The Meaning, Experiences, and Behaviors of Nurses Caring for Women With a Perinatal Loss

Objective: To explore the experiences of obstetric, postanesthesia, and emergency nurses in caring for women after fetal death. Design: Qualitative study using focus group (FG) interviewing. Setting: Two large, acute care hospitals with level 3 nurseries. Sample: Four FGs were conducted involving 24 total participants. Participants were registered nurses currently working in labor and delivery, antepartum, postanesthesia, and emergency departments who have been employed for at least 1 year and had experience in caring for a patient with fetal loss. Methods: The FG questions were carefully constructed based on the major concepts of Swanson's Theory of Caring: open‐ended, clear, appropriately sequenced, and supportive of the group process and response maximization. Participants also completed a brief demographic questionnaire. Interviews were audio‐taped, transcribed verbatim, and deidentified. Transcripts were then uploaded for coding by research team members. Analysis was conducted using a continuously emergent process of data collection, reduction, display, and interpretation. Team members coded the transcripts that were then compared for agreement. Any discrepancies in coding and theme identification were resolved through discussion and group consensus. Results: Nurses in all areas of specialty demonstrated Swanson's nurse caring behaviors but used them preferentially according to situational exigencies and level of rapport developed with the patient. Themes that emerged from the data included Strategies for Coping in the Moment, Making Meaning of the Experience, Situations That Make Care Easier, Situations that Make Care More Difficult, and Priority of Care. Symptoms of compassion fatigue described by nurses included anger, intense sorrow, feeling incompetent, overwhelmed, exhausted, inconsolable, and having a desire to avoid patient care. Conclusion/Implications for Nursing Practice: Nurses who are indirectly exposed to trauma through their work are at high risk of developing compassion fatigue. There is limited research to identify whether nurses in obstetrics, emergency departments, and postanesthesia units who provide care to women who have experienced fetal death are at increased risk of developing compassion fatigue. Nurses try very hard to give the best care they can to women after fetal loss. In doing so, they make themselves vulnerable to compassion fatigue. Further research is needed to identify ways to support nurses as they provide care to these traumatized patients.