Address emotional trauma of post-mortem C-sections
It is extremely traumatic for family members when both the mother and child are lost following a post-mortem cesarean, notes Renee Holleran, RN, PhD, chief flight nurse and clinical nurse specialist at Cincinnati Medical Center.
"You are dealing with an especially difficult situation because the family may not only lose the baby, but the mother, as well," she says. "This would definitely be considered a critical stress incident."
The scenario is also emotionally charged for staff, especially for flight nurses and other prehospital personnel who lose the mother in the field, says Cindy Jimmerson, RN, trauma/transport outreach coordinator for Community Medical Center in Missoula, MT. "First, they hit an emotional low, then have a high’ of hope that they can save the baby by maintaining the moribund mother," she says. "If they discover the baby will not survive, it creates another devastating low."
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Critical incident stress management is a must, stresses Jimmerson. "The loss of a parent, disruption of a family unit, orphaning of a child, or loss of an unborn life is so easy for each of us to relate to," she says. "It can be extremely painful, and will be disruptive to our work lives to try to assimilate this without help."
It’s best if this is done within 48 hours after the event, says Jimmerson. "This is an opportunity for the individuals involved with care to sit in a safe environment and talk about their role in the event and how they felt," she explains. "I like to describe it as an opportunity to unload emotional baggage."
Ideally, everyone involved in the event should participate, including prehospital personnel, says Jimmerson. "This kind of stress is cumulative. By unloading this baggage we can prolong our emotional life span, which allows us to continue to be effective in the kind of work we have chosen."
Critical incident stress management should be done for events that exceed the normal expectations of tragedy that is associated with working in the ED, Jimmerson recommends. "Examples of this include death of children, babies, pregnant moms, gross disfigurement, multiple victims, and violent crime," she says.
Observe your colleagues to detect when an event has exceeded the emotional capacity of the staff and suggest critical incident stress management, Jimmerson advises. "This is not about analyzing correct medical treatment," she says. "It is about care for the caregiver."
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