how to deal with loss in the NICU

[leighTX]

Hey all, I'm currently a BSN student in Texas (graduating May 2014). Although I have no clinical experience in NICU (yet, at least!), I keep finding myself being drawn to it. I'll be interested in other specialities, but it always fades, yet here I am on the NICU nursing board week after week!

I've gone through a lot of posts talking about all the good things about NICU and all the healthy babies you get to send home from parents... but I was wondering, exactly how sad is it when babies don't live? Would you say the majority of your babies do survive and go home, or do a lot of them die? I just want an idea of exactly how hard it is to deal with an infant death... obviously it's very hard, but is it extremely emotionally taxing? How often does it happen? Are the happy moments truly enough to outweigh the bad?

Sorry for all the questions, but I'm just wondering how you amazing NICU nurses handle the sadness that comes from new life ending in just a short amount of time :/

[karnicurnc, MSN, APRN, CNS]

I have been a NICU nurse for 12 years. We are a 60 bed level 3, so we have a lot of patients. That means we also see our fair share of deaths. Some are expected and others are sudden and tragic (alive at the beginning of my shift and coding by the end of it). Most babies die from infection, whether it be NEC, overwhelming septic shock from a CLABSI, fungal infection, or meningitis. Some are withdrawn from life support because of devastating brain bleeds (think massive hemorrhagic stroke), conditions incompatible with life, or anomalous birth defects. Some are micro preemies, surviving on the cusp of life. Others are full-term. Each death experience is unique, as is each baby and the family. For me, it does not get easier. I still cry. But I cope better than the newer nurses because I understand the reasons behind what happened. I also have training as a grief counselor and that helped. That training may help you as well. Lean on each others a well as the pastoral services at your facility. Develop a palliative care team with a protocol. Schedule debriefings. Take time for you to grieve the loss of your patient.

[AnonRNC]

Most babies go home and are perfectly healthy and normal.

The few who die... are ready for it, and it is usually a relief to me when they do. I cry at home. Once in a while at work. When I cry, it's not for the baby (I believe they are in a better place), but for the parents' grief. I'd hate to lose one of my children.

[Bortaz, MSN, RN]

I agree with the above posters. Also, I've said before...I never imagined, before NICU, ever praying for a baby to die. But I've done it as a NICU nurse. Sometimes, death is better for the baby. I do mourn for the parents, though, as Anon said. All of my deaths have hurt me, some will be on my heart for the rest of my life.

But, the GOOD outcomes far outweigh the losses, and it makes it alright. Sorta.

[krenee]

I just went from a level II nicu to a level III and just experienced my first death of one of my patients . . . actually she wasn't my patient when she passed, but I had taken care of her. I agree with the above poster who said it can be a relief. We knew she was going to die and near the end, it was so hard to take care of her as we didn't feel like we were helping her, more like torturing her for 12 hrs. I was glad when the decision was made to take her off the vent, and it was the right decision. But I still cried, because is it sad. I'm sure more experienced nurses have better answers to your question, but I can tell you from my first one, you can survive it. It didn't make me want to quit, I want to help the babies that I can.

[lemur87]

I am a newer nurse in NICU and just lost a baby...I have been her primary nurse for 4 months and it has been absolutely devastating. I had become so close to the parents that it absolutely broke my heart to watch them go through that whole process of deciding to withdraw care and then hold her in the last moments. I cried with them. I cried when I got home. I cried at the funeral, and I sobbed the whole way home. I am sure there is a better way to handle/cope with loss like this, but I've not yet found it. My hospital doesn't do anything for the nurses in the event of a loss...no debriefing, no grief support or pastoral visits...we are kinda on our own. At the funeral we lit candles in her memory...I kept that candle as well as the funeral program and plan on having a special box made (my boyfriend is a carpenter) to place it, and future memoirs in. I hope this will help me recognize the loss, and let it go. There are of course many happy stories...most are happy stories...but the devastating stories can be just that...absolutely devastating.

[Nessapereira21]

On 3/22/2013 at 11:48 PM, lemur87 said:

I am a newer nurse in NICU and just lost a baby...I have been her primary nurse for 4 months and it has been absolutely devastating. I had become so close to the parents that it absolutely broke my heart to watch them go through that whole process of deciding to withdraw care and then hold her in the last moments. I cried with them. I cried when I got home. I cried at the funeral, and I sobbed the whole way home. I am sure there is a better way to handle/cope with loss like this, but I've not yet found it. My hospital doesn't do anything for the nurses in the event of a loss...no debriefing, no grief support or pastoral visits...we are kinda on our own. At the funeral we lit candles in her memory...I kept that candle as well as the funeral program and plan on having a special box made (my boyfriend is a carpenter) to place it, and future memoirs in. I hope this will help me recognize the loss, and let it go. There are of course many happy stories...most are happy stories...but the devastating stories can be just that...absolutely devastating.

I'm crying out just by reading to your story. I'm not sure if I can be a nicu nurse