Saturday, November 14, 2009

Good Shift


I had a long but very satisfying shift at the hospital today. It started off, I have to admit, with an act of cowardice: when I walked in, I saw a nurse trying to deal with an irate patient in the hallway. That's the kind of situation where I'm supposed to step in and calm everybody down, but I just wasn't up to it first thing in the morning. As I watched, the nurse managed to get the patient back into bed, and I thought, "I'll start with another room, and if this situation's still a problem after that, I'll step in."

I chose my other room randomly but well, since I wound up spending forty-five minutes with that patient, who responded to my introduction with, "I can't tell religious people about this."

"What is it that you can't tell religious people?"

And out came the entire story, a very sad tale of loss and family problems and self-blame. When the story was done, I said, "Why can't you talk to religious people about that?"

"Because religious people are too judgmental."

"Really? I'm religious and I try not to be judgmental --" although, of course, I'd just been judgmental, or at least cowardly, about the irate patient -- "and most of my religious friends are the same way."

"Hmmmph!" Turned out the patient has a close relative who's a hospital chaplain, "like you," but very judgmental. This relative had called the patient "a sinner" for not, in the relative's opinion, properly mourning a dead loved one.

Inwardly, I felt myself groaning. Terrific. That one must do wonderful hospital work. Just what we need: somebody else giving faith a bad name.

See what I mean when I say that I try not to be judgmental? I'm judgmental of people who are judgmental. I've been wondering how to solve that problem for years now.

Anyway, the patient kept talking about the situation, and it became clear that there was a lot of internalized guilt. I said, "You know, the problem with judgment is that it hurts. But you're judging yourself about this, aren't you? And that means you're hurting yourself."

The patient looked at me as if a lightbulb had just gone on. "Hey! You may have something there! Maybe that's part of why I hurt physically!"

Originally, the patient had said, "You can pray for me, but only when you're out of the room, not with me." But now the patient said, "I believe in God, and I know I help other people when I pray for them, but I can't pray for myself."

I said, "Well then, why don't I pray for you? May I do that?"

And I did, right there, holding the patient's hand, and afterwards the patient said, "That was nice. Thank you! That pretty much mirrored exactly what I was thinking."

If part of this patient's pain was guilt, another part was a chronic medical condition that hasn't been properly medicated or treated for the last year because of healthcare-coverage issues. So I collected a list of social agencies and clinics for the underserved and gave the list and relevant phone numbers to the patient, who happily began making plans of where to call first and even accepted a free rosary from me. "I'll treasure this because it came from you."

Talk about a feel-good visit! I love being able to combine spiritual care with connections to concrete local resources. Better yet, a few hours later the patient's nurse tracked me down and said, "Thanks so much for visiting that patient!" Evidently the patient had shown the nurse the list, talked again about the schedule for phone calls, and said what a help I'd been. This is the kind of feedback that will get me through many a quieter, or more difficult, stretch at the hospital.

Meanwhile, though, another nurse had glanced up from paperwork, seen me, and said, "Oh, there's one of you guys here today! We needed a chaplain before and I couldn't find anybody. I called the hospital operator and they had no idea who was around."

"I don't think the operators have access to the volunteer schedule. What did you need?"

"We had an irate patient who was giving a nurse a hard time."

"Oh," I said, stomach sinking. "Actually, I saw that happening, and I avoided it. I'm really sorry."

The nurse forgave me -- "it just would have kept the patient here longer and tied up your time" -- but we talked about how it would be nice if the staff had some idea who was on duty. When I first started volunteering, there was a space marked "Chaplain" on the white board where we put our names and the hours we'd be working. White boards have come and gone since then, and there hasn't been space for chaplains on them for several years now. But after my conversation with the nurse, I went up to the Case Manager and asked if we could bring back the Chaplain box, and the CM said, "Sure. I think that's a good idea. Go talk to the team leader about it."

So I did, and the team leader said, "Sure. You can put the Chaplain box right over here. This whole column is pretty much just junk notes." So we now have a Chaplain box. Hey, we're a visible part of the healthcare team again! Whaddya know!

It was now near the end of my shift. I still hadn't seen one particular patient who'd come in near the beginning, but had been surrounded by medical staff every time I passed the room. I went out to see if anyone in the waiting room needed to talk (the answer was no, since no one was there), and the intake nurse said, "Hey, there's somebody who came in a while ago who'd love to talk to you, I think."

She gave me the room number. Sure enough, it was the room I hadn't been able to get into. But by now the medical staff had cleared out, so I went in and introduced myself to the patient -- who immediately began crying -- and to a family member.

Out poured another long tale of loss and family problems and stigma and self-blame, complicated by the fact that other relatives were dismissing the patient's feelings, and using very hurtful language to do so. "I'm so sorry to tell you this horrible story. I just can't get it out of my head!"

