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Your bereavement program should include critical incident stress debriefing for care providers, says Darlene Bradley, RN, MSN, MAOM, CCRN, CEN, director of emergency/trauma services for University of California-Irvine Medical Center in Orange.
"Generally, we don’t expect children to die, but when it happens, stress debriefing helps staff come to terms with the death and to review any measure of care that could be bothersome to the provider," she suggests.
When Bradley was working with a team resuscitating an infant who appeared to be a victim of sudden infant death syndrome, the mother of the baby had just returned that week to work after a prolonged maternity leave. "The mother had done everything right, even leaving the baby in the care of a very competent child caretaker skilled in CPR," she says. "This case affected every nurse in the department."
Long-term accumulations of stress can lead to physical and mental problems as well as burnout, Bradley warns. "Providing the staff a chance to address their fears, concerns, anxieties, or guilt can prevent the disorders seen from chronic stress."
Peer support groups are also helpful, says Bradley. "These programs assist the providers in working through their feelings about loss and death."