care of patients with a loss

  1. 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!
    •  
  2. 16 Comments

  3. by   flightnurse2b
    jrring, i am so sorry for your loss and i will keep you and your family in my thoughts. i too lost a baby at 16 weeks and had to deliver. never in my wildest dreams would i have imagined the amount of attachment i had for my baby and the amount of grieving i would have to do. it truly is something you cant understand unless you have experienced it. take care of yourself.. and thank you so much for posting this. ((((((((((())))))))))
    Last edit by flightnurse2b on Nov 27, '07
  4. by   cardiacRN2006
    I'm so sorry to hear you lost your precious baby. It's tramautic at any gestational age.



    Quote from jrring1019

    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?

    Yep. I've never lost a baby, but as a person dealing with infertility, I see/feel this ALL the time.

    Makes no sense...

    Again, I'm so sorry...
  5. by   poodleH
    Jrring1019, I am very sorry for your loss and will pray for healing and blessings. I have never been through your heartache but I know how important children are! I have 2, a boy 11 years old and a girl 14 soon. Love em heaps, more than life itself. All the very best! and thinking of you.
  6. by   June55Baby
    Jrring.. I am so sorry that your baby died.

    One thing I have learned caring for families who have experienced the death of a baby is that each person handles grief differently.

    A dear friend lost a beautiful baby girl at 34 weeks with anencephaly and she said that she always KNEW she was going to get mad when a person started the sentence with..."Well, at least..."
  7. by   jrring1019
    After reading my original post I have to add that not all my care was bad. My labor nurses were great. My delivery nurse did a lot of pictures. We all know that the pictures never look all that great, and I have found this great service for stillborns or neonatal losses that do BEAUTIFUL photos. It is available in many places , it can be seen on the web site: Now I lay me down to sleep. The pictures are amazing, better than we can do and it is free.

    Also, I have never heard anyone discuss the emotional side with a pt, and had this WONDERFUL doc talk to me and then took my husband aside to also let him know what we would be going through at home emotionally. That was so important.
  8. by   crissrn27
    I am so sorry for the loss of your baby, jrring1019. I have had two losses, and have heard all the things you have, good and bad. Thanks for sharing your experience with us, especially for those who haven't had a loss, it is good to know from our pts what worked and what didn't.

    Thanks also for mentioning nowIlaymedowntosleep, it is a beautiful service, and such a comfort to the parents to have those great pictures. Here is the link for anyone not familiar with this service.

    http://www.nowilaymedowntosleep.org/
  9. by   crysobrn
    First of all I want to say sorry to you. Second thank you for having the courage to write down your thoughts during this tough time.

    I had a miscarriage this summer at 12 wks... I never could have imagined that an early loss could have been so terrible but for me it was. I got much more support from people on line than I think I did in real life because most of the comments I heard from people were those you mentioned.

    I work in OB and have a new found respect for anyone going thru a loss at any stage of pregnancy. We do have the now I lay me down to sleep program at our hospital and other bereavement steps that we go thru. However if a person is under 20 wks there is really nothing done... I inquired about it and my director told me that we were not in charge of bereavement on med surg because pt's that are under 20 wks are not "our" patients.

    When I had my d&c... at the hospital I work at, with nurses caring for me that I have worked with. NOT one said anything about a baby, no one asked how I was feeling, physically or emotionally... I had been bleeding, cramping and dying inside for 3 wks before I finally made the decision for surgery... these nurses were obviously uncomfortable with the whole process, I felt like no one really took care of me... My OB was really great for the two seconds I remember seeing her, she said she understood, she too had endured several miscarriages and eventually adopted, she knew it would be hard to go back to work...

    I still know exactly how many weeks I'd be... The countdown is getting closer and closer, I know that my due date will be hard, I took that week off from work... We've been trying again and I just got a bfp so here's hoping this little one sticks!!

    Again I'm sorry
  10. by   DTCC PreRN
    I'm so terribly sorry for your loss. Thank you for your post.
  11. by   ElvishDNP
    Very lovely post, jrring. Thank you so much for the courage to post for all of us to see here. No matter how many times I've cared for someone with a loss (at any gestation), it never ceases to break my heart.

    I am so sorry for your loss. Please take care of yourself.
  12. by   traumaRUs
    So very sorry for your loss.
  13. by   NPinWCH
    I am so sorry and you are in my thoughts....
  14. by   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.

close