Should Student Get the Dead Baby From the Morgue? - page 3

This has been bothering me since Tuesday, so I finally decided to start a thread. At my clinical site a student is working on the oncology floor. A woman had cancer that had spread everywhere, and... Read More

  1. by   mstigerlily
    I appreciated the "sink or swim" because it weeded out some people who weren't serious about nursing. We all have areas we don't like and things that are hard for us. The time to pick and choose is after graduation when you can get a job in something that interests you.

    I knew who wasn't serious way back during the prerequisites in Microbiology when our instructor had us bring in our toothbrushes to culture them, then gave us a swab, sent us to the bathroom to get an ecoli sample from our own body. I figured the students who were balking at touching a qtip to their OWN butts wouldn't make it through and I was right. Those who giggled and made jokes during the reproductive or birth control lectures didn't make it through either. Nursing is a serious profession.


    Quote from tencat
    Thanks for all your input. I just have to say that it wasn't me that had this happen, but a fellow student. I just wanted to hash it all out and find out what others thought about it. I think that a lot of you are right when you say that it's something we will have to do when we are nurses, so why not begin now? But just a thought: I wonder if the 'sink or swim' idea causes burnout later. Just because that's the way it's done and maybe some of us had it done to us doesn't mean it's the best way to handle teaching someone how to do something. I think it is helpful if students could be taught ways to handle their emotions and reactions to situations like this one, or at least talk to seasoned nurses to find out how they've handled them and continued to be nurses. People aren't just 'born' with the ability to handle stress and stressful situations. I don't think it means you're 'weak' if you feel that a situation is stressful and don't know how to process it. Most of us have not ever had an experience like this one before, and some of us will be able to handle it better than others. JMHO.
  2. by   mariedoreen
    Quote from mozartthebear
    I think there is an ethical delema here that has been overlooked. It is a totally different matter to ask a nursing student to take part in handling a 17 month old baby that has been "terminated." Not everyone agrees with abortion. I don't think it was a wise decision of this instrucor to assume that the student would be ok with this. The issue isnt just about facing death.
    This mother has cancer. CANCER. When you're pregnant you cannot receive treatment. She would potentially have to wait another 5 months for intervention. When you're pregnant your increased hormone levels can also cause your cancer to grow WAY FASTER than it ever would have otherwise. 5 MONTHS of accelerated growth with no treatment. This mother would have been risking her life by continuing her pregnancy. Perhaps she has other young children at home, perhaps terminating her pregnancy was the most difficult, heart-wrenching decision she will EVER face. And we are supposed to be overwrought with compassion for a nurse who may not agree with her decision to abort? How dare we.
  3. by   Spidey's mom
    Quote from mariedoreen
    This mother has cancer. CANCER. When you're pregnant you cannot receive treatment. She would potentially have to wait another 5 months for intervention. When you're pregnant your increased hormone levels can also cause your cancer to grow WAY FASTER than it ever would have otherwise. 5 MONTHS of accelerated growth with no treatment. This mother would have been risking her life by continuing her pregnancy. Perhaps she has other young children at home, perhaps terminating her pregnancy was the most difficult, heart-wrenching decision she will EVER face. And we are supposed to be overwrought with compassion for a nurse who may not agree with her decision to abort? How dare we.
    Actually, there have been many cases where women with cancer have received treatment and continued to carry their child and there were no negative outcomes. It is becoming standard to NOT abort.

    But I think this woman was in bad shape - she had cancer that had "spread everywhere". Not sure about this case and continuing a pregnancy and getting treatment.

    I didn't get the feeling this was about abortion.

    I wonder about the nurse assigned to this patient - what did she/he have to say about it? Isn't there a set protocol to follow - seems like the teacher sent the student off willynilly with no direction or support.

