the nurses.  The bonding has not occurred when the mothers are going through the motions that the nurse are going through.

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This study cannot be generalized as the researcher only used one race and only fifteen mothers.  It was very specific to the one NICU.  This study population is of course similar  to the population I will be working with, because as noted earlier, prematurity does not make exceptions to race, economic status or age. The researchers concluded that nurses in the NICU need to ask the mothers if they want to be involved at the different stages of the baby’s care so that they can feel connected as a family.  Nurses are sometimes very quick about their agenda and will forget to ask the mothers about being involved because they have an agenda to take care of.

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References

Heerman, J. A., Wilson, M. E., & Wilhelm, P. A. (2005, May/June). Mothers in the NICU: Outsider to Partner. Pediatric Nursing, 31(3), 176-200.

 

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