In
Part 1, I described in general what an ICU is like and and a number of the conditions you are likely to encounter when you make a visit.
In this post, I want to describe some of the preparation I use to help me be effective when I enter the ICU. Hopefully, the information I presented in Part 1 helps you understand that an ICU is not a place you just walk into lightly. It's a very serious place because the patients there have serious medical conditions, they and their family members are anxious, and the medical staff has important work to do.
My presence in the ICU will hopefully be calming, encouraging, and non-intrusive.Preparation is further important because I really have no idea what I'll encounter when I walk into the patients room. I have minimal information, usually just the patient's name and room number. I don't know their condition, what they've been going through, or what family members may be present. Sometimes I have visited them before, and so I may know something of their story. But basically I go into every visit pretty much blind as to what I'll find and what the needs are. Surprisingly, that's enough.
My goal is to go into each room neutral so that I can match -- and not contrast with -- the mood of the patient and family members. That requires that I be able to put aside whatever else I've been thinking about, worrying about, enjoying, or whatever has happened earlier in the day. I want to be able to give the patient and family my complete focus while I'm with them.
Sister Alice Potts, who was the first chaplain at M. D. Anderson, was a mentor to all of the staff chaplains that followed, and also to a lot of us who do lay chaplaincy. She's the one that impressed on us the importance of being neutral going into a room. Her message to us was that if the patient is angry, then we should reflect their anger. If the patient is frustrated, then we should reflect their frustration. If the patient is rejoicing, then we should reflect their joy. If they are speaking slowly and quietly, then we should speak slowly and quietly. You get the idea. "Join the patient where they are," was her constant admonition.
My training and my mentors have also impressed on me the importance of being present for the patient. Being present has many facets, but important to me is that I go into their room with no set agenda except to meet their needs as they express them at that moment. That means going into the room with all my senses heightened. I need to sense whether this is a good time for a visit, whether a conversation is appropriate, make a split second assessment of what's already going on in the room, and many other things. Being present can mean just leaving a card and slipping out quietly. Or it can mean spending significant time engaging the patient and/or family. Being there, though,is the most important thing I do, whether I say or word or not.
It's also important to me that I enter the room as God's representative, with the purpose of ministering to the patient and family. I'm still me, with my skills, knowledge, and intuition -- and with all my baggage too. The visit is to be about the patient and family, and not about me. I'm there to listen to them, not to tell them my stories.
My preparation is simple. Since I generally make these visits on Monday afternoons, I'll spend some time Monday morning reminding myself why I'm making them. At some point during the morning or while driving to the medical center, I'll pray for my effectiveness. After arriving at the hospital, I'll review my list of folks that I'm to visit, and if they are folks I've visited before, try to jump start my memory about their story. I generally try to make my ICU visits first, before making visits to patients in regular rooms, to be sure I can spend whatever time is needed with them. But sometimes I'm led to visit elsewhere first. And occasionally, I find that I need to take a few minutes in a quiet place to re-center, to get ready to engage another patient.
That gets us to the point of entering the unit. In Part 3, I'll describe how I conduct the visit and some of the common tools I use.
Posted by email from Alright! (posterous)