    steph
  4. by   fergus51
    Quote from tencat
    Thanks for all your input. I just have to say that it wasn't me that had this happen, but a fellow student. I just wanted to hash it all out and find out what others thought about it. I think that a lot of you are right when you say that it's something we will have to do when we are nurses, so why not begin now? But just a thought: I wonder if the 'sink or swim' idea causes burnout later. Just because that's the way it's done and maybe some of us had it done to us doesn't mean it's the best way to handle teaching someone how to do something. I think it is helpful if students could be taught ways to handle their emotions and reactions to situations like this one, or at least talk to seasoned nurses to find out how they've handled them and continued to be nurses. People aren't just 'born' with the ability to handle stress and stressful situations. I don't think it means you're 'weak' if you feel that a situation is stressful and don't know how to process it. Most of us have not ever had an experience like this one before, and some of us will be able to handle it better than others. JMHO.
    I guess I just don't consider it "sink or swim" as long as the student was supported in the experience. I think it would be far worse to have that duty fall to you as a new nurse without any real support there (and that's how it will often be as a new nurse). With an instructor and other classmates and the nurses on the floor, I think she could have received the necessary support and she should have spoken up if she didn't feel she was getting it or if she didn't want to do it.

    I would have been greatful to have experienced this first as a student rather than on my own as a nurse like I did. The first time I looked after a fetal demise, I was a new nurse and I was alone (the other RNs were too busy to help me). I have since come to feel incredibly honoured when a family allows me to help them through their grieving. Some of the most meaningful experiences in my life have been working with dying babies and their families. It isn't for everyone, but you'll only find out if you are exposed to it.
  5. by   Spidey's mom
    Quote from fergus51
    I guess I just don't consider it "sink or swim" as long as the student was supported in the experience. I think it would be far worse to have that duty fall to you as a new nurse without any real support there (and that's how it will often be as a new nurse). With an instructor and other classmates and the nurses on the floor, I think she could have received the necessary support and she should have spoken up if she didn't feel she was getting it or if she didn't want to do it.

    I would have been greatful to have experienced this first as a student rather than on my own as a nurse like I did. The first time I looked after a fetal demise, I was a new nurse and I was alone (the other RNs were too busy to help me). I have since come to feel incredibly honoured when a family allows me to help them through their grieving. Some of the most meaningful experiences in my life have been working with dying babies and their families. It isn't for everyone, but you'll only find out if you are exposed to it.
    I was alone too and already a nurse. Fetal demise at about the same as this but she was induced and labored and gave birth. I also considered it a priviledge.

    steph
  6. by   fergus51
    Quote from stevielynn
    I was alone too and already a nurse. Fetal demise at about the same as this but she was induced and labored and gave birth. I also considered it a priviledge.

    steph
    Mine was a perfect term baby. The mother came in with contractions excited that she was about to give birth and we couldn't find a heartbeat. There were no indications of problems before that moment and we never found out what caused the death. She looked absolutely perfect when she was born. It was heartbreaking.
  7. by   Spidey's mom
    Quote from fergus51
    Mine was a perfect term baby. The mother came in with contractions excited that she was about to give birth and we couldn't find a heartbeat. There were no indications of problems before that moment and we never found out what caused the death. She looked absolutely perfect when she was born. It was heartbreaking.
    That happened to an acquaintance of mine when I was preggers with my 1st - almost 23 years ago.

    Yes, heartbreaking - to know your baby is gone but have to go through labor and deliver.

    steph
  8. by   Tweety
    Quote from stevielynn
    I wonder about the nurse assigned to this patient - what did she/he have to say about it? Isn't there a set protocol to follow - seems like the teacher sent the student off willynilly with no direction or support.

    steph

    When I have students and sticky questionable things come up, I collaborate and ask "do you want to do this, are you allowed to do this?". Probably this happened and the student then went to the insturctor as asked and was given the answer....."you don't have to but............".

    I think most of us are in agreement that the student should not have went alone, nor presented the baby to the couple alone. But to be part of that process with a professional is appropriate, in my opinion.
    Last edit by Tweety on Oct 22, '05
  9. by   Tweety
    Quote from tencat
    Thanks for all your input. I just have to say that it wasn't me that had this happen, but a fellow student. I just wanted to hash it all out and find out what others thought about it. I think that a lot of you are right when you say that it's something we will have to do when we are nurses, so why not begin now? But just a thought: I wonder if the 'sink or swim' idea causes burnout later. Just because that's the way it's done and maybe some of us had it done to us doesn't mean it's the best way to handle teaching someone how to do something. I think it is helpful if students could be taught ways to handle their emotions and reactions to situations like this one, or at least talk to seasoned nurses to find out how they've handled them and continued to be nurses. People aren't just 'born' with the ability to handle stress and stressful situations. I don't think it means you're 'weak' if you feel that a situation is stressful and don't know how to process it. Most of us have not ever had an experience like this one before, and some of us will be able to handle it better than others. JMHO.

