not sure what to name this thread..need advice (bereavement)?

[kitti419]

Hi,

I am a pre nursing student (mother of 2). I would love to be in L&D. My problem is this: I cry for every birth I see. I'm getting better with it (just tearing up), but to me the whole experience is very moving, and I get emotional. I can be pretty "clinical" about stuff, but I feel that life is a gift and at the same time I feel incredibly lucky/blessed to have given birth with problem-free pregnancies to two perfect children.

Now, a good friend of mine is pregnant for the 3rd time. Her 2nd child was full term. She went in for an induction but had to have an emergency c section due to no FHT. They were there the day before but the baby's cord was twice around neck and once around chest. He passed. I had no idea how to comfort her. When last we spoke she was going in to have her baby boy. I checked in on the family 12 hours later to find out the baby had died. Needless to say I was devastated. She is pregnant again and due soon. We are all holding our breaths. How do you all deal with this?

On a sidenote, a good friend of mine is dealing with a parent w/ cancer. We are in our late 20's so our parents are relatively young. Her father has a laryngeal tumor and is slowly suffocating. He has refused medical treatment and it's just a matter of time. He has had several heart to hearts with his daughter (my friend) regarding the strong probability that he will take his own life when it becomes unbearable for him to live. It is very sad and she is struggling emotionally. She lives w/ & takes care of him. I have no idea (once again) how to comfort my friend. I want to be a nurse. I am anxiety-ridden waiting on acceptance letters for this fall, but I'm afraid that when the time comes I will not know how to act. I just try to be a listening ear and to be a presence that brings my friends smiles. I try to bring them things that will make them forget their pain for a moment. I have a BS in Psychology, but I never wanted to be a counselor b/c this sort of thing makes me uncomfortable, but I have buried at least a dozen loved ones and half as many my age due to car accidents or drug related deaths. I feel their loss tremendously and I am very sensitive to overwhelming grief of some people. I just want to give them a hug and tell them this will all be ok, but how can I do that and come home to my perfect children, family, etc? I would love some advice or possibly some direction into where I can better prepare myself to respond to the poor souls who have to deal with these losses. I wish all pregnancies and childbirths were like mine, but after reading the posts here and knowing of some in real life, I know they cannot all be textbook.

[cloister]

The mere fact that you realize how hard it is to offer comfort in these situations puts you ahead of a lot of folks, in my opinion.

Some situations are just unbearably sad. I always cringe when I hear people talk about "getting closure" after the death of a loved one. Some things are never closed, and I would imagine the death of an infant to be one of them.

You mention being in your late 20s. Sounds like you've experienced more death and loss than many others in your peer group. Kudos to you for facing all of these events and not running from them.

I cry when I see babies born, also. I also tear up when we have young people in our ICU or watch families struggle with the deaths of their loved ones. I don't see that as a detriment in this line of work. I have probably become a little more sensitive to these things as I've gotten older, but I'm also much more at ease approaching families and offering comfort. Nursing provides one with a lot of practice comforting people in the face of death.

My advice? Pursue L&D nursing. Put yourself on the front lines. Don't deny yourself the opportunity to pursue a career choice simply because it stirs some deep emotions for you. I have found ICU to be deeply rewarding, but it still gets to me from time to time, and I imagine it always will. I also think it has made me more compassionate, more joyful and more aware of what matters and what doesn't. Sounds like L&D might be the same way for you.

[NIGHTWOLF87]

my first impression is that you are a genuinely compassionate and caring person. for that, i salute you. but....you cannot get emotionally involved with your patients as if they were your family or friends. you must learn to be empathetic and not sympathetic; you must detach yourself from the emotional side of nursing, because if you don't, you will be emotionally drained and will not last long in the nursing field. plus, you present a liability to your patients and colleagues. for example, say you are in a delivery and the baby is in bad shape. since you say you "tear up" at the birth of babies, i will assume you will do the same in this example. while you are emotional over the baby, your patient all of a sudden starts to go down and results in a "code blue." how are you going to react? are you going to freeze in that situation? are you going to be so caught up in the baby's situation that you are slow to react to your patient? time is crucial. i speak from experience, that i want a nurse that does not get emotionally involved with her patient and is quick to react to the situation. i'm sorry if my opinion sounds cold and uncaring, but you have to have your mind clear at all times, because you never know what can happen in a matter of minutes. if all goes well, then fine, rejoice with the family in their new miracle for a few moments, then move on. there are always other patients that require your attention. i know you will be a great and caring nurse. just try not to get too emotionally attached. good luck!

[KalipsoRed]

I agree with both posters, but more with the second than the first. I have only been a nurse for a year, but I was a student nurse in a level one trauma center for 4 years prior to becoming a nurse. If you don't learn how to be empathetic instead of sympathetic this job will eat you alive. It is the single greatest thing I think I have struggled with being a nurse. I tend to put myself in my patient's shoes or relate to something about them that reminds me of my family. This is very bad because it does leave me very emotionally drained. It is why I decided that the ER was not really the place for me. A lot of sad things happen in an ER. Very sad and devastating things and after a while I had to put up a wall and quit feeling for the patient or the family otherwise I couldn't do my job. It sounds cruel and not at all what the view of a nurse does in our current society, but it is necessary for your sanity. I just try to be kind and considerate to all my patients, but I don't get much more emotionally involved than that.

