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Loss in the Eyes of a Nurse…

02 March 2017

As I write this entry, I am reminded of being in the hospital, holding the hands of all those patients who were experiencing one of the worst days of their lives. I had not yet experienced my own miscarriage, however, I found a way to be there and nurture so many families when they were faced with this horrible news. I think two things can occur from caring for patients who suffer loss: either you are inspired to feel more compassion or you become too drained to provide the consideration your patient deserves. Unfortunately, the overworked and burnt-out staff can sometimes outnumber those who are more able to tackle the difficult times with the sensitivity our patients need.

When I first started working as a registered nurse, people would smile to the point of lighting up a room when I told them I worked in Labor & Delivery. I felt absolutely blessed beyond words to have my dream job. Each experience with a patient gave me a new perspective. I saw so many different scenarios with each shift and I grew professionally in my new role as a nurse. I thought I could conquer the world and hoped there was always a way to bring a better outcome from even the worst circumstances. As time passed and new patients were assigned to me, the high-risk scenarios increased. Eventually I started to take on a new type of patient: those experiencing loss. The longer I spent in the labor unit, the more reality struck that it’s not always rainbows and flowers. Each delivery can pose a different set of risk factors and things can quickly take a turn. That aside, people forget about those families who come in expecting a happy outcome, but leave the hospital without a baby. The patients experiencing loss came in waves, sometimes half of the floor would have loss signs on their doors, telling those passing in the halls to be considerate of outside noises. At shift change, many nurses wouldn’t offer to take over those cases because it was too emotionally draining. I, however, would usually raise my hand. I wanted those individuals to at least have a nurse who offered to be there as opposed to someone who couldn’t handle another sad night. With time, we started to realize who was better equipped emotionally to care for patients experiencing such a devastating loss.

Some healthcare workers are better at dealing with loss than others. Hours before my shift was over, I would already know to which nurse I wanted to hand over care of my patients. I had enough insensitive experiences with colleagues to know that I didn’t want my patient to have anything but a positive interaction during this dark time. One of my worst experiences with a loss-related delivery was caused more by my interaction with the physician than with the family. Before going into detail, I should say I do try to be considerate of the fact that everyone deals with loss quite differently. And every story, including those from healthcare professionals, tells a different tale. We are all affected by loss in various ways and sometimes our skin is thicker because of our experiences. But this particular instance truly opened my eyes as to how insensitive people can be during such a heart wrenching time in a family’s life. This patient, who would deliver on my night shift, had experienced a second trimester loss. She came in because of the baby’s decreased movement and ended up discovering she no longer had this life growing inside her. The physician, whom I’ve worked with multiple times, simply and coldly said what the plan of action would be from that point forward. No empathy, no caring gesture to show he felt sorry for what she was going through. Instead, after we left the patient’s room, he turned to me and said, “Call me once she’s delivered.” I stopped dead in my tracks. I couldn’t have heard him correctly. I quickly said, “Yeah, I’ll call you when you are needed for delivery.” He quickly corrected me, “No, afterwards is fine.” I ignored his request and called him when he was needed for the delivery. He complained when he arrived, but I let it go. I followed hospital policy, so he couldn’t go to a supervisor and complain. His compassion was nonexistent; to him this was just another case. To me, it was one that cemented the fact that compassion is necessary in this field. It’s what can make the hospital experience a positive one even in the most tragic of times.

My experiences have gone beyond the hospital setting. I’ve had my own personal tough encounter with an obstetrician when I experienced a miscarriage. I became concerned when I started to noticed the early signs of miscarriage during my second pregnancy. When I spoke to my doctor on the phone, she had a very irritated tone, exclaiming, “If you’re experiencing a loss, there’s nothing I can do about it at this point in the pregnancy!” Right then, I shut down. I realized my own doctor wasn’t on my side. Imagine how lonely I felt sitting there, with all the knowledge in my head as a nurse, and the one person who should show compassion turned her back. I couldn’t believe someone would have so little empathy for this tragic event in my life. A professional who I trusted to deliver my son had so easily thrown my feelings aside. Alone and afraid, I had to stand on my own and pick myself back up. No physician, especially one specifically trained to handle loss, should let their patients feel that way. There is no excuse for her attitude in that moment and, unfortunately, her words have stuck with me years later.

When we walk into someone’s life right at their darkest moment, we must remember that we, as healthcare providers, are there to serve our patients and offer a shoulder on which they can lean. We are not there to criticize or judge. Our role is to show them how to take a step forward when all they want to do is run back. Without a doubt, our experiences will change us, but our hope is that it will be for the better. I’d go as far as to say that we don’t have the luxury of having a “bad day” around people having the worst day of their lives. We must put in our all. It is important to be mindful that our shift will end, but the sadness will not go away for these families. Our compassion will stay with them as they tell their story about this significant day. You can either be remembered as a person who helped them see the beauty in life or as someone who made their day harder.

My biggest suggestion to healthcare professionals tending to patients who have suffered the loss of an infant is to be sensitive to this type of grief. The loss of a child is unique because it’s not something we mentally prepare for when we become pregnant. We know loss is immanent in each one of our lives, but the loss of a child is not something we expect in parenthood. It is heartbreaking and it is a feeling you need to be able to sit with. Feel the pain with the family because it will open your practice for others to follow.

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