Читать книгу Hospital Handbook - James T. Wagner - Страница 12

Unlike the free-standing hospital of the past, which provided crisis intervention when illness or accident occurred, the system will market health care. Persons who wish to participate in maintaining or enhancing their state of health will find organizations such as Wellness Centers available. In this sense, the shape of health care will become more wholistic, which is a positive development. The dimensions of health which systems will find themselves least able to provide, however, have to do with life questions of meaning and purpose.

These are spiritual concerns which have as much to do with our health as good nutrition, proper exercise, and stress management. Although chaplains and social workers will continue to be employed by hospitals, the need for the Church's ministry during the crisis of illness will probably increase. This will be true because of several factors, all related to illness being a “teachable moment” that invites a re-examination of life values. First, the patient's experience of hospitalization will likely become more brief and intense. Inpatient days will be reduced. There will be less time in the hospital, both before and after the onset of illness or having surgery. Second, opportunities to review life experiences and reframe values and priorities will be minimized. Yet questions like “Why is this happening to me?” “What meaning does it have for my life?” “What have I learned?” remain important in the adjustment and recovery process.

What is being communicated here is not that pastoral ministry to ill persons is new or that pastors have neglected their parishioners. The message is that the need for the Church's ministry is heightened by the changes going on in hospitals. In his popular book Megatrends,⁵ John Naisbitt talks about the growth of high technology creating a corresponding need for “high-touch.” It is not the intent of hospitals to be less personal as they become more businesslike and as medicine relies increasingly on new technology. It will happen, nevertheless. The patient's need will grow for someone to enter his life who has no form for them to complete, no technology to be explained, no procedure to be done. The pastor is someone who can sit quietly, hear what the patient is feeling, respond with empathy, and relate it to a faith that enhances healing and wholeness.

This same need for “high-touch” exists for persons who work in hospitals. The new technology saves lives, but it can also prolong and unnecessarily complicate dying. It isn't simply that a respirator frustrates the natural occurrence of death. More critically, a machine that can breathe for you has almost become a part of the natural order. In the case of reversible causes, such as a drug overdose, the respirator breathes for you until life is safe and recovery under way. The emotional problems which lead to the overdose can then be sorted through. In other cases, the respirator provides needed time to evaluate and diagnose, or to give further treatment. But when it is believed, but not yet a certainty, that meaningful life is not possible, no uncomplicated decision-making process exists to discontinue life-sustaining treatment.⁶ Hospital staff need the sustenance of their faith to adequately cope with the stress of being responsible for difficult decision-making.

Ministers and churches need also to be aware that, as health care systems and participating hospitals become more competitive, they also become more sensitive to public relations and community opinion. The Church can encourage support for chaplaincy as well as the pastoral care of individual ministers by communicating with the administrations or boards of the hospital. There are many services churches can provide to hospitals. For example, almost every hospital has an auxiliary for volunteers. A church which invites the director of that service to speak and encourages participation breeds good will. Parishioners hospitalized can communicate their appreciation for a chaplain's visit or the accessibility to their pastor, even in an intensive care unit. Obviously, any church expressing these interests must represent needs and concerns common to every denomination and not attempt to manipulate personal advantages. At times, a responsible Ministerial Association can assume this role.

Just as pastors are gaining new understanding regarding the emergence of health care delivery systems, parishioners will benefit from a similar exploration. Perhaps the idea of establishing a Health Care Committee in your church would assist in educating members to these new structures. Other, equally important concerns need exploring also. For example, most major faith groups are increasingly relying upon lay persons to provide ministry during life crises. Although a chapter of this book discusses the topic of lay ministry in depth, a Health Cabinet can provide a portion of that education.

Moreover, there are several direct ways in which the Church's educational program can speak directly to the national issues of preserving availability of health care and cost containment. First, the Church can remind its membership of stewardship which relates to care of the body. The larger issue is that of preventive health care. It is hoped that research will soon emerge to provide cures for many types of cancer. Even if this happens, most of the dramatic breakthroughs which impacted so positively on health, like the discovery of germ theory, antibiotics, and polio vaccine are past history. Most authorities agree that the major breakthroughs lie in the realm of individuals adjusting their life style, specifically reducing caloric intake, eating better foods, exercising more, and learning to manage stress. The major killers, such as coronary artery disease, strokes, and hypertension, cannot be cured with a vaccine. The Church should take a more active role in spreading the “good news” which relates to an abundant, physically healthy life.

Second, containing costs of health care is not simply the responsibility of physicians and hospitals. The need is for all persons to become informed consumers. Out of a false sense of fidelity, for example, an individual might decide against seeking a second medical opinion. Checking into a hospital on a weekend, apart from an emergency, will usually not result in any meaningful treatment until a weekday, but it increases costs to the consumer. Being hospitalized for minor surgery because you are reluctant to investigate an out-patient alternative does not mean you will receive better care. It does guarantee higher bills. The patient-physician relationship previously characterized as paternalistic but now becoming more collaborative is probably a healthy one.

Yet none of these changes is easy, not for individuals nor for institutions such as the health care system. What motivates the changes is the necessity to preserve availability of health care at a cost that is affordable to all. That is the hope. The voice of the Church and ministry is a powerful one. Informed and aware, it can assist in shaping the structures and practices which develop. Historically, it can continue to be a meaningful part of a life experience that is common to all. Its ministry, in both professional and lay forms, must be prepared to increase input. The alternative is further fragmentation of life experience, particularly the search for meaning and purpose in the midst of life crises.