I intentionally chose the image of the light bulbs with only 1 bulb lit and the others dark.  For me it provides a visual of how we feel when we experience a change that we have not chosen, but because it has happened we now have to decide how we will respond to the change.

I attended a workshop this week on the changes in life cycles for churches.  The point of the workshop is that once a congregation reaches the point of decline, the decline will continue until something is done turn the direction of the church.

As I reflected on the workshop the next day between patient visits I realized that when patients face sudden change in their health status they encounter challenges similar to those that congregations experience when they start to decline.

Let me share one of the types of change a patient can face and two different ways they can respond to the change.  Let’s call this patient “Bob” to personalize the experience.  Bob has just learned that his diabetes has decreased the blood circulation to his leg.  Infection has developed that antibiotics can’t eliminate.  Left untreated the infection will circulate through the rest of his body and he will die.  The physician has just defined the change.  The choices of how to move ahead will the result of collaboration between Bob, his family, and the medical staff that are caring for him.

I have listed below 5 Facets of Change that we have to deal with as me move forward.  I will use Bob’s situation to show how we integrate these facets into addressing the change.  In Bob’s case the change is the declining circulation in his leg and inability of pharmaceuticals to eliminate the infection that has developed.

Five facets of change to be dealt with once you define the change:

• Communicate the change
• Manage the change
• Deal with the change
• Relate to the change
• Lead the change

The first facet has already taken place.  The physician has communicated the change to Bob and his family.  They have been explained the best option for extending his life is amputation of his leg.  The other option is to decline the surgery and prepare for his death to happen much more quickly than he would like to happen.

Bob and his family discuss what his life would look like if he had the amputation.  He could be fitted with a prosthetic leg and be able to continue to enjoy most of the things he finds pleasurable in living.  Bob also struggles with the reality that he does not want to have a prosthetic leg; he wants the leg “God gave him at birth”.   This is the facet of managing the change.  Bob and his family look at the result of both having the surgery and not having the surgery.  Both options before him are not ideal, but he has to choose one.  If he makes no choice the infection will move through his body and he will die anyway.  If he makes a choice he retains some control in the process.  If he lets nature take its course he declines to make a decision.

Bob seeks many sources of comfort and assistance in making this decision.  He hears from physicians, family members, friends, and also asks the chaplain to visit.  Bob feels overwhelmed at all the information and differing opinions he has received.  The physicians feel the surgery is the best option.  His family is divided, some feel the surgery is must while others can see how Bob can justifiably decide between surgery and letting the illness proceed without surgical intervention.  As a chaplain I engage Bob in a discussion about his beliefs and how his faith is influencing how he feels.  Bob admits his core belief is that at his age he does not want to deal with the surgery and recovery process.  He has lived a good life, and dying from an infection is no better or worse than dying from any other illness.  He will miss his family and knows they will miss him.  He knows if he decides against surgery he will be pressured by some to change his decision.  He feels he is in God’s hands and that God has given him a good life.  He is ready to move toward the change from earthly life to eternal life.  In this process Bob has decided how he will deal with the change.

Bob realizes now the hardest part of the change process is about to commence.  He is going to have to share his decision and experience the reaction of people whom he loves to what he has decided.  This is the process of relating to the change.  He will undoubtedly be asked why he is declining surgery by many people.

The final facet of change is how he will lead the change.  This will involve the process of saying good-bye to many people.  It will involve deciding what measures of comfort care he is willing to receive and the setting in which he will receive them.  Arranging for people to care for him as he gets weaker will have to addressed.  The hardest part of leading the change will be dealing with resistance and complexities of taking care of all the steps in this process.  For anyone in his situation it is a process he has never been involved in before and because it is new there are moments where fear will creep in.

I could have just as easily written this scenario with Bob making the choice to have the surgery.  While the outcome would be the different the facets in facing the change would be same.  I used this example to hopefully stimulate a discussion about the significant changes my readers face and how effectively they use the 5 facets of change to aid them in the process of responding to change.  I know this blog article is significantly longer than most of my articles.  I thank you for bearing with me and reading this entire post.

