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)

4 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).

5 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

6 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).

7 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.

8 Sample Demographics Age Ranges: up to 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

9 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

10 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

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

12 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.”

13 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…”

14 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

15 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

16 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

17 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.

18 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.

19 References Puckett, P., Hinds., P., & Milligan, M. (1996, October). Who supports you when your patient dies? Registered Nurse, 59, 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 )

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