THE CHAPLAIN Series

 

The Healing Ministry - Institutionalized

            Nurses, Lydia discovered, were much like other human beings.  They had babies of their own, their children were injured, family members died. The stresses of life sometimes brought them to seek a chaplain’s counsel.  She baptized their children, performed their marriages, sat by their bedsides when they found themselves on the wrong end of an IV line.  It was all part of her job.

            It was no secret that the nursing staff was grumpy.  What once “felt like a family” was now a factory, according to them.

            “We used to feel we were all in this together for the sake of the patients,” one explained.  “We also had the silly idea that the hospital cared about us as nurses, as people.   

            The hospital had hired a consulting firm whose first recommendation was to replace as many nurses as possible with low-cost patient care technicians.  The nurses were to teach these PCTs the easy, less demanding, parts of their jobs.  To nurses, all parts of the job were important and not to be shuffled off to someone else.

            Then the hospital approached the State Board of Nursing with a plan to establish a new job category. They would hire fully-licensed, recent nursing school graduates, give them staff nurse assignments, call them clinical support associates, but pay them considerably less than they were currently paying nurses.  The Board said, “no.”

            It wasn’t just the nursing staff being scrutinized for cost-saving opportunities.

            “We won’t have the luxury of ‘being nice’ under managed care,” the supervisor told the chaplains.  “When a patient is diagnosed as brain dead, it costs money to wait 24 to 48 hours before turning off the life support system.”  The current policy was to delay such action until the family had come to terms with the situation.  Sometimes that took a couple of days.

            “This might be true,” Lydia reported to the Presence, “But I hope I never have to tell a patient’s family that it is just too expensive to keep mom ‘alive’ until all the children get here.  A little silence for lost innocence, lost humanity, please.”

            The Presence remained quiet, honoring her request.

            Politicians, news commentators, researchers, and local PTA chairs all carped about the soaring costs of medical care – and how to contain it. Nurses had not had an increase in salary for several years. Even so, this was not their major concern.  The real issue was cutbacks in staffing were not conducive to good patient outcomes.

            An occasional comment here, a bulletin board notice there, the nurses carried on. But the tension was spreading like a bad infection. 

            “Catholics can’t strike against a Catholic-owned hospital,” one nurse confided to her. “It would be like striking the Church. We were told that in a meeting today.”  Absolutely certain this was not the case, Lydia began researching Catholic social teachings and the labor movement. 

            “Might come in handy at some point,” she told the Presence.

            Ummm, came the response.

            The snow began to fall.

 

            Lydia became a grandmother that winter. Her daughter-in-law gave birth to a healthy, chubby girl. Lydia’s son could not have been a prouder father.

            That same day, two babies were born to another couple at the hospital.  The tiny boy twin was very fragile. His sister survived, but he did not.

            Lydia was delighted at the arrival of her grandchild, but she was also concerned about the family whose child had died. At a family dinner that evening, conversation focused on cars, drama productions, diets, schedules and jobs.  There was some talk about the healthy grandchild, but none about the little boy.  No one knew about him.

            Except the Presence.  When the family evening closed, Lydia lay in bed talking with her Companion, trying to sort out the conflicting emotions of the day.  She gave thanks for her granddaughter and prayed for her son and daughter-in-law.  She also asked God to watch over the second family.  She prayed for the twin sister who would grow up wondering what it would have been like to have a brother. 

            Finally Lydia went to sleep.

 

            Winter was wonderful in this part of the world.  Temperatures would plummet, and ice fog would roll in.  When the fog lifted, there would be incredible, bright cerulean blue skies, with dazzling ice crystals encasing the tree branches, the mailboxes, any underbrush yet peaking above the fallen snow.  As evening approached, the sky would turn pink and finally deep blue black with a sprinkling of stars.  It was too cold for new snow, but the breath of man and beast would freeze in the air and one could hear the crunching of ice crystals under foot.

            It wasn’t so bad to be dragged out of bed in the middle of one of these cold, clear nights.  Lydia would breathe in the icy air and sleep would vanish.  A light headache would remain, but she was awake and able to be with and to pray with a grieving family.

            It wasn’t the cold winter nights that were the worst, it was the warmer ones. Newly fallen snow would pile up six inches, then eight, maybe twelve to fifteen inches deep. Backing out of a garage on a sloping hill during one of these nights was scary – but not as terrifying as when the wind joined forces with the snow to impede a would-be motorist.

