How would you tell a patient

[cheels]

So say a 18/19 year old girl comes in, shes been in a pretty bad car accident. She was also 2 months pregnant and misscarried.

What or how would you tell her assuming you dont know if she knew she was even pregnant??

[Pudnluv, ASN, RN]

I would refer all questions to the MD. Or I would wait for the doc to tell her. Then I would be available to her if she wanted to talk about it.

[BrnEyedGirl, BSN, MSN, RN, APRN]

I wouldn't, that would be up to the physician.

[Jolie, BSN]

It is the physician's responsibility to provide this information to the patient when her condition allows. It is imperative that she be told because of the need for follow up, possibly including Rhogam.

[cheels]

Yeah i thought it would be the physicians role to explain the condition etc.. But most of the physicians ive worked with tend to explain important things when the patient is drowsy or out of it (might just be the area ive worked in post-op recovery..) so most of the time we call the Physician back later and yeah just curious for like trauma areas what they would do in the situation.

[flightnurse2b, LPN]

Yeah i thought it would be the physicians role to explain the condition etc.. But most of the physicians ive worked with tend to explain important things when the patient is drowsy or out of it (might just be the area ive worked in post-op recovery..) so most of the time we call the Physician back later and yeah just curious for like trauma areas what they would do in the situation.

yeah they do tend to try and tell half sedated people biopsy results and usually stroll into the room when the family member has just stepped out for coffee, lol.

in the ED, the MD/PA/NP is responsible for breaking bad news. nursing staff is there for follow up teaching and support.

[mama_d, BSN, RN]

I agree, it's the docs responsibility. But I'd want to try and have someone from pastoral care or a nurse from L&D specially trained to deal with fetal demise available just in case.

[RNperdiem, RN]

When faced with the telling issue, I consider a couple of things:

1. How do you know she was pregnant and miscarried?

The information you get third or fourth hand might be distorted or untrue. Correcting misinformation is the last thing you want to do.The doctors are the ones usually with the first hand information, and they generally do the telling.

2. Did the patient ask?

[canoehead, BSN, RN]

If I've heard the doc tell the patient something I will reinforce it or explain it if they were too sedated, or too confused when he was there. I refer more in depth questions to the doc, and/or explain to the family that I don't have the knowledge base to answer more than what I've told them. I think it's important to answer honestly what you can. I wouldn't share information if the doc hasn't gotten a chance to get there, or go into treatment options beyond the most basic information. I think nursing can be a big help when families have to process new information, and we can assist them in thinking through the situation so they're ready with new questions the next time they see the MD. Sometimes they have to restate what's happened 3-4 times before it actually becomes real to them.