Wednesday, December 31, 2008

Psychological Impact of Infertility

One of my biggest complaints about my first infertility clinic was the lack of individual care. The compassion scale was set at about a -10. Every time I went there I was seen by a different nurse who I had to explain my situation to, where I was in the process, etc. Nurses play a critical role because a patient is examined by them more than the doctor. I probably could have gone to medical school after my experience. I also did not have my own doctor. There were five in the group and it all depended on who was available that day. This not only included exams but the actual IVF procedures. To me that is just as upsetting as a woman's OB being on vacation when she goes into labor. It is not very helpful to someone who is emotionally unstable and needs support and guidance. I suffered many losses and ups and downs during my infertility care. The people that were supposed to be helping me the most actually ended up contributing signifcantly to my feelings of loss and hopelessness.

This article was taken from the website:
It is advice to nurses working in the infertility field. If you don't find that your medical professionals are taking this advice, speak up or move on. You need to rely on empathy and personalized attention to get you through infertility.

Couples experiencing infertility seek many different types of treatments. This increases the opportunity for nurses to encounter these patients, making it crucial for nurses to be prepared to address their physical and emotional needs.
Because of the increasing technological advances of infertility treatment, nurses are often more comfortable discussing the technical aspects of care. When nurses put more emphasis on technology, couples may interpret this as insensitive and uncompassionate. To effectively meet the needs of these patients, nurses need to be technically proficient while at the same time able to connect on a personal level.

Nurses must assess the needs of the individual as well as the couple. Individuals experiencing infertility often move through the grieving process. Men and women do this in different ways, which can make decision-making challenging. Some research has shown men are more likely to choose ART for their partner than for themselves. Having a child is often more of a life goal for women, and they are more likely to initiate treatment as well as undergo the risks of experimental and painful treatments.
If treatment has been unsuccessful, couples are faced with the decision to either continue treatments or make other choices. Choices include adoption, either domestic or international, foster care and living child-free. It is important to recognize that all of these options are difficult decisions to make. Couples need to grieve the loss of their own child before they move forward with their decision making. Nurses must be sensitive to the fact that adoption may not be an acceptable choice for some couples and the process to adopt also is not easy.
Additionally, couples who desperately wanted to have children of their own may decide to live child-free after experiencing years of struggles and failures. In any case, couples must be treated with respect and support through their decision-making process. They may have come to peace with their decision and comments that contradict their personal resolution may be psychologically damaging.

Helping Couples Cope

Similar to living with other chronic illnesses, infertility can consume a great deal of physical and emotional energy. You may be in a position to help couples make decisions about how to expend their limited energy.
Some helpful advice may include encouraging couples to conserve energy by turning down invitations to situations that may be difficult for them, such as large family gatherings or events where they may feel uncomfortable if they may be asked about plans for a family. Social withdrawal is common among couples with infertility due to the stress and pain they are experiencing.
One of the best strategies in working with these patients is to offer to listen to their concerns. Although it is tempting to share every positive outcome of others you know who have gone through infertility treatment, try to keep these stories to a minimum.
Couples going through infertility treatment are well aware there are success stories, but they have not yet had this experience. Sharing the success of others can make them feel like more of a failure if they have already had an unsuccessful outcome with a similar treatment. As a nurse, you can explain to infertile couples that others often share these stories because they are uncomfortable and don't know what to say.
Undoubtedly, nurses play pivotal roles in helping address the unique needs of these patients. With an increased understanding of the infertility process, nurses can be better prepared to provide emotional and compassionate support to couples during every stage of their journey.

Stacy L. Lutter is assistant professor of nursing, York College of Pennsylvania, York, PA.
References for this article can be accessed at
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