Our health system has a policy of mandatory flu shots for all employees and volunteers.  There are ways to get an exemption if you have a medical justification that is documented or a religious prohibition that is documented by your faith group.  For those who have been employed for volunteered this event is routine and does not cause much stress.  Yesterday we had our Flu Shot Tent set up from 5 AM to 11 PM.  By the time I left work, 551 people had received their flu shot.

We have a new volunteer in our department that had never had the flu shot and was scared of the process.  I suggested she get the shot early in her shift, and then if she had a reaction she would still be surrounded by a plentiful supply of health care staff to document the reaction and also provide relief from the symptoms.  She saw the logic in my suggestion but still was not convinced she really wanted the vaccine.  I went on with my day and did not give it much thought.

Later I saw the volunteer and she told she had the vaccine and so far she was not having a reaction.  I gave her praise and asked her if she was relieved the process was over.  she replied it was great not having the fear looming in the back of her mind.  Fear is a real emotion, it can weigh us down.  Chaplains often help people process their fears.  This is just an example I can share where fear was relieved and the removal of that fear helped her step forward.  I wish you all the best in confronting your fears and moving beyond them.

One of the congregations in our community was hosting a Presbyterian Clergy on a sabbatical for a week.  He spent 3 hours with me at the hospital.  We had a rich lively conversation about the differences between hospitals in the Czech Republic and the United States.  In the Czech Republic they have a government controlled health system and everyone pays a mandated premium.  The large cities are the locations of the best hospitals.  Pre-qualification for treatments is required and high cost medical options are only available if you can pay the cost yourself.  As we talked about the needs of the people, we found much more in common.  Their patients have anxiety when they are sick, just like patients I encounter every day.  Their patients have worries about health care coverage, just like our patients do.  Their patients value pastoral care, just as our patients do.  But in the Czech Republic when it was under communist rule, clergy were not allowed in the hospitals to visit patients.  Trained chaplains are not nearly as common in their country as they are here in the USA.  Though we had never met before it was amazing how much we shared in common as we took a look at the issues people face when they are in need of health care.

I had to be out of the office for health system related reasons.  When I returned I found that several people had tried to contact me by voice mail or email and were surprised I could not be reached.  As I contacted them to let them know I was just receiving their message and that I had been out of the building, each one understood my absence.  There was also another recurring thread in their responses.  That thread was that I am usually to easily reached it surprised them when I did not respond promptly.  Until this event happened I had not realized what a reputation I had built of being prompt in responding to messages and emails.

I am intentionally prompt to show people I care about them.  It was affirming to see that people notice it and value it, even though it took my not being available to prompt them to share their feelings.  My learning from today: “Make people a priority, they will notice, and they will appreciate it”.

Physicians have a difficult task when they have to explain the medical status of patient in critical condition.  The family generally wants to know what is wrong and how long it will take for the patient to get better.  These are logical questions, and most of us can see how the answers to them can bring comfort to the family members of the patient.  Not all medical situations present themselves with immediate answers.  At times deciding what is wrong is a process of ruling out one possibility after another.  With testing, waiting for results and consultations this is not always a quick process.  I with a physician recently who was trying to explain what was happening to very distraught family members.  I was impressed at by the calmness in her tone of voice.  She was consistent in her answers, even when the family essentially tried to ask the same question in many different ways.

The family eventually was able to calm down partly due to the calmness projected by the physician.  I tried to help the family by reminding them of what the physician said when they were remembering what had been said incorrectly.  As the family received signs of expression and support from those who sent them text messages or called them, they began to calm down.  Providing companionship and a non-anxious presence is exactly what some family’s need as they wait for their medical questions to be answered.  This is truly a team process.

We have a small pastoral care department.  Thus there are frequent times when no one is in our office.  Our office is also nowhere near the chapel, so if someone looks in the vicinity of the chapel it is not highly likely they will find a chaplain.  We do have phone on the wall a sign with directions on how to have a chaplain paged.  This week I was on one of our nursing floors walking down the hallway.  The group ahead of me was talking loudly enough that anyone in the vicinity including me could hear them.  The conversation showed they wanted a chaplain and did not know how to find one.  I spoke from behind them and introduced myself as a chaplain and offered to assist them.

