So I'm doubly sorry to have missed last week for having been swamped—literally—by Tropical Depression Ernesto, who kept me offline upon my return from San Francisco. And this is the question you should have seen then, submitted by Bedside Manner Pastor. Jan, St. Casserole, and Rev Abi all stepped up to share their wisdom, and what wisdom it is. I have other questions that came up as well, but you can rest assured that they will be published in future editions, with equally insightful answers.
Also, look for Ask the Matriarch to be posted earlier in the day in future editions, now that our introductions have moved to Monday.
Onto the question! Here's what Bedside Manner had to ask:
I would like some guidance on doing a hospital visit. I've done them and I know there's no blueprint, and you have to be responsive to the person's situation and needs, but there are some basic guidelines that I somehow managed not to get.
Do you call first?
J: Probably not. If you make an appointment (“I’ll be there about 4”), that doesn’t mean technicians and others won’t drop by and whisk your parishioner off to x-rays or something. The only reason to call might be if you hear that no visitors are permitted and you want to check on that.
St. C: I show up at the hospital unless I do not know the person I am to visit. I may call the unknown patient’s family (whoever appears to have the closest relationship with the patient, if possible) if I feel I need more information.
Do you have to check in at the nurse's station or just walk in like you own the place?
J: If the patient is in ICU, CCU, NICU, or the ER you probably have to get past a nurse or even a guard before you can enter that unit. Most nurses will let a pastor enter unless the patient is in the middle of some highly embarrassing procedure. Otherwise, you can venture on in, assuming you know which room your patient is in.
St. C: If I am going to an unfamiliar hospital, I will introduce myself at the nurses’ station as a courtesy. Otherwise, I just go to the room. If the door is closed, I may go ask a nurse if the patient is in the room, off for tests or sleeping. If the door is open or cracked, I stick my head in and announce myself. If the room is loaded with family members, I ask if they would like for me to come back at a later time. Most want the preacher to come in for a visit.
Rev Abi: Some hospitals enforce the HIPAA Act in such a way that the patient has to put you on the visitation list, but when they are traumatized or there is an emergency, that is not always possible. I bring a card for the nurses if they don't know me, or I am new in town, and as well as one for the patient, as sometimes they are sleeping or gone to a test of some sort. That way I can leave a note if they are gone to let them know I was there.
Visiting hours only?
J: It’s kind to visit during these hours so patient can attempt some rest during non-visiting hours, unless you’ve been called in the night, it’s a life-threatening thing, etc. Again, most nurses and doctors are happy to have the pastor there, especially if there’s something critical going on.
St. C: I don't pay much attention to visiting hours unless I’m forced to do so. Intensive Care and similar units control all of the visiting time. If you want to see the patient in Intensive Care, go open the unit door, identify yourself and ask to visit the patient. In some situations, this will be fine. If the patient is "out of it," put your hand on their arm—probably the upper arm where there aren’t any tubes—and tell them who you are. If you don't get a response, pray for them in a POSITIVE way so that you do not add to their anxiety or give the impression that you are doing a stealth version of Last Rites. If they are responsive, visit briefly.
Rev Abi: Visiting hours are to protect the patient. But I have gone early morning and late night if that was the only time I could go. Usually those are short visits, maybe before surgery or after as well. Interestingly those have been some of my best visits with patients.
How long do you stay?
J: Don’t stay long—maybe 10 minutes? So much depends on the situation. Patients need their rest. The exception would be the rare times when a patient or family has asked you to stay because of special circumstances. I was once asked to stay all night with a dying man because his family couldn’t get there until morning and they didn’t want him to wake up and find himself alone.
When my mother was dying, the pastor (whom she didn’t even like much) stayed way too long, which was difficult for family and close friends who wanted to say good-bye with a little privacy.
St. C: All hospital visits should be brief. Unless the patient is chatty, don't stay long. A few minutes is enough time to show your support and pray. Do not sit on the patient's bed. Do not kick the pee bag. Do not ask to eat their treats or pick a few flowers from their floral arrangement. Be aware of how comfortable they are—that if the patient is gassy, he or she will do their best to refrain from pootage while the Holy Preacher Of God is in the room. Do not stay long. Gas held in hurts; gas released produces shame. Abdominal surgery means gas. So does most else.
Rev Abi: I try to keep the length of stay to a minimum, but sometimes I stay longer. You can ask or sense that, or tell them.
Do you bring a card, or anything else with you?
J: A business card is handy, especially if the patient is asleep when you arrive to visit. You can write a note on the back and put the card in a place where someone will find it, such as by the phone. Also, that way the family will have your number if they need it. I also bring a small Bible if I think someone will want scripture. And I bring communion, especially if it’s Sunday and the rest of the congregation just celebrated communion.
