Abstract taken form the ISANDS Guidelines for Professionals, written by Professionals
The death of a baby provokes many reactions in Health Care Professionals and others. Unfortunately, many of us have little or no training to help us deal with a situation, which can make us feel uncomfortable, uncertain and even threatened. Of course there are some professions that by their nature have training in this area of care and some of those professionals have given insightful information for the ISANDS Guidelines for Professionals.
However that does not take from the fact that this area of care is difficult and can be challenging. It has an impact on us and may affect us in a number of ways.
The Guidelines may help us to understand why we find it difficult and more importantly to recognise that the sadness can challenge us and leave us feeling unsure. However, it is worth mentioning that we do play a vital role and important to remember we can and do make a difference at a very vulnerable time in parents and families lives.
“Our child’s life and death becomes the basis by which we judge ourselves and those people who were part of that and what they did and said becomes the basis by which we judge them. How we cope and survive is based on what we are left with, what our memories are.” - Mother
Good communication is fundamental to providing good patient care and is essential when delivering sad news. This can range from telling parents that their baby will not develop like other babies, telling parents that their baby will die before or after birth or telling them that their baby has died.
Breaking sad news is always difficult. Talking about death at the same time as birth is especially difficult, both for the professionals breaking the news of the death/impending death and for the expectant parents who were looking forward to the baby’s birth. Feelings of joy and fulfilment are in conflict with feelings of sadness and failure.
“At 2pm after a painless labour, I gave birth to my wonderful daughter. This was the happiest moment of my life, despite being the saddest. Within seconds of her being born, I was holding my beautiful girl and was overcome with joy and torn apart with heartache all at the same time yet with a peace and feeling of absolute love.” - Mother
Many professionals have received little or no training in delivering sad news, and may rely on observing more experienced colleagues doing so. Formal training in communication as part of undergraduates’ education and ongoing training in their professional lives would give health care workers the necessary skills to communicate effectively with their clients.
The professional’s own experience of bereavement can influence how they deal with death; it may also make them feel vulnerable or uncomfortable when talking about death and may affect how they communicate with parents. This is why reflective practice is very important.
“It brought it all back to me when I saw their distress, when I saw their dead baby, I could hardly breathe but I knew I had to do my job.” - Nurse
“It was one of the most difficult things I have ever had to do. Myself and my wife have just had a healthy baby boy, so I know the joy. Even though I could not have changed what happened, it was awful to have to change that joy to sadness by telling them their baby was dead.” - Doctor
Good communication will enable the professional to give information to the parents in such a way that they understand and remember what is being said. The parents will trust the professional and feel that they are involved in the decisions, which need to be made. Good communication will make a considerable difference to how parents manage the pending death and cope with their grief afterwards.
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