Lived Experiences of the Nurse Assisting With Perinatal Loss

Lived Experiences of the Nurse Assisting With Perinatal Loss Melinda Ruiz, MSN, RN Point Loma Nazarene University

Objective • To discover and examine the lived experience of the Labor and Delivery Nurse (RN), and how it pertains to a family with perinatal loss

Background • Parents and family members feel that their grieving process was assisted by the proper bereavement care they received by hospital caregivers (Rock, 2005). • Personal experiences, death education, or insufficient training can cause the RN to respond differently to the situation (Rock, 2005)

Background Continued • Many obstetrical nurses are uncomfortable and want to avoid the patients dealing with perinatal loss (Rock, 2005). • Nurse may not know how to care for themselves or resources available to help them (Puckett, Hinds & Milligan, 1996).

Sample Process • IRB approval obtained: • Three Southern California Hospitals • Point Loma Nazarene University • Advertising signs were posted • Criteria for participation: • 18 years old or older • Labor and delivery nurse who has worked with families experiencing perinatal loss. • The nurses contacted the researcher • Participant number given a confidential number

Design and Methodology • Qualitative phenomenology using van Manens’ lived experience • Formulates a question • Discovers and explores the personal experience, feelings and thoughts • Analysis of the life-world descriptions assist in isolating themes (Speziale & Carpenter, 2003).

Data Collection • Written Consent describing risks and benefits • Stated all responses confidential • Semi-structured interviews: • Conducted in a quiet secluded conference room • Written consent describing risks and benefits. • Stated all responses are confidential. • Demographic questionnaire • The interview was recorded and later transcribed by the researcher in order to ensure accurate recording of data.

Sample Demographics • Age Ranges: 19-29 up to 50-59 • Ethnic Background: 6 Caucasian, one Sicilian, one Asian, and one American Native Indian • Marital Status: Never married, married, and Divorced • Number of Children Born Alive: 0-4 • Highest Level of Education: Associates Degree on up to Masters Degree • Years as a RN and Obstetrical RN Range: 0-5 up to 31 + • Hours worked per week: 8-40

Data Analysis • Each participant and theme was color coded. • Each verbatim theme was cut and pasted onto another document • Labeled as an essential or incidental theme • Saturation occurred on the ninth interview

Trustworthiness • Credibility: • Participants recognized their lived experiences by the data collected. • Audibility: • The person being interviewed followed what was being asked. • Fittingness: • The nurses will use this study information with other situations of loss. • The results will be meaningful to those involved in the study, other researchers, and at all hospitals

Results • Five Essential themes: • Hurting or Damaging the Baby • Emotions and Feelings with Perinatal Loss • Comfort Level • Level of Preparation • Nurse Support

Essential Themes • Hurting or damaging the baby: • Comfort or discomfort when touching the baby • “I was afraid to touch the baby, the baby just looked so fragile, and it was a little scary at first.”

Themes Continued • Emotions and Feelings with Perinatal Loss • Sadness in their grief for the family • Crying for the family “That was really hard for me. I think it was just shock, and when I got home I cried, and cried…”

Themes Continued • Comfort Level • Choices to terminate a baby • Praying with the family • Religious upbringing • Personal life experiences • Going to the morgue to bring the baby back to the family

Themes Continued • Level of Preparation • Death education • Classes on perinatal loss • Education in nursing school • Nurse Support • Expressed wanting someone to • assist with first encounters • Support people: co-workers, chaplains, social workers

Conclusion • Recommendations: • Further educational training • Experience during their orientation period • Have a second RN assist them with the care of the baby when new to the experience

Limitations of Study • The study could benefit from being done at different hospitals, rural hospitals, and include a larger sample. • Larger sample of different ages, ethnicities, and spiritual beliefs • The findings of this study may or may not fit in other samples.

Future Research • School programs on death and dying from Kindergarten to 12th grade. • Nursing school educational programs on death and dying. • Hospital educational programs for the nurse caring for a family with perinatal loss. • Increase the nurses’ comfort with perinatal loss.

References • Puckett, P., Hinds., P., & Milligan, M. (1996, October). Who supports you when your patient dies? Registered Nurse, 59, 48-53. • Rock, J. (2005). Comfort levels of obstetric registered nurses caring for parents who have experienced a perinatal loss/stillborn infant. (Doctoral dissertation, Capella University, 2005). (UMI No. 3119159)

References Continued • Speziale, H., Carpenter, D. (2003). Qualitative research in nursing: Advancing the humanistic imperative (3rd ed.). New York: Lippincott Williams & Wilkins.

Lived Experiences of the Nurse Assisting With Perinatal Loss