In
Part 1 and
Part 2 I provided general information about making an ICU visit and the preparations I usually go through prior to walking into the ICU area. In this post, I'll talk some about the actual visit.
At M.D. Anderson, where I regularly make chaplaincy visits, the ICU units are organized as Pods, with rooms enclosed by glass sliding doors arranged around the stations where the medical staff works when not in a room. That allows a visitor to see into the room before entering, and get some idea of what's going on and who's in the room. After washing my hands, and sometimes putting on required protective gear such as gloves, a mask, and a gown, I gently knock on the door to let those inside know that I'm present. I open the door and walk in, at the same time trying to get a picture of what's going on.
I've learned to introduce myself clearly and slowly to give the patient and family members a chance to figure out who this new person is and why he's there. They're used to people coming in and out frequently, but it gets confusing to figure out who's who and why they've entered the room. I also hand the patient or family member one of my business cards, as that also helps them process who I am. The words I usually say are, "Hi, I'm Jim Hughes from Lifeline Chaplaincy. We're the church of Christ chaplaincy here in the Texas Medical Center, and I just wanted to come by and see how you're doing today." Most of the folks I visit have identified themselves as members of the church of Christ, so that provides an immediate connection, even if they're not familiar with Lifeline Chaplaincy. Sometimes I add a little more information, especially if they've been referred to us asking that we visit. I'll tell them that, and mention the name of the person that asked us to come by.
Sometimes just that introduction is enough to start a conversation. But most of the time, I ask a couple of questions to stimulate the conversation. One that nearly always works well is, "So, what's going on today?" That gives them an option to say as little or as much as they want to, and I just listen, and try to respond in a way that they know I've heard them. I find that I use words like, "Wow!" or "Oh My" a lot. Sometimes my response may be, "Sounds like things are getting better, right?" Other times I may respond, "Sounds like you're having a tough time right now." Again, those are not only words to let them know I'm hearing what they're saying, they're also invitations to say more if they want to. If they don't bring it up in their conversation, which is maybe half the time, I'll inquire about how they're doing emotionally and spiritually. Sometimes I'll just ask using those words. Other times, depending on how the conversation has gone to that point, I'll use a phrase that's a little different, like "How are you and God getting along these days?" That's a different question to many folks than "How's your relationship with God?"
The conversation may be quite short, depending on circumstances. Or it may go for a lengthy period. We may talk about a lot of other things, and they may be important. It's not uncommon that the patient has a question that they've been thinking about, and want to have a discussion around that. I'm there to go where they want to go -- they lead, I follow.
At then end of the visit, I usually say something like, "I'd love to pray with you if that would be okay." Most of the time, the answer is "Please." But sometimes it's not, and that's okay. If they want to pray, I also like to ask them, "What would you like to pray about today besides the medical issues going on?" or simply, "What would you like to pray for today." I'm surprised by how often there are other issues that are weighing on them that need prayer as well.
Then we pray, and what we pray about is what we've talked about during our visit. In addition to carrying their needs and concerns to God, I want my wording of the prayer to convey to the patient and family that I've heard what they've shared with me, and that I am also concerned. We generally then visit for another minute or so to close out the visit.
Sometimes, I'll also have a visit with a family member in the waiting room. That conversation usually follows the same general path, but with some additional conversation about how things are for them in the role of caregiver. That gives an opportunity to talk about issues that the family member might not want to talk about in front of the patient.
No two situations are ever the same. I remember one patient I visited weekly for a couple of months. He couldn't talk, but was awake. I'd reintroduce myself, say a few words of encouragement, and pray with him. Sometimes the patients are delirious. Sometimes they are alert and feeling good. Sometimes their church experience has been good, sometimes it hasn't. Sometimes they're getting better, sometimes they're in the process of dying, or anywhere in between. But what they all have in common is that they're going through difficult days, they're anxious, and they're glad to have someone stop by and for a few moments share their life.
So what's it like to make an ICU visit? Seeing the pain, seeing people in such critical situations, seeing the effects of cancer up close and personal is not fun, sometimes even shocking even though I've been doing this for a while. But making a deep connection with someone, even for a few minutes, is an amazing feeling. And the more of life I experience, the more certain I am that making deep connections with others is what this life is all about. Learning to love, as God is love.
