Very early this morning, approx 0200, L&D took a 32 week gestation woman back to the OR for a c-section. The baby had multiple anomolies and died shortly after birth. I was not the shift coordinator for the shift, but the nurse who was shift coordinator came to me and asked my opinion about L&D transferring this patient to us, the postpartum unit. I told her to refuse transfer of the patient. First, because we are not trained in handling bereavement care. Second, L&D is supposed to keep the women with a demise, and finally, because it is cruel and inhumane to subject a woman to living, breathing, crying babies when she has just lost her own infant. The shift coordinator in L&D accused me of being unprofessional and said I was yelling at her. Yelling? No, but I was firm in my decision not to accept this. The reason I got for them wanting to send her up was because she was a c-section and that's the way it has always been done in the past. Well, I have worked on our postpartum unit for almost four years and only once in that four years have I seen a patient with a demise transfer up to our unit. That patient's family complained because they thought it was incredibly insensitive to put a grieving mom on the same floor with healthy, crying babies.
I think this is an ethical issue. I lost a baby nine years ago at 18 weeks gestation and would have been utterly appalled at the mention of transferring me to the postpartum unit. Am I off the mark on this one, or just being overly sensitive because of my own loss?
We actually keep our demises on the LDRP unit. The thinking was that they have less privacy on L&D and gyne and rooming them in with another mother baby couplet on PP is cruel. Our LDRP's are private so the mom and her family can grieve with their family alone and we can help her with the grieveing process. Yes they sometimes still here the new babies and though it's not ideal right now it's the best option we have. We put them in the farthest room at the end of the hall so hearing the other newborns is minimized but it's better there then any other ward where she will not get adequate care because the staff is not trained for it.
Just wanted to post 2 different personal experiences as I am only a pre-nursing student...when I suffered a the loss of my daughter at 21 weeks gestation I was kept on L&D for 12 hrs and discharged home. It was hard for me to hear the heartbeat on the monitor from the room next door. And I wished someone had been a little more thoughtful when they placed this laboring mom next door when there were other rooms available. It seems they were filling in order room 101-102-103 at that time. Because this was my first pregnancy I had no idea about what would happen PP and because I never went to the PP unit I was never told. Boy was I in shock when my milk came in, and heavy bleeding came with clots and pain.
When I had a healthy but premature daughter in 2006 she had to stay in the NICU. It had been a full moon and all the L&D and PP rooms were full. The hospital was actually on "lock down" because nursery was at max with 26 I think. I was lucky to get in before all the excitement and into a private PP room and was pleased that they were thoughtful enough to place a mom who had suffered a loss in the room next to me knowing that there would never be a baby crying in my room to upset her.
I think a choice is a great idea and everyone should be considerate but I think there will always be something that may upset a mom who has just such a tragic loss. It just depends what is best for the patient at that time and who is able to care for her best at that time.
Thank you for sharing your experiences! I'm sorry for your loss and I hope your baby is doing well now. You hit it right on the head with your last sentence and when the decision was made to refuse transfer of the patient with the demise, everything you mention was taken into account, thus my refusal to bring her to our floor.
I have an appointment tomorrow with the hospital bereavement coordinator, which I'm looking forward to. She used to be the RTS coordinator when she was an L&D RN. I think her insight will be very helpful.
Our PP unit NEVER deliveries any gestation. All deliveries - all gestations - deliver on L&D. The only exception is D&C's (they go to the main OR) or inevitable AB's under 16 weeks - those are in the ER, where they usually present 99% of the time.
That being said, we sometimes make exceptions, and will deliver someone under 16 weeks on L&D, if they are delivering lady partslly.
Sorry about my last post - I totally missed what the original post was about.
Our demise patients are given the option of going to the PP unit, or the women's health unit upon discharge from L&D level of care. We take special care to ensure that if they go to PP, they are placed at the far end of the unit, away from the nursery, and away from other rooms with crying newborns.
If mom is going to be d/c'd from L&D after a short stay, then we will just keep her on L&D until d/c time, provided that we have the bed space available - and many good nurses will fight to keep her on L&D, so she doesn't need to go through the trauma of going to PP or women's health for even a short period of time (I mean, really, it's just cruel!).
eden
238 Posts
We actually keep our demises on the LDRP unit. The thinking was that they have less privacy on L&D and gyne and rooming them in with another mother baby couplet on PP is cruel. Our LDRP's are private so the mom and her family can grieve with their family alone and we can help her with the grieveing process. Yes they sometimes still here the new babies and though it's not ideal right now it's the best option we have. We put them in the farthest room at the end of the hall so hearing the other newborns is minimized but it's better there then any other ward where she will not get adequate care because the staff is not trained for it.