I spent a evening earlier this week in the ED, while I was only a couple of weeks pregnant I started cramping and bleeding heavy. SO while in the room the doctor after running my Hcg levels which was only 25.5 told me that I was only a little bit pregnant and went on and on about how 1 in 5 pregnant women have a miscarriage and on and on. I was also told by this doctor that since I am only 20 years old it was not as bad as if I was 40 and had been trying to get pregnant. Now I understand that yes this happens because of nature but what would make anyone think that by telling me it's not as sad for me to have a miscarraige but it would be if I was 40! :angryfire
I understand that yes if I was 40 it probably would be more upsetting but why would you tell anyone this?
Just needed to vent because with everything going on with me that day I was appauld that anyone would think that information was comforting.
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
I don't think it's ever appropriate in the ER when a woman is actively miscarrying. Of course in the future a woman will be glad if she can have more children, but at the time of the miscarriage of a wanted pregnancy I think that comment coming from a healthcare provider is dismissive, disrespectful, insensitive and crass. How on earth would a health care provider who has known a woman for a few hours have any idea how this would be received? This isn't your friend that you've known for years. This is a stranger. As such it makes sense to try to avoid making comments that MANY women will take as hurtful.
I would be mortified if anyone in my institution ever said that. This is exactly why some hospitals won't put women who have experienced fetal demises on med-surg floors.
I agree, trite platitudes offered by medical or nursing personnel are never appropriate for those of us experiencing pregnancy losses. EVER. Maybe such people who think this is ok should learn more about how devastating it can be to have these said to us. Not during the crisis, should these things be said.
I spent a evening earlier this week in the ED, while I was only a couple of weeks pregnant I started cramping and bleeding heavy. SO while in the room the doctor after running my Hcg levels which was only 25.5 told me that I was only a little bit pregnant and went on and on about how 1 in 5 pregnant women have a miscarriage and on and on. I was also told by this doctor that since I am only 20 years old it was not as bad as if I was 40 and had been trying to get pregnant. Now I understand that yes this happens because of nature but what would make anyone think that by telling me it's not as sad for me to have a miscarraige but it would be if I was 40! :angryfire
I understand that yes if I was 40 it probably would be more upsetting but why would you tell anyone this?
Just needed to vent because with everything going on with me that day I was appauld that anyone would think that information was comforting.
I am sorry for your loss and the manner in which you were treated. As one other poster suggested, a letter to the Chief of ER medicine might be in order, as well as a copy to the CEO of the facility.
I don't think it's ever appropriate in the ER when a woman is actively miscarrying. Of course in the future a woman will be glad if she can have more children, but at the time of the miscarriage of a wanted pregnancy I think that comment coming from a healthcare provider is dismissive, disrespectful, insensitive and crass. How on earth would a health care provider who has known a woman for a few hours have any idea how this would be received? This isn't your friend that you've known for years. This is a stranger. As such it makes sense to try to avoid making comments that MANY women will take as hurtful.
I would be mortified if anyone in my institution ever said that. This is exactly why some hospitals won't put women who have experienced fetal demises on med-surg floors.
Some women need to hear that is okay..and that they still may be able to have children again some day, along with how sorry you are for their loss...having hope for the future is not a bad thing, and I never deny their feelings about their present situation..And its not just my friends that I have dealt with for this type of situation. I've been a nurse for 10 years, 6 in the ER...We see a large amount of miscarriages, most of which if not teenager are in their early 20' s...I have never had any problem or complaints from any woman or family member that I have said it to...There are certain women that I certainly would not say anything of such too...I think a lot of it has to do with what area of the world you are in...and what kind of clientale you are dealing with has alot to do with how comments as such would be received...I have not once ever been told that it was something horrible to say, I have also heard plenty of L and D nurses say it to women who have had still born's in our ER, as they have come over to assist the OB doc for whatever reason...I think you can't speak for everyone in this case, its not a comment for everyone...with that I agree.
I agree, trite platitudes offered by medical or nursing personnel are never appropriate for those of us experiencing pregnancy losses. EVER. Maybe such people who think this is ok should learn more about how devastating it can be to have these said to us. Not during the crisis, should these things be said.
I don't think that you can assume these people never experienced the same situation just because they feel that "everything happens for a reason and you are young and have time to have more babies"...you have no idea what these medical or nursing personnel have been through...maybe they are speaking from their own personal experiences...
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
As a rule, we are told these platitudes and attempts at reassuring women in crisis, are not really so reassuring. That is one tenet of many grief programs/semimars we OB nurses take in order to deal with all manner of losses. Rarely have I found the woman even able or willing TO be reassured DURING the crisis, that she "can try again", or that she is "young" and will have many more chances at other babies someday.
During the loss of a baby, one's mind is usually rather far-removed from trying to get pregnant again. She is too busy just trying to accept THIS child is really dead. And, if she has had multiple losses, she may be scared to death TO try again. You have no way of knowing during the actual loss where her mind is. Just saying you are sorry and really being there for her, willing to listen, and letting her lead any discussion from that point, would be the best and most sensitive way to proceed.
These words of reassurance will usually help usually AFTER the crisis of the actual miscarriage or loss has passed--and denial and shock have had time to resolve.
From someone having been there myself, too much, I can see where such words, offered during crisis, prematurely---- might ring very insincere or shallow.
