Monday, April 09, 2018

GSW

As mentioned, I was starting to feel a little bit frustrated with Clementine over at County Hospital because any number of enticing possibilities had been mentioned in my first six months there without a single one of them coming to fruition. She had said that I might like to work with the palliative care team, or with forensic patients (prisoners), or on the psych unit, or in the ED. Those all sounded great except for the forensic patients. I’m not scared of them; I’m susceptible to getting crushes on them. In any event, none of those things had happened.

More recently, she asked if I’d like to be trained to hold babies in the NICU (neonatal intensive care unit). My school requires volunteer work, so I told them I was volunteering at County Hospital as a chaplain, but they said that would not do—a person who wishes to be a hospital chaplain should find some volunteer work other than as a hospital chaplain. I loved the idea of holding babies in the NICU, because: babies! And I also thought it would be both an intensification of chaplaincy work—because what is worse than a baby dying?—and also a nice balance for it, in the case of babies that get well and go home with their families.

Clementine said to email County Hospital’s volunteer coordinator and ask about training, copying her. I also sent school a note making the case outlined above. I was pretty sure they were going to reiterate that I should not do my volunteer work in a hospital, period, but they wrote back and said this sounded like an excellent idea. However, after I sent my note to the volunteer coordinator, Clementine replied to both of us and asked that this be put on hold until she could speak with staff members in the NICU.

At this point, I started to feel distinctly disgruntled: Why can’t I hold babies in the NICU, since presumably any old person off the street can apply to do this? When I arrived for my volunteer service one Friday afternoon, I asked Clementine if there is an existing mechanism for people to be trained to hold babies in the NICU, and said I was worried that if I didn’t get going with that, I’d end up having to pick some other volunteer work for school, and then I wouldn’t have time to hold babies in the NICU, and I really want to hold babies in the NICU!

She said there is a mechanism, but that the NICU has had bad experiences with chaplain baby holders in the past, and she would actually like several of us chaplains to be trained to do this, so she was worried that if I went ahead on my own and got turned down, it would wreck things for the other chaplains. She said that she would move talking to the NICU higher on her to-do list. At just that moment, we were nearing the office of the exact person she needed to speak with, and she marched over and knocked on the door. The person wasn’t there, but my frustration dissolved completely at that moment. Clementine is a totally remarkable person, and she is doing the work of about five people.

Not only that, but that same day, she took me to three units where she would like me to serve and introduced me to other care team members. We spent about 90 minutes together, which itself was a big treat. In the NICU, she showed me the labor and delivery area, and postpartum. She said that the mother of a dead baby is often put in a room in labor and delivery rather than postpartum, so she doesn’t have to hear other people’s babies crying.

Then we visited the ED, which is vast. She pointed out what color gown means the person is a psych patient, and what color means the person is a fall risk. She said it’s fine to say hello to any patient in the ED, and that you can basically round in there continually for a whole shift, since things change so often.

She said it might take six months for people to warm up to me in the ED. The staff tend to be less religious—she said some lose their faith because of what they see there—and accordingly tend to have more negative projections onto chaplains; e.g., the chaplain is a Christian zealot who seeks to proselytize. I hope this does not prove to be hubris, but it seems to me that nothing I see could cause me to lose my faith, because my faith is in the laws of nature themselves: this causes that.

She said some chaplains always wear gloves when they are in the ED, which is optional except that if there is blood, I should wear gloves. And I should refrain from ever saying to another care team member, “Hope the rest of your shift is quiet,” because that is a jinx.

She said that the hospital has a joke about what kind of high school students go into what kind of work in the hospital. She gave several examples, but the only one I can remember is that it’s the students who smoked and cut class who end up working in the ED. In my era, we called these people, of which I was one, “burnouts.”

Clementine said that, after a murder, the family often wants to see the deceased patient, and that the only person who can grant permission for this is the medical examiner, not the detective or anyone else. And she said that frequently the M.E. gives white families permission to do this and refuses permission to black or brown families. She said that sometimes when people grieve, it is loud and physical. People may scream and pound the wall, and when those people are large black men, they tend to get a negative response. She said not to ally myself with the M.E.; for instance, not to sit next to him in family meetings.

She reminded me that County Hospital has the city’s only Level 1 Trauma Center. Gruesome car accidents, murders, gunshot wounds (the abbreviation used in charts is “GSW”), children who are thrown down the stairs—or worse—by their own parents end up there. Our mayor died there not long ago. Quite frequently a car pulls up outside carrying a gunshot victim, a rolling crime scene quickly encircled in yellow tape. Clementine warned me, “There are things you can’t un-see.”

(If you have chest pains or are short of breath or break your leg, you would do well to come to the ED at the hospital where I do my paying job. This could mean the difference between waiting for ten minutes and waiting for six hours.)

Clementine said that working in the ED has some things in common with disaster chaplaincy, that it demands one’s very best self-care, and that I should debrief with her or the head of spiritual care after a shift in the ED as necessary. She said the staff there deal with a tremendous amount of trauma, and some do better self-care than others. She pointed out that besides the emotional highs and lows, there is an intense body process of adrenaline spiking and draining away; plus, it can just be heavy physical work.

She instructed me to shadow another chaplain in the ED on my next shift, and after that, she said I could be an ED chaplain! I was thrilled—this is probably the most intense hospital chaplain work in the whole city—and also a tiny bit nervous. I am at ease with ill and dying people, with bereaved people, and now with dead people. But I do not like gore, so it appeared that this would be a growth experience. (However, there is one significant perk: Visits in the ED don’t get charted.) Maybe if I can get the hang of this, when I’m old(er), I can travel the world as a disaster chaplain.
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