My Life Adventures, Travel Experiences and Reflections

Saturday

The Jehovah's Witness Protection Program

http://jwpp.bandcamp.com/

My first clue that 'something was up' lay in the fact that it was 7 am in the Intensive Care Unit and getting to my patient was a challenge for all of his visitors in his room.

My second clue that 'something was up' lay in the fact that my patient was African-American and all of his visitors were white.

Now before we get all racially sensitive, I am very aware that many families are blended in many ways and many of us are close friends with people of all races. As well it should be. However, in the hospital where I work, it is an uncommon sight to see a room full of white people at the bedside of a black man at seven in the morning. Just sayin'.

My patient was a Jehovah's Witness and was losing a great deal of blood. He chose not to receive a blood transfusion. Fair enough. I respect his decision. But I had work to do, so I asked that only two visitors remain in the room. Three men remained.

The oldest of the three, a diminutive man dressed in a white shirt, beige trench coat and glasses with 'flip-up' sunglass lenses stood staidly at my patient's bedside and without introduction said, "I would like to speak to the doctor". I asked my patient if it would be OK for the man to speak with the doctor on his behalf. He consented.

When the doctor arrived, the little guy in the trench coat said "We want EPO and Iron only. No blood products. Fingerstick blood samples only".

The plot thickened. I suspect that these men were from the "Jehovah's Witness Hospital Liaison Committee". or what I referred to as the "Jehovah's Witness Protection Program". Although they never did introduce themselves or state their relationship to my patient it was clear that they were at his bedside to advocate for his choice not to receive blood.

My problem was not with my patient's choice.

My problem was with the fact that the JWPP guys came off all self-righteous and pushy. No "please's" or "thank you's". It was clear that they considered us, the health care team, to be the enemy. At one point, another JWPP rep abrasively questioned, "Why is it taking so long to give the EPO and Iron? Didn't the doctor order it?" Sucking it up, I chose not to say "It's been 15 minutes."EPO" and Iron are not going to save this guy." But instead, I gently informed them that "these medicines would be given in a timely manner, but that they were not considered 'emergent' at this time."

My JWPP team seemed sadly misinformed.

Explaining that "fingersticks" are a great alternative to classic blood draws if you haven't already lost 3/4 of your circulating blood supply was received with incredulity. I had to show them my patient's white, almost translucent fingertips in order to prove the point. I still don't think they believed me.

"EPO" (as they referred to it) is actually "Erythropoetin" a building block of red blood cells that is normally manufactured in our bone marrow. My patient had no difficulty in manufacturing red blood cells. He was just losing them at a rapid rate. "EPO" may not hurt - but in the immediate treatment of profound blood loss, it was not going to help.

Iron is a component of our blood that helps carry hemoglobin (oxygenated blood). Again, without an adequate supply of blood, giving Iron is somewhat moot.

An incredibly courageous choice. My patient knew that receiving blood would save his life and that we were ready to give it to him but he chose not to receive it. Was it his strong faith? Was it his fear of being shunned? Was it the fact that he was not strong enough to change his mind? I will never know.

I do know that his decision was respected by all members of his health care team. I also know that the JWPP could have chosen to sit with him and hold his hand throughout the night while he lay dying in a hospital bed, but instead he was left alone, holding the hand of a health care worker, a nurse he had just met a few hours earlier.


10 comments:

Anonymous said...

I ran across your post accidently and have to comment as this is similar to an incident that I experienced several years ago as an ER nurse. I had a patient with a severe GI bleed who was escorted and guarded by the JWPP. I had a slight sense that my patient and his wife might have wanted to change their minds about the whole "not recieving blood products" rule had they been left alone for a few minutes to think about the ramifications. This man died and I have often thought about him and the situation.
Kudos to you for your work and heart for nursing.

Joan Young Spotswood said...

Thanks for your comment. I was conflicted about writing this post due to its sensitive subject matter.

Heather said...

This is the kind of thing that angers me often. I realize that the JWPP probably thought they were caring for the man's eternal soul, but you're definitely right in that they could have made the transition to the next place more pleasant by comforting him and remaining with him. Thank you for sharing what must have been a difficult situation for you.

Joan Young Spotswood said...

Heather - I tossed and turned many a night after this incident. I still do.

Anonymous said...

You are all severely misinformed. My Mom who is 86 is a Jehovah Witness and I have been at many of her friends hospital bedsides when they have refused blood due to their strong faith. Now, although I am not a Jehovah's Witness, I can tell you that these people or nothing like what you are trying to project. They are warm, loving to all people, never hurt/harm/insult anyone...including the non-belivers such as myself. I think you are trying to project your own 'personal' take on a group of people which you personally dislike, which is completely unfair. I suggest you actually speak to a member of their religion. You will find my statement absolutely true.

Joan Young Spotswood said...

To "Anonymous":
Thank you for your take on my experience.

Let me make it clear that I did not, at any time categorize all people of the Jehovah's Witness faith as people who would "hurt/harm/insult anyone". I merely expressed my own observations and how I was treated by the three people who represented themselves as Jehovah's Witnesses and I am not "trying to project" anything other than my own experience that day.

You begin your comment by saying I am "severely misinformed". Would you mind being more specific?

zodiac rings said...
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Anonymous said...

I've never accepted blood as an option. I was raised a Jehovah's Witness but not a practicing one.
I've had the dire need to be given a blood transfusion because my OB suctioned my baby out of me when I was 8cm. I required over a 100 stitches. The dr informed me and everyone in the room including the nurses who tried to take the suction off my baby's head only to unplug the machine as a last resort that I was going to die and to pray for me. He then walked away, tracking my blood all over the hallway to return with a form for me to sign saying that in the event that he couldn't stop the bleeding (not knowing where it was coming from) I agreed to have a hysterectomy. I was 25. I signed it.
After a double IV, IRON and a week in the hospital I was released.
2 yrs later, I delivered my youngest at 6 mo because of an incompetent cervix. I need a transfusion then according to the drs. I didn't have one. Same procedure as the last time, but with hospital admin keeping an eye on everything.
My youngest was a test participant for a new drug while she was in the NICU it was called EPO. They informed me that most preemies receive a minimum of 6 transfusions while in the NICU. All thru the study she never received a transfusion. She has since had 12 surgeries including MV repair, spinal fusion, on and on. Never once did she has a transfusion. They used the cell saver machine and she was given EPO shots prior to her surgery.
My Aunt just had a transfusion and ended up getting a blood clot to her lung from it.
I'm not saying no one ever dies from not receiving a transfusion, I am saying there are many other options available as an alternative to one.

Joan Young Spotswood said...

Anonymous - Your personal journey has been a rough one. Thank you for sharing.

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