The worst thing I've ever seen on my L&D floor...

Specialties Ob/Gyn

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The other day we had a diabetic full-term patient being induced on cervidil. Without any real warning, she had a spontaneous fetal demise. The baby was on the monitor and then it wasn't.... The nurse of course assumed it was just signal loss, so she kept searching, asked other nurses and residents for help, and by the time they figured out that the heart rate was just no longer there and took her back for a stat c-section, it was too late....

I was her nurse on the next shift (about 2 hours post-op).

It was the most intense day I've ever had at work.

She kept the baby in her room with her for 7 hours of my shift. The baby was purple and mottled and cold but she still thought it was the most beautiful thing she'd ever seen and kept hugging and kissing it.

She had about 10 family members in there, all crying, all day....

When my manager and I went in to tell her that we'd have to take the baby to the morgue soon, 10 people starting sobbing and wailing at once.

We had to undress the baby (she had dressed it in her own outfit), and shroud the baby to send it to the morgue.

This was so different than any other fetal demise I've ever had.

First of all, it happened on OUR watch. (not before the pt was admitted).

Second of all, it wasn't a little 24 week fetus. It was a full term 11 pound baby. It was my first real contact with a dead body that felt like a person.

And I've also never had a fetal demise for that long. Because of the special circumstances, we let her stay on our unit and keep the baby with her for a VERY long time.

I was surprisingly not very emotional during the actual shift, but today I've been very depressed and have spontaneously cried a few times thinking about.

It's also one of those days where I feel like maybe I'm not cut out for L&D.

I started fantasizing about working in a pediatrician's office or somewhere that babies don't die....

All I know is I can't handle the emotional rollercoaster of L&D forever....

Specializes in ER.

Hugs- Anybody who works OB for any length of time will run into this, myself included. Try to remember that as nurses, we can't always change the outcome, but we can ALWAYS make a situation for the family involved, as well as the patient just a little bit easier to cope with. Feeling sad after the fact is normal. Recognize you had empathy and had developed a relationship with the pt/family. It's one of the best things about being a nurse.

She needed you that day to be calm and you sound like you were. We do keep calm in the heat of the moment. Sounds like you are cut out for it and have learned alot. I think if it didn't affect you so profoundly then YES find a different place but it sounds like you are where you should be.

I was going to reply pretty much the same thing. If this experience had no effect on you

whatsoever, ah...I would say, you need to get out of L&D, the sooner the better.

You may not be able to stay it in forever, but your moms and babies are lucky to have

you while you're there.

Sounds like you were EXACTLY the kind of nurse she needed. I know this must be hard for you, and especially the family. My prayers go out to all.

Specializes in L&D.

Your duty to the family in this situation is to hold the space and provide compassionate care. You did that. It is difficult. Being around loss - especially unexpected - is difficult. Your hospital probably has an employee assistance program, I would encourage you to talk to them for counseling/peace through it (some even have hotlines and can give you appropriate referrals), talk to other nurses involved if you can, and perhaps your hospital chaplain.

Hang in there.

Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.

Working the NICU made me realize the preemies weren't the most heart wrenching...but the FTermers...without any reason whatsoever...I feel for you...you are mourning...please seek help...

Specializes in Nurse Manager, Labor and Delivery.

You should be worried when this kind of thing DOESN'T bother you. Demises are heartbreaking, but term ones are the worst, especially in the case that you are describing. It is all part of the circle of life, and as nurses we see it all. It is devastating. You need to do something for you right now...a massage, a long walk, treat yourself to something special. You were there for that patient and her family in a moment of need. You touched their lives even if they do not realize it yet because of their grief. You did good.

We, too, have an open policy for the baby being in the room. Even if the baby goes to morgue (or pathology in our institution) we can retrieve if the parents want the baby. Sometimes we are up and down going to get the baby and taking it back. Pack your baby in ice if it is a prolonged visit (ice packs in diapers or gloves next to the baby's skin under the clothes or blanket) or in ice in a bassinett or basket for times the baby isn't being held. I find that helps. I like to keep the baby with the parents for as long as they need to make memories.

You will get thru this. Just give it time. :redbeathe

I hate to say this, but stuff like this happens any where you go. My first patient i had by myself, off orientation, came in with an MI. (i work on a cardiac step down unit). He was a healthy 52 year old man, 1 daughter my age, a beautiful loving wife, no prior medical history. He had a 100% occlusion to his RCA (not good!!). They were able to stabilize him until he was going to go in for a CABG in the morning. he was 2nd case so he was going to leave for surgery at 8am. I got on shift at 6:30 and went to do my SBAR at the bedside with previous nurse. We walked in and the patient started getting VERY restless, he was swinging his arms, lashing out, attempting to get out of bed within 2 minutes he goes unresponsive. GGREEEAT! first day all by myself, and a new grad.

Immediatly yell "CODE BLUE" and start chest compressions. Ok so we started coding this guy around 6:45 and people are asking me tons of questions, i got drips and lines hanging every which way, i'm trying to check compatability with like 12 IV drugs going, i'm running out of IV spots, the IV nurse can't get more started. The guy is posturing (not a good sign). I didn't get done with him until 2:30pm when finally things settled down, we did all that we could. I transferred him up to ICU to be placed on the RVAD.

Echo showed the complete right side of his heart was dead, it was not pumping at all. Only means of survival would heart transplant. Arrangments were being made to get him to a transplant hospital, but because of HORRIBLE weather med-flight was unable to fly and ground transport wasnt an option (Blizzard). We were stuck what to do. Kept him on RVAD. well, come to find out he was pronounced brain dead and never made it.

i was devastated. i kept asking my self, What did i do wrong? was there something else i could have done?? truth is...you can't blame yourself. We cannot save everyone. Things like this happen in the healthcare field no matter where you go. Its unfortunate that it had to happen to an infant.

After my patient i told you about died, the patient after that was a lady who was going home after a CABG. She was excited to go back to gardening after rehab and was happy she was living long enough to meet her grandchild who was on the way!! Stories like these are the ones that keep us going from all the bad that does happen in our profession.

Keep your head up!! You should feel honored that you were able to care for this family. I'm sure the care you provided them will never be forgotten. You allowed them time to grieve with their baby in a way they wanted to.

Not to be too picky, but I don't think it's so good to tell someone how he or she SHOULD feel. We feel what we feel. The OP is not really in a place yet where she can feel honored. She is freaked out, she is scared, angry, hurt, whatever. Maybe someday she will feel honored, but not just yet.

For OP: death is part of life. Death is a reality we just have to face sometimes. Try to take it one step at a time and be realistic.

We lost triplets 11 years ago, our first children after years of infertility treatment. One of the things I remember vividly was my nurse, Helen. She was an angel and got me through the worst night of my life.

You did a great job for that family even though it may not have been evident. I have been on the nursing side of the death of a child as well--the helplessness that I felt was overwhelming. Peace to you.

I agree, sounds like you were the best nurse for the job. Its nurses like you that give the rest of us a good name. Thank you for serving that family so well.

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