Managing Ambiguity When Caring for Women Who Stillbirth

Objective: To examine the interactions and social processes involved when nurses care for women who experience fetal demise and subsequent stillbirth. Design: Qualitative design using grounded theory. Setting: Single-site urban medical center in New York City. Participants: Twenty registered nurses who worked in the labor and delivery department. Methods: I collected data via in-depth interviews and recorded, transcribed, and analyzed the data using constant comparative analysis. Results: Managing Ambiguity emerged as the overarching preliminary theory to describe how nurses cared for women who experienced stillbirth. This preliminary theory included three themes: Experiencing a Spectrum of Emotions, Managing Patient Care in an Ambiguous Context, and Managing Institutional Ambiguity. These themes provided an overview of the creative/protective and avoidant/conflicted behaviors that nurses brought to their work with women whose fetuses died in utero and were stillborn. These interactions were complicated by institutional policies and additional factors, such as workload, that often denied nurses the resources needed to engage in the patient care processes required to address the trauma experienced by women and their families. Conclusion: The preliminary theory Managing Ambiguity provided a perspective on the experiences, behaviors, and social processes involved in caring for women who experience stillbirth. The absence of preparatory education, effective protocols, and institutional support contributed to the ambiguity inherent in caring for these women.

Automated summary

The study found that nurses faced challenges in managing emotions, patient care, and institutional policies when caring for women who experienced stillbirth. These challenges led to the need for nurses to navigate various creative/protective and avoidant/conflicted behaviors, while being constrained by institutional policies and factors such as workload.