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A nurse from the University of Illinois Medical Center asked the Preeclampsia Foundation, "What do you think we, as nurses, could do to support patients when they are in a situation (preeclamptic pregnancy) similar to yours?"
We wondered aloud and nearly three dozen survivors responded via Facebook and our online Community Forum to share their experiences and provide their suggestions to the nursing profession. While there was very vocal appreciation for the majority of nurses who have cared for our women, there were also many helpful suggestions. Based on patient input, here are:
Top 10 Ways Nurses Can Support Preeclampsia Patients:
1. Know the symptoms, educate your patients. Know how dangerous preeclampsia can be, know the full breadth of possible symptoms, and be proactive about diagnosing and managing it. The Foundation's motto "Know the Symptoms, Trust Yourself" is targeted at pregnant women, but as healthcare providers, you can help those of us who may not know the signs and symptoms.
2. Be willing to listen and learn. We know your shifts are busy and your demands are many, but listen to us, your patients. Don't ignore symptoms we report. Be willing to be educated and educate us also. Tell us about the Preeclampsia Foundation so we can get additional support and more information.
3. Don't be a victim to common medical errors. Medical acuity is always important in the hospital setting. With a syndrome as complex as preeclampsia, the details definitely matter! Common medical errors such as taking BP in the wrong position, retaking it until you find a pressure you "like", or not staying on top of delayed test results, can add stress to our already traumatic experience.
4. Be sensitive to vulnerable emotional states. Don't hold it against us or inadvertently make it worse. With or without perinatal loss, there is often great emotional strain on the patient and family; different family members may be feeling different emotions from one another (e.g., fear, sadness, anger, relief, emptiness, joy) or be focusing on conflicting factors (i.e., mom vs. baby). We do appreciate the care you are giving to us, but may not be in the best frame of mind to make that clear to you.
5. Shower us with compassion and kindness. Even though some patients may drive you nuts with their demands and "high maintenance", survivors of complicated pregnancies have additional physical and emotional traumas, are often in severe pain, and are usually shocked by any bad outcomes during childbirth. Please show us extra compassion and be patient with our needs. Your actions will be forever remembered. Remember that magnesium sulfate makes us feel horrible! "I think it was the little things that I appreciated, like helping change my daughter's diaper or helping me with her first bath. That is stuff we really want to be a part of when we are feeling better and strong enough." "One nurse in the ICU washed and braided my hair for me - it was a small gesture, but it did make me feel a lot better."
6. Be aware of post traumatic stress disorder (PTSD) risks inherent in complicated pregnancies. Even without longer term PTSD, there will likely be short-term emotional pain, beyond post partum depression. And the dads are not immune, although they may look stronger in the short term. Even without a formal screening process, nurses can play an important first line of defense to help us be aware of the impact preeclampsia may be having.
7. Be aware of the impact that your shift and location changes can have on patients. As with any hospital patient care, there are almost always opportunities to improve team communication among healthcare providers, especially during shift changes, to ensure standards of care are upheld. In addition, if we're transferred post-partum to another ward, the original labor and delivery nurses can play an important role in the transition by sharing sensitive emotional care information to other staff.
8. Be honest with us. Tell the truth . . . but with compassion, friendliness, and caring. Don't tell us not to worry, but tell us what we should be looking out for.
9. Help patients and their families cope with a loss or having a baby in the neonatal intensive care unit (NICU). Nurses can devise a way to alert visitors and all health care staff that there has been a loss (e.g, hang a small wreath on the door) or that baby is in the NICU, preventing inappropriate comments and questions. Similarly, please be sensitive to what we may overhear from nearby happy-outcome families. "I was put on the ward with women who had delivered healthy living babies...that was the worst experience of my life. I thought I would die just from the emotional pain."
10. Remember that your patients may be struggling with feelings of guilt for having failed at pregnancy. Nurses may directly or inadvertently contribute to this misplaced guilt by suggesting that we could have eaten more/less/different foods, exercised more/less, weighed more/less, etc. "Bugging me over the should/would/could haves will only make things more painful!"
California Maternal Quality Care Collaborative
Preeclampsia Toolkit Review and Patient Support
September 25, 2015
Dignity Health Summit, Las Vegas, NV
October 1-2, 2015
Grand Rounds - Tampa General Hospital, Tampa FL
October 28, 2015
March of Dimes Prematurity Prevention Conference
Crystal City, VA
November 17, 2015
11th Annual Texas Conference on Health Disparities
Ft. Worth, TX
June 9-10, 2016