Managing Ambiguity: Nurses Caring for the Mother of a Stillborn Baby
Human; Grief; Interviews; Grounded Theory; Perinatal Death; Audiorecording; Constant Comparative Method; Life Experiences -- Evaluation; Obstetric Nursing
Purpose: The aim of this study was to describe and conceptualize the experiences and processes involved when labor and delivery nurses provide care to women experiencing a stillbirth. Background: The care of a woman experiencing a stillbirth is an important topic that requires attention, however, there is a paucity of literature on the specifics of a nurse's experience as she or he cares for a grieving mother. These experiences may shed light on gaps in care that may exist as well as gaps in the resources, education and support needed to appropriately prepare nurses for providing care to a mother at such a difficult and vulnerable time. Stillbirth is increasingly referred to in the literature as a traumatic death, unexpected and unplanned, resulting in post-traumatic stress responses. Understanding what the bedside nurse does, thinks, and feels during these moments of traumatic bereavement will contribute to a greater understanding of the nurse's experience of providing care to a patient. Method: This study used a grounded theory approach. Data were collected via in-depth interviews with 20 labor and delivery nurses. Each interview session was recorded, transcribed verbatim, and analyzed using the constant comparative method of analysis. Results: Based on the inductive method of grounded theory and a thorough comparative analysis of the data, the theory Managing Ambiguity emerged as the basic social process of how nurses struggle to care for a mother whose baby was stillborn. This theoretical underpinning summed up the substance of what was occurring when nurses cared from a mother experiencing a stillbirth and was characterized in three different categories by labor and delivery nurses as Experiencing a spectrum of emotions, Managing the ambiguous patient, and Managing institutional ambiguity. These factors contributed to the overall ambiguity the nurse had to manage when providing care for the patient whose baby was stillborn and became the three main categories of the overall theory. Conclusions: This theory of Managing Ambiguity provided a perspective on the experiences, behaviors, and social processes involved in caring for a woman delivering a stillborn baby. This theory also provided insights into how the interactions between the nurse and herself, the nurse and the patient, and the nurse and her environment impacted the process and the meaning of the event. The importance of this study is the resulting understanding of factors that impede and enhance the process of providing care to a mother whose baby was stillborn. Feelings of uncertainty, ambiguity, and discomfort must be addressed at the nursing education and nursing leadership levels.
Nurse NJ
Managing Ambiguity: Nurses Caring For The Mother Of A Stillborn Baby
2018
Speaking a Different Language: A Qualitative Analysis Comparing Language of Palliative Care and Pediatric Intensive Care Unit Physicians
Child; Communication; Critical Care; Female; Human; Inpatients; Intensive Care Units; Language; Male; Palliative Care; Pediatric; Physicians; Support; Preschool; Retrospective Design; Descriptive Statistics; In Infancy and Childhood; Audiorecording; child; human; female; male; Content Analysis; Field Notes; Fisher's Exact Test; Funding Source; Kappa Statistic; Mann-Whitney U Test; Patient-Family Conferences; Record Review; Psychosocial
Background: Family conferences in the pediatric intensive care unit (ICU) often include palliative care (PC) providers. We do not know how ICU communication differs when the PC team is present. Aim: To compare language used by PC team and ICU physicians during family conferences. Design: A retrospective cohort review of ICU family conferences with and without the PC team. Setting: Forty-four bed pediatric ICU in a tertiary medical center. Participants: Nine ICU physicians and 4 PC providers who participated in 18 audio-recorded family conferences.
Ciriello AG; Dizon Zoelle B; October Tessie W
American Journal of Hospice & Palliative Medicine
2017
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1177/1049909117700101" target="_blank" rel="noreferrer noopener">10.1177/1049909117700101</a>
Continuing Bonds with the Living: Bereaved Parents’ Narratives of their Emotional Relationship with their Children
Audiorecording; bereavement; Child; Emotions; Grief; Human; Interview Guides; Narratives; Only Child; Parent-Child Relations; Parents; Psychosocial Factors; Qualitative Studies; Semi-Structured Interview; Siblings
Abstract
The death of a child can be seen as one of the most devastating experiences for parents which can result in a unique and enduring grief. Parents with surviving children face the task of navigating their own grief while continuing to parent. This narrative inquiry explores bereaved parents’ stories of their emotional relationship with their surviving children. Parents told stories of emotional connection and disconnection with surviving children, influenced by the competing and potentially incompatible tasks of ‘parenting’ and ‘grieving’. The need for a relational focus to bereavement research and practice is highlighted. The findings demonstrate the need for clinicians to provide i) parents an opportunity to explore their sometimes contradicting and troubling experiences of grief and parenting and ii) children with support to make sense of their experiences in relation to the parent-child relationship.
Shankar S; Nolte L; Trickey D
Bereavement Care
2017
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1080/02682621.2017.1386400" target="_blank" rel="noreferrer noopener">10.1080/02682621.2017.1386400</a>