Lived Experiences of the Nurse Assisting With Perinatal Loss

1
Lived Experiences of the Nurse Assisting With
Perinatal Loss

• Melinda Ruiz, MSN, RN
• Point Loma Nazarene University

2
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

3
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)

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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).

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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

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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).

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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.

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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

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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

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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

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Results

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

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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.

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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

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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

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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

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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

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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.

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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.

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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)

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References Continued

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