# Please help this Postpartum nurse be a good nurse...



## Mariposa (Nov 12, 2002)

Hi all. I have read several pages here and just want to send hugs to all of you who have lost a baby. I can't even imagine how hard that must be.

I am a nurse that works in Couplet Care/Postpartum and occasionally we have mother's on our floor who have lost their baby. Our first choice is antepartum, since there are no crying babies there, but sometimes they are full and the mom is given a choice between med/surg floor or us. Many still choose us even though they know they will be on the floor with other mom's who have their babies.

I had my first mom a couple of weeks ago that had a loss. She actually lost 2 babies as she was pregnant with twins and one had a severe incompatible with life birth defect and they had recommended selective reduction of that child and her and her husband had agreed. This had taken place 3 weeks earlier. She also had placenta previa. Her surviving twin was born alive at 17 weeks and died very shortly thereafter. This was an IVF for them and it was very sad.

I was so scared to do the wrong thing, say the wrong thing, be in her room too much, not be in there enough. I was afraid to cry though when I got report from her L&D nurse, we were all in tears. I tried to listen and validate her feelings and try to help her not to think it was her fault, which was what she was thinking and voicing. I offered her a sponge bath when she requested a wash rag since she had been in antepartum for a few days and she let me do that. I kept her glass full of her requested drink and with lots of ice and sat and listened when it seemed she wanted to talk and held her hand. She was alone as her hubby had to be home with their other kids.

If you don't mind and have the time, could you answer these questions for me? I think it would help me to be a better nurse the next time that I am a nurse to a mom who has lost her baby.

1. If you had a great nurse when you lost your baby, what did she do/say?

2. If you had a horrible nurse, what did she do/say that made it a bad experience?

3. What would your advice to nurses that work with moms who have experienced a loss be?

Thanks so much. I just want to be a better nurse than I was. I know that I tried as hard as I could and really tried to help her to know I was there for whatever she wanted me to be, but I still feel like I could be better the next time.


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## KittyKat (Nov 17, 2002)

Wow, good for you. The very fact that you care enough to come here shows your heart is in the right place, and that's the most important part. I think the worst thing would be to stay away and not say anything out of fear of saying the wrong thing. Listening and being there is the best thing you could do.

If you have already read the threads at the top of this board, you know the general type of remark that hurts worst (It was for the best, you can always have another, at least you...)

Saying "I don't know what to say, but I care" is fine. Being there and listening, is really the best you could do. Nothing is going to make it "all better" but having kind and caring people will make it easier than having someone who is cold and "professional" and doesn't act like their heart is in it.


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## Mamax3 (Nov 21, 2001)

I am a L&D nurse....I read here for the same reasons as you Mama Nurse.


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## liseux (Jul 3, 2004)

I had many horrible nurses and a few good ones. The good ones let me know what I could do, keeping me aware of all of my options and not putting their own spin on things. My son died when he was 7 weeks old so I had nurses advising me on how long I could hold him afterwards and really intense things like that. Hopefully your hospital has copies of "When Hello Means goodbye" or another book or pamphlet on loss and what a parents rights are. Every parent is so different, but offering to take pictures and handprint/footprints or providing kits is a good idea. Some people may want nothing to do with their baby, it happens sometimes like that, but giving options helps, they can think it over and you can just be with them.

Also, don`t be afraid to cry, many nurses cried with us and it helped a little to see they were human too. The only thing I can say about the bad nurses is they didn`t mean any harm, many were just ignorant. Good luck to you and thanks for asking this!


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## QueenOfTheMeadow (Mar 25, 2005)

I think you did so great. I had a D&C when I had a loss on the outpatient floor, and it sucked, because no one showed any sympathy or really seemed to care a whole lot. I would have loved to have had a compassionate nurse like you there with me. Definately staying with a women if she was alone is a good idea. You feel so alone and empty after a loss, and it is awful to feel even more alone. Don't be afraid to cry. It means you care and that helps. Make sure that everyone, especially lab people and people coming in to clean the room, know this was a loss, so no one askes questions like, "oh, you had your baby, was it a boy or girl" kind of thing. Most of all just listen, which you did. Sending







for you being such a good nurse and person.