St. C: You don't have to take the patient anything. You are the gift. For children, I take a gift because as a child, I received gifts in the hospital and I loved them.
How and when do you pray?
J: Don’t wait until the end of the visit to pray. Sometimes a heartfelt prayer opens up the discussion and frees people to address fears/hopes/needs that a simple “friendly visit” wouldn’t. If you wait until the end of your visit, you might not have enough time before your next appointment to address things that it feels easier to say having prayed together.
I generally begin by asking, “Could I say a prayer with you?” or “Would you like me to pray?” Sometimes they say “No,” which we need to respect (especially if patient is ticked off at God). That’s okay. Also, I’ve found it helpful to ask them, “What should we pray for?” It gives you a window into their issues. (Are they most worried about dying? Their kids? Pain?) I always touch them when I pray. (Gently—and not near the sutures! )
St. C: I do not leave a patient’s room without offering to pray or leave a blessing. I give the patient a choice because I am aware of how emotional a hospital stay can be for the patient. I ask, "I’d like to pray for you. Is this a good time or would you like me to pray later?" Pause for a second. If they are unsure if they can maintain their dignity or control if you pray for them, then you’ve allowed them to refuse prayer gracefully.
Rev Abi: Prayer is such an interesting thing. Too many of us, including myself, use it as closure, but people seem to be okay with that. I do tend to ask if I can pray, but I have had people say, "Pastor, can we have prayer before you go?" Sometimes I ask for what they need prayer for, and sometimes I don't if I already know they are going in for or the surgery was completed.
How often should you visit?
J (and echoed by Rev Abi): Since hospital stays are notoriously brief these days (barely 24 hours for a mastectomy; 2-3 days for open heart surgery), one visit will probably be all you need. If someone is seriously ill and in for a lengthy stay, once a week or once every 10 days might be appreciated. If someone is literally on the cusp of eternity, you can probably sense if the family or patient wants you to check in every day.
Is it better to visit a new mom in the hospital or at home (or both)?
J: Moms seem to prefer a brief in-hospital visit, maybe bringing along a treat not available in the hospital cafeteria (such as a really good decaf latte). Once home, the baby’s adjustment and the presence of others in the house make things so hectic, it seems best to let mom and family get used to each other in peace. Just visit briefly, say a prayer of thanksgiving for a healthy baby, and offer lots of comments on the little one’s cuteness quotient.
The exception would be the situation of a sick/dying baby. Still bring the treat to the hospital (and maybe something for dad), but be prepared for a slightly longer visit with some theological discussion: “Am I being punished for something?” “How could this happen?”
Be prepared to baptize a sick baby. Nurses can get sterile water for you. (I’ve even baptized a dead baby.) These moments are clearlly not the time for a theological debate on the efficacy of baptism for a dead or dying child. Just bring comfort and a shoulder and keep reminding mom and dad how much that baby is loved.
St. C: As a woman, you can visit a new mom in the hospital with more ease than I think a man is able to have. Then visit her at home, too, after reassuring her that she is not to prepare ANYTHING for your visit and that you do not care if she hasn't had a bath in 5 days!
Anything else I should know?
J: Just love your people, especially in these weakened moments as patients. It is extraordinarily holy to be the one called in for such milestones: the births, the deaths, the life-altering surgeries. It is an enormous privilege. Oh, and it’s okay just to sit and say nothing. Be real.
St. C: It may be helpful to wear your clericals. The clericals identify you as a person who is authorized to be in the hospital. Try to avoid wearing perfume. Put out your cigar before you go into the room and keep a breath mint in your pocket. If you see gushes of blood and guts, ask God to keep you from reacting with a dead faint or nausea. When a patient tells you that her boyfriend's "thing" untied her tubes, try to keep a straight face. This happened to me and I was dying to see the boyfriend! I can recall every person who every visited me when I've been hospitalized. That's how important these visits are. God bless you for going to see the sick.
Rev Abi: Dress comfortably but look professional. There have been times when it was a crisis and I had to drop everything to run to the hospital—in shorts! It's not a problem—just bring your nifty card. Wear comfortable shoes, you are going to have to walk. If hospital visits are hard on you, take deep breaths and visualize yourself being able to visit this person with ease. Or, take someone with you. Go see your patients, sit down, touch them, hold their hand, listen, pray and then leave. But leave your anxiety at the door. Bring your presence. If you haven't had Clinical Pastoral Education, go take it, you will learn a whole lot about hospitals, visitation, facing your fears, and be more comfortable with yourself, or not, and then do more CPE or get some counseling to face you.
Me: I've asked RevAbi to share her handy "Guide to Hospital Visits" over at her blog, too! You are welcome to use them for your congregation, yourself, or to share with others. Thanks to revabi, and her friend Rev. Amy Raser.
Happy Thursday, all!