Bereavement

[iluvnicu]

I have been asked to head up the Bereavement Committee at my level III NICU. We have started implementing a few new things, but would really like some input on how other NICUs handle these situations. We have a "Checklist" that I put together for the nurse taking care of a dying baby that has numbers for chaplain and social work as well as what to do for postmortem care. We have a photography department that can come take pictures, after parents consent. After bathing and dressing the baby, we have a white wicker basket that we put the baby in to present to the family in the Overnight (room-in) room. We let the family stay for as long as they wish to say their good-byes. When the family is ready to go, we bring the baby back into the unit and place in a casket and then in a bag to take to the morgue. My first question is what is your procedure for taking the baby to the morgue? I've had a lot of older nurses ask about swaddling and actually carrying baby. The morgue in our hospital is on the complete opposite side of the NICU, so the bag is so we don't have to carry through the hospital. However, I understand that putting the baby in a box/casket and then in a bag can seem a bit inhumane, esp if the family sees you. What do you do? We are in the process of getting sympathy cards made to send to the families, but I don't know what message to put in the card. And how often do you send out cards? We also have some memory boxes ordered. In the boxes, we will have an envelope for a lock of hair; a charm for a necklace/bracelet; a card; hand/foot prints; hand/foot impressions; and a diaper, blood pressure cuff, or anything else family may want. We have a booklet called "Why Mine?" and another for families that have to make the decision to withdraw care (sorry I can't remember the name of it right now). What are some other things you do for the families? Any suggestions/comments are welcome!! Thanks!!

[virgo,student nurse, CNA]

That is so beautiful. i recently had a death in the family. It was one of my best friends who lost her baby. She told me that the best thing the nurses did for her, was to allow her to be in the moment with her child. They allowed her to cry and spend time with her child. The nurse manager even called her to ask how she was weeks after the death. I think all the ideas you have are great. It takes a special person to deal with what you deal with. KUDOS.

[ittybabyRN, RN]

Our unit does similar things to yours, every experience is different of course.

Last weekend I experienced my first patient death, it was very very sad but looking back probably one of the better experiences I, and her family could have had. She was full term but when her mom went for an induction the FHR was 20, after the stat csection she had no HR. She was resusitated and came to my NICU for three days of cooling but her EEG and CT were very poor, after rewarming she had only minimal brain stem activity and her parents made the heart wrenching decision to withdraw care and allow a natural death. They had two days to enjoy her. I encouraged them to bathe her and I took many, many photos for them. I asked if they wanted to assist me with the things we often do after a baby has died - hand/foot prints, 3d hand/foot molds and they did assist with those things because each thing they got to take part in was one more memory for them to have of their daughter. We cut locks of hair and filled up the memory boxes we provide. They had her baptized, chose a stuffed animal for her and for her siblings and were provided with pamphlets and small books on grieving for them and their family. They had the opportunity for all her family to come in and say good bye and then quietly, peacefully two days after support had been withdrawn she died in her parents arms.

Her parents stayed for about 2 hours and then they left their arms filled with the memories they had collected of their baby. Once they were gone I took a few more photos and emailed them to her family later. Then she was shrouded per our hospital policy and swaddled in a blanket. We have a basket we use to transport infants to the morgue but I think it's kind of obvious if you're carrying it, I chose to carry her in my arms with a blanket over her and my shoulder. Our morgue is also pretty far from our unit and its impossible to get there without meeting someone on the way but I found it nicer to carry her.

Our unit sends a card to families about a week after the baby has died, many people from the unit, whether they cared for the baby or not will sign it, they do mean a lot to the families.

[Mags4711, RN]

We send cards after death, six months, and then at a year out. We order our cards (and a nice natural paper box) from Memories Unlimited, Inc http://www.memoriesunlimited.com/

Our transporters take the baby down in a basinette to the morgue.