Not to be argumentative Mommatrauma, but just because no one has complained about your comments doesn't mean they were never hurtful. You wouldn't believe the number of stories I've heard from women who have experienced losses and remembered a very hurtful comment (mostly made by docs oddly enough). When I express my sadness and ask if they followed up with the hospital, not one of them has ever said she did. They were too wrapped up in grieving to bother with letting the nurse or doctor know they'd hurt them with a comment. This comes up a lot at my job because many of our NICU moms have experienced multiple losses. The fact that they would even bring it up to me, often years after the loss, tells me that many still have a lot of unresolved sadness and anger about how they were treated. This comment is one that I've heard over and over again in those stories of both early and late term losses. (Also on the list comments like "Well, at least it happened now and not after you got to know and love the baby", referring to the baby as "It", saying "Well, it obviously wasn't meant to be" or "these things happen for a reason"... I could go on).
I agree that hope for the future is important, I just don't think the comment "you're young, you can try again" is the best way to bring that up unless you KNOW how it will be received and it's pretty hard to know that in the ED when you've only known a patient for a very short time. Sure, some people could find that comment comforting. But why make it if you know many others could find it painful (and clearly many of the women on this bb who have experienced losses say it is hurtful to them)?
I just wanted to say something about the whole "you're young so you can have more" speech. I have a very dear friend who is in her mid 20s who has had an enormous amount of difficulty in concieving. She and her hubby just recently found out they are expecting after many fertility drugs and 3 rounds of in vitro with one little baby. If she presented in your ED with the above described situation I can safely say the last thing she wants to hear from someone is she could always have more later. Yes, she could adopt and she was in the process of stating the paperwork when she found out she was pregnant. BUT, that is still very insensitive to someone you don't know. Just my two cents.
I just wanted to say something about the whole "you're young so you can have more" speech. I have a very dear friend who is in her mid 20s who has had an enormous amount of difficulty in concieving. She and her hubby just recently found out they are expecting after many fertility drugs and 3 rounds of in vitro with one little baby. If she presented in your ED with the above described situation I can safely say the last thing she wants to hear from someone is she could always have more later. Yes, she could adopt and she was in the process of stating the paperwork when she found out she was pregnant. BUT, that is still very insensitive to someone you don't know. Just my two cents.
Sunny
Along the same lines, the youngest patient I've had with fertility problems was 22. She has severe tubal damage so she and her husband could only conceive through IVF.
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
Not to be argumentative Mommatrauma, but just because no one has complained about your comments doesn't mean they were never hurtful. You wouldn't believe the number of stories I've heard from women who have experienced losses and remembered a very hurtful comment (mostly made by docs oddly enough). When I express my sadness and ask if they followed up with the hospital, not one of them has ever said she did. They were too wrapped up in grieving to bother with letting the nurse or doctor know they'd hurt them with a comment. This comes up a lot at my job because many of our NICU moms have experienced multiple losses. The fact that they would even bring it up to me, often years after the loss, tells me that many still have a lot of unresolved sadness and anger about how they were treated. This comment is one that I've heard over and over again in those stories of both early and late term losses. (Also on the list comments like "Well, at least it happened now and not after you got to know and love the baby", referring to the baby as "It", saying "Well, it obviously wasn't meant to be" or "these things happen for a reason"... I could go on).
I agree that hope for the future is important, I just don't think the comment "you're young, you can try again" is the best way to bring that up unless you KNOW how it will be received and it's pretty hard to know that in the ED when you've only known a patient for a very short time. Sure, some people could find that comment comforting. But why make it if you know many others could find it painful (and clearly many of the women on this bb who have experienced losses say it is hurtful to them)?
Good point,and along those lines, some of us are WAY too vulnerable and emotionally-shaken TO take on insensitive, glib remarks like this, anyhow. I know having lost pregnancies, and dealing with insensitive or careless remarks, I had NO strength in me to object or utter a word of protest. I was just too emotionally overwrought to deal with insensitive people, in the midst of my crises, to try.
and later on, it may be WAY too painful to even revisit the situation to address the remarks. It's sometimes hard to even want to look back. It's a damned shame that so many assume all is ok just because it may have been "early" or "not the right time" ---or because the patient does not make complaint or say anything later on about the mishandling of her grief. We as a society, lack severely in helping others grieve and facing such things. So often, it's just swept under a rug figuratively. The isolation and pain a person feels at times like this can be almost unbearable, yet we are made to feel less than strong or human to talk openly about it.
What irony. What we medical/nursing personnel may interpret as the patient's acceptance, may instead, be painful, gut-wrenching silence.
I will tell you one thing: I remember MOST the ones who were geniune and caring and did not try to minimize my losses with meaningless reassurances and cold monologues. The ones who simply said " I am so sorry" and put their arms around me and just listened. THEY are the ones I try to keep in my thoughts when my mind allows me to go back to those times when I lost so much.
Trauma, I know you want to do the best, right thing for your patients. Please know I am not meaning to pick on you. This is a subject way too near and dear to my heart.
Along the same lines, the youngest patient I've had with fertility problems was 22. She has severe tubal damage so she and her husband could only conceive through IVF.
Exactly and as I said, there would definitely be times when saying those things would not be appropriate, this is one of them...I always ask about attempts and how long have you been trying and how many miscarriages etc...I don't go into it as blindly as you think...
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
No one said you are going into it blindly. I am glad you are asking the right questions---it's just I have found it rare for a woman to want to discuss further attempts/pregnancies during the actual crisis.
No harm, no foul. I appreciate your caring attitude, Trauma.
z's playa
2,056 Posts
I got that speech too
Z