The group was thrilled that after searching on their own I suddenly appeared when they were not expecting me.  They had concerns about the patient they were visiting and did not want to have the conversation in the patient’s room.  I told them we could use a nearby consult room and led them to that location.  I was intrigued about why the conversation could not be held in the patient room and felt rather than ask I would wait and see if they would volunteer that information as we interacted.  They felt badly about a request the patient made of them that they were not able to honor, and wanted to process whether they were doing the right thing and how they could move forward without feeling guilty.

Their situation reminded me that no one wants to disappoint a patient: hospital staff, family, or friends.  There are times what the patient wants is very understandable but the resources to meet that request just are not available.  The family was not able to take the patient home to care for the patient and the patient did not want to go to a nursing facility.  The conflict between the patient’s desire and family’s resources was the reason for discomfort.  Being a person who likes to “fix” problems I felt badly that I did not have an instant solution to provide them.  By listening to them tell their situation they had the chance to hear their reasons for not being able to take the patient home.  They were convinced their reasons were valid.  I offered affirmation that they had not dismissed the request without thoroughly examining how it might be accomplished.  I offered to go with them to the patient’s room and be a resource as they explained their limitations to the patient.

That is what happened.  The patient was not mad at the family; the patient knew their situation but was hoping they had a solution.  The patient affirmed how the bond of love was still just as strong and that if going to a facility was the resolution that would be fine.  The patient asked me to pray, that did not surprise me.  The second part of the request did surprise me.  The patient continued she wanted me to thank God for providing such a loving and concerned set of children.  The request for the prayer brought the family more comfort than I have words to describe.  I did pray with everyone and we did join hands.

As I left the scene I was thrilled that I had happened to walk behind them and hear their need for a chaplain.  More importantly it was fantastic to see that the bond of love within the family was strong enough for them to remain in a positive relationship with each other when the children were not able to meet the request of their parent.  This displayed to me that it is often okay to not grant a request as long as we show we are not dismissing the request without giving it serious consideration.

“Facing a Brick Wall” is an expression we use in conversation to indicate we have come upon a stopping place we did not expect and did not desire.  Some writers also call this “writers block” when they are unable to write when they really do want to write.  My daily readers will notice I have not blogged for roughly a week.  I was “Facing a Brick Wall”.  The problem with brick walls is that if you are not athletic like I am not, you can’t scale the wall.  I am afraid of heights so a tall ladder is not an option.  Going around the wall also was not an option.

My brick wall was making a difficult decision.  I found myself in the shoes of many of the patients and family members I deal with regularly at the hospital.  They have been given facts, they have been given options, and they do not like any of the options to deal with facts they have been given.  Difficult decisions are one of the hardest things we face in life.  And it appears many of us have to face more of them than seems fair at times.

When I come along-side a person or family wresting with a difficult decision I listen.  I offer assurance.  I try to get them to think about their values and what direction their values give them in possible responses.  Sometimes we pray, but even if prayer is not spoken at the moment these conversations and times of non-anxious presence have a sacramental nature to them.

This week I took my own advice and found a prayer partner to help me sort my way through the decision I was making.  Now that the decision has been made, I am able to write again.  I write not out of sense of duty but out of sense of transparency – being open about my work and my approaches to life events in the hopes that what I write can benefit others.  If you have missed my daily postings I am glad to tell you I am back to writing.  Thank you for reading along with me.

In Sunday School today we discussed the terms “covenant” and “contract” to learn how we relate to God and how we ought to relate to each other.  In doing a word search I learned that the word “covenant” is almost exclusively used in a religious context.  Since I am trying to make this blog interesting to readers of all faith perspectives, I want to spend time with you today thinking about “covenant” without putting it in the context of a faith community.

