In Today’s Issue:

🔗 The best resources I found this week
📖 Deep dive: Deep Dive: A 15-Minute Debrief Script for Nurses After a Difficult IUFD (Step-by-Step)

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Want to learn how to get Forget Me Not Boxes in your hospital? Reply “Bereavement boxes”

🔗 The Best Resources I Found This Week

🧠 STS and “I’m thinking about leaving L&D”
This paper zooms in on 144 L&D nurses at a Northeastern academic health system and connects the dots between STS scores and workforce impact.
Secondary Traumatic Stress Among Labor and Delivery Nurses​

🗣️ A 5-step debrief structure you can steal tomorrow
If you liked the 15‑minute script in today’s deep dive, this is the underlying framework.
Impact of the PEARLS Healthcare Debriefing Cognitive Aid on Debriefing Quality​​

📊 IUFD Staff Support Tracker – free download
To make this week’s topic as practical as possible, we created a simple IUFD Staff Support Tracker you can use to log which nurse was assigned to a demise, who followed up, when, and how. Link here.

📖 Deep Dive

Deep Dive: A 15-Minute Debrief Script for Nurses After a Difficult IUFD (Step-by-Step)

I recently had a call with a nurse at St. Luke's in Boise who shared something brilliant.

They keep a simple spreadsheet. Every nurse assigned to a demise goes on it.

Within 24-48 hours, someone reaches out. Not with a heavy conversation. Just acknowledgment.

"What you went through today was heavy. I appreciate you, and I'm here if you want to talk."

Here’s a link to a similar spreadsheet we created you can use as a template.

Why This Simple Step Changes Everything

Research shows that 35% of labor and delivery nurses experience moderate to severe secondary traumatic stress.​

That's more than one in three.

When nurses care for families during stillbirth, they absorb grief in ways that mirror the families themselves. They feel sadness, helplessness, and often question their own competence—yet they suppress these emotions to stay professional.​

Research by Dr. Marianne H. Hutti and colleagues shows that grief after perinatal loss can be intense and long-lasting, especially when the experience clashes with parents’ expectations and they feel unable to act or get support. Nurses who care for families after fetal loss report feelings of helplessness, grief, and emotional exhaustion that mirror some of the emotions associated with compassion fatigue. Because of privacy concerns and the culture of “staying professional,” this grief is rarely talked about openly, which can leave nurses feeling isolated in their experience. (Read her research here)​

And here's the paradox—the more skilled and compassionate a nurse becomes at bereavement care, the more vulnerable they are to psychological trauma. The nurse who stays present during those sacred moments, who creates beautiful memories, who provides the kind of care families remember forever? That same nurse is opening themselves to profound emotional impact.​

A single text message changes that equation. It tells the nurse: Your experience matters. We see you.

The 15-Minute PEARLS Debrief Script

The PEARLS Healthcare Debriefing Tool is an evidence-based framework used across hospitals to help teams process difficult clinical events. It stands for:​

• Promoting

• Excellence

• And

• Reflective

• Learning in

• Simulation

Originally designed for simulation training, it's now used for real clinical debriefs—including after stillbirth and infant loss.​

Here's how to use it on your unit.

STEP 1: Setting the Scene (2 minutes)

Gather the team who cared for the family. This can be the primary nurse, charge nurse, and any other staff directly involved.

Say this:

"Thank you for being here. The purpose of this debrief is to support each other and reflect on our care—not to judge or blame. Everyone's participation is welcome. We'll spend about 15 minutes together. Everything shared here stays confidential."

STEP 2: Reactions (3 minutes)

Start with emotions. Not clinical facts. Emotions first.

"How are you feeling right now?"

Let silence happen. Someone will speak.

Common responses: "Heavy." "Sad." "Drained." "I keep thinking about them."

Validate every response. Nod. Make eye contact.

"That makes complete sense."

STEP 3: Description (3 minutes)

Now get everyone on the same page about what happened.

"Can someone walk us through what occurred—just the facts?"

This isn't about judgment. It's about creating a shared understanding so everyone processes the same event.

Clarify any confusion. Fill in gaps.

STEP 4: Analysis (5 minutes)

This is where reflection happens.

Ask these questions:

• "What went well in our care?"

• "What was challenging?"

• "Is there anything we wish we'd done differently?"

• "What did this family need most from us?"

Focus on the work, not personal traits. If someone says "I felt so awkward," redirect to "What could help us feel more prepared next time?"

STEP 5: Application/Summary (2 minutes)

Close with forward focus.

"What's one thing we can take from this experience into our next shift?"

"Is there any follow-up anyone needs—whether that's more training, a conversation with someone, or just checking in tomorrow?"

