From my title you are probably wondering how the needs of patients with a longer length of stay vary from those with a shorter length of stay.  Today I was involved in a conversation about these patients and how pastoral care can best help them deal with the stresses they have in their lives.  I quickly realized as I looked at the specifics of several patients with lengths of stay over 10 days that each patient has their own unique story.  What would be helpful for one patient would not be helpful for another.

So instead of working a plan for care based solely on length of stay we needed to add more factors to our shaping the plan of care.  In looking at current patients I discovered that 3 of our long term patients I have been seeing three times a week.  I knew their stories, their hopes and their challenges. I also had some knowledge of their support network.  Then there were patients in clinical areas that I am not assigned to visit.  Those patients I knew nothing about them other than their name and length of stay.

We decided our first step in meeting the needs of long term patients is to do what I had already been doing on my units.  See them frequently and develop a relationship with them where we know their hopes, dreams, and also their challenges so we can provide them pastoral care that is tailored to their needs.  It was a healthy conversation and I have high hopes it will improve the care we provide.

This picture is not my hospital.  It does show a hospital with many parking spaces empty following a snow storm.  The snow storm today brought many changes to the Monday morning routine that are rare:

• Many parking spaces were empty.
• Many volunteers chose not to venture out in the weather.
• The normal line at the Pharmacy counter was non-existent.
• Patients received fewer visitors than is typical.

As I walked the hallways making my visits it reminded me of the pace we have on holidays like Thanksgiving and Christmas.  Many of the patients seemed much more interested in my visits and the visits lasted long, which meant in total I made fewer visits.  Then it hit, when the patients had fewer friends and or family members coming to see them they were in higher need of the companionship a chaplain can provide.

With continued snow in other areas along the Northeast this dynamic will be replicated in many hospitals on Tuesday.  I pray that chaplains in those institutions will be present to help patients deal with the unplanned and uncontrolled detachment from their support network.

Someone’s prayin’, Lord, kumbaya;
Someone’s prayin’, Lord, kumbaya;
Someone’s prayin’, Lord, kumbaya;
Oh, Lord, kumbaya.

I love to sing Kumbaya!  It is one of those songs that have many made up verses for it created by the leader of those who are singing it.  The verse I have printed today is not part of the original song.  It does fit my topic as I have altered it.  Our Sunday School lesson was focused on prayer and how to come to prayer with faith while at the same time not attempting to control God.  When people we love are sick sometimes are prayers are just that attempts to force God to bring a physical healing when God has another outcome waiting for the person we love.  I won’t attempt to explain why God’s outcome and our desires do not match.  I don’t think there is any universal explanation for that fact.

Everyone in our class agreed they had been in the situation of having to accept God answering prayer differently than they had requested.  Each person though still said they feel God hears prayer and they trust God to do the right thing.

Today in many hospitals and homes people are praying for healing for those they love.  Let us be mindful of their moments of concern and pray for them to accept what God is doing and keep their faith even if they don’t like the way the situation is turning out.

Today I received a Twitter message from a High School Student.  It was very neat to receive a portion of Scripture completely out of the blue from someone I cares about me.  Here is the passage that was sent: 1 Peter 5:7 Give all your worries and cares to God, for he cares about you.

It was a great reminder that even I can’t see anyone else around me there is someone who is with me who loves me, that person is God.  Even having God’s love and presence with me I still have to act responsibly and not make bad choices that are loaded with potential for harm.

All of us have the option that this High School Student exercised by sending me a Scripture quotation.  So for all who read today, be encouraged by the words of St. Peter!

At our Hospice I am the only assigned chaplain, which means I am on call 24/7 with the provision that if I am not available I can decline the call or postpone the referral to a time that meets my availability.  The exception to this policy is when I am on scheduled time off (ie. vacation) and we have a volunteer chaplain cover only emergency calls that arise in my absence.  I have recently started dating and don’t want to have to “run out” on the person I am dating because of a call.  So I have begun to ask some of our volunteer chaplains to be on “stand-by” when I have a date scheduled so I can refer the call to them.

