Like most of the pictures I have used this is a stock picture from the internet and not a picture of an actual patient from our health system.  (Privacy rights prohibit the use of pictures of actual patients.)  This week I have had to let of patients who have died.  While this happens every week, this week was different.  I had not realized it but I had bonded with some of the patients and their families more deeply than I realized.  As a result of that the death of the patient caused more of a personal emotional reaction inside me than I expected.

So I have found myself using the advice I give to families on how they might want to process their grief in the days ahead.  I will be attending one of the funeral visitations.  I have been praying for several of the patient’s families as I have seen the sad expressions on their faces, have seen their tears and know that they had a strong bond of love with the patient who has died.

I write about this just to let readers know that health care employees in all areas (nursing, physicians, therapists, and specialty technicians) all face the process of letting go of patients they have grown close to during the treatment process.  Even if the staff member does not tell you how much the death of the patient has affected them you can be sure if a bond was built that the patient will be remembered many times following the death.  I consider it a privilege to be able to spend enough time with patients and their families that these emotional bonds are formed.

I am a member of a work group that is planning on how mentors can help participants in a new program that is being started.  At our second meeting we looked at several drafts of the job description of a mentor.  At the outset this seemed like an easy task to me.  We would pick the description we like best and then edit it to include good ideas from the other submissions.

As we looked at the material we realized that in many cases a mentor can be seen as either being an expert or in some way being superior to the person they are mentoring.  Neither of these images were what we had in mind for the program we are designing.  So we settled on the title “Ally” in place of the word mentor.  An ally is someone who is rooting for your best interests.  An ally is someone who will listen and give you feedback.  An ally will share from their personal experience and then not try to force any specific response on the person they are working with.

Now our problem is what term to use for the person the ally is assigned to work with.  We are looking for a title that does not set up a hierarchy between the ally and the person they are paired to work with.  Some options we looked at are: navigator, pathfinder, and seeker.  We closed our time together still thinking we had not discovered the term that best fits what we are trying to design.

Following the meeting I thought about all the times people have been allies to me without there being a formal assignment or job description.  I think many of us have gained benefit from relationships like this in our lives.  If this article reminds you of an ally you have found valuable, why not reach out and thank that person for being there for you?  They will find it a boost to their day and also an encouragement to be in that ally role for you or for others in the future.

One of the policies of our health care system that I receive the most complaints about is our 100% no smoking policy on any property whether you are outside or inside a building.  The policy is logical to me since the dangers posed to non-smokers from second hand smoke are documented.  Also as an institution dedicated to improving health it would be inconsistent to encourage being healthy and encourage smoking at the same time.

Everyone once in a while a patient tells me they are glad we have a no smoking policy.  This always gets my attention.  Hearing people speak favorably about the policy is an infrequent event for me.  Several patients tell me that after a hospital stay of several days when they have not smoked they have a resolve to continue to cease smoking when they are discharged.  I have not done any record keeping to be able to tell you what the percentage of patients is who resolve to cease smoking.  I have no data on how many are able to keep their resolution when they are discharged.  I love the idea that our enforced no smoking period is helping patients make a change in behavior that not only helps improve their health but also helps improve the health of those around them.

In the worship service today the pastor reminded us that Easter is quickly approaching.  She issued the congregation the challenge to make Holy Week (The days from Palm Sunday through Easter Sunday), a spiritually meaningful time by increasing our focus on God and the spiritual disciplines.

I chose the graphic above because it illustrates how difficult change and be even when they change we are trying to make is beneficial.  As I sat in the pew and contemplated what I could do personally to make this time meaningful ideas would come to my mind and then I would immediately realize I probably would not be able to make them work for one reason or another.

This blog entry does not offer an answer.  It just continues to put the challenge I received in worship in front of the readers of this blog.

Yesterday I wrote about the first day of Spring and how the weather resembled Winter more than it did Spring.  Today the weather is bright and sunny and it feels good just to be outside in the open air.  I reflected on this and thought, “What a difference a day makes?”

As I reflected on my change in attitude in the weather it reminded me of the change in mood in patients when they start to feel better than when they entered the hospital.  Here some comments I receive from patients that tell me they have improved during their stay:

• “I thought I was going to die last night in the Emergency Room, who would have thought all I had was heartburn?”
• “When I learned I had a stroke I felt my life was over. Now with therapy I am going to be okay, I’ll just have to take things more slowly.”
• “When I heard the word ‘dialysis’ I was sure my days were numbered. Now I have been on treatment for 2 years and I find the treatments have given me the blessing of continuing to watch my grandchildren grow.”

All of these encounters have caused me to remember a simple but true statement: Don’t put a period where God has placed a comma.  I am going to try to remember this outlook as I move forward in life.  I invite you to join me!

Each day I encounter patients who know their date of discharge is approaching.  Patients fall into two basic groups when they learn this information:

• Those who are thrilled to be going home.
• Those who are afraid about how they will manage when they are back at home.

Ministry to the first group is easy because I love celebrating good news people.  These conversations are full of smile and laughs.  Many times the patient is already wearing their “street clothes” and have all their belongings in bags piled on top of the bed.

Ministry to the second group is more difficult because the joy in the first group is replaced with fear and anxiety in these situations.  I always ask the patients to describe to me why they are feeling the way they do.  The answers to this question vary however some of the most common concerns mentioned are these:

• I don’t feel strong enough to transfer from the bed to the wheel chair on my own.
• I won’t be able to drive immediately and worry about being home and not being able to get something I need from the grocery or drug store.
• My children live too far away and/or lack enough vacation time to spend a few days with me so I can see that I can make it at home.

