Abstract:
In New Zealand, it is estimated that one in every five pregnancies end in miscarriage. Many miscarriages occur in general hospital settings. Research has suggested that emotional trauma related to miscarriage can be debilitating for many women. Despite this, there is limited evidence based information to guide nurses on how to respond to women’s emotional needs. The aim of this study was to explore the challenges nurses face when caring for the emotional needs of women experiencing miscarriage in a hospital setting. I used my own practice as a focus of inquiry. The portfolio is comprised of three key parts: a literature review, an autoethnographic study and a critical reflection. The purpose of the literature review was to identify what is known about emotional needs of women experiencing miscarriage in a hospital setting and the role of nurses caring for such women. Results indicated that women’s emotional responses to miscarriage are diverse. To be effective, nurses need to take an individual approach to each woman. In the second section, I used autoethnography to investigate my experiences of caring for women going through miscarriage with particular focus on challenges I face responding to their emotional needs. I wrote three narratives based on my practice and reflected on these through layered writing and thematic analysis. For ethical reasons, my insights are presented in the form of fictional vignettes and associated stories that capture challenging moments in my practice. I also created two poems in response to my narratives. Findings show that miscarriage is a complex, unpredictable and emotional experience for the women and their nurses. To provide effective culturally sensitive emotional support to the women, selfawareness was essential. Coping strategies such as mindfulness, debriefing, clinical supervision and critical reflection were recommended for me and other nurses. The third section contains a critical reflection based on four patterns of knowing; personal, aesthetic, ethical and empirical knowing with comment on how emancipatory knowledge can improve the nursing care of women experiencing miscarriage in a surgical unit. Through critical reflection some insight was gained on how nurses respond to women’s emotional needs. Social and political barriers that need change were therefore uncovered. Strategies to improve nurses’ practice through clinical supervision, debriefing and mindfulness were suggested. Overall, the portfolio found that nurses need emotional support in form of clinical supervision, debriefing and mindfulness to effectively respond to emotional needs of women experiencing miscarriage in a hospital setting. Recommendations are made for further research on emotional care of women experiencing miscarriage in a hospital setting in New Zealand.