This is a touchy subject for me. I lost a baby in the second trimester in the ER of our local hospital seven years ago and that experience really scarred me for awhile. I was not a nurse then, but I remember the one nurse who was kind to my husband and I.
I am now a postpartum nurse and recently this was brought up at a fetal demise inservice. I know that moms less than 20 weeks pregnant are not allowed to be on the L&D floor - and I understand that. We can't have every woman whose test has come up positive passing tissue and taking up beds on the L&D floor. I understand that. But 18 week fetus is clearly a baby, and the mom has most likely felt that baby move already, maybe even had a sonogram. I did - I was 16 wks, I'd had a sonogram just the day before due to mysterious bleeding but baby was alive and well and sucking his thumb. I still have the picture actually.
Anyway, even if the mom is only 6 weeks pregnant and the loss is nothing more than a heavy period, there is a grief process and I know that during my visit to eh ER, the staff didn't understand that. Once it was clear I wasn't bleeding to death they were done with me and made some very callous statements and I was sent home very quickly. To top things off, I was going through a bad patch in my life - lost my job, my husband and I had just started dating so this pregnancy was unwanted to begin with, and since I was jobless and without insurance I'd filed for Medi-Cal to help pay for the unexpected pregnancy and it had not yet been approved so I can't tell you how badly they treated me because of this. Like I said, out of all the health care staff who I met with that day, from the triage nurse to the PA, to the doctor, to the other nurses, there was one older nurse that was kind to me, actually took the time to put her arm around my husband as he cried, got teary eyed with him and brought my son over in a little box all cleaned up so I could look at him before she took him away. I don't remember exactly what she looks like, it's all a blur, but I wish I could thank her.
It would have been nice to have either a L&D or postpartum nurse come to visit me there to speak with. Or, a social worker that works on the L&D/postpartum floor to visit with the moms. It would have been nice to hear what to expect, danger signs to look for, when I would get my period, when to try again, how can I find it what caused this miscarriage (if anything). I know ERs are in a rush to get you out so I'm not going to be invited to stay for awhile. But someone to visit me (other than the person asking how I'm going to pay for my visit!!) would have been nice.
At our hospital, our fetal demise or late miscarriage patients (after 20 wks) stay overnight on the L&D or postpartum floor in a quiet corner away from crying babies to recuperate. We work with the social worker to help them recover from their grief and they have a brief postpartum stay just like everyone else (only more brief) - where they get abx if necessary, pain meds, fluids, assessments, etc - just like everyone else. I know that's not practical for everyone having an early miscarriage - and they don't need that. But again, a little more attention would have been nice.
That is lovely that you are so sensitive to their loss, esp at a time when you are so obviously pregnant. For all you know, this could be the woman's third or more loss with no live births and seeing you would be quite painful. Thank you for realizing that
I guess to answer your question my advice would be to have a nurse or social worker who specializes in OB care come and assess or speak to the patient. Don't hassle her for money, even if she is uninsured - or at least wait until she's off the exam table. Tell her you are so, so sorry. Read the list of things NOT to say like "Oh well at least you have a baby already" or "You're young, you can try again" or "Oh it was just some tissue, not a baby yet". Let her talk a little bit about her feelings and let her cry. Take the five minutes to just do that - we know you are busy. But it really means a lot to the patient.
Quote from Aneroo
I often find myself at a loss when I have a pt in the ED who is told she is having a miscarriage. I don't know what to say, what's right, other than "I'm sorry".
Any advice? Words of wisdom?
I have been trying to steer clear of them lately though. I feel it would be wrong for an 8month pregnant lady to come in with discharge paperwork with the words "miscarriage" on it- talk about a slap in the face. :stone