Reflections on Chaplaincy during a pandemic

The bakery, I Canita Cake, in Roswell donates bakery goodies for first responders. I get the chance to bring them to the hospital on occasion.

A year ago on December 14, 2020 I began as a Registry Chaplain at a major hospital in the Atlanta area. Like so many families in 2020 our income was suddenly stopped. Both my husband and I do freelance work most of which relies on face-to face meetings. My husband is a photographer and I do project work in the nonprofit sector. When face-to-face gatherings suddenly ended in 2020, I was faced with finding another source of income. Hospital chaplaincy appeared to be my best option and one I’ve felt called to for years.

I applied to every opening in the greater Atlanta area. By October of 2020 I began to schedule interviews with three different major hospital systems. In November I was hired as a Registry Chaplain, which is PRN (as needed) work. As it turns out I am working 20-30 hours a week regularly, very good for PRN work.

The past year has been a whirlwind. In some ways it has passed quickly, but in others I feel like I’ve aged years. At the hospital where I work chaplains handle the decedent paperwork in addition to being a caring presence for the families of the deceased. This means we give the medical staff the death certificate worksheet to complete, make initial calls to both Lifelink and on occasion the Medical Examiner. We also are the main contact for the families when they decide on a funeral home. When a patient is near death a chaplain is often called to be with the patient and their family. The total time with the patient and family and then to complete the paperwork can vary between 2 – 4 hours before during and after a death to the completion of the paperwork.

Since December of 2020 as a part-time chaplain I’ve handled the decedent paperwork for 76 patients. At my one year anniversary I was curious how many people I had handled this for in less than 120 days of work, so I went through our log book and counted. I needed to see the proof as to why I felt so heavy.

Early on in my time at the hospital I was trying to get as may hours as I could in an effort to make up some lost ground in our household income. All was going well until somewhere in mid-February I hit a major wall. I felt awful and was thoroughly checked out medically. I realized I felt awful because of the shear numbers of dead and dying patients and their families I had met with in a few short months. In one 12 hour shift in January of 2021 I had 6 deaths. In that 12 hour period I had no time for even a sip of water or a bite of food. It was at this time I learned to take breaks as I could. Often taking quick breaks to eat a protein bar or drink water. I no longer packed my schedule.

The need for self-care is not optional in this work. Writing about the things I’ve learned is one way for me to take care of myself. My hope is that my reflections will help others who find themselves in this reflection and take time for self-care.

A few random things I’ve learned in the past year in not particular order:

  • Our healthcare workers are true heroes.
  • I watched the medical staff in more Code Blue situations than I can count. It is an amazing situation to watch. Scores of people descend on a room and each knows their role, and what is expected of them. This is team work in literal life and death situations. I am left in awe each time I report to a code.
  • I was surprised to find over the past year the number of nurses, doctors, physician assistants and nurse practitioners who will tell us, the chaplains, they couldn’t do our job.
  • Related to the point above, healthcare and the fire service is similar. At a fire scene as chaplain I go to the family to comfort them as they watch smoke and flames billow out of their home. The firefighters tell me they couldn’t do what I do, but they walk into the flames. I cannot do what the firefighters do nor what the nurses at the hospital do. We each have our role to play and are highly trained to do it.
  • Nothing will frustrate an ICU or CCU medical team more than a family who will go against the patients wishes and not make them DNR (do not resuscitate). The medical team knows that at a certain point keeping a person’s heart beating does not mean they will get better and go home. Many times it just prolongs the suffering of the patient. It is far more compassionate to let a natural death to occur. See THIS article about doctors and end of life care.
  • Another frustrating thing for medical workers is the spreading of false information and conspiracy theories. Just don’t do it. People are losing their lives because they are not vaccinated.
  • Medical staff is often left with many questions when a family who professes a faith in God, and the belief that life does not end, but that a faithful person will live on with God, prevents their loved one from that hopeful death.
  • In the midst of some really awful days, sharing a photo of a new baby or puppy can really brighten the moment.
  • The funeral homes and their transportation people are also feeling the stress from the pandemic. Did you know there is a whole business just to pick up deceased patients and take them to the preferred funeral home? While the pandemic may be good for these businesses the people who work for these businesses are feeling the strain too.
  • Hospital staff appreciate people in the community sending in treats. Hearing thank you helps.
  • Hospital administration, at least at our hospital, work very hard at finding ways in which to support the staff. Their work is a different type of tough with it’s own set of stressors.
  • Humor is a great stress reliever. I learned that when my oldest son was to be commissioned in the Army then again before his deployment to Afghanistan. I took a comedy writing class before each of those events. The lessons learned in those classes has seen me through some difficult experiences since. You can see the graduation videos Here and Here.
  • I work with some amazing people in the pastoral care office. It is so refreshing, and rare, to work with a team of professionals who support each other.
  • The role of a chaplain is misunderstood by many. A hospital chaplain is trained to listen, be present and help people access their own means of support. We are a caring presence for people at some of the toughest times of their lives. At the core of being a chaplain is being present for people going through a tough time. We can’t change what is happening but we can let a person know they are not alone at a time they may feel completely deserted.

