What Would You Like; What Do You Need?

[medic09]

I was sitting with a doctor today working on a lecture series we are collaborating on. He is a PhD in Ethics, and a Jew who is interested in promoting a Jewish understanding of medical ethics. In the course of the conversation, and looking at our topics, we both noted that nearly all discussion in secular and Torah circles relates to 'medical' decision making. Very little relates to direct patient care. Direct patient care is, of course, our realm. The realm of the nurses.

So, I am interested in hearing what are the issues you want answers to or discussed. Some have already come up in this forum, and I'm sure there's much more. What are the questions, dilemnas, conflicts that concern you as a Jewish nurse? Anything is fair game. Even if you've already asked your rav and have your answers; please share it here so that we may all learn from the question itself.

What will I do with all this? For myself, I will make some of this subjects to be looked into and learned. I will almost certainly discuss some of it with rabbanim to both elicit their insights and inform them of the concerns nurses have. In some cases I may set aside time to discuss an issue with a posek.

I'm not sure what will come of this, if anything. I'm not even sure if I should share potential answers here, so as not to impose on anyone and also to avoid starting a potential dispute. I can, of course, share potential answers if people think it is appropriate.

If you would like to present some ideas to me, but aren't comfortable doing so here, you may email me directly at myscher at comcast dot net.

May Hashem bless you all with compassion and success in your work!

[achot]

Are you allowed to lie to a pt about their diagnosis if the family asks you to because they think the pt cant handle it?

[Rivka P]

I know this has come up on other threads before, but what are the factors involved with a nurse working on shabbat? It seems that it makes a difference whether the nurse is in eretz yisrael or the diaspora. Also, out of curiosity, why might there be a difference in ruling about a nurse vs a doctor?

[medic09]

Two good questions so far! Keep 'em coming!

[achot]

Rivka Posted: "I know this has come up on other threads before, but what are the factors involved with a nurse working on shabbat? It seems that it makes a difference whether the nurse is in eretz yisrael or the diaspora. Also, out of curiosity, why might there be a difference in ruling about a nurse vs a doctor? "

Halacha is halacha in Israel or the states, differences in Shmita observance maybe but nursing duties? ...same problems. We have a pen that has ink that disappears and has to be rewritten after Shabbat with a real pen- but you can get that in the states as well. We have Shabbos Goys to write if necessary on Shabbat, . Its better to break a blisterpacked medicine before Shabat but if you forgot or didnt, you can open the pack in order to give the pt what he needs. We precut peices of tape and there is tape that can be torn on Shabbat,
Whatever you can do before Shabbat is better.
As to the dif btwn MD and Nurse- lots!! A very religious doctor asked me to answer his emergency calls on Shabbat while he went out of the country- I refused as there is nothing I can do to help the pt over the phone and we decided to just leave a message to all emergency callers to go to the ER. But when he is home, he answers his phone himself as a doctor he is allowed and can prescribe treatment including meds.
I am sure there is more- I gotta run.... BeHatzlacha

[medic09]

I'm in CT at the moment doing some close up kibud em ;-), but I'm still monitoring for those questions! I'm looking forward to Rav Herschel Schachter's shiur on Monday in Queens on end of life issues.

Achot, I will just briefly point out that by many poskim there are definately differences between Israel and outside on issues such as taking call/working on Shabbat. In Israel there is a normative halachic presumption that those available to run the healthcare system are Jews. Similarly, there is a presumption that most patients will be Jews. These fundamental presumptions shape much of the p'sak in the issue. Outside Israel, those presumption do not exist. The notion of being on call/working on Shabbat is far more difficult to justify/defend. No time to elaborate now, since I'm on a borrowed computer.

The latest d'var Torah for Yitro is up at Kol Beramah for anyone lacking something to read.

Shabbat Shalom!

[achot]

I guess in my naivete I don't differentiate between a jewish and nonjewish pt, Sakanas Nefashot applies equally there. I will ask my Rav.

[Rivka P]

I think the main distinction between medical professionals in America vs Israel is that there is an abundance of non-Jews who can easily work on shabbat instead of a Jew, whereas in Israel, a very significant percentage of the nurses are Jewish.

Any word about the difference (if any) between doctors and nurses in terms of working on shabbat?

[achot]

While my Rav disagrees with Medic09 , I respect that Halacha is subjective, If Hillel and Shamai can have a Machloket leShem SHamayim - then my Rabbeim and yours can have chilukei dayot.
For your information. Here in Israel there is an abundance of non jewish staff for SHabbat and the chagim. There is also an abundance of non jewish patients. I still hold that life is sacred and Sakanos Nefashot applies to jews and nonjews alike.
Jews work on Shabbat - not because of the lack of nonjewish staff, that is a falacy- we are asked to work so as to maintain a Shabbat environment on the units, prevent problems that could be caused if the hospital is left in arab hands all day, and to ensure proper care. If we wanted I could arrange all the non jewish or nonreligious staff cover the Shabbat shifts, Iwould shudder to imagine what would go on.
TRUE STORY: a nsg home left Yom Kippur with non jewish staff who were supposed to sleep in so as to avoid traveling expenses. That night they made such an orgy- barbequed treif on the facility , ran around naked etc. It was terrible. Since then we all make sure to maintain enough of a jewish presence to ensure that the facilities operate properly- K'Mo SHeTzarich.

As to your question about difference btwn MD's and RN's working on Shabbat- I was told that while I am allowed to receive a ride by a non-jew who holds the door open for me, to work on SHabbat, I am not allowed to receive a ride home. While a MD can ride home. It is also preferable for me to walk part of the way to work instead of being picked up at my doorstep while MD's can be picked up at doorstep.
Let's hope this Machlokes is LeSHem SHamayim , May Hashem guide our hands and our work so as to bring a refuah shelaima to our patients and a Kiddish Hashem for Klal Yisroel

[Rivka P]

so if you dont live walking distance to work, it's quite difficult to accept a job that will require you to work on shabbat?

[mypprincess]

As a teen working as a Direct Care Worker, I worked 7 days a week with my rav's blessing. He said that since I get paid by the week and not by the day, and because I don't have to perform anything muktsah, it is perfectly OK. I was doing home care in the afternoon after school with a developmentally disabled girl. She always looked forward for the attention and companionship I provided her with. So I guess there are many other variables that have to be taken into consideration too. Not all cases are remotely the same.

[chanab]

"So I guess there are many other variables that have to be taken into consideration too. Not all cases are remotely the same." True that mypprincess!

All the above are more reasons to thank Hashem every day that I work in a facility with no weekends! And that's so accomodating of religious needs.

Back to the same ol' same ol' - negiah. The role of the dr and nurse are so diff when it comes to that issue. Almost everything the dr will do in terms of negiah is tx based, and as nurses looking at the holistic view for the pt, we're in a diff ballpark. And as mypprincess said - everything situation is diff.

[achot]

You can work on SHabbat far from home (obviously within reason) but cant get a ride home!! you can either stay in the home or nearby, some nurses bring their families close by for SHabbat, or work the Shabbat afternoon shift so you can get a ride home after Shabbat and the shift is over. This also works well for writing nsg notes after Shabbat. Some homes wont ask you to sign for meds on SHabbat or at least wait till after Shabbat to sign for them as it isn;t pikuach nefesh.

[Rivka P]

So theoretically, I could maybe work an evening shift on Saturday and chart after tzeit hakochavim...

[achot]

which is why I wrote "Writing nurses notes after SHabbat"
Most facilities have someone to make havdala although its enuf to day "Baruch Hamavdil..."