[kitti419]

Thank you for your replies. I appreciate them sincerely. I have been accused by some of my family members as being detached. I have to chuckle at that because it is absolutely true, but they confuse me as being unfeeling. I tend to handle my emotions best when alone and do not really allow many people to see me "break down." I can be detached enough to get the job done. I often have delayed emotional reaction, which gets me through some tough situations. I have never been on the front lines in healthcare. I really don't know how I would react in the above scenario. I usually do well under pressure and I pray that my training would be enough for me to react wisely to save a life. This may not compare in any way, shape, or form, but I spent a few years as a volunteer at an animal shelter when I was in my early teens. Even though I was nuts about animals, I participated in animal euthanasia hundreds of times, simply because there was nothing else to do with these animals. They weren't anyone's pets, no one wanted them, and more were coming in on a daily basis. There simply wasn't room for them all. It was sad and tragic, but it drove me to be more proactive in educating the general public to spay and neuter b/c you would be shocked at the number of perfectly healthy, precious, puppies and kittens that die each year because of irresponsible pet ownership.

Now, regarding my original post, my question was not so much, "Do I have what it takes?" Time will tell, and I don't think anyone can really tell me that. Physically and emotionally, I think I am as good a candidate as my competition, as I have dealt with some earth-shattering situations. My real concern is how to treat people who are going through devastation that I could not imagine, such as having that life inside of them that does not make it into "our world," or watching a parent die slowly and painfully of cancer. The two people in my above post *are* my family/friends. They are not some patients in a hospital that I need to save or be detached from. They are my close friends who are experiencing/have experienced tragic losses. I just want to be a comforting presence, and am just kind of looking for some advice or some bereavement training of my own to make me better able to be that rock that my friends, and hopefully my eventual patients, will find comfort in.

[graceomalleyRN, RN]

I'm only a student nurse, but as I'm very much as you describe yourself being, here's my take:

You'll do fine. I used to cry at Baby Story, etc. but in my OB rotation saw a lot of births and that wasn't the case in "real life." At a birth, your focus will be on assessing the baby while you're suctioning and drying him and doing the many things you have to do the first 5 minutes of life. There's no time to emote at all, at least there wasn't for me. I get the impression you'll be the same way.

As for bereavement -- my program trains us never to tell someone it's going to be okay. Just letting the person talk and emote without saying much -- just a loving hand on the shoulder, empathetic countenance and open body language is the best thing you can do. You sound as if you *are* a "comforting presence" and that's as good as it gets during a loss situation. And don't worry, your program will prepare you for grieving patients and families.

[AOX4RN, MSN, RN, NP]

I used to cry at Baby Story, etc. but in my OB rotation saw a lot of births and that wasn't the case in "real life." At a birth, your focus will be on assessing the baby while you're suctioning and drying him and doing the many things you have to do the first 5 minutes of life. There's no time to emote at all, at least there wasn't for me. I get the impression you'll be the same way.

Exactly. Not weeping with joy doesn't mean you don't care, it just means you're being attentive. I am a midwife and attended a birth recently where the doula was a friend of the mother's and student midwife. The birth happened and everyone in the room was a weeping mess, except me and my assistant. The student said, "Darn, I wasn't going to cry this time I told myself! I bet you don't cry after hundreds of births!" But the truth is that I cry when I'm not the one responsible for the outcome I can be more emotionally invested in the outcome when I am not the one who has to maintain the calm and do split second assessments.

[ktwlpn, LPN]

When attempting to comfort a friend whom has suffered a loss or an impending loss like you describe the best you can do is be an ear and shoulder...You can't hug a friend or patient and tell them "everything is going to be allright" because it's NOT......As difficult as it is for you imagine it is so much worse for your friend/patient.If you can't find the right words don't say anything-that is perfectly OK-Shedding some tears is fine,too-as long as you can continue to deliver care. Your losses have taught you the fragility of life-continue to rejoice in what you have and not dwell on what has been lost.You may want to consider some counseling-your sensitivity may be a bit extreme.You may have some un-resolved issues that a good counselor can help you through.You'll be an excellent nurse...

[nerdtonurse?, BSN, RN]

I don't think this is adequately addressed in nursing school -- the fact that nurses can be the "collateral damage" in patient tragedies. You can be the toughest nurse on the floor, but there's going to be something that gets to you -- kids, someone that reminds you of a family member or friend. I've put more people in body bags than I ever thought I would, and while sometimes (most actually) I can realize that death is the end stage of life, and was a blessing to someone dying by inches, there are going to be patients that crawl inside your skin and live in your head for a while. I've had patients ask me what they've done to deserve cancer...COPD...CVAs. And I tell them death is like gravity. A leaf falls from a tree, not because of sin or evil, but because of gravity -- gravity just "is." Death just "is" -- it exists, and eventually, we all fall into it.

Realize that you are going to cry with your patients, laugh with them, rejoice when you see someone you thought was a goner tottering around the Walmart under their own steam. You're going to be made privy to family secrets -- like the adult children of a dementia patient I had that refused surgical consent because the man abused them in every manner possible, and none of the 4 children could bring themselves to "save" their tormentor (we got a court appointed guardian). You're going to be present at miracles and tragedies, but the most important thing to keep in your mind is this is not your miracle; this is not your tragedy. Observe it, but don't own it.

Never stop caring. But only the patients should be the ones bleeding.