[If you do not see a blue menu bar on the right, click here. You are at "Nurses".]
There is an organization of nurses called Nurses For the Rights of the Child, whose members call themselves "concientious objectors" to assisting with neonatal circumcision. Their website explains,
Nurses working in St. Vincent's Hospital in Santa Fe, New Mexico, were expected to participate in this procedure. However, when we confronted this difficult issue, we set a historical precedent for nurses in organizing and taking a leadership role in the reform of this medical practice.
Our medical position was that neonatal circumcision was unjustifiable. Our ethical position was that it violated a newborn's right to a whole, intact body. As patient advocates and nurse-educators working in maternal-child health, we believed that we had a professional duty to dispel myths and offer parents factual information about circumcision, and that we had a duty not to participate in a procedure that surgically altered the normal genitalia of unconsenting minors.
We observed physicians routinely asking parents if they wanted their child circumcised, in effect soliciting the surgery. Uninformed parents not only mistakenly believed that they had a right to make such a decision, but that an immediate decision was necessary.
Our conscientious-objector stand began in October, 1986, when we worked in the newborn nursery and submitted a letter to the nurse-manager and Vice President of Patient Services stating that we no longer wanted to assist with routine circumcision of newborns....
In October 1992, we declared ourselves conscientious objectors to circumcision and submitted a formal statement to the physicians, hospital administration, and staff, announcing our refusal to assist any further with the procedure. Other nurses came forward to join us and, in the end, a total of 24 maternal-child nurses--nearly 50% of the staff, including every Jewish nurse--declared themselves conscientious objects and agreed to our position statements.
"MOST nurses oppose circs....do you have any idea how many nurses wrote to the Nurses at St.Vincent Hospital in NM for their help? They were the ones who stood up and refused to do circs, especially unanesthetized...34 out of 36 agreed! While my son was in the NICU at Emanuel Hospital here in Portland (second largest hospital in Oregon for children) I asked all his nurses what they thought of circ, without them knowing I was a nurse also! Only 1 told me she supported it! EVERY other one was opposed to it....told me the pain was number one, and the simple unnecessity of it second! One Oriental older nurse (such a sweetie!!!) simply said 'Why? Why would you do that?' She was so neutral-sounding about everything else, but circ, she said waoso so 'silly' and so 'needless'....I saw a note on the isolette next to my son's...it said the baby's par;ents wanted him circ'd. I asked the nurse if they did them on babies so small; she told me it was hard to find a doc to do them period! That most of the Neonatologists were opposed to them! My ob was also opposed, calling it his least favorite surgery. My perinatologist was also [opposed], saying his 2-year-old twins will thank him later! WHY would people lie? Why would there be such an issue even made out of circ if it were not harmful or painful? Why are over 70% still done with NO anesthesia? Why did we used to do open-heart surgery with no pain relief either? Don't tell me 'it's not so bad or it would not be done'! LOOK what we used to do!!! We are shocked at the 'medicine' of the past...as we will be of circ come future!" --Denise, LPN (10/99)
Finally, in early October 1999 -six days before my due date- I gave birth to my daughter. From the moment of birth, I kept her with me in our "birthing suite", except to get her bath the following day. There were many babies in the extremely small nursery at the time, so Nataleigh and I waited. (I watched one baby boy get his PKU test- that heal prick thing they do. OUCH! But that's another story...) Finally, it was Nataleigh's turn for her bath and footprints. A knock came at the door frame on the other side of the slim room. It was another nurse. Could "my" nurse assist with Baby Boy X's circ. for her? The reply was a "No way!" kind of reply. Reminded me of the old tv commercial for "Life" cereal with "Mikey": "I don't want to assist with the circ; YOU do it." "No, I don't want to do it; YOU do it!"
"Expose yourself on a DAILY basis - and not just to the "good" ones. It is horrific. Whacking off skin with a knife without anesthesia is horrible. Man, you didn't want an episiotomy without an epidural - why can't your child have the same consideration? I have seen so many 'hack' jobs, where sometimes we wonder if this child will ever be able to urinate or have sex when he is older. I have seen babies literally roll their eyes into the back of their heads. I have witnessed pain like no other human being has felt pain - and for what??? Because people think he will forget it in a matter of minutes????"-- Tena, Labor and Delivery Nurse who assists with circumcisions. (3/99)
However... Nurses also get the "fun jobs"- don't they always?- like holding the infant's head to one side in case he vomits during the circumcision so he won't "asperate" the liquid into his lungs. Some babies even defecate on the Circumstraint. Unless there is a serious medical reason to halt the circumcision- for instance, the baby is a hemopheliac, or his penile anatomy is not normal- the doctor will finish the procedure, even while this goes on. Many learn to block out the screams of the babies. [See the "Pain" page in the "Issues" section of the blue menu bar and the "Video" page in the "How: Methods" section.] All this must be cleaned up before the next circumcision.
