Nurses' Perspective on Caring for Women Experiencing Perinatal Loss

Abstract

Purpose: The purpose of this study was to describe the experience of caring for women with a perinatal loss from the perspective of the nurse and to determine the extent to which the response to perinatal loss reflects a process. Study Design and Methods: A purposive study was conducted with nine labor and birth nurses with experience in caring for women with a perinatal loss. The nurses were from two acute care hospitals within one healthcare system in Southeastern Massachusetts. A qualitative descriptive design with in-depth interviewing based on Rubin and Rubin (2012) was used to gather and analyze data. Results: Several themes depicting nurses' experience were identified: struggling with emotions, carrying on in the moment, being present for the patient, expressing conflict, and taking care of self. A process was identified by nurses describing their response to perinatal loss. The process began with recognition of the loss and progressed through phases including the recognition of their emotional impact, connecting with the mother, dealing with emotions, acting professionally, preparing to return to work, and never forgetting the woman. Clinical Implications: Nurses identified a need for more education and managerial support for excellence in care of women with a perinatal loss. Education to prepare nurses to meet the physical, psychological, and spiritual needs of women is recommended. Debriefing after caring for a woman with a loss was suggested by the nurses. When nurses' needs are met, they are better prepared to care for women experiencing a perinatal loss.

Involuntary Pregnancy Loss and Nursing Care: A Meta-Ethnography

“…Quality assessment of included studies [25]. 1 2 3 4 5 6 7 8 9 10 Nallen (2006,2007) † [26,27] -Nash (2018) [28] - Willis (2019) [29] - McCreight (2005) [30] - Beaudoin and Ouellet (2018) [31] Hutti (2016) [32] - Roehrs et al (2008) [33] Martinez-Serrano et al (2018) [34] -Jones and Smythe (2015) [35] Jonas-Simpson et al (2010) [36] -Abbreviations: yes-unclear no; critical appraisal questions: (1) Is there congruity between the stated philosophical perspective and the research methodology? (2) Is there congruity between the research methodology and the research question or objectives?…”

“…Nurses and midwives found the health system unhelpful when it came to handling their own grief. This lack of backing was further exacerbated in early pregnancy losses [26][27][28][29]. A midwife referred to the abandonment of the health system as follows: "Sometimes, you are left to deal with it on your own; especially, sometimes, it's on nights.…”

“…Midwives and nurses reported a lack of preparation and knowledge regarding how to care for these parents, how to communicate with them, and how to behave besides a scarcity of tools to manage the emotional demands of parents and their own [26][27][28][29][30][31][32][33][34][35]. This caused them to feel insecure when caring [32].…”

“…Some of them reported a lack of appropriate communication skills, and they found it difficult to know what, when, and how much to say; how to approach families; and how much to get involved [26][27][28][29][30][31][33][34][35][36]. "My personal difficulty is this: what do you say to this woman?…”

“…A particularly controversial aspect was the lack of congruence regarding socially accepted behaviour with parents. This caused doubts about whether to show or contain their own emotions [26][27][28][29][30][31]33,35]. While some understood that emotional expression is a tool for establishing a bond of trust with the family, others felt that the emotional demonstration could further harm the parents, since the loss belonged to the parents [26,27,[29][30][31]33,35].…”