The church that hosted the workshop now has to decide how they will handle the 5 facets of change as they prepare for their future.  My prayer for them is that they will find a path that leads them to renewal and a new phase of dynamic ministry.

Today I attended a funeral visitation for a friend whose son had died. Deaths of child are some of the most difficult deaths for people to experience. In this example the family had done everything to care for their child impeccably through his whole life. The have the peace that they know there was nothing more they could do for him. They are also strong in their faith and believe he is in Heaven even as they a grieving his death.

At the visitation there was nothing profound that anyone said that brought comfort. The family indicated most comforting thing was the number of people who took time from their schedule to come to the funeral home, stand in line, and then offer heart-felt expressions of love and support to the members of the family. Anyone who attended the visitation probably wished they at a more enjoyable activity. What they may not realize is the gift of their presence at that precise moment was a gift of grace and love to the grieving family. I am glad to see so many people chose to make time to give that gift to the family as they grieve their loss.

Yesterday and today I tried to make a follow-up visit to a patient who was originally seen by one of our On-Call Chaplains.  Each time I went to see her our Patient Transport staff was in her room preparing to take her for a test.  Since I know the patient believes in the power of prayer I asked the staff to allow me a few minutes to pray.  The patient appreciated the prayer but the whole visit lasted less than 2 minutes each day.  I am really hoping that on Thursday I will be able to have a visit with a long enough length of time that it can be meaningful for the patient.

This is one of the surprising dynamics of hospital chaplaincy.  Even though the patient is an in-patient and in our building 24 hours a day, getting a chance to see the patient can be a challenge when the patient is having diagnostics or surgeries that have them outside of their room.  I know that is aware of my diligence in trying to have a quality visit and until we can have a longer visit this will have to suffice.

This week is Volunteer Appreciation Week.  Our local newspaper published a picture of a volunteer who plays the piano in our hospital lobby every Friday.  I am not able to post that image because it is not downloadable from the publication’s web page.  So I have used a stock image for this post.

Volunteers make a huge difference in every area of the hospital.  Even though people generally feel chaplains are in place for patients and visitors, we are also in place to provide spiritual care for employees and volunteers.  In addition we have volunteers at our hospital that provide spiritual care for patients in these roles:

• Volunteer On-Call Chaplains
• Volunteer Prayer Partners
• Volunteers who call churches to notify them of members who are in the hospital.
• Eucharistic Ministers who provide the Sacrament to Roman Catholic patients.
• Volunteers who help with various pastoral care mailings.

As a chaplain I am thankful for the times that volunteers help me and I am also glad for the times when I can provide direct spiritual care to volunteers when it is requested.  The next time you encounter a hospital volunteer take a moment to thank them for sharing their time.  It is guaranteed to put a smile on their face!

Today in church I was told about a cartoon of one of my favorite characters “Dennis the Menace”.  In the panel Dennis and his Mom were leaving church and greeting the pastor at the front door.  Dennis asked the Pastor, “Are you sure Moses only had 10 Commandments?”  The pastor replied, “Yes”.  Then Dennis replied, “So why then does my Mom need 100 rules for me?”

Dennis appropriately noticed that human beings were not able to behave as God wants us to with the 10 Commandments and so other laws have been developed.  Even though Dennis represents children, Dennis in this comic strip is also representing adults because adults also have demonstrated the need to have more than 10 Commandments to guide our behavior.

So my challenge today is to be as astute as Dennis when it comes to monitoring my behavior.  I know I will mess up, that is what human beings do.  But I know when I mess up, I can ask God to forgive me, and I know that God will.  That is the good news by which we are all saved!

I spent two days this week at an education event which had an emphasis on the important of listening as people tell their story.  In many stories people choose to tell you can gain insight into the subtext which they have not told.  In many cases being able to give voice to these subtext stories can produce the most emotional healing and benefit for the person.  So for a chaplain or other care provider to recognize where there is a subtext story and invite the person to discuss it processing the memory can produce emotional healing.