At its root in a covenant there are two parties.  Each party agrees to do something and both parties are intended to be better off working together than they would be working alone.  Let’s take this example: My friend needs someone to drive his children school because the time of getting to school conflicts with the time he is due at work.  I agree to drive his children to school and ask that in return since I have no mechanical skills the father of the children will do repairs on my car.  The father benefits because his children get to school safely and dependably.  The driver benefits because he knows his car will be repaired when needed.  For each of them this is a “WIN-WIN” agreement.

In the example I have crafted above neither party is forced to share in the agreement.  But both parties can have a high level of trust that each will hold up their end of the covenant.  In my mind the mutual nature of a covenant stands out in stark contrast to some contracts where one of the parties is able to exercise some method of enforcement to make sure the other party conforms with the terms as stated.

I feel all of us would be better off in our relationships if we approached them from the covenant model rather than the contract model.  What do you think?  I’d love to hear your thoughts.

Every day I encounter many people who ask me to pray for them.  I am happy to meet them and pray with them because that is my calling.  This past week a family requested me to visit them, and I did so very willingly.  I also had some hesitation because of the particular health issues of their patient.  Frankly, I was afraid the patient’s health was declining and that was the reason my presence was requested.  I was pleased to see that the patient was off the ventilator, sitting up in bed and talking.  The spouse introduced me to the patient and told me about all the times I had been with the family praying over the past week.  The patient still being weak said “thank you” and smiled.  The spouse said she had requested that come so I could share in the victory of healing that was happening.  Smiles and hugs were exchanged.  It was probably one of my most enjoyable visits of the week.

This exchange has resonated in my mind and gotten me to thinking about the codes we have at the hospital.  We have:

• Code Blue (Cardiac Arrest)
• MET (Medical Evaluation Team for sudden declines in health and falls)
• Code Yellow (Disaster)
• And many other codes

In our own lives I think we should add a “Code T” to the list.  The “T” is for the word thankful.   All of us have many good things that happen routinely in our lives.  I know myself I am not as disciplined to give God thanksgiving as I am to ask for help when things overwhelm me.  I am pledging to my readers and myself to be more diligent about calling a mental “CODE T” and giving God thanksgiving when I recognize something as being good.  Will you join me?

Every patriotic holiday I have a tradition of wearing a neck tie that closely resembles the one pictured here.  Today people who saw me wear it were saying in various phrasing, “Thank you for remembering.”  That response surprised me because the attacks 13 years ago are still very vivid in my memory and like most other Americans my life has been affected by the security precautions that now exist in our post 911 world.

Their responses reminded me that there is power in showing others that you remember.  First it says they are not alone in remembering.  Second it says the event is or was important to you just like was to them. Third it opens the door for a conversation, and often those conversations help us process our emotions.

Again I was reminded that even 13 years later emotions still run very high about 9/11/2001 and the events that have followed since then.  Yes I remember and, yes I am willing to discuss it with anyone who desires to.

One of the most frequent decisions I find patients or their family members making is “When is the right time to consider comfort care or hospice?”  People have a difficult time with this decision because embedded with it is the realization that cure of the patient through medical intervention is no longer going to be the focus of treatment.  The focus of treatment will be keeping the patient comfortable.  Frequently this involves medicines to relieve pain.  Federal law requires that patients be given information on all treatment options including comfort care and hospice.  Many people don’t want to mention these options until they feel comfortable with the decision.  The problem with this tendency to wait to give the patient the option is that the right time to make the decision is when the patient is comfortable with making it.  Waiting for a provider or family member to become comfortable before giving the patient the choice is not appropriate both due to legal mandates the right all human beings have to have dignity, even to have dignity in the process of dying.

When I work with family members who are hesitant to even have the discussion I look for opportunities to point out that simply having the conversation does not mean a decision will be made today.  But having the discussion gives the patient the gift of independence by being able to consider all the options that are available.  I would never attempt to force comfort care or hospice on anyone.  On the other hand having the conversation is valuable because you often learn from the patient was is truly important to them at that stage of life.  If you are facing this struggle, please know having the discussion can bring peace to the patient and family members in ways you can’t imagine unless you have been a part of this discussion previously.