Saturday, October 08, 2016

Poorly Healy Stump

What one patient’s chart says he has.

One patient I saw this past week, not yet 50, had gotten terrible news and said that if it were up to him, he would decline chemotherapy and let things take their natural course, but his loved ones aren’t in agreement, so he is going forward with treatment, even though his greatest fear is of being in pain, and he is aware that chemotherapy may well be horrible. Per the feedback on my first verbatim, I felt free to own my reaction: “I must confess that I feel distressed hearing you say this. I understand that if it were up to you, you would not go forward with treatment, but I hear your love and concern for your relative and your partner.” He said he doesn’t even dare tell his partner what his wishes are. Sad. I put all of this in detail in his chart, and I also told his nurse, who looked gravely concerned to hear it.

Another patient I saw this week said, “You have the affect of a chaplain.”

The nurses on my units are starting to recognize me as their chaplain and to ask me to see this or that patient, such as ones that are crying, agitated or complaining a lot.

Friday afternoon I and three others from my overall group went to a fancy center on campus where they simulate patient encounters, using real actors, to support professional development. I worked with a pharmacy student and a medical student to examine / interview a “patient,” decide what his problems were and write a plan of care. I have yet to lead an actual patient in a guided meditation and figured this was a perfect opportunity to practice, so I did that. I think the patient had been instructed to seem depressed, and he never once smiled at the pharmacist or the doctor, but he did actually smile at me.  

My colleagues had no idea what a chaplain did when the afternoon began, but expressed enthusiasm by the end of the day. They also said they were envious that I get to dive right in and ask about things they feel are off-limits to them, like the emotions of the patient. The medical student said she liked the meditation herself; all three of us were in the room at all times. We are responsible for caring for patients’ families and for staff members, as well, and we’ve been told that providing care to one staff member translates to better care for ten patients. 
Several faculty members were present to lead debriefing sessions after the simulations, and Jodie happened to co-lead mine. She was beaming at me in a very tender fashion, so I think she was pleased with my performance. We will all receive videotapes of ourselves so we can see what we look like in action, and we will receive our peers’ feedback on how we did interacting with the patient and how our teamwork was. We will also find out what problems real doctors thought the patient had, and what their own plan of care would be.

Based on my experience over the summer, I honestly thought this clinical pastoral education program was going to be a year of nonstop misery, but it is absolutely, completely fantastic. I love it, and so far, I am savoring every moment. I am literally getting paid to do something I would do, and have done, for free. Every single day, I get to bring to bear what means the most to me—my practice of being awake—and I am invited to bring my whole self to work and to open my heart, while also trying to be at the top of my game in regard to self-awareness and interacting with my peers. On top of that, academic instruction is offered during the workday. I like everything about it, even just walking down an empty hallway knowing I’m a chaplain.

At VFMC last summer, I was able to do all of my writing assignments during the day. By cheating: Someone clued me in to a hidden bank of public computers, and I went there and did all my writing, so I wouldn’t have to do it over the weekend. I’m doing the same thing at TWMC—but with their explicit permission. Jodie said to go ahead and take a couple of hours a week for writing, which is more than enough time.

Over the summer, I tried to arrange things so that I would have one day each weekend to spend with a friend, but I’ve let that go, and it feels better to have really cleared the decks. All I do, I can say without too much exaggeration, is work and sleep. I understand that this might sound horrible to most people, but to me it seems simple and wonderful: every single thing I do is something I want to do and/or am deeply honored to get to do.
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