As a mother who has experienced miscarriage, my empathy towards new mothers is different than that of someone without children of their own, or who has never had a loss. My nursing practice isn’t necessarily better, but I tend to notice different elements of my postpartum patient than other nurses. I sometimes understand why the patient is acting a certain way towards their baby or about their hospital stay in general. On average, I take care of more than one patient who has experienced loss each shift I work.
The Bedside Report
One of the things nurses are expected to do is bedside report to the oncoming shift. The current nurse and the nurse who is taking over your care go into the patient’s room and tell them about the mother and the baby. Aside from current status of both the mother and the infant, they discuss labor and delivery events, recent lab values, medications, physical assessments, as well as past medical history of the mother. How many times the mother has been pregnant (Gravida) as well as how many live births (Para) she has had. It rolls off the tongue very quickly and nonchalantly to us nurses. “This is Katie, 29 years old, patient of Dr. D’Angelo, no allergies, Gravida 5 Para 2.” Pregnant five times, but only two live births. Simple, to the point with important information, but can be very gut wrenching to the patient.
Involving Patient in Care
There is a lot of fuel behind facilities doing bedside reporting, as it has been shown to improve patient satisfaction scores for hospitals. The patient is supposed to feel more involved and in charge of their care when they are included in this report. I can’t help but feel that this may cause some sadness on such a happy occasion. Most of the time this information is said so quickly and matter-of-factly that a patient may not even notice the words, some people may not even know the meaning of these medical terms. But every time I am getting report on a mother who has experienced a loss, I just wince inside thinking of her pain.
Although this is pertinent information from a medical standpoint, it could be hurtful or bring up bad memories for the mother. I can openly discuss my miscarriages now, but right after I had our rainbow baby hearing this would have made me very tearful. It was the last thing I wanted to think about in the first few days after having our daughter. The postpartum period can be stressful as it is, with the transition into motherhood, physical pain, making sure you and baby are well enough to go home, making sure your milk is coming in; bringing up previous losses does not need to be added onto these stressors.
Showing Empathy to Patients
Knowing the importance of bedside report, I feel it does serve a purpose. I do however feel that some more empathy should be shown to our patients, and as nursing professionals we should understand that this may be a sensitive subject, and not be so casual as we rattle that information off. Nurses, we need to be better at treating our patient instead of looking at everything as an objective piece of information, such as a Gravida and Para number. Mothers, we need to make sure we realize our nurses are taking great care of us, and don’t always understand the depth of loss we may still feel from previous pregnancy losses.
One solution for this would be opening up communication about pregnancy loss as a community, and making it acceptable to discuss our feelings with our medical providers. Another solution would be for medical providers not to brush off previous losses as if the mother is done grieving. She very well could be at a point of acceptance, but this is not always the case. Communication and empathy are very important parts of nursing practice, and we could all use a little more of each.