End with gratitude.

"Thank you for the care you provided this family. And thank you for showing up here today."

Who Should Lead the Debrief?

This doesn't have to fall on one person. Here are five options:

1. Bereavement Committee Member – If your hospital has a perinatal bereavement committee, this is ideal. They're trained and removed enough to facilitate without being emotionally entangled.

2. Charge Nurse – They already have team oversight and can carve out 15 minutes for this. It also signals that leadership values staff well-being.

3. Clinical Educator or Nurse Manager – They're skilled facilitators and can identify if someone needs additional support.

4. Peer Volunteer Model – Designate 2-3 experienced nurses who've been through PEARLS training. They rotate as debrief facilitators when needed.

5. Chaplain or Social Worker – They bring expertise in grief and emotional processing, and they're often already embedded in bereavement cases.

The key is it's assigned. Not optional. Not "if we have time." Built into the protocol.

Simple Ways to Add This Into Your Process

Option 1: The Tracker System (St. Luke's Model)

Download the spreadsheet below. Assign one person—bereavement committee chair, educator, or charge nurse—to manage it.

Every time there's an IUFD, the nurse's name goes on the list. Within 24-48 hours, someone reaches out.

Text example: "Hey [Name], I know yesterday was really hard. Just wanted to check in. I'm here if you need anything—even just to vent. You did beautiful work."

Option 2: The 72-Hour Debrief

Schedule a brief team debrief within 72 hours of any stillbirth. Use the 15-minute PEARLS script above. Make it part of the protocol—like how you'd debrief a code or maternal emergency.​

One study found that nurses who participated in structured debriefs after perinatal loss showed significant decreases in distress scores and improved job satisfaction.​

Option 3: The Buddy System

Pair every nurse with a "debrief buddy"—someone they can text or call after a difficult case. It's informal but intentional. No one should have to process alone.

Option 4: Standing Debrief Time

Dedicate 15 minutes during weekly staff meetings for anyone to share about a recent difficult case. It normalizes the conversation and creates ongoing support.

What the Research Says About Why This Works

Debriefing interventions reduce secondary traumatic stress, compassion fatigue, and burnout among healthcare workers.​

But here's the critical piece—it has to happen early. Within 24-72 hours.

When feelings aren't addressed early, patient quality of care decreases, and loss of wages and turnover occur. Nurses start calling out sick. They request assignment changes. Some leave L&D altogether.​

One study of 144 labor and delivery nurses found that 35% met symptom severity scores associated with secondary traumatic stress. Those with scores ≥38 were significantly more likely to consider leaving their jobs after witnessing a traumatic birth (p < 0.001).​

Early intervention stops that cascade.

Dr. Joanne Cacciatore, creator of the ATTEND model for bereavement care, puts it this way:

Debriefing gives nurses space to feel. To honor the weight of what they've carried. And to know they're not alone in it.

Your Emotions Are Valid

If you've just experienced your first fetal demise—or your fiftieth—please remember this.

You are not meant to "get used to" this.

As one nurse shared: "When it gets easier, it's time to retire."

Your sadness is not weakness. Your tears are not unprofessional. Your need for support is not a burden.

Research confirms that the nurses who provide the most compassionate care are also the ones most affected by secondary trauma. That's not a flaw. That's the cost of showing up fully for families in their darkest moments.​

Take time to grieve. Debrief with someone you trust. Access support resources.

You deserve care, too.

👋 That’s a Wrap!

Before you go: Here are ways we can help your hospital

Education: Please share our newsletter with your co-workers. Our priority is empowering nurses with the tools to support patients with modern, evidence-based bereavement education.

Bereavement boxes: Our bereavement boxes were designed out of a need for a modern high quality solution for families suffering from miscarriage, stillborn, or infant death.

Reply to this email “Sample” to get a free sample sent to your hospital.

What we prioritize:

1. Tools for hospitals to create a bereavement experience for families to begin their grief journey

2. Educating nurses with modern bereavement standards and continuing education.

3. Helping hospitals build a foundation of trust and support, so bereaved families feel seen and cared for—now and in the years to come.

These boxes were born out of our own personal losses, including Jay’s (CEO) 15 years of experience working in labor and delivery as a CRNA and witnessing time and again how the hospital experience can profoundly shape a family’s grief journey, for better or for worse.

Until next week,

Trina and Jay
Co-founders of Forget Me Not

How did you enjoy today’s deep dive?

(Select one)

⭐️ It was extremely helpful and gave me new insight

👍 Helpful, mostly a good refresher

✅ I didn’t learn anything new, but it validated what I already do

😕 It missed the mark or I have feedback