care of patients with a loss

[jrring1019]

I have been an RN 12 + yrs (OB fro 10), I experienced a fetal demise at 16 weeks and and I can't believe what a new perspective I have. I cannot even begin to remember all of the pts I have cared for over the years who have experienced loss, but I hope that I did the best I could for them. None of us are perfect, and I think we could all learn something from a patients perspective.

Things not to say to pt: 1.)At least it wasn't your first. ( this wisdom was bestowed upon me by a stupid/young resident). I quickly told him that I had lost my "first" to an early m/c. And just because it was my 4th child DOES NOT make it easier.

2.) "At least it happened now" (as opposed to later or having a sick baby). I totally get that, but it does not need to be said. The pt/SO know this on some level. This does not ease anyones pain.

3.) "At least you have kids at home" Once again, I get that . Yes, I am very lucky/blessed but this also was my child. Until you experience this, it is hard to see "it" as someones baby. But the parents very often view this as a very real part of the family already and it is a loss of that dream.

4.) "God has a reason" I guess you have to know the pt pretty well before this is a safe thing to say, but trust me I am religious and I HATED hearing this. After you lose the baby you hear EVERY SINGLE STORY on the news about every abuse in the world and it makes you think..these people get to have healthy babies? Where is God in all of that?

The words that meant the most to me were "I am so sorry for your loss". Other things that helped were "I can't imagine what you are going through but I am thinking of you", "I will keep you in my prayers" Someone even asked if it was OK to pray for me, which actually was nice because you never know how a patient feels about people praying for them.

I could go on and on. Also, it is OK to assess the pt as you normally would. My PP nurses avoided me like the plague and DID NOT EVER assess me and checked my VS 18 HOURS after my recovery (at the time of discharge). WHAT!!??!! I had to stay b/c of a hemorrhage and meds I received which required lab work q 6 h. The lab actually was closer to me than ANY one of my nurses. I did not deliver where I work because if insurance.

Also, the parents should have a say in disposition even under 20 weeks, it is not a specimen to them!

[SmilingBluEyes]

I am so sorry for your loss. Thank you for the poignant reminder that ALL losses are enormous to us, and that we need never forget the human side of what we as health care practioners, do, to help our patients and their loved ones cope. I wish you health and healing.

[alianeco]

This is a really helpful post. I've been in L&D for a year and I have never nursed a family with a loss. I know it's going to happen sooner or later and what scares me is that I won't be a good enough nurse. I have no children, so I don't see how I could possibly understand what a loss this is for a family. And I'm terrified about saying the wrong thing.

It helps to have a list of what NOT to say, and to know that it's okay to say that I don't understand the loss, but that I'm very sorry for it.

I really am sorry for your loss.

[mgalloLPN]

I also don't understand what it is to lose a child. I have lost many people in my life and it was some of the hardest times of my life so I can imagine that losing a child is that much harder. I am very sorry. I hope you are able to find comfort during this time. I wish you and your family all the best. Many prayers are with you.MindyI have seen the now I lay me down to sleep website through another post. I cried so much looking at all of the pictures. It's such a wondeful company to do that for families.

[Halinja, BSN, RN]

I am so very sorry for your loss. I miscarried twice, and even though it was 20 years ago (give or take) I remember the feelings clearly. It is a real pain, a real loss, though some don't see it that way.

I would like to add to the things NOT to say.

"it would have been deformed anyway" Sigh. I guess that's a variant on 'it's for the best'.

A hug went a long way...but most people preferred to pretend it never happened.

Blessings, and I am thinking of you. ((((hugs))))

[danissa, LPN, LVN]

jrring, I'm so sorry honey, for the loss of your dreams. I know how it feels, I miscarried, into the toilet at around eight-nine weeks gestation, after the birth of my son, which was probably way too soon to be pregnant again, and would have been baby number four...we could not have coped as the other three were under five yrs old. Still, when it happened, I didnt realise I was pregnant, (still feeding my boy), and had almighty pain, then this wee embryo clearly lying there. Screamed for my dh, and we sat there crying for what seemed like eternity, and he finally, after what seemed like days, flushed the wee thing away. I dont know if I could have done it, but for his strength. What else to do?

After nearly 15 years, I never forget that sight, neither does he, and to this day, I applaud his courage, in doing what I could not. We dont really speak about it now, but it's still there, baby number four, as precious as the other three, and though we dont have any real faith, I'm sure that wee one will meet us all someday, somewhere. Saddest thing, miscarriage..........loss of so many wishes, even if you dont know the wee one is there............