title: Reorientation of care in the NICU.
abstract: Where possible, both parents should be present whenever bad news is broken. Professional calm and carefully chosen words are essential. Staff must be aware of cultural and religious beliefs of the family, and should be cognizant of linguistic and educational capabilities. The unexpected collapse and death of an infant is rare but is exceptionally demanding on communication skills. Time must be given for the family to ask questions, and staff should acknowledge the tragedy and the uncertainty, but should convey a determination to discover the truth for the family. A predictable deterioration allows staff and family to work together towards a "guided consensus" over future management. Compassionate care involves time, comfort and dignity for the child and parents. It is crucial for the family to receive empathetic support from senior nursing and medical staff. Mementoes may help the grieving process. Necropsy may also play an important role in allowing the families to rebuild their lives.
authors.affiliation: Simpson Centre for Reproductive Health, Royal Infirmary of Edinburgh, Edinburgh, UK. ian.laing@luht.scot.nhs.uk
authors.forename: Ian A
authors.initials: IA
authors.lastname: Laing
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Freer
mesh_terms: D001291:Attitude of Health Personnel; D001293:Attitude to Death; D001344:Autopsy; D001601:Bereavement; D003643:Death; D004645:Empathy; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008297:Male; D010166:Palliative Care; D010290:Parents / Q000523:psychology*; D011368:Professional-Family Relations; D014342:Truth Disclosure