Saturday, January 28, 2017

THE Hospital Chaplain

Doing joint visits with a peer proved to be so illuminating that many of us have gone on to do others voluntarily; we don’t need to provide written feedback on these. Tony and I did this yesterday and it was hugely educational. That same day, I’d had a brainstorm about my opening question. When I began this year of clinical pastoral education, I would ask patients, “How are things going?” The answer to that is often, “Fine,” or “OK.”

Then I started asking, “How are you doing today?”, which is slightly more personal and sometimes leads to a longer answer. Yesterday I started asking people, “Can you tell me a bit about your experience in the hospital so far?” Bingo! Every single time I asked this, I got a very long, detailed answer.

I keep falling into wanting to fix patients: to rid them of their uncomfortable feelings or somehow resolve their difficult situations. This urge is stubbornly persistent, even though it is contrary to my caregiving philosophy and even though I know perfectly well that it is not helpful (and also impossible). I do believe that it is the relationship that heals, and that it is attuned conversation that helps create a relationship that feels trustworthy, so I’m excited about my new opening question.

Tony pointed out that most people mention their biggest concern within ten seconds of starting to speak, and said I did a good job of remembering these statements and returning to explore them later on. He advised that, instead of saying, “I’m the chaplain for this unit and I visit everyone who is here to let you know that we offer spiritual care and emotional support while you’re here in the hospital,” I might announce grandly, as he does, “I’m the hospital chaplain.” He thinks that makes the patient feel special: the hospital chaplain has come to see me! He doesn’t say the whole thing about spiritual care and emotional support. He says, “We are here to offer care and comfort. That could be prayer or meditation or just talking.” More concise, and also offers some possibilities to choose from.

I explained that Samantha told me to say I visit everyone on the unit after I saw a woman who seemed disturbed by my visit. Samantha suspected that I had scared her: “A chaplain is here? Am I dying?” Explaining that I visit everyone prevents this misunderstanding, but Tony said I can always add that if the patient seems perturbed. Tony said that if it seems necessary, he adds, “I’m the unit chaplain and visit all the patients on this unit. Most will go home happy and healthy, and hopefully you will, too.” That latter is a nice touch.

He advised that if a patient appears to be having a lot of emotions or looks like she is about to cry, I could say, as he does, “Wait, hold on just a second. I want to let that sink in for a moment. You just said [whatever]—that makes me feel really sad [or angry].”

He said that he tells people, “One of the benefits of having a chaplain come is that we hold space for you to tell someone things you might not feel comfortable telling others. With me, social niceties are off the table.”

He told me that he makes a point of offering his hand to every family member who is in the room, starting with the patient’s mother, if she is there, and he said that before he leaves the room, he stands near the door for one long, uncomfortable extra moment to inspect everyone and take in dynamics. He said it took a while for him to feel comfortable doing this. Since being aware of interpersonal dynamics is the one outcome I still have to meet before advancing to Level II CPE, I am going to give this a try.

While I was observing Tony in action, he visited a patient who, upon learning that a chaplain had entered his room, said in an emphatic way, “I’m fine.” When that happens to me, which it does often, I say, “OK. Well, if you ever want to talk to anyone, we’re here 24 hours a day. Just let your nurse know. It was nice to meet you.”

Tony, however, did not take that for an answer. He said, “Strong agnostic/atheist?” When the patient confirmed this, Tony said, “Me, too.” At this, the patient looked slightly surprised. Tony went on, “I’m not here to preach or teach—just here to hold space for you to talk about what matters to you.” It is considerably more likely that that patient will feel like talking to a chaplain than one who hears what I usually say, so I’m definitely going to steal that approach.

Tony invited all of us students to his place after work last night. Two of us were on call, as always, one at each campus. Besides Tony himself, that left 11 potential guests. Six of us showed up at his place, where we ate burritos and met his wife and darling two-year-old little girl. After dinner, we played a game that involves drawing pictures and describing in words the pictures drawn by others; that was fun. I have known these people since early September and we are already, with pleasure, socializing outside work. I worked for 18 years at a large corporation and knew many great people, but did not make one single friend there that I saw outside work, other than for weekday lunches. This corporation sent me my last paycheck on Friday: a year and two weeks of my full salary as severance pay. I will always be grateful. I happened to bump into this corporation’s CEO not long ago and took the opportunity to thank him in person.

Last night was also an open mic at the soup kitchen. It was at such an event that I first laid eyes on F. He no longer hangs around the soup kitchen much, but it had occurred to me to go to the open mic just in case he was there. When I got home from Tony’s, I called my walking friend, who runs the soup kitchen, to see if F. had been there. My friend said that he had indeed been there, and had performed in top ranting and raving form, and had “seemed to be in a good space.” For some reason, that was terribly painful. Even though I officially want him to be happy, knowing that he actually is cheerfully going about his business gave me a tremendous pang.

It was a hard night, but I did not call him. It helped (a lot) that I know he would not answer my call nor call me back. He has closed the door and I am sure he will not open it again. This is just as well. It was the closest thing to an abusive relationship I have ever been in. I don’t want to be the person whose partner loses his temper with her all the time, nor the person whose partner hits her so hard and so often that he drives her brain stem several centimeters into her spinal cord. This is much farther down the continuum than the harsh words I received, but it is the same continuum.
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