We post an ethical or situational concern that has arisen in a facility where one of our readers works. It has no identifiers included. It gives you only the facts of the case. Then, you can respond to that concern. This is an ongoing dialogue, with comments added as they come in. In the following issue, assuming it has been resolved, we give you the outcome from the facility where the incident took place. Please send any cases that you would like considered for inclusion to: info@plainviews.org

We hope that this new addition will help to inform not only those who are dealing with the issue, but will enable all of our readers to learn from the experiences and perhaps mistakes of others.

PLEASE NOTE: Due to unanticipated continuing responses to both the case and the resolution of the case, added responses can be viewed in the archives. Click HERE.

CaseConference #13 Resolution

In the chaplain's initial assessment, the patient focused solely on her pain issues. In the conversation, the chaplain asked the patient to identify what had successfully soothed her spirit during her life. The patient stated she had always liked classical music, to which the chaplain suggested that music might assist her in soothing her pain. The patient was doubtful at first, but agreed to try. The chaplain obtained a CD player with classical music and headphones, set it up for the patient, and then sat quietly with her. Within minutes, the patient fell asleep. The chaplain documented the intervention and updated the RN. The chaplain made additional brief contacts with the patient, first several hours later, and then the next day, to inquire how the pain was being managed. On the 3rd contact the patient – who had been managing successfully without asking for a sleep aid – told the chaplain that "she wished the music would soothe the pain in my heart, too." The chaplain invited the patient to conversation and care began to address the patient's grief at the death of her husband.

By the end of the patient's hospitalization, plans for community follow-up had been made and agreed to by the patient so that she would have ongoing grief support.

CaseConference #13

Nursing paged the chaplain to make a referral to see a 75-year-old woman recovering from back surgery performed seven days ago due to non-compliance with recovery care. The nurse explained that she had just spent 45 minutes with the patient who was insisting on receiving a sleep aid in addition to her pain medication. The patient had been seen by the pain specialist and a pain plan was in place, but she was still refusing to cooperate with nursing or participate in therapies, saying, "I just want to sleep it all through because it hurts so much." The nurse added at the end of the referral request that the patient's husband had died two weeks ago.

What is your role as chaplain in this situation?

How would you approach the patient?

How would you go about assessing this patient?

Would you raise the issue that her husband had just died?

Please check the archives below for comments made about the last CaseConference.

Send your comments about CaseConference to info@PlainViews.org.