This week due to some special projects and an increase demand of my time for hospice patients I have not been able to do as much visiting of hospital patients as I would like to do.  Today I began my rounding in the hospital with a sense of enthusiasm and a desire to see as many patients as I could.  Initially my enthusiasm was drained because the first three patients that I could speak with declined pastoral care for various reasons.  I know this was not a personal rejection of my, but with my emotions so fully loaded to see as many patients as I could three patients consecutively declining pastoral care was unexpected and downright unpleasant for me.  I began to ask myself, “Why am I here where there are other things I could be doing back at the office?”  I answered myself quickly by reminding myself of how few hours I had been rounding in the hospital and that there surely were patients who would desire a visit and benefit from our time together.

The very next patient I visited responded with these words once I identified myself and why I was in her room. “I am so glad you came, I need someone to talk to.”  Needless to say my heart jumped when she stated not only could we visit but told me she needed a visit.  We had a very positive visit and I felt like I had really improved her day.  One of the measures I am using to measure this is while I was in her room physical therapy came in and offered to help her walk, she said we were not done yet and asked them to come back later.  Then a social worker came into the room and she told the social work the same thing.  This patient did not realize it but she gave me a gift of reminding me, just when I needed a reminder, that pastoral care does matter greatly.  It is up to me not to get discouraged when some patients are not up to having a visit for whatever reason.  There is always another patient who is waiting for pastoral care.

If you have discouraging days in your job, try to remember times when others have affirmed your work.  Then like I was, you will be renewed for the tasks you are attempting to complete.

Our weekly meeting in Hospice for the staff is titled “Team Meeting”.  It is the only opportunity all week where the nurses, administrators, social worker, medical director and chaplain are in the same place.  We review those patients who have been admitted and those who have been discharged.  We also discuss patients that have a change in condition.  This conversation has the sole goal for us to provide all the appropriate resources available to the patient and family members and/or care-givers.  This week I had two patients that I needed additional consultation on to help me make sense of what I was observing.  This week two staff asked me specific questions on how I handle situations with patients from the perspective of chaplaincy.  I told them the best way to describe me to a patient is, “A companion on the journey who will show empathy and affirmation.”  They were surprised because they would not have on their own chosen those words to describe how I support families and patients.

Being someone who gives affirmation and shows empathy is not something only chaplains are capable of doing.  Most of us have those tools.  The question is how often do we think to use them?  I hope reading this post helps you keep affirmation and empathy at the top of the list of how you support the people you encounter whether you find them as part of your employment or in a leisure setting.

I apologize to those who have become accustomed to a daily message on this blog.  The last two nights I have been out attending to families at the moment of the death of a beloved family member.  Late evening is generally when I blog.  I hope you will see a new post tomorrow!

Our Sunday School Class today focused on the role of reconciliation in our lives.  Reconciliation benefits both people or both sides of “the divide”.  In my dealings with families I deal with some where one or more members are not reconciled with the rest of the family.  As I listen to the stories about the divisions I have empathy for those involved because I know their lives could be more joyful if the issue that caused the separation could be resolved.  In Sunday School we learned that it almost always takes each person being willing to forgive the other person for reconciliation to blossom.

Sometimes illness can be a catalyst that moves family members to forgiveness because they don’t want the animosity unresolved.  Sometimes this is evidenced when a dying parents tells two adult children to please get past their differences so I can die knowing you will be there for each other.  When this situation arises and one of the children engages me in a conversation about the request of the dying parent, it is an emotional experience for the child and also for me as the chaplain.  Instead of ignoring my emotions I use them to guide how I respond to the person as they share their story.  In many cases the person is seeking some justification that they have a right to be upset with their sibling.  If they ask me if I agree I generally can relate with why they felt hurt and can affirm the event or events that caused the separation are legitimate reasons to be upset.  Then I go a step further and ask them if perhaps they have held onto the pain long enough and maybe now is the time when they could let go of it.  When you look at past hurts, they share one thing in common: they are in the past.  Nothing we do now can change the event for erase the pain that has been felt.  But if we ask ourselves the question, “Do I want to be burdened by this pain into the future?” we learn surprisingly the answer is “No”.  Once we reach that point then describing what actions would be required to grant forgiveness can happen.  In my experience no one will really move toward forgiving someone until they reach the point of wanting to be unburdened.

I’ll ask the same question our Sunday School booklet asked: “Is there someone you need to forgive today?”  Is so, what is stopping you from taking the first step?  It is a good question to think about as you start the path of living reconciliation in your life.

