Supporting yourself

Professionals often do not receive sufficient support to carry out the personally as well as professionally demanding work of supporting bereaved families. 

The need for staff training and support

Many professionals are concerned that they have not had sufficient or appropriate counselling skills training to offer grieving families the support they need. Professional carers need a clear understanding of the importance of setting boundaries in their caring relationships, both for themselves and for others.

"Though the experience of a child dying is relatively rare, many professionals feel that they do not know what to say or do. Training in this area is a crucial part of their professional development." Dr Bryn Neal, GP and CBC Trustee

"Thankfully the death of a baby or a child in the UK is relatively rare, but this means it is often completely unexpected and can leave the family and staff caring for them shocked and distressed. Staff  need to feel confident in their ability to provide the best care they can to the bereaved family. Good training that enables participants to reflect and learn from their own and others experiences, access accurate information and support those around them is vital."  Carolyn Basak, Midwifery Adviser to The Royal College of Nursing.

The chance to share feelings and experiences

All carers can benefit from sharing their own feelings and discussing experiences about particular situations with which they have been involved. They also benefit from hearing and learning about other people's experiences.

"If you realise that you are not the only person affected by the difficulty of knowing what to say to a grieving family, you feel less alone and more able to care." Abla Trebble, Nurse and Health Visitor

The chance to develop counselling skills

Developing counselling skills means learning how to be a better listener and how to communicate more effectively, which will help you to feel less inadequate in your work with bereaved families. An important part of developing counselling skills involves drawing on our own experiences and resources. Learning counselling skills is not the same as training to be a counsellor. For information on training to be a counsellor and what bereavement counselling may involve please see our article 'The role of the bereavement counsellor'  You may like to visit the website of The British Association for Counselling and Psychotherapy at http://www.bacp.co.uk/

"Certain areas of training need very sensitive handling, for example speaking to parents about the possibility of heart valve donation. We were so grateful that we had the chance to save Ryan's life." Ryan's mother, Oxford Heart Valve Bank, John Radcliffe Hospital, Oxford

"HIV has the potential to cause devastation within the family that few diseases can match. Young children may experience the loss of both parents, brothers or sisters. They themselves may be coping with increasing ill health. Professionals caring for these families clearly need to have access to appropriate training and peer support."  Julia Trott, Serology Specialist Nurse, Heatherwood and Wexham Park Hospitals NHS Foundation Trust

"Whilst GPs and health visitors believe they are the most appropriate people to do follow up care for those families whose child dies suddenly and unexpectedly, nearly everyone would value more training." Peter Flemming and Ann Dent, Department of Child Health, Bristol University

"No-one can imagine the shock, fear and distress of an expectant couple who have just been told their much wanted baby has a serious problem. Medical teams will endeavour to discuss options in a compassionate way and families will do as much as possible to help.  However, ARC with its network of trained volunteers, many of whom have had similar experiences, adds an extra dimension of support and information which I know from my own patients is highly valued.  Prof Dian Donnai CBE Academic Unit of Medical Genetics and Regional Genetic Service, St Mary's Hospital, Manchester - February 2007

The detection of an abnormality in an unborn baby is devastating for parents.  "Established in 1988, ARC is the only UK charity offering non-directive information and support to parents during antenatal screening and testing and when a problem is diagnosed in their unborn baby.  We give support for as long as is needed whatever decision is made about the future of the pregnancy.  ARC provides support through a national helpline, website and moderated online groups, a range of publications and a UK-wide network of volunteers trained to offer telephone support.  ARC recognises that the field of antenatal testing and its aftermath puts great demands on practitioners involved in caring for women and so we are keen that we work together to ensure parents receive sensitive individualised care.  We run a highly regarded training programme for health professionals which is informed by our contact with parents.  We also recognize the excellent work the Child Bereavement Charity does in helping professionals provide the best possible care to bereaved families."   Jane Fisher, Director of ARC - May 2007

What about support?

It is important that the professionals involved with a bereaved family work as a team and are able to offer each other support and understanding. Their need for support is not a sign of professional inadequacy or personal weakness, but rather a sign of maturity, recognising that you need help to do this work well. Most professional carers are very good at caring for others, but far less good at caring for themselves or for each other. If you know that one of your colleagues is involved in some stressful work, try to find the time to listen to them and how they feel afterwards. It can make an enormous difference to have a colleague that cares about you. This is no less important if you are a consultant or a manager.

"Tea pots need to be refilled if they are to carry on pouring cups of tea. Professionals and volunteers need to be cared for and supported if they are to carry on caring and offering support. Most people know this, but few actually do anything about it. The Child Bereavement Charity address this crucial aspect of bereavement care through its resources, courses, and support line."  David Trickey, Consultant Chartered Clinical Pyschologist

You will also find it helpful to be aware of the people in your hospital who are responsible for particular areas relating to bereavement, such as the mortician and the bereavement administrator. Communicating with them will help you to work as an effective team. It is only by adopting these practices that we will change the professional culture of medicine and nursing.

"I believe very much that I should support my staff and it follows down the line that they should all support each other. We had a young porter once who had come to take a baby away in a small white box. It was the first time he had had to do this and he was very distressed. We were aware of the situation and were able to help him." Jean Macdonald, MBE

"Nurses and midwives are often the first to be involved with the family after the loss of a child. The Royal College of Nursing fully supports the work done by the Child Bereavement Charity and values the education and support that has been provided to healthcare professionals over the last two decades"  Carolyn Basak, Midwifery & Women's Health Adviser, The Royal College of Nursing