One the most stubborn impediments to listening is the fact that many times we are in the process of forming our response before the person we are listening to has completely finished their sentence.  Effective listening includes waiting to even form a response until the person who is speaking has finished what they are saying.

The event was very helpful to me and I can see that it will assist me in being a better chaplain in the future.  The lesson from the event can help anyone be a better listener and have more substantial conversations with those people we meet.  Here is a test of how well you listen.  The next time you are listening monitor yourself and see if you start to form your response while the person is still speaking.  If you do that, then you need to resist the urge to form your response until the person is done speaking.

On the NBC news this week several stories have been broadcast about Blue Zones.  A Blue Zone is the name attached to several hot spots around the world where people have the longest longevity of life.  The Blue Zones organization studies what dynamics create this longevity and then introduce them to communities who want to improve the longevity and health quality of their population.

One new city entering this program is Fort Worth, Texas.  One of the learnings from Blue Zones is that consumption of red meat (including beef) needs to be kept in a proper proportion to the other foods you eat.  Fort Worth is in the heart of “Cattle Country”, so suggesting any reduction in the consumption of red meat is an upward battle.  But the community with the support of Blue Zones is taking on this difficult assignment as a way to make their community a healthier place to live.  I have to applaud any group that works to improve the health of others.  It was good to learn about their work by watching the evening news this week.

I have never had a PET scan.  I have been with many people who have gone through this diagnostic procedure.  One of the things they share in common is wondering what the result of the scan will be.  They also wonder what treatment will be suggested when they consult with the oncologist.  This image example of a PET scan image.  It is funny how when the image is of a stranger you can look at it with curiosity and wonder.  When the image is your image or the image of someone you love the intensity of emotion that you feel and the fear of what you will be told increase exponentially.

When being with patients I seek to find from them what gives them comfort.  Many reply that just having someone with them so they are not going through the experience alone makes all the difference.  Others depend on their faith and have everyone they know praying for them.  When I offer a prayer you can see expression contentment come across their face.  The tools of presence, listening and when requested – prayer, can make all the difference to someone who is facing the unknown ahead of them.

I have often dealt with patients who have just begun physical therapy.  They tell me they know it is important but doing the therapy is painful and exhausting as they begin.  I have always told them that their therapist won’t push them farther than it is safe for them to go.  I have also encouraged them that as time moves forward and they have more practice the exercises will become easier for them.

Now I am involved in a 12 preparation for a 5K run.  Today starts week three.  For the first week we ran 30 seconds and then walked 30 seconds for 20 minutes with a .5 mile walk prior to and following run/walk sequence.  The second week we used the time of 60 seconds in place of 90 seconds.  Now this week we will be using 90 seconds as our time interval.

Just as I start to feel comfortable with the routine, the routine changes becoming progressively more exerting.  Now a lot of the comments patients have made to me about their therapy make a lot more sense to me.  In addition to the physical health benefits of this class, the class is making me a better chaplain for my patients.  Literally it is hard to understand what some really feels until, “you walk a mile in their shoes”!

I visit a lot of patients who have experienced surgeries that had a desirable outcome.  Even though when I see them they still pain from the incision area they express genuine gratitude for the surgeon and others who take care of them.  The picture above which was not taken at our hospital illustrates this dynamic.

Grateful patients I often think are unaware of the gift they give to the members of their treatment team.  Everyone likes to be appreciated.  That is true regardless of your occupation.  Healthcare becomes a more demanding environment to work in each year.  So in a more demanding environment when a patient shows genuine gratitude it gifts a sense of reaffirmation to those who feel called to their role in healthcare.

One way patients can shape the atmosphere in healthcare is to show gratitude when it is deserved.  It inspires the providers to continue to give excellent service and at times encourages them to go to a higher effort to produce comfort for their patients.  When I see a staff member come out of a room smiling, they take that smile into the next patient’s room.  Gratitude is powerful when shared and not nearly as difficult to share as the benefits it produces.