The hard part...

[L&dRNLizzi]

I've been working as an L&D nurse for a year now, and I absolutely love it. Most patients have a happy ending to all the worry, and pain, and work. When its a sad outcome, it's VERY sad. I have been pretty successful thus far in those situations providing quality nursing care and bonding with my patients during their stay. I lean on faith to comfort myself that some things, some babies are not meant to be. I find myself struggling though, when the worst could have been prevented and was not. ie. Stillbirth due to maternal drug use and other similar situations. I still provide the same nursing care, but my feelings are very ambiguous towards my patient. I deliver these women, and then prepare the infant, I bond with their families, but I do not have the same peace about the situation at the end of the day. I am both angry with and sorrowful for the mother. So I wonder, if this is a typical response? Does it indicate a weakness in my nursing ability that I am not always able to sympathize with my patient. I'm sure there are some experienced nurses out there, and I would love some feedback.

[Bortaz, MSN, RN]

I don't think there's anything at all wrong with the way you feel. I agree with you, in fact.

[Fyreflie]

I'm of two minds on that. First, that it's natural to have an opinion about things and beliefs are beliefs, especially brought to light in situations that are sad and possibly preventable.

Second, though, if you believe your own judgements result in a different standard of care for women whose lifestyle or choices don't match yours, you might want to move out of the field that allows that discrepancy to happen. Because let me tell you--you might not think they notice the judgement, but they do. And that has the power to negatively impact their outcomes.

I know some women who work with me who are very pro life and we were talking about a new hospital opening nearby that will provide care for women choosing genetic terminations around 20 weeks. None of them will apply because they know they couldn't care for women in that situation and give them the same care they would give an "accidental" loss. I respect them for that.

I'm very passionate about baby loss. The first family I cared for changed my life and we're still in touch. Judgement needs to be taken out of the equation in order to give the best possible care. Is that immensely tough when it's a clear case of a mother not taking care of herself? Of course. But ultimately not one of us have the right to pass our own brands of judgement because we're not in that place. Our job is to give excellent care to families experiencing loss and meet them where they are in their journey. That doesn't mean getting super emotionally involved with every case and there are some families who seem to touch you more than others!!

One thing that helped me the most was taking RTS Bereavement Training. They have a great program and resources for caregivers!

[Mermaidblues]

I think that as OB nurses, we all struggle with outcomes that we feel might have been prevented by the Mom making better choices. Not all end in loss of life to be sure! I have and always will try to be honest and straight forward when discussing what some of those "choices" might do to alter a baby's health or the health of the mother herself. It helps to know that, while I have walked the walk and talked the talk for over 30 years, my patients have not. Do I have to swallow a little bit of anger, impatience, or bitterness occasionally in order to care for and educate moms to do what is right for themselves and the baby inside of them who cannot choose for him/her self? Yup. But because we know and see firsthand every day just how good and bad it can be, we are in a unique position to have an impact that just might change someone's whole way of life. That is what it's all about for me.