Supporting a family through the loss of a newborn requires sensitivity, empathy, and a comprehensive approach.
Nurses play a critical role in providing care and comfort during this challenging time. Here are key actions that nurses can take to assist families dealing with neonatal loss:
Acknowledge Their Grief
Recognize the profound shock and sadness the family is experiencing. Acknowledging their bereavement validates their feelings and sets the tone for compassionate care.
Answer Their Questions
Be available to answer any questions the family may have. Understand that they may initially struggle to trust the medical community. Fulfilling promises and providing clear, timely information can help rebuild this trust.
Assess Their Understanding
Determine the family’s knowledge of the situation. Ensure they understand what has happened and inquire about any previous experiences with loss that may influence their current grief.
Offer Clergy and Additional Support
Ask if the family would like a visit from clergy or if there are any other ways you can support them at this time.
Assist with Early Pregnancy Loss
If the pregnancy ends spontaneously or requires a surgical procedure, explain the process and timing in detail. Offer the parents as many choices as possible. In the Emergency Department, strive to reduce trauma by providing a private room when available.
Support During Late Pregnancy Loss
For losses at or near term, help the parents adjust their birth plan and discuss pain management options. Provide an overview of the labor and delivery process, especially if they have not completed prenatal classes.
Prepare for Magical Thinking
Understand that parents may hold onto hope for a miracle, even after a diagnosis of fetal death. They may only fully grasp the loss upon delivery, which can lead to visible displays of grief.
Encourage Naming the Baby
Encourage parents to name their baby, reinforcing the baby's identity and significance in their lives.
Facilitate Holding the Baby
Suggest that parents see and hold their baby, explaining the benefits of this contact. Describe the baby before handing them to the parents, especially if the baby has been in the morgue.
Support the Claiming Phase
Provide details about the baby, such as weight, sex, and physical features. This helps the parents in acknowledging their baby’s individuality.
Photographs and Keepsakes
Encourage parents to take photographs of their baby. These images may become cherished mementos. Also, create footprints, handprints, and save a lock of the baby's hair if possible.
Create a Sensitive Environment
Use a special sign or symbol to indicate that the family has experienced a loss, preventing inappropriate comments from staff. Offer the choice of staying in the postpartum or gynecologic unit to avoid exposure to other families with newborns.
Autopsy and Medical Closure
Encourage parents to consider an autopsy. The results can provide important information and help alleviate feelings of guilt and anxiety.
Prepare for Physical Changes
Inform parents about the physical changes the mother will experience post-loss, such as breast milk production and lochia. Educate them on how to manage these changes.
Postpartum Care and Warning Signs
Advise on postpartum danger signs, such as symptoms of endometritis, retained placental fragments, urinary tract infections, and deep vein thrombosis. These details are crucial even if the discharge occurs sooner than usual.
Provide Written Instructions
Given that parents may be in shock and not fully absorb verbal instructions, ensure all care information and guidance are provided in writing.
The most valuable thing a nurse can offer to a grieving family is a deep sense of nonjudgmental caring and personal involvement. By being present, empathetic, and proactive, nurses can make a significant difference in the family's healing journey.
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