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Perceptions of Nurses Caring for Pregnant Women in Vegetative States

Fedorka, Patricia D. PhD, RNC-OB, C-EFM, CNE; Heasley, Susan Wallace MSN, RNC-OB; Patton, Carol M. PhD, RN, FNP-BC, CRNP, CNE

MCN, The American Journal of Maternal/Child Nursing: March/April 2014 - Volume 39 - Issue 2 - p 80–85
doi: 10.1097/NMC.0000000000000010
Feature: CE Connection
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Purpose: To explore the perceptions of labor and delivery nurses caring for women in persistent vegetative states with viable pregnancies.

Study Design and Method: For this qualitative research study, participants included a purposive sample of 13 RNs who provided bedside care to pregnant women in persistent vegetative states. The researchers simultaneously collected and analyzed data from the participants. When the researchers achieved saturation of the data, they presented their results to the participants for corroboration.

Results: The nurses reported both knowledge deficits and skill deficits in caring for this patient population. Nurses described emotional responses related to perceived limited support from administration, and reported seeking education from other sources. Although considered experts in labor and delivery care, the obstetrical nurses in this study reported feeling like novices when caring for patients with a diagnosis of persistent vegetative state. The nurses' caregiving concerns were found to originate in their ethical beliefs of beneficence and nonmaleficence.

Clinical Implications: When a patient presents to an obstetrical unit with an uncommon multidisciplinary severe complication such as vegetative state, the nurses perceived the need for support in order to give the best care. This includes education, a multidisciplinary team approach, and continued instruction throughout the patient's stay. Although nurses consider themselves experts within their practice area, they admit shortcomings when unusual complications are apparent.

While L&D nurses are real experts in their field of nursing care, what happens when they suddenly need to care for women who have neurological injuries requiring intensive care?

Patricia D. Fedorka is a Professor at Chamberlain College, Downers Grove, IL. She can be reached via e-mail at fedorka.pat@gmail.com

Susan Wallace Heasley is a Staff nurse at Forbes Regional Hospital, Monroeville, PA.

Carol M. Patton is a Parish Nurse, Healthcare Informatics, Associate Clinical Faculty, Drexel University, Philadelphia, PA.

For 150 additional continuing nursing education activities on maternal/child topics, go to nursingcenter.com/ce.

The authos and planners have disclosed no potential conflicts of interest, financial or otherwise.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins.