Managing Ambiguity: Nurses Caring for the Mother of a Stillborn Baby

<p><strong>Abstract</strong></p> <p><strong>Purpose</strong>: The aim of this study was to describe and conceptualize the experiences and processes involved when labor and delivery nurses provide care to women experiencing<strong> </strong>a stillbirth.</p> <p><strong>Background</strong>: The care of a woman experiencing a stillbirth is an important topic that requires attention, however, there is a paucity of literature on the specifics of a nurse’s experience as she or he cares for a grieving mother. These experiences may shed light on gaps in care that may exist as well as gaps in the resources, education and support needed to appropriately prepare nurses for providing care to a mother at such a difficult and vulnerable time. Stillbirth is increasingly referred to in the literature as a traumatic death, unexpected and unplanned, resulting in post-traumatic stress responses. Understanding what the bedside nurse does, thinks, and feels during these moments of traumatic bereavement will contribute to a greater understanding of the nurse’s experience of providing care to a patient.</p> <p><strong>Method</strong>: This study used a grounded theory approach. Data were collected via in-depth interviews with 20 labor and delivery nurses. Each interview session was recorded, transcribed verbatim, and analyzed using the constant comparative method of analysis.</p> <p><strong>Results</strong>: Based on the inductive method of grounded theory and a thorough comparative analysis of the data, the theory <em>Managing Ambiguity</em> emerged as the basic social process of how nurses struggle to care for a mother whose baby was stillborn. This theoretical underpinning summed up the substance of what was occurring when nurses cared from a mother experiencing a stillbirth and was characterized in three different categories by labor and delivery nurses as <em>Experiencing a spectrum of emotions, Managing the ambiguous patient, and Managing institutional ambiguity</em>. These factors contributed to the overall ambiguity the nurse had to manage when providing care for the patient whose baby was stillborn and became the three main categories of the overall theory:</p> <p><strong>Conclusions</strong>: This theory of <em>Managing Ambiguity </em>provided a perspective on the experiences<strong>,</strong> behaviors, and social processes involved in caring for a woman delivering a stillborn baby. This theory also provided insights into how the interactions between the nurse and herself, the nurse and the patient, and the nurse and her environment impacted the process and the meaning of the event. The importance of this study is the resulting understanding of factors that impede and enhance the process of providing care to a mother whose baby was stillborn. Feelings of uncertainty, ambiguity, and discomfort must be addressed at the nursing education and nursing leadership levels.</p>

Name thesis:degree_name

Doctor of Philosophy

Level thesis:degree_level

Doctoral

Discipline thesis:degree_discipline

Nursing

Grantor

The Graduate School and University Center of The City University of New York

Year dc:date.available

2018

Author dc:creator

• Nurse, Natasha J

Advisor dc:contributor.advisor

• Barbara DiCicco-Bloom

Committee members dc:contributor.committeemember

• Arlene T. Farren
• Rana Limbo
• Donna Nickitas
• Barbara Gail Montero

• Maternal, Child Health and Neonatal Nursing
• Nursing Midwifery
• stillbirth
• ambiguity
• labor and delivery
• perinatal loss
• stillborn

Repository record dc:identifier

https://academicworks.cuny.edu/gc_etds/2483

OAI identifier oai:identifier

oai:academicworks.cuny.edu:gc_etds-3556