Читать книгу Hospital Handbook - James T. Wagner - Страница 17

Having completed your tour, you are now ready for visiting hospital patients from your church. We share here a variety of styles offered by pastors and hospital personnel. You need to decide which of these styles you are comfortable with.

Depending on the situation of your community, it may be worth calling before visiting. In a large church there may always be enough patients in the hospital to make calling ahead unnecessary. If the church is small and the hospital some distance, then call to confirm that your patient is in the hospital. Call the room to find out if the patient has tests or therapy scheduled so you can plan the best time to visit. This also helps the patient order the day in a setting where the patient has little control of life.

Stop at the nurse's station at each floor you visit. Identify yourself and find out if there are any precautions you must take before entering your patient's room. You may also explain to those at the nurse's station that you will be visiting and would like a certain period of privacy. Some clergy carry religious “Do Not Disturb” signs they hang on the door. I prefer just to mention my visit at the desk. Realize too that if your patient has any particular difficulties, you can go to the nurse's station for help. Having stopped there first facilitates receiving help later.

Knock at the patient's room and wait to be invited in. Hospital patients suffer many indignities. We need not increase them. A patient may be on a bed pan, in the midst of significant pain, or may have just gotten a chance to nap. Give the patient a chance to express personal needs easily.

Don't feel foolish about introducing yourself, especially if you are from a large church. It is easy for a patient to be disoriented and not recognize you outside the context of the church.

Believe it or not, there is division among the ranks of church professionals as to whether one should sit down in making a hospital visit. One school of thought states steadfastly that the pastor should remain standing. The reason for this is to keep the visit short. Another perspective states just as firmly that one should definitely sit and be at eye level with a patient while visiting. We favor the latter point of view, believing enough personnel enter quickly, stare down at a patient, perform their duties, and then hurry off. In the sit or not to sit debate one more detail remains. If you do sit, remember to return the chair to its original place when you leave. Small details like this make a big difference in a crowded hospital room.

The length of a visit is important. Knowing the tendency of clergy toward longwindedness, many resources encourage short visits. Hospital personnel remind us that patients are weak or they would not be in the hospital. However, there is also the superficiality of the pastor who stands in the doorway, waves a jolly greeting, offers a quick blessing, and then departs. Have in mind an idea of a reasonable period of time for a visit before you enter the room. Take your cues from the patient. If this is a time the patient really needs to talk, then stay, and listen. Otherwise keep the visit brief. Common sense is the key.

Speaking of common sense, there is one rule so basic as to be embarrassing, but which nevertheless deserves a quick mention. Do not visit the hospital if you have a communicable disease or are even at the slightest risk of coming down with one. We all know this, but the workaholic strain in clergy requires this reminder. It has often been the case that a co-worker has had to remind me not to visit the hospital on those days when I was dragging around with a hacking cough or a pre-flu funk. You are no good to anyone, especially someone sick, in this condition. Send a card instead.

With all the preliminaries out of the way, it is time to consider the visit itself. Begin with gentle data gathering. It is important to let the patient share his condition, even if you have already received a report from someone else. Let the patient know you are concerned about him. This means asking more than a conversational “How are you?” without communicating dread or disaster. Queries like “Tell me what brought you here.” “How are you feeling right now?” or “How long do you expect to be here?” give you the information you need to begin your care for this patient. You let the patient speak about herself, which may be a significant step in the patient's understanding of her situation.

Another question, “How sick are you?” lets the patient share a feeling as well as a clinical diagnosis. It quickly establishes how much the patient knows of her own condition. There have been times when I was told that a patient did not know of a malignancy. When I have asked such patients how sick they were, they often replied, “I have cancer.” It was a relief for them to say it and a welcome opportunity for both of us to deal with their illness realistically.

It is good to compare the response you recieve from the patient to that of medical personnel and even family. Your own plan for pastoral care should take discrepancies into account. This may mean talking further with doctor and family to facilitate communication and hear other concerns.

