PBC Case Analysis & Practical Application 3 — Questions and Answers
Question 1: A Muslim family requests that the stillborn baby be buried within 24 hours per their religious tradition, but the hospital requires a 48-hour waiting period for paperwork. What is the bereavement coordinator's best action?
- Explain that hospital policy cannot be altered for individual families
- Advocate with administration and legal to expedite documentation to honor the family's religious needs (Correct answer)
- Ask the family to request a religious exemption from the state health department
- Suggest the family bury a symbolic item while waiting for the body
Correct answer: Advocate with administration and legal to expedite documentation to honor the family's religious needs
Advocating to expedite documentation demonstrates culturally competent care and respect for the family's religious obligations.
Question 2: A nurse is assessing a couple after their 32-week stillbirth. The father says he is 'fine' and focuses on logistics, while the mother is openly crying. How should the nurse interpret this scenario?
- The father is in denial and needs immediate psychiatric evaluation
- People grieve differently; the father may be expressing grief through problem-solving while remaining emotionally distressed (Correct answer)
- The father does not bond with pregnancies as strongly as mothers do
- The nurse should focus support entirely on the mother
Correct answer: People grieve differently; the father may be expressing grief through problem-solving while remaining emotionally distressed
Grief expression varies between individuals and genders; task-focused behavior is a common coping style and does not indicate absence of grief.
Question 3: A family's 26-week infant dies in the NICU. The parents ask to bathe and dress the baby themselves before transferring to the morgue. Which response reflects best practice?
- Decline since only trained staff should handle deceased infants
- Support the parents in bathing and dressing their baby as a meaningful ritual (Correct answer)
- Allow it only if the charge nurse approves in writing
- Offer to take photographs but decline the bathing request
Correct answer: Support the parents in bathing and dressing their baby as a meaningful ritual
Supporting parents in bathing and dressing their baby validates their parental role and creates meaningful memories.
Question 4: A bereavement volunteer is visiting a family two days after a second-trimester loss. The mother says, 'I feel like I'm going crazy — I keep thinking I hear the baby cry.' What is the best response?
- Suggest she speak with a psychiatrist about these hallucinations
- Normalize this experience as a common grief response and offer continued support (Correct answer)
- Encourage her to distract herself with activities to avoid these thoughts
- Document the hallucinations and notify the clinical team immediately
Correct answer: Normalize this experience as a common grief response and offer continued support
Auditory grief experiences such as hearing a baby cry are common, normal grief phenomena and should be normalized rather than pathologized.
Question 5: Hospital staff failed to identify a room as one where a bereaved family was staying, and a new nurse entered cheerfully asking about the 'new baby.' The family was devastated. What systemic change should be prioritized?
- Require all nurses to review the full patient census before entering any room
- Implement a standardized room-marking system such as a leaf or butterfly symbol to indicate bereavement (Correct answer)
- Discipline the nurse who entered incorrectly
- Move bereaved families to a separate wing away from postpartum patients
Correct answer: Implement a standardized room-marking system such as a leaf or butterfly symbol to indicate bereavement
A standardized room-marking system alerts all staff to approach sensitively before entering, preventing inadvertent harm.
Question 6: Parents of a baby with a lethal fetal diagnosis are considering continuing the pregnancy for palliative care. What is the bereavement specialist's role at this stage?
- Advise them to consider termination to avoid prolonged grief
- Begin birth planning and help create a palliative care plan that reflects their values and wishes (Correct answer)
- Defer involvement until after delivery
- Focus only on preparing the parents for the baby's death
Correct answer: Begin birth planning and help create a palliative care plan that reflects their values and wishes
Beginning birth planning and helping create a values-aligned palliative care plan is the bereavement specialist's role in perinatal palliative care.
Question 7: A nurse notices that a colleague consistently avoids entering rooms with bereaved families and delegates those assignments. What is the most appropriate initial response?
- Report the colleague to administration for neglecting patient care
- Have a private, empathetic conversation with the colleague and offer to co-navigate a bereavement room together (Correct answer)
- Reassign all bereavement cases away from this colleague permanently
- Assume the colleague is managing a personal loss and make no comment
Correct answer: Have a private, empathetic conversation with the colleague and offer to co-navigate a bereavement room together
A private, empathetic conversation and co-navigation offer support for the colleague's discomfort while building capacity for bereavement care.
PBC Case Analysis & Practical Application 3
A Muslim family requests that the stillborn baby be buried within 24 hours per their religious tradition, but the hospital requires a 48-hour waiting period for paperwork.
What is the bereavement coordinator's best action?