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## queencarr (Nov 19, 2001)

I think it says a lot that you are here asking. One of the things that struck me the most was that my nurses openly cried as she was being born. Not hysterical out of control crying, just that they were touched. When they came in to check on me or needed to tell me things, they usually held my hand or touched me in some way; the same with my family members. They came very quickly whenever I called. They took her hand and foot prints, and tried desperately to get me casting material to do a belly cast (we were unable to get them in time, though). Normally, they did plaster casts of hands/feet as well, but were out of casting material that day







They took the standard newborn photos, as well as a roll of film back in the nursery with the outfit, stuffed animal, and blanket I was given. They didn't tell me about these until later and told me that I could pick them up when/if I wanted them. They gave me a memory box that included the bracelets that we would have used and her hospital birth certificate.
I was kept in labor and delivery at the room at the farthest end of the hall, so no crying babies around me. I was given food and drink throughout labor. I was given as much pain meds as I wanted, whenever I requested. The exact quote was "You only have to feel as much as you want to". I was allowed access to sleeping medicine as well (nd they sent me home with pain and sleeping medicines, which were greatly appreciated). I was able to labor however I wanted, despite having severe preeclampsia. Basically, I was given whatever I wanted; when I asked for a catheter because I wanted to be drugged unconscious for early labor, I got one. They stopped visitors at the nurses station when I requested and let everyone in when I requested, including my then 4yo ds.
My doctor told me ahead of time that it would be strange after she was born, that it would be suddenly quiet. Logically I knew this, but the shock of no crying would have been even more difficult had he not mentioned it. After she was born, they realized that she had died several days earlier than we thought, and they warned me of the physical changes before they handed her to me, and covered all of the areas that had begun to peel with the blanket. They talked to her and cooed to her as though she were alive, and when she was not being held, she was in the warming bed (they did an external exam, as we declined the autopsy). I will say this was a biggie, because her body stayed warm this way.
As usual, I went really long, but I wanted to give you an idea of the things that, for me, made a big difference. Our birth story is in the link in my signature, if you would like to read it. I hope this gives you some idea of waht you were looking for.


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## Maderella (Mar 20, 2005)

Hi there mamanurse. I unfortunately just delivered my baby last thursday - she was 22 weeks, stillborn.

I can honestly tell you that the nurses I had (went through 3 shifts) were all WONDERFUL. I'll be honest with you, because of past experiences, my opinion of the medical community is usually pretty low but these nurses were just great. They all had different personalities and I clicked with one more than the others but all were very kind, compasionate and caring. Don't be afraid to get close (physically or emotionally), banish the term "at least" from your vocabulary.

I was alone during my delivery too, hubby had to be with the kids at night. The nurse during that time told me that I was her only patient and she could be with me the whole night if I wanted or she would just stay outside the room if I'd rather be alone.

DOn't leave the patient alone for too long, check on her regularly. One thing I always hate in hospitals is that if the nurse needs to contact the doctor (say to check if the patient can have food or a tylenol or somehting) it always takes FOREVER and you just feel like you were forgotten about. Make sure you let the patient know that you are waiting to hear back fromt he doctor in that situation.

I wanted to be on the labor and delivery floor - I was having a baby, not having some surgical procedure like getting an appendectomy and I think the labor and delivery nurses are much more attuned to that kind of situation.

Warmly
Maderella


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## gossamer (Feb 28, 2002)

I agree with what all of these women have said.

I think it is really important to just tell the mom you are sorry. Don't tell her it is God's will, she can have more babies, the baby is better off or any other trite infuriating cliche.

I was so sick I don't really remember my nurses except the one who was 12 months pregnant and took care of me less than 24 hours after Mary Rose died. If at all possible, check the schedule and see if you can avoid having a pregnant nurse take care of a grieving momma. Ask the momma questions about her baby. Let her know she can ask to see the baby as long as she is in the hospital. Tell her how beautiful her baby is. Treat her like a momma.
Gossamer


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## warriorprincess (Nov 19, 2001)

It's wonderful that you're here and want to be comapassionate in your care. It sounds like you did a great job.

All my nurses were great. They kept me informed of my options, and treated our son as the loved little person he was. I remember that when the nurse who was on shift for the actual birth had to leave, she asked to hug me and told me what an honor it was to share our son's birth. They were also sensitive to the comings and goings of our pastors, and delayed procedures to give them time alone with dh and I. When the pastor arrived after Benjamin's birth, all the medical staff just filed out without saying a word and waited to be invited back in. They kept him wrapped in warm towels and on a warming bed the whole time we were there, and we knew we could have as much time as we wanted.