Of course, the nurses don't actually perform the circumcisions, but they do set up the room beforehand. They lay out all the instruments, and blue paper "chucks" pads, etc. During, they may hand the doctor the instruments. When the "procedure" is done, the doctor walks away, leaving the baby to be attended to by the nurse. She dabs some antibiotic ointment on the raw penis undoes the velcro straps on the Circumstraint [See "Different Methods" in the "How" section of the blue menu bar.], rediapers the baby in a special "post-circumcision" diaper , and takes him back to his mother.
"I am a nursery/NICU nurse. I hate being around when docs circ! I can't stand the shrieks from those poor defenseless babies." -Melissa. 05/17/02
"We either assist or lose our jobs at worst. I have lost a job from refusing to assist. Because he [the doctor] refused to use adequate pain relief. MANY nurses quit after and before me. The poor babies-- it was devastating! I do, however, tend to 'push' my views....not my emotional views, but my factual info. I tell parents to really think about it; tell them it is painful; the risks; that no medical organization recommends it, etc. I say more than I should maybe.But I don't have patients return who regret it, or cry because they never knew there was such pain, or etc. I would rather say too much, in a tactful way, than not enough. I want my patients to make informed-- fully-- decisions. And if after all the info, they choose to circ (some still do) I assist. I make sure it is done in the [as] painless [a way] as possible.... I make sure there are no bright lights shining in babies' eyes; I make sure enough EMLA* is applied and it is fully numb for the ring block, I make sure the warming pad is warm before I lay the baby down....in addition to opening the sterile packs, cold tray, etc. I still get sad; I still cry, as do some of the babies. But until every parent out there is fully informed, I will continue to do what I do! My husband is circ'ed and my son is not. If my daughter, who is 8, [had been] a son, I would have had her circ'ed. I had planned to. I am thankful she was not a he! I would have deeply regretted if after I entered the medical field. I don't want parents to regret anything!" --Denise, LPN (10/99)
"Hi Denise...You are right...Life is full of 'If I had only known''s, isn't it? That is where we come in,to INFORM. Interestingly enough, I posted a question about this topic the other day on a nurses' bulletin board, asking what they told their patients when it came to having newborns circ'd. VERY few responses, and most just said that 'It is a cultural and personal preference'. Hmmm...Maybe we ought better to be looking to our own PROFESSION, than criticizing the moms and dads who consent to circs. Don't ya think?? I mean, if NURSES don't do proper and thorough health teaching, it voids "informed consent" and puts the whole profession in a bad light. In fact, it COULD be considered a breach of standards and practices....even ethics. Think about it." --Heather (6/00)
"It's INFANT circumcision I have a hard time with and am against. And again, I lost my last job for refusing to do circs. (Assist in them) I do occasionally- rarely but yes- assist in a circ now. Why? How? Well, I do make sure it is done in the gentlest, painless method possible. I am against circ for many reasons; pain is the first and foremost. By me doing it, I am assured it is done correctly. If I refuse, it will still occur, but Susie down the hall (or whoever!!!) will assist and maybe she won't apply enough EMLA, or won't talk to and comfort the baby. Will she make sure the light is on the penis and NOT the baby's face? Will she remember to use the warmer first? I doubt it. I know plenty of nurses who could tell jokes and carry on a conversation while handing insruments to the doc, or scrubbing the penis- all while baby boy is screaming and in pain or fear. I can assure myself that IF it is going to occur, it will be as painfree as possible! I guarantee it!
"Do you know how many parents walk away and leave their sons to be circ'ed? Don't stay with them? How many nurses tell them to leave so they won't get upset? Screw the baby, we're worried about mom getting upset? By the truth? Bullsh*t. Parents should stay, lend a comforting hand and voice. But they don't. Many of them.
"So yes, I may be hypocrite, but I can sleep at night! I do all I can to discourage the circ, I educate and inform the parents...and it works a lot of the time. But not all. I talk to the doctors, hospitals when I can, etc. I am doing my part, I do what I am comfortable with, what I feel is right. You know I also work 1 day weekly at an animal urgent care.....I have to do euthanasias. It makes me sad, sick....BUT I KNOW it is painless, I do it humanely, I do it with care, gentleness, etc. If I refuse, what will happen? They'll go elsewhere, or dump the cat/dog to die from HBC, cold, starvation, disease..all slow painful deaths. Or they'll go to the next vet who may not hold them as gentle as I do, or talk to them comfortly. THIS is how I feel. Rip on me, criticize me, whatever. Maybe it's silly to you, but it's not to me" --Denise (11/1999)
*Webmaster's note: EMLA is a topical anesthetic in the from of a cream produced to lessen the pain from the stick of an immunization. Its manufacturers state that it is contraindicated for circumcision. All the nurses that I have asked about neonatal circumcision and pain relief-- both at labor and delivery and at the pediatrician's office-- report that, basically, both the EMLA cream and the lidocaine shot (both the usual methods for pain relief during neonatal circumcisions) are useless in relieving pain. That doctors at my hospital do not even use it, unless you specifically ask. One nurse even relayed a story that a mother who was having her second son circumcised in the office commented that even though he'd had EMLA cream and the ring block, he still cried and screamed just as much as his older brother who'd had no pain relief.