Yesterday just as I was leaving to prepare for a scheduled date I received an urgent request for a chaplain home visit.  I called the volunteer who agreed to cover for me and he prepared to visit the home.  I value the caring relationship I have with our volunteers that allow me to engage in important leisure activities and not have to suddenly be back on duty.  Out of caring for our patients and their families I would have inner conflict simply turning down a request.  By being able to refer a request to someone who has indicated availability, I can pursue personal experiences and not feel guilty for being unavailable.

I have learned that being on-call 24/7 is not as easy as it sounds.  Then I think about God, who is available 24/7.  God must be very powerful and constantly renewed in energy to carry out that level of availability.  Being human and needing rest and desiring to pursue personal goals; I need time when I can be unavailable.  The relationship I have started has boosted my energy level and creativity and is actually empowering my chaplaincy ministry and my personal fulfillment.  So I am learning being unavailable can be a good thing not just for me but for those I serve.  This is only possible through the cooperation of our volunteers to whom I am very grateful.

My patient assignments include the most acute patients in our health system.  In the words of the patient, “I know I am doing to die, why doesn’t God just take me and get it over with now?”  When this question is asked of family members by the patient it produces an emotional response depending on the way the family members view the situation.

One time when I asked visitors and a patient how I could help them one of the visitors said, “Help me tell _________ to stop asking to die?”  With the tone of voice and the body language I could tell this was not the first time the topic had been discussed.  I responded by asking the visitor what had been said to the patient by the family when the request to die was voiced.

Below is a compilation of answers I have received from different encounters when this serious topic is being addressed:

• “Only God controls the time of our death, it is not right to question God”
• “Don’t talk like that _______ it makes me hurt.”
• “You need to have patience.”
• “Don’t give up maybe you will be the miracle patient and receive healing.”

Listening to the family member tell me what has been said before and watching the reaction of the patient and/or others in the room gives me clues about whether there is unity of opinion or a diversity of opinion on why the patient is still living.  Eventually though I have to open my mouth and respond.  Here are some principles I follow when I respond:

• I don’t put myself in the position of answering for God. (Who am I to say why God does what He does?)
• I don’t brush aside the question or make anyone feel badly the question has been asked. (I often find a way to point out that difficult moments in life are the ones that force us to lean on our faith and discover what we believe.)
• I find a way to inquire about what gives the patient a sense of worth. Often I find they don’t feel in the midst of their illness they are contributing to the well-being of their family like they had been able to in the past.  (I try to find ways to remind the patient that just being present can be a way they can be a comfort to their family even though they doing physical caring for the family in ways that are familiar.)

I hope this entry helps you the next time you have to think about why someone you love is “lingering” and how you can help them to have comfort and feel loved as their life continues even if it only continues for a few hours.

Today is National Hug Day!  I did not know it until I started getting Tweets about it on Twitter.  Hugging patients and their visitors is a part of my ministry as a chaplain.  Both when celebrating with families or sharing compassion with families; hugs can be effective.  Even when language is a barrier or we are at a loss for words, a hug can be the “universal language” that brings comfort.  Even though today is the designated National Hug Day any day is a good day to give a hug when the situation is appropriate for a hug.

Think about the last five times you have been hugged.  What message was that hug conveying to you?  Here are the situations of the last five hugs I have received:

• My son gave a text hug when I was offering him comfort for the cold he is fighting, he lives 800 miles away so the hug could not be done in person.
• I am dating a wonderful woman and I hugged her hello and good-bye when she was at my house last night.
• Today a church member saw me in the hallway and told me how glad she was to have me attending the church and gave me a hug.
• My boss gave me a hug as an offer of comfort as I was discussing my emotions over patients who have died recently while I was providing them spiritual care.
• An employee left the hospital for a new job and we hugged each other good-bye on his last day at the hospital.

