Tuesday, November 6, 2007

This presentation is part of : Women and Children Healthcare Issues
Action through Leadership in the Office Setting: Promoting Sensitive Care after Perinatal Loss
Melanie Chichester, BSN, RNC1, Patricia Drake, MSN, RNC2, Lydia Henry, BSN, RNC1, Cheryl Swift, RNC1, and Barbara Temple, RNC1. (1) Labor & Delivery, Christiana Care Health System, Newark, DE, USA, (2) Department of Nursing, University of Delaware, Newark, DE, USA
Learning Objective #1: Identify 3 supportive interventions for ancillary office staff when caring for the woman who has experienced a perinatal loss
Learning Objective #2: Identify 3 non-supportive actions of ancillary office staff when caring for the woman who has experienced a perinatal loss

Women who have attended a perinatal loss support group have voiced complaints about what they perceived as insensitive staff. This study was undertaken to determine what mothers’ expectations were of the ancillary office staff. Surveys were mailed to all those who had attended a local perinatal loss support group during the period from 1999-2004 who had experienced a loss from 16-41 weeks gestation at least one year prior to the survey. Participants were asked what helpful and non-helpful things were said and done by the office staff. 88 surveys were sent out with a cover letter explaining the purpose of the survey. Consent was assumed if the survey was returned. No follow up calls or letters were sent so as not to distress those who declined to participate.

Supportive interventions identified by the mothers included:
o     Being aware/Acknowledging the loss
o     Offering support/compassion
o     Sheltering the woman from exposure to pregnant women

Non-supportive actions identified included:
o     Failure to acknowledge the loss
o     Avoiding patient contact
o     Allowing them to wait with pregnant women

Returning to the OB/GYN office after a perinatal loss can be difficult. Women expect the office staff to be aware of the loss, and to be compassionate and sympathetic when they present for care. Nurses who work in an office setting have the opportunity to teach ancillary staff members, including licensed practical nurses, nursing assistants, and clerks, and to teach appropriate statements and actions to promote sensitive care for the woman who has experienced a perinatal loss. Developing a communication system to identify women who have experienced a perinatal loss further promotes excellence in care when such a vulnerable patient returns for follow-up care.