Fetal demise

BecomingNursey · Oct 13, 2015

I don't work L&D or anything like that. ER is my forte, but I had a patient not long ago that had been trying to have a baby for a long time and had started bleeding. After the doctor went into the room and told them that there wasn't a heart beat on the ultrasound and she was experiencing a miscarriage I went in to check on them. They were both crying on the stretcher, the husband holding his distraught wife. The were praying and the wife just kept asking God; "Why?" I came into the room and sat on the stretcher next to her and hugged her. I asked them if I could pray with/for them and with tears streaming down my face I prayed with them.

I don't think there is anything that we can say to make them feel better. Just like when my cousin died, no one could say anything to make me feel better.

The most that I feel that we can do in these circumstances is just to be there and let them know we are there if they need anything.

cdsavannah59, CNA · Oct 13, 2015

I work mother baby unit as a Tech, we were advised to not say anything unless the parents wanted to discuss it.

IamSecond · Oct 13, 2015

That is heartbreaking. Nurses witness so many highs and lows of human life it simply amazes me the depth of emotion we deal with daily in our jobs. I agree that there is absolutely nothing we can say to them to give them any relief from their pain. Of course I still feel compelled to want to acknowledge their loss in some way. I love that you prayed with your patients and I love that I work in a profession where many times that is a completely acceptable thing to do. That is definitely something I will consider doing with my grieving patients if they desire me to do so, It would be an honor.

IamSecond · Oct 13, 2015

My preceptor told me she thought the worst thing you could do is to not acknowledge their loss. Everyone is different, though if it were me, I think I would want the nurse to at least acknowledge my loss.

heron, ASN, RN · Oct 13, 2015

When in doubt, I ask.

In general I think it's fine to let the family see your tears. I think that honest empathy is generally a good thing. Just be careful of being distracted from your job as a nurse. That can be dangerous.

Long-term, learn as much as you can about healthy and unhealthy grieving. I've never researched it, but I would bet the survivors of a fetal demise run a higher risk of major depression, substance abuse, financial collapse and general badness. It never hurts to have referrals available. Plus, offering the referrals gives you an excuse to bring up the subject of grief in fairly neutral and respectful terms.

xxdiscoxxheaven · Oct 13, 2015

I have had a couple of these patients myself this past month. It was complicated by the fact that they didn't speak English. I didn't bring it up to one of them....she was much too quiet when her husband was around. The other I gave a book on infant loss. I don't think you absolutely have to bring it up. Not every patient is the same. I agree about never knowing what is the right thing to say. I really don't bring it up unless they ask or have questions just because I don't want to make them cry if they aren't already.

ktwlpn, LPN · Oct 13, 2015

Sometimes saying nothing is the best approach.A hand on the shoulder, "how are you doing,can I do anything for you?"The healing process barely starts in the hospital.I will never forget the nurse who came in and gave me a back rub and a sleeper.We did not talk much...A week or so later she sent me a card with a lovely note.I cherish it......

Double Dunker · Oct 14, 2015

I lost one of my babies a couple of hours after birth (we knew he wouldn't survive long). I agree the worst thing is to say nothing. I think the best thing is to find out the baby's name and call him/her by that name. "I'm so sorry you lost your precious Sarah Grace. What can I do for you?" Calling them by name acknowledges them in a way no other thing can. If the baby is still in the room with mom, acknowledge that, too. Stop and take a look in the bassinet, admire the fabulous head of hair just like you would a living baby. Offer to take pictures if that hasn't happened yet. It's the only thing we have.

sneaky_des · Oct 14, 2015

I lost my son 32 weeks in utero due to a cord incident. This was my first pregnancy so it was a very difficult thing to go through. The nurses acknowledgement of my baby's life is something that has and will continue to stay with me. The tender way they handled my baby is something I will always be grateful for. If you have the resources, please offer to take photos. Even if one of the parents doesn't want to, ask the other because sometimes in the moment you're in denial and don't want any reminder of the truth, but later they might regret not haven taken pictures. Those first photos fresh out the womb are the best, because once death starts settling in we do change. Also, I was given a Memory Box with info on how to cope with loss and some mementos, like the baby beanie that was placed on my baby's head when his pictures were taken. Give your condolences, and reassure mom you are there if she needs you.

EmRN14 · Oct 14, 2015

I have been wondering the same as I am beginning a new career on the mother-infant unit in a large hospital. I already have a hard time finding the right things to say to patients that are sad so I cannot imagine finding what to say to parents that have lost their baby. I hope that I receive proper education on this topic and learn how to help families going through this. Just say what comes from the heart. And I know that in nursing school they say not to cry but I feel like crying shows empathy and caring. Be strong but show that you care.

ixchel · Oct 15, 2015

What you should say will change from family to family.

There are things you should never, ever say, though. Some of them -

1. This is part of God's plan

2. Really, avoid anything to do with religion

3. Also avoid any statement that alludes to this happening for a reason, or it having any purpose whatsoever

4. Never say it's okay because they can try again

5. Never make assumptions about parentage or method of conception. This may not have been her baby (or his), and they may have conceived the "old fashioned way", or, they may have put all of their life savings into reproductive endocrinologists to help make this baby

6. Don't say anything that will give the impression that the pain will go away. It will never go away.

7. Don't tell them about anyone else you know who went through the loss of an infant. This baby was their child - a unique soul they they loved and wanted.

Don't be offended if they hate talking to you personally about it. The "late term pregnancy loss club" is one that you can only be in through living it. It's one no one ever, ever wants to be in. These families will find the best companionship from others who understand this loss first-hand. I think it's very good of your hospital to recover these moms away from the recently postpartum moms who had live births.

When I talk to moms who have experienced this, I say to them with as much meaning I am capable of conveying...

"I am so, so sorry."

The next thing out of my mouth is based on what they say, but always begins with, "do you want to talk about it? We don't have to if you don't want to."

By the time they come to you, please forgive the graphic nature of this next part, it is very possible they have known they had their deceased child inside them for days, or even weeks, surrounded by people relishing in their "beautiful pregnancy glow," and constant questions about how they feel and how excited they are. They literally have to tell everyone close to them, their baby died. The next question is always, "what happened?!" It's hard enough livin through it actually happens, but to talk about it all the time? Absolute torture.

Forgive the deep level of doom and gloom here. I'm hoping to paint a bit of a picture as to why this is delicate and too difficult to say what you SHOULD say. I applaud your realization that finding the right words, and skipping the wrong ones, is important.

Best wishes going forward!