Maybe a month ago, a nurse at work instructed me not to chart at her unit’s nursing station. I was immediately indignant. My very first CPE supervisor told me to chart at the nursing station. This is part of integrating myself into the units I serve, which is potentially all of them. She also said, as a rule, not to ask a patient’s nurse for permission to visit the patient, but to remember that I am also a member of the care team.
Later that day, I mentioned this to my boss, who also seemed immediately indignant. Her initial response was to tell me to go ahead and chart at the nursing station, but later she said to discuss the matter with the nursing supervisor, so I wasn’t sure how to proceed, but, being myself, was inclining toward announcing, “I’m a care team member and I’ll chart where any other care team member charts.”
The unit where this happened is not one I’m assigned to, so I sent my colleague who is the unit chaplain a note asking what her experience has been and if she had any insights that would be helpful.
Perhaps it was that same night that I got a page after hours asking for a priest. I called the church that is supposed to handle after-hours requests and got what they call in the corporate world a significant amount of pushback. It was possible that the need would end up being the following morning, so I called the priest who is one of our staff chaplains, and left him a message saying he might be needed first thing next morning at a particular campus.
It did end up working out that way, so I left our staff chaplain a message about an hour before our normal start time (actually 90 minutes before, because I temporarily forgot what our normal start time is) asking him to report directly to the ICU in question, if possible. I then texted him apologizing for having phoned him both after and before hours. He texted back saying he would go straight to the ICU to meet the patient’s need, and also that I should tell our boss about what had happened. But what had happened?
I asked what he was talking about: the other priest not having wanted to come to the hospital at night? My having called him outside of normal working hours? Both? He hastily backed off, saying I should do whatever I thought was appropriate, which left me, as with the nurse not wanting me to chart at the nursing station, confused about what to do next.
I went ahead and sent a note to our boss, copying our priest, outlining the entire sequence of events, and ended by saying that my purpose in sending this email was to let our boss know that there is some difficulty getting the priest from that particular church to come after hours. I also said I would welcome some direction as to when it’s OK to call our own priest.
The next time I was in the office, I saw that there had been no response whatsoever from 1) my boss; 2) our staff priest; or 3) my colleague in regard to where to chart on her unit. Now I was starting to fume. This was a Sunday morning. Soon the office phone rang: our staff priest. When he asked how I was, I grumbled that I had done what he had asked me to do—tell our boss something or other—and then neither of them had responded!
He said that he and our boss had continued the email exchange without me, which was fine, since my goal was not necessarily to send and receive email but to have the information I need in order to do my job. As to that, our priest explained that outside priests often have a lot on their plates, and that we should be understanding of that, and that if necessary, it’s OK to call him, our own priest, and it is certainly fine to call him with information he might need first thing the following morning. That was basically what I needed to know. (Although now that I’m writing this, I realize I still don’t understand why he wanted me to say anything at all to our boss.)
As long as I was on the phone with him, I asked what he does if he is discouraged from charting in a certain area. He said, “I might be understood as a coward,” but said he just saves his charting up and does it in his own office. That was helpful in that it made me feel there was no dishonor in not going to war with my colleagues.
Later that day, I also discovered that my fellow chaplain actually had sent a response to my question. It wasn’t in my inbox in the messaging system; it appeared as a comment on my original note. Fortunately, I enjoy reviewing messages I have sent so I can appreciate my own sparkling prose for a second or third time; that’s the only reason I saw her response, which was that if the nurse asks her politely to go chart somewhere else, she doesn’t mind doing that, but if the nurse is rude, I should discuss it with the nursing manager. She has told me in the past that those exact nurses are among the unfriendliest she has encountered.
At this point, I felt fine about not insisting on charting at the nursing station, and relieved that I wasn’t obligated to get into a fight about it. My colleagues, who both had initially annoyed me, ended up saving me.
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