Levang Elizabeth, Limbo Rana, Ziegler Tammara Ruiz
Elizabeth Levang is a Psychotherapist, Levang & Associates, Inc., Golden Valley, MN. Rana Limbo is a Senior Consultant, Associate Director, Resolve Through Sharing Gundersen Medical Foundation, Inc., La Crosse, WI. The author can be reached via e-mail at
MCN Am J Matern Child Nurs. 2018 Jan/Feb;43(1):19-25. doi: 10.1097/NMC.0000000000000389.
Compassionate clinical practice guidelines for healthcare providers for respectful disposition after miscarriage are presented. When woven into the whole of a clinician's practice, these guidelines provide the framework for giving women and their families the care they want and deserve when experiencing miscarriage. Relying on theoretical concepts of personhood, place, and protection, care providers can assess the unique meaning a woman assigns to her early pregnancy loss and offer interventions that embrace the concept of respectful disposition. Respectful methods of disposition involve a continuum of care that shows respect for remains and relies on person-, family-, and culture-centered nursing care. Policies, practices, and perspectives that flow from respectful disposition have women and families at their core and flexibility to cocreate care. This involves courage and competence. Several states have enacted fetal disposition laws, but these mandates are of questionable benefit because the expertise of healthcare leaders, nurses, physicians, chaplains, and other stakeholders must be involved in this sensitive and important area of care. Compassionate care cannot be legislated. We offer a practical approach to respectful disposition, including how to handle and prepare remains and examples of burial and memorial services, which will give clinicians the ability to respond empathetically and respectfully to the heart-rending plea of a woman who asks, "Where is my baby?"
本文提出了针对医疗服务提供者的流产后尊重处置的同情性临床实践指南。当融入临床医生的整体实践中时,这些指南为女性及其家人在经历流产时提供她们想要且应得的护理提供了框架。依靠人格、场所和保护的理论概念,护理人员可以评估女性赋予其早期妊娠丢失的独特意义,并提供包含尊重处置概念的干预措施。尊重的处置方法涉及连续的护理,既要尊重遗体,又要依靠以患者、家庭和文化为中心的护理。源于尊重处置的政策、实践和观点以女性和家庭为核心,并具有共同创造护理的灵活性。这需要勇气和能力。几个州已经颁布了胎儿处置法律,但这些规定的益处值得怀疑,因为医疗保健领导者、护士、医生、牧师和其他利益相关者的专业知识必须参与到这个敏感且重要的护理领域。同情性护理无法通过立法实现。我们提供了一种尊重处置的实用方法,包括如何处理和准备遗体以及葬礼和纪念仪式的示例,这将使临床医生能够对一位女性令人心碎的请求“我的宝宝在哪里?”做出感同身受且尊重的回应。