Had my first experience with a fetal demise today (m)

[eandgsma]

I am an RN extern on an L&D floor. Today was my 4th day on the floor (I had been in High risk OB for the last 6mos prior). At 15mins to 7p (end of shift) we get a pt coming up from triage...15yo, no heart tones. The charge nurse was taking her because we were full. The girl is in labor, all alone, scared. There are 5 nurses in there taking care of her. I'm trying to find heart tones (not knowing they couldn't find them in triage), couldn't get them no matter where I tried and I started getting a sinking feeling. Another nurse tries...no luck. MD does a US and 3 of us nurses are left, we all look at each other and the MD has to tell this poor scared alone girl that her baby has died. I just bit my tongue so as not to cry. I managed for about 2 mins and then walked out after the doctor. In the hall I was trying not to cry but when the doctor asked if I was ok I couldn't hold it in. I held my hands in my face and shook my head no. I went into an empty room and cried for a few secs, got my composure and went out to apologize to the doc and told her that was my first experience with a fetal demise. I knew it would happen at some point. I helped the other nurse move her to the area where we have fetal demise moms deliver and tried to comfort her. She was SO scared. I felt bad leaving at change of shift but there was nothing I could do for her at that point. She was with a good nurse after that. I just can't stop seeing how scared she was.

Now I'm thinking that I should not have shown my feelings like that in front of the MD. We were all upset, even the MD but no one outwardly cried. But I guess that is to be expected the first time. I'm sure it will get easier to "hide" my feelings until its "safe". I don't think it will ever be easy though.

Thanks for listening. I just needed to "tell" someone who understands.

-N

[JaneyW]

No need to hide your feelings. I have cried with patients. It is OK. Sometimes it is even helpful. The important thing is to not lose sight of your function. You have a job to do, but you are also human and your patient will benefit from your empathy. It is a horrible part of our job.

Jane

[angelfoodcakeRN]

Crying means you care. And believe it or not, some mommies appreciate the fact that a robot isn't taking care of them or their baby. (Not saying that if you don't cry you're a robot; people express emotions differently.) I understand where you are coming from (NICU). It's OK. I have cried tons of times. I always feel better after. It means I am not numbing to the emotional issues that come with my job. We have a job to do yes, but if we need to take some time to experience normal human emotion then we should do it. You were right to go and take a minute to take care of yourself, so you could go back to taking care of your patients. Be strong! Never lose that connection! It's a Beautiful thing.

[rnin02]

The last fetal demise I dealt with, everyone was at least teary eyed, if not crying a little (staff that is), even the doctor. I don't think you need to hide that from the MD, it is a very emotional experience.

[RNSC]

Everyone appreciates compassion I think. One of my first experiences with neonatal death (in the NICU) was reliving a nurse in the grieving room. I held the baby in a darkened room while she went to get the parents. I did not know this baby, the parents or the situation except the death was expected for congential problems. I had just come on shift and was asked to hold the baby. As I held the baby, I rocked her and quietly sang to her and thought I can do this. However when the parents and the nurse came back I surprised to find tears in my eyes. As they flowed, the nurse "Thank you" in a surprised and grateful tone.

[NPinWCH]

:icon_hug:

It is OK to cry. I cry every time I'm involved with a demise. I've cried at deliveries, while I bathed the baby, when I hand the baby to mom. I've cried beside the bed of grieving families, holding hands and praying with them in the middle of the night. I've cried in front of the docs, and I've watched them crumple to the floor in the hall after these deliveries, so I've even knelt down beside them and cried with them.

We are human, and every family I've cared for during or after a demise is grateful that we are. I'll never forget the letter our unit received one day:

"You guys cried everytime I did...even though you didn't know me you were there for me and you made me feel I wasn't alone when I felt like my heart had been torn out. I felt like you loved my little girl and I know you took good care of her. My husband said he saw one of you rocking her in the nursery with tears running down your face, and we will never forget any of you. Thank you for helping us celebrate the little girl she was."

We keep a copy of that letter posted in our locker room...it reminds us why we do what we do. So please, don't ever apologize for crying!!

[TrudyRN]

I have mixed feelings about staff crying in the patient's presence.

When I was a patient and a nurse cried, it upset me. I think it was because I needed her to be strong and to comfort me and she wasn't doing that.

I have to marvel, though, that, as nurses, we are expected to bury and deny our own feelings of sadness, joy, etc.

Go figure, huh?

I remember getting into the ER a little girl who was burned by soup on her arm and tummy. Mom was a total wreck, crying, probably hadn't even thought to run cool water on the child, just panicked and brought her to the ER. I started cooling her off with chilled saline and found myself crying, quietly and in a controlled manner, still able to do my job, just with tears in my eyes. I just couldn't help it. The doc saw me, realized I was still functioning, didn't say anything, just left me to do my work. I think she shared my feeling of profound sadness and sorrow. We never talked about it. I don't feel bad that I cried. It just came out and I was still functional. We are human.

[rnmomtobe2010]

It is so wonderful to know that there are caring nurses out there. I can't help tearing up while reading this thread. It's ok to cry. Is there a smilie that gives hugs?

[Elvish, BSN, DNP, RN, NP]

It is absolutely OK to cry with/around your patients. No need to apologize for it. I don't know a good nurse that hasn't at least once.

[ShifraPuah]

:icon_hug: Remember, your compassion is a key part of who you are. NEVER apologize for it.

As to IUFDs, the good news is, you don't get used to it (they don't happen all too often, but seem to come in threes, from what I remember). The bad news is, you don't get used to it (every one is different and yet the same).

Sounds like to me you got the makings of a good nurse.

[m0m2boys]

First of all I want to give you big hugs for having to deal w/ such an emotional situation. I have only been doing l&d for a few yrs and no matter what the gestation of the demise I wail like a child. I don't always do this in front of the pt, but just getting it out helps me feel better. Full term demises are the worst and I wish I could say that I have never had one, but that is not realistic. My last demise when taking pics of the baby, I took an extra copy just for me. The family was in such denial they did not want to hold the baby, see the baby or even talk about him. This was very hard for me, so I took a pic of him to remember him by, since I felt his parents weren't mourning over him. Long story short......everyone mourns differently. I happen to wear my heart on my sleeve. This particular circumstance the family tried to pretend nothing was even going on. As long as you show the family you care, offer them places to receive support and perform nursing duties for the mom I don't think there is a right or wrong way of doing things.

If this is still bothering you see if your hospital has bereavement counseling for staff.

*LF* :flowersfo

[SmilingBluEyes]

I remember my first year (10 years ago) in OB and my first demise was about 1 month into my new job. I cried my eyes out, carrying that little baby into the nursery. I was not ashamed (nor am I now ever) to cry in such cases. I will hug patients/families and am geniune and real in expressing how I feel for them. I have experienced losses myself, so it sometimes brings it all back to me, in a painful way that is sharp and breathtaking. Yet it helps me be "real" when I do get involved in the care of people experiencing such sadness in their lives. Just be yourself----never be ashamed you are sad in such cases. Stoicism is highly over-rated in this case. That is not to say to make it about YOU-----but to be there and be available and yes, cry with these families, if you feel the need, shows your capacity for empathy and compassion and will be appreciated by them, much more so than if you came across as cold, clinical, even if competent. Trust me on this.

It will never get "easier" but you will gain skills in coping with these sad losses. Just give it time and do your best. Don't be afraid to lean on colleagues if you need to, in times like these. We all understand how you feel.