When the patient describes his condition with technical medical terms, ask the patient to explain them. This can clarify understandings for the patient and you. Verify explanations later to make sure both the patient and you have a correct understanding. The glossary in the back of this book is a reference. Other resources for medical terminology are listed in the annotated bibliography at the end of this chapter. Neither the glossary of this book nor any medical dictionary should be a substitute for gathering complete medical information from a physician.

After you have gathered primary data about the patient's condition, take time to listen to other stories the patient wishes to tell. Resist the temptation to tell of your own hospital tales. Follow the level of disclosure the patient presents. Be careful of denying deep fears and concerns. Hospitals are frightening places. Even a brief visit for a minor illness can be scary. Listen for this concern, and accept it.

A patient in the hospital for a long-term illness has different needs from the short-term patient. If you will be making numerous visits, then it is important to encourage a variety of stories, memories, and topics. With elderly patients, memory is a golden link with life, and it is good to ask about stories of specific times in their lives.

Many of the current resources on wholistic health report the importance of joy and laughter in healing. Here is a place for great sensitivity and balance. Laughter can be for the spirit of the hospital patient what jogging is for the person of good health. Gentle, joyful news and stories are good gifts for any patient. And as with any good thing, there are limits to the benefits of joy and laughter, especially for patients with abdominal sutures.

Having listened to the patient's immediate concerns, it is also important to ask about needs the patient has outside the hospital. Who is taking care of other family members? Are there people at work who need to be contacted? Are there household chores that need to be taken care of? Use the congregation to respond to these needs. Clergy too often take on these tasks themselves, and this is what the church is for.

Find support tasks suitable to the size of your church. Most clergy in this country serve churches of under 200 members. One of the gifts of the small church is the special, personal care that can be given to patients and family in times of illness. These are opportunities for deep sharing between pastor and parishioner and for good churchwide support. The church can be the enabler of truly wholistic care.

In a larger church extended care will have to be structured. Lay care teams let church members share hospital support with staff. Good organization can keep hospital care personal.

It is important to close the visit with a purpose rather than to just act like you have run out of time. Here the question arises: To pray or not to pray?

There is a stereotype of the graduating seminarian as one unwilling, unable, or unprepared to pray at the hospital room. It was true for me, and many journal articles still proclaim it. There is good reason to be somewhat wary of substituting prayer for good pastoral care. We have seen the opposite stereotype, the “pray at the drop of a hat” pastor. We have seen clergy hide behind sanctimonious prayer rather than engage people in honest struggle over painful issues. We have seen glib, self-serving prayers forced upon unconsenting bed-bound victims. Thus I was hesitant to institutionalize prayer into my hospital visits when I began my ministry. For some people an offer to pray was a suggestion that they were dying. Others found it unnatural or intrusive. But I also had to admit that much of my hesitancy was grounded in my own discomfort and uncertainty in offering prayers. My style is informal and the transition into prayer often felt clumsy. As a result I limited my prayers too severely.

In time, people I have visited taught me how to pray and showed me the power of it. The consensus of virtually all clergy surveyed for this study is that the patient should be asked if she wishes a prayer.

The important step is to ask. The patient's condition, situation, and room environment all contribute to whether or not the patient may desire a prayer. But ask, and offer. Clergy roles are confused. Sometimes we feel out of place in a hospital, not knowing what to do when everyone else has a task to perform. Many of us have rebelled against a tradition of piety. Prayer is what we can and should share.

A simple scripture passage often has deep meaning for the hospital patient, and the clergy person should be prepared to offer this as well. This is not a time to preach or evangelize. This is a time for practicing the presence of the Holy Spirit, opening with gentleness this time and place for grace.

Guidelines for hospital prayers and suggested scripture references appear in later chapters. Here it is important to simply remember to offer prayer and scripture to the patient. Pray out of what you have heard in your visit. Offer the hopes and fears through the strength of faith and tradition.

There is one final point to remember about the visit. You have gathered data, listened to the concerns of the patient, found concrete things to do, and offered prayer and scripture. One thing more to remember is to touch the patient. The hospital patient is poked, jabbed, injected, cut open, sewn up, jostled, and inspected. He may feel totally manhandled. But your gentle touch on the hand or cheek can be grace.