Monday, June 08, 2009

Nurse Jackie


Last night we watched the first episode of Nurse Jackie on Netflix. I like Edie Falco, but I have some problems with the show.

The story's set in what sure looks like a Level 1 trauma hospital, which is also a Catholic hospital. There are crucifixes everywhere, and -- bizarrely -- gangs of giggling nuns wearing absurdly voluminous white habits roam the hallways of the ER. I kept expecting them to break into some ensemble number from The Sound of Music. (The nuns I know wear street clothes, since habits largely went out with Vatican II; they don't travel in herds, and would know better than to giggle in an ER.)

And, you guessed it, no chaplains. Jackie does refer to a social worker at one point, which is a refreshing touch of realism, but we never see that person, and of course Jackie winds up doing grief counseling herself.

Don't get me wrong: nurses are great at grief counseling, often better than chaplains. But there'd certainly be chaplains at that hospital.

Sigh.

5 comments:

  1. With the exception of Father Mulcahy on M*A*S*H (and he was largely a very two dimensional character) I am very hard pressed to think of any other medical TV program or movie that has featured a chaplain.

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  2. Arthur: My point exactly!

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  3. Well, maybe if there were more on TV, people would insist on them in the hospital! And, I haven't jumped into this one because I really don't want to hurt your feelings, but I am training to be a professional chaplain--I do think there is a place for theological and clinical training in the work--so I don't look with optimism at models that have all the care done by volunteers with a "staff chaplain" who serves mainly as a scheduler. In your hospital, which staff are designated requestors for organ and tissue donation? Which staff assist patients with advance directives? Mortuary selection? This varies but in the system where I work chaplains are expected to do these things, also coordinate with Red Cross, military, prisons for compassionate leaves or phone calls. Chaplains also serve on the ethics board etc. Some volunteers can certainly do some of these things, but in all honesty work that is done largely by volunteers tends to become work that is seen as "less valuable" systemically, so while I do not devalue the work that you do, I do worry about the future of chaplaincy at a time when it has never been needed more.

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  4. terri c:

    Be aware that among us clinically trained chaplains (and I'm an old man at this by now) there is a great deal of respect for what volunteers can do, with proper training, direction, and supervision. Susan knows where I am on this; but if you're interested, go to my blog and select the label "Volunteers."

    As a chaplain who is a one person department, my volunteers are "chaplain-extenders" just as nurse techs are "nurse-extenders;" and they add a lot to the availability and visibility of the ministry. I certainly see patients and families when referred (note that's not simply when requested by patients or families); but I also write policies, educate on advance directives and donation, participate in the Ethics Committee, an coordinate the Patient Rights portions of our JCAHO activities - as well as other teaching and church responsibilities that my hospital supports. The volunteers who help me are critical to providing 24-hour availability and coverage when I'm away.

    And, let's not forget, our first intervention is also everyone else's first intervention, and often the most important: therapeutic listening. As Susan demonstrates, and as many patients have taught me, in the first instance the help comes from the person who listens first, and not from the person who listens with the "right" professional perspective.

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  5. Terri: See my post responding to your comment.

    Marshall: Thanks for your thoughts!

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