"This is what I'm here for," I said. I dispensed more prayer and another rosary, along with lots of reassurance about God's love, and then left the room to try to hunt down another, much more specialized, community resource. I needed to Google it, and I can't get on the internet at the hospital because I don't have a staff account, but one of my favorite nurses signed me on to his account so I could do the search. Turns out that this specialized community resource has one office in Nevada, and it's in Reno. Hurrah! So I went back to the patient with the agency name and phone number, dispensed more reassurance about God's love, and then went back out into the hall with the family member, who wanted to ask me a legal question.

I didn't know. We asked the nurse, who did know, and who happened to be the nurse who'd thanked me earlier. She said, "We're giving you a lot to do today, aren't we?"

This patient was being admitted, and I'd promised to write a note asking a staff chaplain to visit, so when I went upstairs to sign out, I did that -- including enough info about the family situation so they'd send someone who wouldn't be judgmental -- and also wrote a note to fellow ER Chaplains, asking them to start signing in on the white board again.

There were lots of other patients between those two (notably a very little girl who very politely and earnestly asked me to pray with her and her mother), but those are the two who stand out.

This is the kind of shift that reminds me why I'm there.

5 comments:

  1. Regarding the "judgmental of those who are judgmental thing." I think that particular logical construct is a misnomer. No one is actually judgmental of those who are judgmental. What we are is judgmental of those who are judgmental regarding the things that we think are morally positive/neutral.

    For example, same sex marriage. If one believes that marriage is the most valuable expression of emotive love (something with which I agree whole heartedly), it is frustrating to see someone express disdain for same sex marriage.

    By the same token, if one sees marriage as the only means that the sexual act between a man and a woman can be sanctified (specifically in the creation of a child), then marriage isn't just about love -- or "societal benefits" -- it's about avoiding sin. For someone to desire that institution for an act that cannot create children can be disturbing to this kind of person.

    In neither case is the individual actually being judgmental of anyone in an illogical sense, they are positively responding to their deeply held moral beliefs. I tend to respect that kind of behavior, from both parties.

    While I disagree with those for whom religion is a constant struggle against temptation and damnation rather than an expression of love and thanks, I do have sympathy for them.

    I tend to find anomie far more upsetting than judgmental people.

    The one area, other than pure anomie, that I find disturbing relates to drug use.

    I am very tolerant of those who have used drugs or those struggling with addiction. Having lost my mother to addiction, it isn't hard for me to "see the disease" in the addict or recognize the blind curiosity of the casual user. Those who bother me are the ones who argue that illicit drug use is a "positive good" bother the heck out of me. I can understand self-medication, I can understand those who admit "I'm just trying to have a good time." It's the "it's a spiritual experience, or you can't know if you haven't tried it people" that I can do without.

    I get pretty judgmental about these people. Actually, I think angry at is a better phrase.

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  2. Anonymous12:07 AM

    Hi,
    As a long-time reader of your blog (and after reading this day's blog) I wanted to ask a question. If you are Episcopalian why are you giving out rosaries? I ask only out of ignorance.

    Oh, I also wanted to ask if anything new ever came up about Beth and her missing husband? I pray for her every night, so she's often on my mind.
    Thanks,
    Sal's Girl

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  3. Hi, SG! At my hospital, volunteers make rosaries (plastic ones in bright colors) which are then blessed by priests. The rosaries are pretty, free, and a tangible sign of hope and God's love, a literal lifeline, whether the patient is Catholic or not. When I offer them, I tell patients that a number of different faith traditions have prayer beads, and that there's no right or wrong way to use them; you just say a prayer per bead, whatever works for you. I don't force them on people who don't want them, but as a non-Catholic patient said today when she accepted one, "We all worship the same God." Sometimes friends and relatives in the room ask for them, too; one Christmas several years ago, an indigent patient asked shyly for several to give as gifts.

    As for Doug: no, we've had no word (or I haven't, anyway, but I'm sure the church grapevine would be buzzing if anything happened). Beth's getting on with her life and seems to be doing well, but I can't imagine not being haunted.

    Thank you for your prayers!

    Christian: Drugs as spiritual aids go way, way back. I don't doubt that for many people, drug use is spiritual, at least at the beginning: it's when it starts ripping apart the rest of life that it becomes a problem. And I cheerfully admit that I don't know what it feels like to use heroin or cocaine or even, to any great extent, alcohol. I've seen enough destruction wreaked by those substances (and have inherited enough genes predisposing me to addiction), that I don't want to know, because I'm convinced that the negatives outweigh the positives. But of course there are positives, or nobody would do drugs at all.

    People take drugs -- legal or illegal -- to feel better. This is a basic truth that too much drug policy overlooks. If we don't want people to take drugs, we need to offer safer, more effective and less expensive ways for them to feel better.

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  4. Beloved, a good shift indeed! Conversations like the one with the person angry at "religious" folk are the reason that I say, if our parish colleagues are in Sales, I'm in Maintenance.

    By the way, I'm enjoying Beggar.

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  5. Thanks, Marshall. I'll be curious to hear your comments when you've finished the book!

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