I hope these examples of hugs prompt great memories for you of hugs you have received.

Typically when I am going to pray with a patient prior to surgery it is an unexpected event that is triggered by being paged by our Call Center.  Today I will visit a patient having surgery because I saw him in the hallway last week in the hospital.  He asked me to pray with him because of our relationship with each other.  Several years ago a patient died and because of her advanced age and the number of churches that have closed in Cumberland, her church no longer was in existence. (The building is not even standing.)  As a result of her death and lack of having a pastor I was asked to conduct the service.

He told me I gave him and others so much comfort in their time of grief he would appreciate me being there to give him comfort in his time of anxiety.  Today as I sip coffee and lounge in my recliner before going to work, I know there is at least one patient who is specifically expecting me to see them.  This is so different than the schedule of physicians who see a majority of their patients by appointment.  Most of my patient encounters happen without my knowing who I will see before the event happens.

This has been a nice change because I have already have thought of images I can use in the prayer that I know will be meaningful to the patient.  Some days I wonder, “What will God want me to do today?”  Today I know at least one of the things God wants me to do today!

Today I can’t mail a letter or visit many government offices.  That is fine by me!  That is because we are remembering the ministry of Martin Luther King and his laudable attempt to end racism.  Given that it has been many years since he gave his well known, “I Have a Dream Speech.” I am bothered deep in my soul by the protests proving racism still exists that have taken place in the last year.  My son lives in St. Louis, MO.  Specifically he lives less than 6 miles from Ferguson, MO.  I was there to see him for Thanksgiving in November.  The pain the entire greater St. Louis region was experiencing because of the issues of racism and the lack of trust being raised to a higher level was inescapable to notice!  For the first time in 34 years the live downtown Thanksgiving Day Parade was cancelled due to fears that participants would be injured by protesters.  I marveled that years of snow, freezing temperatures, rain, and sleet did not stop the parade.  But racism and distrust of law enforcement shut the parade down.  This does not seem right to me.  Right or not it is the reality we faced this Thanksgiving!

My prayer is that the observance of the MLK holiday this year will inspire us to be better controlled in practicing racism in 2015.  I also pray that trust for law enforcement will increase in 2015.  Most importantly I dream and pray that as a nation we will learn to live in peace and harmony with each other!!

In 1978 Andrew Gold released this song.  As I have been reflecting on the gifts of friendship I have from many people; today I am sending the lyrics of his song out to everyone who reads this blog as an expression of thanks for the friendships that I have been blessed with in my life!

Thank you for being a friend, traveled down the road and back again
Your heart is true, you’re a pal and a confidant
I’m not ashamed to say, I hope it always will stay this way
My hat is off won’t you stand up and take a bow

And if you threw a party, invited everyone you knew
Well you would see the biggest gift would be from me
And the card attached would say

Thank you for being a friend
Thank you for being a friend
Thank you for being a friend
Thank you for being a friend

If it’s a car you lack, I’d surely buy you a Cadillac
Whatever you need any time of the day and night
I’m not ashamed to say, I hope it always will stay this way
My hat is off, won’t you stand up and take a bow

And when we both get older
With walking canes and hair of gray
Have no fear even though it’s hard to hear
I will stand real close and say

Thank you for being a friend
Thank you for being a friend
Thank you for being a friend
Thank you for being a friend

Let me tell about a friend
Thank you for being a friend
Thank you for being a friend
Thank you for being a friend
Thank you for being a friend

And when we die and float away
Into the night, the Milky Way
You’ll hear me call as we ascend
I’ll say your name, then once again
Thank you for being a

Thank you for being a
Thank you for being a friend
Thank you for being a friend
Thank you for being a friend
Thank you for being a friend

People let me tell about a friend
Thank you for being a friend
Thank you for being a friend
Thank you for being a friend

Tell about a friend
Thank you for being a friend
Thank you for being a friend
Thank you for being a friend