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## mrspeeper (Jun 27, 2004)

I am a former L & D nurse too. I plan to return to postpartum when our finances run out and I can't afford to stay home with DS any longer. This thread is so helpful. I too felt very uncomfortable- I felt like I was never meeting the needs of my patients...I was either offering too much or too little. I remember ducking into the photo area of our nursery once just to cry and wipe the tears away before heading back into my patient's room. I remember seeing a doctor be very rough at a stillbirth and his actions still give me nightmares sometimes. It's too bad most hospitals don't offer grief support training for the L & D staff. I am really interested in hearing about all the special touches the staff can do for mommas (and the whole family) when a loss happens, ie. keeping babe under a warmer, taking a whole role of photos and offering them later, etc. I would like to put many of these ideas in the suggestion box or discuss them w/ my nurse manager in the future. Keep the suggestions and ideas coming! Maybe we can help make someone else's experience more loving when they suffer such a tragedy.
My heart breaks for those of you who have suffered a loss. I cried as I read your stories.


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## iris0110 (Aug 26, 2003)

I think it is wonderful that so many nurses are here asking questions. It shows how much you all really care. When I arrived at the hospital the day my daughter died I didn't know she was dead, and neither did any of the staff. At first they found a heartbeat that they thought was hers. It later turned out to be mine, just elevated by the infection. Everything was so horrible that day. The midwife on call refused to come to the hospital, I am still not sure why, butI have some ideas. One L&D nurse stayed with me the entire time. From the moment I arrived until it was time for Arawyn to be released to the funeral director. She really never said anything, she just stayed with me. She always seemed to know just what I needed. She rubbed my back during labor pains, and handed me tissues. She would leave the room for a little while to give Dh and I some privacy, and then reappear just as we needed her. After Arawyn was born she wrapped her in a blanket and laid her on my chest. After about an hour she weighed her and measured her, gave her a little cap and swaddled her. She stayed two hours past the end of her shift just so she could be the one to take the nursery photos, collect the items for the memory box, and make sure Arawyn was delivered to the funeral director. She definately made everything a little more bearable.

After that I was cared for by the same nurse who had cared for me during my labor with Ds. Any time I go to that hospital it seems like she is the one in charge of my care. Some times I think she is permanently assigned to me. She was very kind, and went out of her way to keep me from being moved to the ICU. She did her best to keep me from being disturbed, though I needed constant temp monitoring and alot of blood work. She brought me all of my meals herself so the maids wouldn't bother me. She even iced the area she administered my rhogam shot.

I think ultimately what helped me was being assigned the same nurses for most of my stay. They were familiar with me and my situation. Also the nurses treated me like an individual person, and my daughter as some one worth greiving for. I really appreciated that.


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## sarah9774 (Feb 19, 2005)

My care during my stay at Norfolk Sentara Leigh hospital was very professional and the nurses were very compassionate (with the exception of a couple) I was very scared and my husband was a mess. My son was stillborn at 40 weeks and 1 day. And, I don't think that I could have made it through with out Rebecca, Amy, and Coleene. The other nurses I can't remember but these are the ones that took great care of my family and made sue we had everything we needed. I think that the only down fall was that there were a couple of new nurses that had no idea what they were doing.. the first one massacered my hand trying to put in an IV, didn't listen to me when I told her that my veins were very small and burst it any way.. blood everywhere.. finally a more experienced nurse came in to do it.. I would not put a new nurse with a mama who has experienced a loss it is too much for them and you can see it on their faces.. It is ok to cry, it lets us know that you are human. As a therapist, I think that it is important to be able to have empathy.. also, the sponge bath was wonderful, and I would have never thought to ask for one. Although I could not bring myself to hold my Beautiful son, the nurses offered several times.. my husband held him and sat with me. and I am so glad that the hospital took pictures, because I did not even think of it.. and the pictures mean a lot to me!! The hospital that I went to has yearly trainings regarding pregnancy loss and stillbirths ( Ann Prescott is the wonerful woman who does the training and support group) The hospital offers a free support group two times per week and free counseling sessions (which I think is very valuable). It is very helpful and I think that all hospitals should have a program like this.. the nurses had a packet of information they kept encouraging me to read and I am glad they did, it talked about everything from funeral arrangements to the stages of greiving.. it was sooo helpful and I continue to go to the support groups and individual sessions offered by the hospital..
SArah


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