Chaplain Cliff Bond on what patients expect from us

"Whatever it is that you do…”

Our inpatient medical oncology patient care meeting was concluding as we gathered at the nurse’s station to plan our day. Physicians were charting at the same desk. One physician greeted me and then gave me a synopsis of a patient’s condition with both a diagnosis and prognosis which were doubly difficult; she was not only young but was also one of our colleagues. The patient, “Vickie” (not her real name), was a nurse in her 50’s who had just been diagnosed with ovarian cancer. The physician then said, “Cliff, whatever it is that you do, go do it now with Vickie.” His comment acknowledged the value of pastoral care and he wanted this for his patient. He also was admitting that he was not suited to deliver this facet of care that was very much needed.

Sometimes we apologize for what we have to offer in the acute care setting. We do not prescribe medications nor administer treatments. In a medical setting where these comprise the vast bulk of care rendered, we can feel overlooked or under-utilized. In our facility, our chaplaincy staff have written entries into the physician progress notes for many years, so we were always visible as part of the care team as long as we actually charted. Notes entered in the past had shared information that was useful to the physicians in their care plan, so it was a natural transition for this physician to ask for assistance when it was needed; it was needed now.

Vickie’s husband was sitting in a chair beside her bed. Both were tense because of the seriousness of her situation. They had a deep faith. As we talked and prayed the tension did not lessen—it changed. The energy of worry became the energy of courage and hope. Vickie grabbed my jacket lapels, pulling me close to her face: “Promise me I will be strong enough to go through these tests.” She did not demand healing. She wanted something more. She wanted what I call “realistic hope.” Vickie gripped my hand and would not let me go until I answered. I said, “As God is my witness, you will be strong enough.” She said, “I will hold you to that!”

I was shaking inwardly at the audacity of my proclamation to her. I went to my fellow chaplains, wanting some kind of feedback. They agreed that in this situation, with this particular patient, it seemed to be a good pastoral care approach.

Vickie went through the treatments which were recommended, fought valiantly and maintained her high level of courage and realistic hope. She died far too soon.

Vickie taught me a most valuable lesson: patients expect more from us than we can deliver, and that is okay. Faith is not knowing what to do; faith involves a certain element of risk, taking a chance, staking a claim, claiming a position, creating hope and trust, all done within the context of a covenant relationship. If we truly believe we are called by God to care for those needing spiritual support, we can trust God to give us the words to say at that time and for that situation. Trusting the moment, trusting the relationship, trusting the Spirit makes pastoral care spiritual—or spiritual care pastoral. Chaplains are in a unique role with unique training and when we can trust that things truly do work together for good when we are called by God, some amazing and even startling things will happen.

This kind of interaction could not have occurred early in my work as chaplain. I had not yet learned to work outside of the “footnotes” of my training and had not yet established the high level of trust needed in relationships with physicians. “Whatever it is you do, go do it with that patient” is both humorous and priceless.

Do you have thoughts about advocacy you’d like to share with your colleagues? Send an e-mail to info@PlainViews.org.