Crisis Scheduled for April

At the November palliative care class, we got to practice delivering bad news to “patients” played by professional actors.

One of my co-workers, when we were discussing a certain patient, pointed out something I’d never thought about: that one of our campuses has a NICU but no adult ICU, and the three others all have an ICU but no NICU. What if both are needed at the same time? We decided that it would be best if this pregnant patient delayed having a crisis until our new hospital opens early next year; it will have both.

I noticed in a patient’s chart the diagnosis of “contrast dye induced nephropathy.” Before my case of mono was diagnosed a few years ago, I had a scan with contrast dye. Sorry to learn it can mess up your kidneys.

Very happy news arrived early in November: that I was working enough hours each week, on average, to qualify for health insurance from my paying job! I was thrilled. My Obamacare premium was $600 a month throughout 2018, and my deductible was nearly $5000, so on top of forking over $600 a month, I paid out of pocket for a lot of stuff (mainly physical therapy for my various aging body parts). I will pay no premiums at all for the insurance I will get from work, and my deductible for 2019 is $250!

Around then, I got a call from my boss, who said she was trying to think how she could give me more hours. She said, “You really do a nice job. I hear about the way you engage with patients.” She asked if, in addition to my weekly 24-hour on-call shift, I could do two additional day shifts each week. I had formerly said that I could not work more than two days per week while I’m in school, but I went ahead and said yes. I think it was in the back of my mind that we’ll be getting a new boss, and that it might be a good idea to be more visible during this transition. I asked my boss if she has any inkling what the future might look like. I thought she was going to say she had no idea, but she actually did say she thinks full-time chaplains will be preferred to part-time chaplains.

For that reason, it was probably good that I agreed to take on the extra shifts, but that night, I was in a minor panic. As I lay in bed, I found myself obsessively going over and over how I was going to fit everything in. I tried to attend to my body, but my attention kept snapping back to the future very determinedly.

I trust my boss’s kind words were sincere, but I did also find out the next day that our only chaplain who was working five days a week had taken a job in another county, so my boss was probably also in a minor panic of her own. What she specifically asked me to do was to take over palliative care, and to attend the weekly palliative care rounds.

When I started working in a hospital, I thought “rounds” meant walking from one patient’s room to the next, and some physicians do conduct rounds that way, but more typically people just stand or sit in one spot, not in a patient room, and talk about the patients. I attended rounds once or twice during my very first unit of Clinical Pastoral Education and found it so tedious that I avoided rounds thereafter.

At my job, we have to keep very detailed statistics. I literally account for every single minute, and record the number of patients I saw and the number of staff members I cared for and so on and so forth. We turn in these numbers on a monthly spreadsheet, but an odd thing is that we never, ever get any feedback on this spreadsheet. No one ever asks, “How did you see only one patient in the course of an entire week?” Per my aversion to rounds, that column has been blank month after month, but no one has ever remarked on it.

In regard to my new work schedule, I soon realized that I’m going to have to do what I did during Clinical Pastoral Education, which was to take things one day at a time, which proved to be wonderful—so simple. In the morning, I would petition the universe to help me through just that one day, and when the day was over, it was over. I didn’t think much at all about the future. I am now returning to that mode, of necessity, but also, something fantastic happened that is going to save me a million hours.

Next year for school I have to do a project and write a 50-page thesis. This is double spaced. If I were just to type, without regard for content, it would take me about two hours. Of course, it’s not quite that simple. We’re supposed to design a project that relates to the learning plan we wrote at the beginning of the program, and the paper is supposed to be a formal academic paper with proper citations and all that. The last time I wrote a research paper, I was about 20 years old and it was traumatic. I mentioned that to my mentor and she was very reassuring. She immediately sent me links for a couple of websites she relied upon when she was doing her own paper.

As for the project, I had been thinking about a couple of things, one being that I would join a group of conservative Trump-voting Republicans in doing some kind of ongoing service work. I would get to know them, read the authors they think highly of (like Ayn Rand), and later interview some of them about how they came by their beliefs. I really liked this idea, and so did my mentor. Another idea was to volunteer with undocumented immigrants and do something based on that. 

Right after I realized that while both of those might be great ideas, I had no time whatsoever to do either of them, I happened to talk to my mother, which I rarely do these days, because her phone is basically dead, and my parents no longer have a landline. My father’s phone is slightly better—I talk to him now way more than I talk to my mother—but it tends to go on the fritz after a while, and he has to step outside to get good reception, and in November, it’s no longer stepping-outside weather. (I don’t want to be a nag, but I did say to my father that it might be helpful for them to have phones that work in the event that one of them has to call 911 to indicate that the other has fallen down the stairs or had a heart attack.)

Anyway, I was talking to my mother and I said something about this project and she said, “Maybe it should be about something you’re already doing.” Brilliant! Since I am serving with the palliative care team at County Hospital, taking a palliative care class at the Truly Wonderful Medical Center, and had just been asked to be a palliative care chaplain at my paying job, I decided my project will be about palliative care. I’ll be able to say what it’s like to be a palliative care chaplain working with a team or one working alone, because I will be doing both.

Then I remembered that it has to pertain to my learning plan and sent my mentor an email asking what she thought. She wrote back, “This will work beautifully as a thesis topic.” What a relief. I can record what I’m experiencing and learning at both hospitals, read papers and books about palliative care chaplaincy, and interview other chaplains. Boom! This is as good as done.