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When goodbye comes too soon

Two nurses at Providence St. Vincent help coordinate a special conference to train other medical professionals about perinatal bereavement
by: JAIME VALDEZ, Nurses Lili Lobingier and Kathleen Grant look over some of the items in a memory book kit St. Vincent keeps for families who experience perinatal death. The two women are pictured in The Butterfly Room, a special area designated for families to say goodbye to babies who are no longer going to live.

Before a baby is born, parents-to-be have a seemingly endless list of things to do: pick out names, put cribs together, buy a ridiculous amount of diapers, take Lamaze classes, and on and on and on.

But what happens when that source of excitement doesn't survive, leaving everyone involved struggling to cope with such a huge loss?

Two labor and delivery nurses at Providence St. Vincent Medical Center understand just how devastating something of this nature can be, prompting them to lead a Perinatal Loss Bereavement Conference for health care professionals on Feb. 19 and 20.

Sherwood's Lili Lobingier and Kathleen Grant of Beaverton both insist the subject of baby bereavement is something not to be taken lightly for anybody, especially those in the medical field and that it is important to handle the subject with great care.

'We need to realize how important babies are to parents, whether they're born living or still and that they need to be all treated with the same dignity and respect,' said Lobingier, a 26-year veteran in the labor and delivery field.

With nearly 100 deaths out of the more than 6,000 babies born each year at St. Vincent, the staff of the hospital must learn to help patients tackle the emotions that come from such a devastating time.

Lobingier and Grant said young couples expect to bury their parents or grandparents, but rarely do they think about the possibility that they could have to say goodbye to their child. This means nurses must be able to guide the families through the grieving process and provide support. Often this involves connecting them with grief counselors and helping to create a scrapbook of keepsakes from the baby's short life.

'Our goal is to provide interdisciplinary holistic care so that we're meeting each family's physical, emotional and spiritual needs,' Grant said.

Everybody on the same page

Grant, who has spent all 24 years of her medical career at St. Vincent, said she and her colleague had been working on putting the conference together for close to a year. At first they only invited nurses from other Providence hospitals, but they soon opened the program to people from OHSU, Legacy and Portland Adventist hospitals. They even had someone from a Providence hospital in Alaska attend.

'It had been a dream of ours for about the past 15 years,' Grant said. 'Our overall goal was to be able to have each of our sister Providence hospitals' staffs come to the two day bereavement training part so that they could learn the basis of the results of sharing our RTS Bereavement Services program . . . and have everybody be on the same page.'

When the conference was first planned, the two women made arrangements to host 60 participants; once those spots filled, they negotiated to add 15 more to the total. Some of the topics touched on in the two-day event were how to make memory book kits (which are used to help gather mementos of the baby for families to take home), how to photograph parents with the body of their baby, how to communicate with grieving families and follow-up support for hospital staff.

A panel of parents who lost a baby also presented ideas for how health care professionals can help them as they go through this emotional experience. A third day event for 20 of the participants gave proper training to those wishing to be coordinators for similar bereavement programs at each of the represented hospitals.

'We really felt encouraged that there was so much interest, and that really spoke to how interested people are in this and made us feel good that there are so many who wanted to learn and . . . wanted to care for patients with a loss,' Grant said.

Attach before letting go

Part of the reason the two nurses feel this program is so important to have in place is because they have seen firsthand just how difficult the loss of a baby is for families to deal with.

'It's really hard if you haven't had training to walk through the door of a patient who has had a loss and know exactly the right thing to say and know in your heart what the right thing to do is,' Lobingier said. 'So it's really helpful for a lot of nurses to have training and have practice learning the communication skills and learning about the different stages of grief so that they can be there to be the presence for that family.'

Grant learned early on in her career just how difficult it is for most patients to handle the news of a baby's death, and during the conference she shares with others the emotional story of helping a young mother push her stillborn baby out of her womb. She said the mother was distraught and refused to continue pushing, only relenting once Grant helped her accept the loss by calling the baby by his name. This was a difficult experience for everyone involved, but Grant said it helped her understand the importance of hospital staff offering as much support as possible.

'I guess what it taught me is that there's an opportunity to make a difference in the life of families that have a loss,' she said - 'and that there is a need for bereavement training and for all caregivers to be consistent in that care, and so hence the dream of all of us getting the same training.'

One of the quotes used in the conference is: 'If you say my baby's name you'll make me cry, and if you don't say my baby's name you'll break my heart.' By remembering this, medical staff can remember that parents must 'attach before they can let go,' said Grant.

One of the ways patients at St. Vincent get to attach is by using the Butterfly Room, a special room put together by nurses at the hospital so families can have a private place to say goodbye to their baby before or immediately after its death. Dedicated in October 2005 and painted by NICU nurse Deborah Haigwood, the room features a place to lay the baby, a comfortable place to sit, a CD player and a sink so parents can give their baby a bath for what could be the first and only time.

Never gets easier

Lobingier said the task of caring for a mother who has just learned of her child's death is very difficult, but it becomes more manageable after receiving the proper training.

'It is very, very hard,' she said. 'I don't know if it ever gets easier, but it's so rewarding. And I think nurses that feel comfortable doing it should be the ones taking care of them.

'Even if you don't know what to say, simply sitting with the patient and just being a quiet presence is real helpful, because they can tell if you're uncomfortable.'

Grant agreed.

Helping families, she said, 'is so rewarding for me. I feel like I learn so much about life and strength and families, being with them.'