A newborn in the neonatal intensive care unit (NICU) is dying as ...

[olgavictoria]

A newborn in the neonatal intensive care unit (NICU) is dying as a result of a massive infection.
 
  The parents speak to the neonatologist, who informs them of their son's prognosis. When the father sees his son, he says, He looks just fine to me. I can't understand what all this is about. The most appropriate response by the nurse would be:
  a. Didn't the doctor tell you about your son's problems?
  b. This must be a difficult time for you. Tell me how you're doing.
  c. To stand beside him quietly.
  d. You'll have to face up to the fact that he is going to die sooner or later.

Question 2

After giving birth to a stillborn infant, the woman turns to the nurse and says, I just finished painting the baby's room. Do you think that caused my baby to die? The nurse's best response to this woman is:
 
  a. That's an old wives' tale; lots of women are around paint during pregnancy, and this doesn't happen to them.
  b. That's not likely. Paint is associated with elevated pediatric lead levels.
  c. Silence.
  d. I can understand your need to find an answer to what caused this. What else are you thinking about?

[jgranad15]

Answer to Question 1

ANS: B
The grief phase can be very difficult, especially for fathers. Parents should be encouraged to share their feelings as the initial steps in the grieving process. This father is in a phase of acute distress and is reaching out to the nurse as a source of direction in his grieving process. Shifting the focus is not in the best interest of the parent. Nursing actions may help the parents actualize the loss of their infant through sharing and verbalization of feelings of grief. You'll have to face up to the fact that he is going to die sooner or later is a dispassionate and inappropriate statement.

Answer to Question 2

ANS: D
The statement, I can understand your need to find an answer to what caused this. What else are you thinking about? is very appropriate for the nurse. It demonstrates caring and compassion and allows the mother to vent her thoughts and feelings, which is therapeutic in the process of grieving. The nurse should resist the temptation to give advice or to use clichs in offering support to the bereaved. In addition, trying to give bereaved parents answers when no clear answers exist or trying to squelch their guilt feeling does not help the process of grief. Silence probably would increase the mother's feelings of guilt. One of the most important goals of the nurse is to validate the experience and feelings of the parents by encouraging them to tell their stories and listening with care. The nurse should encourage the mother to express her ideas.

[olgavictoria]

Gracias!

[kjohnson]

Excellent