One day recently I was at my desk entering documentation of patient visits.  One of my friends from the Information Technology Department came to my desk and said I was just the person he needed to see.  I asked him, “So did you visit me because you felt like receiving a prayer today?”  He smiled and said no he had a question about our records of patient visits.  He had been asked by a manager in our institution to determine how many patients receive pastoral care visits and how many patients have a visit attempted but the visit does not actually take place.  (Reasons for attempts to visit to not succeed are cases where the patient is with another staff member, the patient is having a procedure conducted in their in their room, or the patient is not in their room – which generally means they are having a diagnostic test in another location inside the hospital.)

I had him watch me enter several patient encounters and explained why some fields were not completed because the context of the visit.  In his concern about identifying visits where I end up not seeing the patient I showed him that we have two fields for interventions.  If neither field is completed then we were not able to engage with the patient for any visitor who was there for the patient.  He told me had been reading some of  my entries on his own and was confused about the fact that more fields have entries in one visit than they do in another.  He said by watching me describe the visit and let him know why I documented the visit the way I did, he saw much more clearly how what is documented captures the essential elements of the visit.  I thanked him for taking the time to not just see what I enter, but learn why visits are entered differently based on the unique dynamics of the visit.

As I reflected on the encounter throughout the day I realized I was glad that all the entries I make are being used by others in our system.  Documenting can take several hours of time each day and I now approach documenting with an increased sense of value because I have seen the data be used rather than just being stored.  Plus it was wonderful to be able to explain why I do what I do, and see the person interviewing me take the time to understand the reasons behind what I do.

 Private Practice Setting                                                             Hospital Setting

Today I had a conversation with a female patient and her husband.  They were very positive about the care they received during the hospitalization.  The husband volunteered their only frustration was the new system implemented several years ago where many Primary Care Physicians focus on their office practice and assign their patients to Hospitalist Physicians when the patient is in the hospital.  They both agreed that they like having someone treating them who has known them and their medical history over a significant portion of time.  It was pointed out to me that they had a hard time meeting a physician they had never seen before and then having the same level of trust in the evaluation of the situation as they would with their established Private Practice Physician.  I understood their reasoning and have heard many patients describe the same feelings.

I did explain to them the new system is a change that many people are slowly adjusting to over time and that I was sure our hospital would appreciate constructive suggestions on how the practice could function with a higher level of trust for the patient in what the Hospitalist Physician is telling them.  The husband volunteered one suggestion immediately.  He said he would like the Hospitalist Physician to consult with the Primary Care Physician prior to suggesting any treatment.  In this instance he asked the Hospitalist if he had spoken with the Primary Care Physician and was told no he had not and they he did not see a reason to consult.  The patient and her husband found this disconcerting.

I told them I would share this information in our feedback system, and they appreciated my offer to do that.  I noticed what happened during our conversation, since I had listened to their suggestion and affirmed their emotions a level of trust was established between us.  The visit went on for 20 more minutes and covered a wide range of topics.  When I was leaving the room following the prayer, the patient said to me, “Thank you for listening and seeing my concern from my point of view”.  As I entered the hallway I was struck with a sense of illumination, the patient thanked me for listening.  Listening is an essential element of my ministry and I never expected to be thanked for that component of the visit.  I learned again the lesson I learned in college.  People feel you respect them when you listen intently and then respond to their statement in a manner that affirms their feelings even if you can’t change what is happening.  What a great reminder to have from a patient encounter that was a joy for me and also meaningful to the patient and her husband!

This picture is not from our waiting room.  I am using it to illustrate the focus of this post.

Today I had the experience of sitting at the information desk of our Same Day Surgery Waiting Room while I was waiting for a patient to arrive who had requested a pre-surgery prayer.  Since I had been busy enough the day before that I had documentation to enter into our computer system I thought I would do the “efficient” thing and bring that material with me and enter as much of it as I could while I waiting.  It sounded like a good use of time.  While I was there many people had questions about how their patient was doing and came to me for answers.  I was not able to give them information but I did direct them to the next cubicle where the person there had the information the people needed.  One family did not know how to get to the holding room and need to be guided to that location.  I took them to that area and on the journey was able to get them to discuss their anxiety and offer some encouragement and also a prayer.  Then I began my normal visitation and met a family in the CVU waiting room.  Their patient had come back from surgery but was being settled in the room and still could not have visitors.  They were thankful they had a positive report from the surgeon, but still expressed they would feel a lot better once they saw the patient with their own eyes.  Waiting is not an easy experience when our emotions are high.  When I conclude a Waiting Room interaction and the people I deal with appear less anxious I feel good about the time I have spent with them.  Waiting Rooms are not the only place where we experience anxiety.  So I encourage you to take time and offer an empathetic listening ear the next time you see someone who appears anxious.  Anxiety is often not hard to spot, the picture above shows one way people position themselves while they are waiting and attempting to deal with their anxiety.