            On one such snowy, wind-whipped night, Lydia received a telephone call from a former patient. The woman was feverish, almost delirious; she needed to get to the hospital, but didn’t drive, and had no money for a taxicab.  Would Lydia come and drive her to the hospital?

            Lydia looked out the window.  No. There would be no way to go out this night without being blown off the road.  A slow-moving taxi with chains might make it, but the patient had no money with which to hire one.

            Lydia told her to call a cab to take her to the hospital and she would arrange for a taxi voucher at the other end.  The plan was put in place and Lydia called the house supervisor on duty.  The supervisor was not pleased.  Taxi vouchers were only for leaving the hospital, not for coming to the hospital.  Nonetheless, the voucher was provided.

            Later that night, Lydia received a second call from the patient. She thanked the chaplain for the taxi voucher and explained what the doctors had found when she reached the hospital. A venal nerve stimulator implanted in the woman’s chest sent electrical shocks to her brain to short-circuit epileptic seizures. The area around this device had become infected and the infection had spread to her brain. It was apparently pretty serious and she was being flown to a Seattle hospital that night.  She thanked the chaplain again and hung up.  Lydia nodded toward the Presence and went to bed.

            The next morning Lydia waited for the snow plow before she could leave for work.  At the hospital, she was summoned by the house supervisor to explain her actions of the night before.  The supervisor accused her of misusing hospital resources by demanding the taxi voucher for a friend.

            “She was the hospital’s patient long before she was my friend,” the chaplain retorted.  

            “You should have told her to call an ambulance,” the supervisor insisted.

            Weighing the potential thousand-dollar ambulance charge against a five-dollar taxi voucher, Lydia decided the comment deserved no response.

            I wonder who paid for the emergency flight to Seattle, Lydia wondered to herself.

            “Check with the emergency room,” Lydia demanded, “The patient was flown out of here early this morning – a critical situation that the hospital apparently did not feel it was capable of handling.  This was a damn emergency!”

            The conversation ended. The patient eventually recovered and returned home.  Lydia wasn’t sure who paid the return airfare either, but she felt certain it amounted to more than the taxi voucher.

            You know, I’m just not an institution person, the chaplain later explained to the Presence.

            You may be right, the Presence sighed.  Let me think.

                                                                        ~~

            Lydia spent that week conducting mental health healing circles, parent grief groups, groups for aspiring chaplains, and a wedding.  As chaplain for the neonatal intensive care unit, she had found a wonderful woman who would knit miniature caps and blankets for the tiny neonates who arrived in this world and then quickly left again.  When a child died, the nurses would dress the tiny baby in one of the matching little ensembles before handing the child to its parents to say goodbye.  Some times the baby was buried or cremated in the little outfit, but more frequently, the parents kept the cap and blanket as a remembrance of their child.  This afternoon, the chaplain picked up another dozen of the sets to take back to the hospital.  The woman who knit them would accept no compensation, considering this her ministry.

            Lydia stopped at a grocery store to buy some teabags and cookies for the nurses on her units. When she returned to the hospital, she was summoned to the emergency room to sit with a youngster named Edmund while his mother, who had been in a motor vehicle accident, underwent surgery. 

            “I’m glad I got back here in time,” Lydia whispered to the Presence.

            Me, too, the Presence replied. Otherwise it would have been just him and me.

            Lydia and Edmund – aged about five – toured the facility and became close friends.  One hour turned into several, and Lydia began to worry about Edmund’s mother.  Edmund, on the other hand, seemed totally at ease.

            “I like you.  You walk like my grandmother in New York!” he informed the chaplain.

            Precocious little kid, Lydia noted, with a glance toward the Presence.  Laughing at herself, she took the boy back down to the cafeteria for more ice cream.

            As the day came to a close, word came that Edmund’s mother had survived nicely. She’d awakened, talked with the nursing staff, and was able to arrange for a neighbor to rescue Edmund for the night.  She would be discharged in the morning.           “Nice day,” she told the Presence on her way home. “Baby booties, Edmund and ice cream.  Thank you.”

            Don’t forget to take in the groceries, the Presence reminded her. The Pastoral Care tea party.  The feast on wheels designed to reach out to nurses and bring a spot of relief during their busy shifts.

            “Nurses might better appreciate extra staff so they can take a break in the first place,” the chaplain said out loud. 

            True, true.  But in the meantime, don’t withhold the tea and the cookies.

 

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