In order to balance the load of caring for perinatal loss families equitably among our staff, we had set up a rotation for loss assignments. However, we discovered a problem.. Women returning from maternity leave were being assigned to a loss their first day back, as it was, after many months off, “their turn.” Our goal was to find a fair solution for returning staff members.

Our “loss book” had each person’s name and date of the last loss assignment. The charge nurse would check to see who had been the longest without caring for a loss family.  Pregnant colleagues were “excused” from these assignments once “showing.” After 5-6 months of pregnancy, then 3 months of leave, upon returning, it was this nurse’s turn. Nurses complained it was difficult enough to leave their baby and readjust to work. In the spirit of shared decision-making, the Bereavement Council issued a letter to the staff asking for their input:
The survey was sent out asking what they considered an acceptable “grace period” after maternity leave before being assigned a perinatal loss patient?  Suggestions ranged from the day of return to a request for 4 weeks grace time.

Caring for families who lose a baby is a rewarding, but emotionally draining assignment for obstetric and neonatal nurses. Cultivating new ways to care and support each other to reduce the risk of burnout and emotional bankruptcy is a professional commitment all nurses should make. Making reasonable accommodations for nurses returning to work after leave of absence, while not required at the expense of unit functioning, improves employee satisfaction (Koviack, 2004), and support from co-workers reduces stress in the workplace (Glozier, Hough, Henderson, & Holland-Elliott, 2006). By using a shared governance model to uphold accountability in our profession, we were able to determine our own practice.

The staff survey results were markedly split. Fifty percent believed that if a nurse was ready to return to work, the nurse should be able to take any assignment, as bad outcomes could happen at any time. The other 50% recommended a 2-4 week “grace period” before being assigned a perinatal loss.

Although research has demonstrated different values between generations (Widger, et al, 20007; Apostolidis & Polifroni, 2006), there was an equal split for and against a grace period either by more experienced vs. less experienced obstetric nurses. Although one might expect a higher percentage of new mothers/childbearing age nurses to recommend a grace period, as returning to work carries unique stressors (McGovern, et al, 2007), there was an equal split between nurses of childbearing age vs. nurses past their childbearing years.
Our council’s decision was to compromise and give 2 weeks grace when returning from a maternity leave. To encourage personal accountability, it is the nurse’s responsibility to place her date of return in the book so the charge nurse is aware she has 2 weeks before a loss assignment.