I am sure I’ll think of other lessons from the past year, but for now these are the ones I’ve had on my mind. As we battle the latest variant of the virus and continue to battle misinformation, I’m sure I’ll feel the need to write again.

A few photos follow of some pretty neat things that happened the past year.

A fun note from a co-worker starts the morning off right’
When a young patient told me he loves HBCU marching bands and the movie Drumline, I enlisted the help of my friends at the Chick-fil-A Peach Bowl. They put me in touch with Kelly Fanning, VP of Marching Bands for the Bowl (pictured on the left). Kelly then put me in touch with the directors of several HBCU marching bands who each sent T-shirts, lanyards, and hats to our patient. Then Kelly and his friend Geoffrey Thompson (pictured on the right) visited. (See the video HERE. ) Both Kelly and Geoff had a role in the movie Drumline. Geoff then asked his friend actor, Jason Weaver (pictured in the middle), to visit the patient. Jason played Ernest in the movie Drumline. To say our patient was speechless is an understatement.

Forewarned is forearmed: First Responders and Traumatic stress

The ancient Latin saying, ” Praemonitus, praemunitus,” later in 16th century England became “Forewarned is forearmed” can apply to a wide variety of situations. For this post I’ll be discussing the importance for first responders to learn about the potential dangers of their work to their mental health.

Before I begin it is important to note that each individual will process their experiences differently. Not everyone who is exposed to a traumatic event will end up with a traumatic stress related injury. Advance knowledge of Post Traumatic Stress Disorder (PTSD) and related disorders can help first responders help themselves and their co-workers.

Post Traumatic Stress Disorder (PTSD) is fully explained on the website of the National Institutes of Mental Health. I encourage all first responders to read the information on their site.

For the purpose of this entry I share the criteria the NIMH list on their site for a diagnosis of PTSD below. In the last paragraph the BOLD type was added by me for emphasis:

“To be diagnosed with PTSD, an adult must have all of the following for at least 1 month:

  • At least one re-experiencing symptom
  • At least one avoidance symptom
  • At least two arousal and reactivity symptoms
  • At least two cognition and mood symptoms

Re-experiencing symptoms include:

  • Flashbacks—reliving the trauma over and over, including physical symptoms like a racing heart or sweating
  • Bad dreams
  • Frightening thoughts

Re-experiencing symptoms may cause problems in a person’s everyday routine. The symptoms can start from the person’s own thoughts and feelings. Words, objects, or situations that are reminders of the event can also trigger re-experiencing symptoms.

Avoidance symptoms include:

  • Staying away from places, events, or objects that are reminders of the traumatic experience
  • Avoiding thoughts or feelings related to the traumatic event

Things that remind a person of the traumatic event can trigger avoidance symptoms. These symptoms may cause a person to change his or her personal routine. For example, after a bad car accident, a person who usually drives may avoid driving or riding in a car.

Arousal and reactivity symptoms include:

  • Being easily startled
  • Feeling tense or “on edge”
  • Having difficulty sleeping
  • Having angry outbursts

Arousal symptoms are usually constant, instead of being triggered by things that remind one of the traumatic events. These symptoms can make the person feel stressed and angry. They may make it hard to do daily tasks, such as sleeping, eating, or concentrating.

Cognition and mood symptoms include:

  • Trouble remembering key features of the traumatic event
  • Negative thoughts about oneself or the world
  • Distorted feelings like guilt or blame
  • Loss of interest in enjoyable activities

Cognition and mood symptoms can begin or worsen after the traumatic event, but are not due to injury or substance use. These symptoms can make the person feel alienated or detached from friends or family members.”

It is natural to have some of these symptoms for a few weeks after a dangerous event. When the symptoms last more than a month, seriously affect one’s ability to function, and are not due to substance use, medical illness, or anything except the event itself, they might be PTSD. Some people with PTSD don’t show any symptoms for weeks or months. PTSD is often accompanied by depression, substance abuse, or one or more of the other anxiety disorders.

I added the bold type above to emphasize the fact that feeling off or experiencing any of the reactions listed above immediately after a traumatic event is normal. The phrase often used is, “It is normal to feel abnormal .” If the reactions do not lessen after a month or so, that is a sign to seek additional support from a therapist or doctor.

First responders, like service members, often hesitate asking for help. No one wants to be taken off of active duty, or to say they are struggling. Fortunately in the military great strides are being made in de-stigmatizing asking for and seeking help. Due to increased awareness of suicide rates among first responders, steps are now being taken by public safety administrators to increase peer support programs and enhance employee assistance programs. More work need to be done in this area.

Administrators of public safety departments need to lead in the realm of education on mental healthcare for their department.