UNLV School of Nursing alumnus Matthew Mastalski has been a nurse only since February 2020 and already has dealt with two end-of-life situations with child patients in the Pediatric Intensive Care Unit at University Medical Center (UMC).
Whether it’s two or 200, he says, the outcome is always difficult. “There are no words that you can tell a parent that will make the situation OK,” says Mastalski. However, with the help of UNLV Student Nurses Association (SNA), UMC is introducing a new program to ease the bereavement process for both families and those caring for them.
The Precious Prints Project provides a physical memory of a child for grieving parents. The program originated at the College of Nursing at the University of Tennessee-Knoxville (UTK) in 2011 and spread to area hospitals. Earlier this year, UTK nurses came to Las Vegas to train UNLV students to administer the program, who then trained the staff at UMC, where the Precious Prints Project is now officially underway.
The program enhances what a nurse is required to do in difficult situations — comforting a distraught family while balancing their own emotions with their professionalism.
A Chance for Closure
The hospital’s child life specialist stores the Precious Prints kits until the unfortunate situation arises where a child dies and a kit is requested. Cassandra Ricci is a certified child life specialist at UMC. Her role primarily focuses on the patient’s psychosocial needs, specifically their coping, understanding, and adjustment to the hospital experience. During end-of-life situations, she focuses her coping and grief support on the family.
Ricci knew of programs like “Precious Prints” and was encouraged to see it introduced, saying, “This is, to me, the first truly tangible, beautiful item we can provide the families.”
After a child dies, the specialist will take the patient’s finger and roll it onto a clay mold. The mold is placed in a protective case and sent to Precious Metal Prints in Tennessee, where it’s turned into a sterling silver pendant. The first pendant is sent for free to the family. There is no obligation to wear it or even look at it, but it is there for them.
“We don't ever want to force something on a family,” Mastalski explains. “At that moment, their child has just passed away; it’s hard to face that. We have to present [the kit] to the family, and that can be difficult.”
Samer Abu-Huntash, a level 3 UNLV nursing student who attended the SNA training this year, says Precious Prints is designed to provide closure for the parents. “The child touched the pendant, and now that goes with them,” he says. “Part of the child is with them always.”
Professional But Human
While Precious Prints is designed to comfort families who lost a child, it’s just one part of the bereavement process. A healthcare professional still needs an appropriate level of composure when interacting with a patient’s loved ones in the face of tragedy, but there is a fine line of being professional but human.
As Mastalski puts it, a nurse may need to temporarily compartmentalize their emotions without neglecting a mourning family. “You have to still be a nurse,” he says. “You still have patients. As soon as that patient is gone, you will have another one to fill that space. But you have to take the time to sit down and show your emotions to the parent.
“Even though the patient is gone, their family is still there, and they're still someone you need to take care of until they leave the hospital.”
Ricci says she values the ability to connect on an honest level. “We want to display a professional, put together form of ourselves,” she says. “At the same time, it's important I'm not cold, that I'm not flat, that I am true to who I am. I continually remind myself if I get emotional or need to step out of the room, that's OK.”
Mastalski says there is a debriefing process following a patient’s death. Aside from assessing the facts, it is a chance to talk through the pain in a group setting. At home, Mastalski manages his feelings by talking to his own family, his partner, and relaxing with his dogs. He stays attuned to unexpected triggers.
“I had a patient die unexpectedly,” he recalls. “Then, I was watching TV, and I saw a kid that looked exactly like her. It was just a teenager, texting on her phone. Those moments just overwhelm you a little bit, and you just breathe through them.”
Ricci copes sometimes by crying or by walking away. She also credits her co-workers at UMC and friends for providing an essential support system. Stability is critical, she says.
Mastalski has seen some health professionals shield themselves for self-protection but at the risk of seeming emotionless. Mastalski affirms, “Any day that a child is sick, you have to care. Otherwise, you shouldn't do it.”
Reminders of Love and Care
The Precious Prints Project is relatively new, so it’s still too early for substantial feedback from families who have received kits. But it’s already had an impact on those who deliver them.
“I feel like it adds another level of care to what I provide,” Mastalski says. “At the darkest time for a parent or family, it allows me one more way to give something finite, something they can remember. [It’s] an experience that while not positive, is reassuring and comforting. They know they can look back and remember the care that was given to their child. They can remember, at the last moments that their child is on earth with them, that we understood, and we had a way that we can give to them.”