None of these concerns are frivolous in nature.  All of them should be a part of the discharge planning process.  Our Care Management Team does their best to address these concerns when designing a discharge plan.

So as a chaplain what is my role in helping the patient cope?  I can’t be their live-in care assistant, I can’t be the shuttle that brings them things they want or need from stores.  I certainly can’t step in and take the role of their children.

I see my role as letting the patient express their concerns verbally to an impartial listening ear.  I see my role as reminding them of their faith beliefs (that is in cases where we have discussed this topic), and simply asking them what resources they do have that they might use.  If it is appropriate I offer to pray with them.  In instances where the patient has given me information that I am not sure Care Management has heard, I ask the patient if I have their permission to talk to the manager on their case.  In some of these situations I am given the care manager information that changes what is felt to be appropriate to the discharge plan.  In summary, I try to give the patient encouragement and affirmation as well as listen to see that important keys to the discharge plan have not been overlooked due to miscommunication or any other reason.  Patients like the fact I take time with them and show a genuine interest in their fears and anxiety.  Often they tell me that just our conversation has made them feel better.

When a patient is rushed to a surgery on an emergency basis, each moment the patient is away from the family seems to drag for the family.  That is why I chose the picture in today’s post because so clearly depicts what family members are feeling.  During the course of a week I usually spend time with several families who are in this uncomfortable situation of waiting for news following the surgery.

While each situation has unique specifics most of them also share these details in common.

• The family was shocked because the condition of the patient changed so quickly when the need to call the ambulance arose.
• When only one family is waiting with the patient they experience emotions of being alone and wishing someone special to them was waiting with them at the hospital.
• Family members consider what they will do if we are not able to save the patient’s life and restore their health so they can go home again.

Sometimes the person waiting wants to discuss one or more of these thoughts.  Sometimes the person wants to wait in a prayerful silence.  Sometimes the person needs to expel their anxiety through a lot of conversation.  I am there to let the person do what they need to do to help them cope the best they can while they are waiting.  The family members who are waiting find words to let me know they were glad they did not have to wait alone.  The gift of presence in time of stress, what a great gift I am allowed to give through my ministry as a Chaplain!

In High School I took Latin as a foreign language for 4 years.  Along with learning the words of the language we learned the history that took place while it was in use.  One of the most famous days in history is The Ides of March.

Wikipedia defined the day with these words:

The Ides of March is a day on the Roman calendar that corresponds to 15 March. It was marked by several religious observances and became notorious as the date of the assassination of Julius Caesar in 44 BC.

Anyone alive in the Roman Empire knew where they were when they learned of the assassination of Julius Caesar.  When I meet families at the time of death I observe that the date and time they learned of the loss is written indelibly in their memory.  Death, no matter the cause, is a profound event in our lives.  The actions of processing the information, dealing with the flood of emotions we feel, and wondering what we should be doing next are all things people deal with at a time of loss.

I feel blessed that as a Chaplain I am able to be with families at this time to offer spiritual comfort and presence.  I also help the family with questions they have about protocols for how the deceased will be transferred from our facility to the funeral home.  I also look out for their comfort needs which sometimes include getting them a beverage and at other times may include making a phone call for them.  If they seek a better understanding of what happened medically, I arrange for one of the staff involved in direct care of the patient to come and explain how they death happened.

Death is never an easy event to process.  However anything I can do to help people in their time of stress and confusion is a ministry that is necessary and brings meaning to my work.  Many times later as I encounter these people months later I hear from them how my ministry was a blessing to them in a time of terrible emotional pain.  I can’t imagine what it was like for the person who filled the role of Chaplain for Julius Caesar’s family, but I am sure they like every family were grateful for any comfort and consideration they were given.

Image One

Image Two

Some people love to talk and others prefer to listen.  Anyone who knows me is aware I love to talk!  In some visits talking it not the primary tool I use because the patient is not able to talk.  In order to gain insight into how the patient is feeling I look at the patient’s eyes.  The way they are positioned along with the eyelids and eyelashes gives me important clues into how the patient is feeling.

Look at image one in this post.  The eyes project an image of calm and contentment.

Look at image two in this post.  The eyes project to me an image of concern and/or pain.

If the patient is unable to speak but is able to respond to questions I use a different set of questions depending on what visual clues I gain from looking at the eyes.  Very rarely do the eyes lead me astray in my assessment of the patient.

Try it today as you encounter people, look at their eyes (without staring) and see if their eyes are matching their mood as they describe how they are feeling!

Another day of cancellations due to snow!  Many school children love the sound of those words.  Adults on the other hand don’t find repeated snow storms all that enjoyable.  We had a snow day in our area today.  As I encountered people these are some of the problems the snow storm caused that were explained to me.

• Patients were lonely because their loved ones could not come due to the weather and the roads being dangerous to drive on.
• Volunteers did not come as scheduled meaning some tasks were not done and meaning that others had to be taken on by others.
• Patients with outpatient appointments called to reschedule their appointments to a day when the weather would less of an issue. This left some employees with sections of their day when they were not as busy as they would like to be.

It is obvious to me that we are generally ready for winter to end.  It is also obvious to me that people are doing the right thing.  When they feel at risk by driving in the snow, they change their plans and stay home.  Part of being a chaplain is listening to those who have been effected by the snow tell their story and vent their frustration.