The picture above shows CNN Anchor Don Lemon taking the ALS Ice Bucket Challenge.

A new phenomenon has taken over the nation this year in a fun and challenging effort to raise money to cure ALS (Amyotrophic Lateral Sclerosis).  It involves common folk and celebrities both being willing to have ice cold water poured over them.  For anyone who has a family member with this disease, and actions to help find a cure are welcome relief!  I have dealt with several patients who had ALS.  In addition both my parents had Multiple Sclerosis so this is an illness that captures my attention.  Through this blog post I am doing my part to “spread the word”.

This is one account I had read of how the idea has grown to what it is today:

The challenge was popularized in the United States on June 30, 2014, when personalities of the program, Morning Drive, which airs weekdays on Golf Channel, televised the social-media phenomenon, and performed a live, on-air ice bucket challenge.  Soon after, on July 15, 2014, golfer Chris Kennedy did the Ice Bucket Challenge and challenged his cousin Jeanette Senerchia of Pelham, NY, whose husband, Anthony, has had ALS for 11 years. A day later she did the challenge while her 6-year-old daughter filmed her in front of their house. Senerchia’s network on Facebook connected with Pat Quinn, a 31-year-old in Yonkers, NY, who was diagnosed with ALS in March 2013. Quinn called upon his friends and family. Soon, his whole network was posting challenges, including family in Florida, friends in Ireland and Greece, and a bar full of locals, which was broadcast on local television.

Here are the Rules:

Within 24 hours of being challenged, participants are to video record themselves in continuous footage. First, they are to announce their acceptance of the challenge followed by pouring ice into a bucket of water. The bucket is then to be lifted overhead and poured over the participant’s head. Then the participant can call out a challenge to other people.

This idea has captured my attention so much during recent news of crisis events it has actually made the news fun to watch again.  I wonder how long this challenge will run?  Only time will tell!

In health care we wish we could save the life of every patient we treat.  The reality is there are limits to what medicine and modern treatments can do to extend life and extend it on a quality basis.  Today I met three patients in a row.  All of the patients were in critical condition and the best medical advice based on their condition is that they won’t live very long.  After providing comfort to each family and listening to their stories, their hopes, their fears; I was emotionally depleted.  The problem was the day was not even half over yet and I had many more patients to see.

I took a respite break and called a good friend of mine who is clergy and we shared how frustrating it is to offer comfort in these severe circumstances.  Taking time to release my emotions and to receive emotional support was just the therapy I needed to continue my patient visits.

Today was an exercise in learning that you never know what is on the other side of the curtain until you open it and go in.  Then you have to be prepared to offer hope and encouragement the best ways you can.  What I could not on my own, I did achieve with the help of my friend.  Perhaps that is the best lesson we take away from this experience, our friends can help us when we reach out to them.  I am thankful to have people that I can reach out to when I need them!!!

Over the weekend I had a surprise.  A friend called me and when I asked where she was the answer was she was in front of my house and wondered if I wanted to grab a quick meal with her.  We ended up eat at Roy Rogers here in town.  The funny thing is that I had decided I did not want to eat home alone and was getting ready to head to another restaurant anyway.  But with her arrival and unexpected invitation I changed my plans we went out to eat with each other.

I write about this because the experience was good for me emotionally.  It showed me that I was valued and because we had not seen each other for a while I was missed.  I am fortunate because I had a reunion with a good friend.

It prompted me to think about some of the patients I meet who when they describe their life outside of the hospital discuss how lonely they feel because “no one comes to see them”.  Every person needs emotional encouragement.  One way we are emotionally encouraged is by being around others.  When we are no longer able to leave our homes independently to find social interaction, it is even more necessary for others to come to us to bring us social interaction.

This reflection has me asking myself the question, “Is there someone I need to provide emotional companionship to by making a visit?”   I am not referring to patients I am caring for as part of my chaplaincy, but about people I know through associations in my personal life.  So I invite you to join me is this reflection.  Is there someone who could benefit from a visit you could make to them?  Let’s visit and lift the spirits of others!