    Most of us don't go into nursing school with the experience of dealing with the dead, outside of our families.

    The first time I saw a dead body and dealt with the family, all the book knowledge I had really didn't help me with my gut reactions to the stress. But I knew it was just something that I had to do.

    I'm sure two years down the road if this would have happened for the first time with this nurse, she/he would have still have the same issues of stress and coping. Hopefully a bit more confidence. But these kinds of things are one of those "on the job things" and not a book taught thing, in my opinion. I think the opportunity while having the support of instructors and fellow students to help you process it is better in my opinion. I had to deal with my first death alone as a RN, who had to provide direction and support, etc. all on my own.

    Perhaps having a few death and dying and other lectures would have helped and first semester isn't quite appropriate, but I also see the value in learning our feelings and coping skills whenever the opportunity arises.
  10. by   ortess1971
    It's funny how nursing programs differ in their philosophies as far as what they expose students to. I sometimes feel a little too protected.Nursing is one of those professions that becomes a part of you and you see some beautiful happy things and stuff that tears the heart and soul from you, chews them up and hands them back to you in pieces. I wouldn't have sent the student alone though. I think most instructors(the good ones ,anyway) get to know their students and what they can and cannot handle. How did this student end up feeling about the whole thing?
  11. by   EMTandNurse2B
    IF (I said IF), the instructor was sure the student could handle it, AND the student agreed to it, AND the instructor went with the student; then I think could be a good learning experience. I think facing death for the first time in NS with your instructor present to help you through could be a very good learning experience.
    Personally, I saw my first death as an EMT student, and was so thankful that I had seen it as a student in an environment where everybody knew that this was my first time and they could help me through it. I think that if I had seen my first death after I got my license, it would have been harder without the support. I had the opportunity to see two deaths close up and visit the morgue several times before I even got my EMT license, which I think really helped me. Now, I know what to expect and what my reactions are to death/dying/morgues/family members. It was understood that if at any time I found it to stressful I could leave and be supported in doing so. I wasn't pressure into being there, I wasn't forced to do anything that I wasn't comfortable in doing, and my grade wouldn't have gone down if I had had to leave. I did in fact turn down one situation (would have been my first exposure to a death), it was a body removal call, for a homicide victom that police hadn't released until then. The medics warned me that this was a messy body removal, and were not at all disappointed when I turned down the "opportunity" to go with them to pick it up.
    So, I do think it would be appropriate to learn these things in NS. However, for a first semester student? Maybe for a second or third semester student who is more confident, but first semester is a stretch. As well as a baby, older adults are hard enough to deal with, much less a baby.
    Just my
  12. by   rn/writer
    I just have to jump in here with a thought. Many posts have focused on the effect this request would have on the student. I mentioned this before and I think it bears repeating. This isn't just a matter of how the student might handle the situation. It is also a question of how her reaction might affect the parents.

    I do NOT think it is appropriate or fair to anyone involved to use the "sink or swim" approach when you could very possibly take others (the parents) down with you. Imagine the student freaking out or saying something well-meaning but insensitive or bursting into tears and running from the room. The parents don't need to have that scenario added to their burden.

    If I were an instructor, I would accompany the student down to get the body and talk to her about what to expect, both physically as far as the baby is concerned, and emotionally from everyone involved, including herself. I would want her to tell me what she was thinking and feeling and I'd assess her ability to deal with her own emotions and keep them somewhat in check. Then I'd have her go in and observe the staff nurse working with the parents and participate in a limited fashion.

    She (and I'm speaking hypothetically here as I don't know what actually happened) shouldn't be "spared" the entire experience, nor should she have to carry the whole burden her first time out. And to tell you the truth, if I were the staff nurse, I wouldn't want a student taking the lead in a situation like this unless I was darn sure she knew what she was doing. My first obligation would be to my patient and the student second.

    The down side of "sink or swim" is that some are going to sink who might have been okay with a bit of direction. That's not a tragic loss if we're talking about collecting a stool sample. But helping parents view and say goodbye to their deceased infant is far too important to treat in this fashion. The student needs to watch another nurse handle this well so she will have a model to follow when it's her turn to go it alone.
  13. by   IMustBeCrazy
    :yeahthat:

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