PlainViews

Chaplain Resident Heidi Zlamal on one more viewpoint on family presence

A Chaplain Resident’s Response to
“A Different Voice on Family and Chaplain Presence at Codes”

In light of Mark Colbeck’s response as a Paramedic, I would like to share my thoughts as a chaplain resident with medical knowledge. I am a Volunteer EMT Intermediate from Germany.

I appreciate Mark’s unique experience and practice in Toronto, Canada. Here at the Main Methodist Medical Center, in San Antonio, Texas, we have a special Code Team, the Rapid Response Team, which gets paged to Code Blues. Responders are on the house staff, including the chaplain on-call. My experience has been during the weekends, both day and night shifts.

I was quite challenged in my first unit of residency to find my role in a Code because of my medical knowledge. It was also a challenge in general during pastoral care visits. The danger was that I would drift into the nurse’s territory and put on my "EMT uniform," because the monitors distracted me.

My care differs in each Code Blue. I agree that sometimes family can stay in the room. However, if they are extremely emotional and are destructive to the work of the team, I try to get them out in the hall, perhaps sitting them down in the hallway. From there, they can still watch the team working, so they know everything is being done for their loved one. Sometimes I even take people to another room, so they are able to express their feelings freely. If this is the case, I do not leave the room. The Nursing Administrator informs the family about the condition of the patient. Most of the time, families and friends are so overwhelmed by the situation that I follow up and ask them if they understood what the Nursing Administrator told them. Then I help by translating into non-medical terms what was said using short sentences. I also speak slowly. If I am able, I leave the room to check on the progress of the patient and will tell the family: “The team is still working.” I might not have the chance to watch the Code Blue and talk with the staff. An important question for the Chaplain is: What kind of protocols are in use in the facility and how to prioritize those protocols during the Code? It is a team effort!

I also approach staff about how they are doing and not only during a Code. I also check in with the EMT’s, and the Paramedics in the ER, when they bring in an Emergency, because I feel responsible for them, especially since I am an EMT too.

I like Mark’s idea about a seminar for chaplains about what happens medically during a Code. Residents might also learn about it during their orientation.

A Code Blue can trigger something in me as the chaplain. Some chaplain students and residents may not feel as comfortable as they might seem in their first Code Blue. Even in chaplains with many years of experience, a Code can trigger deeper issues, especially if working in a trauma hospital. I learned to become aware of my feelings during the situation and use these as a tool in my ministry. During my residency, I have had the chance and the responsibility to bring these feelings to supervision and work with them as they are a growing point for me.

For long term professional chaplains, here is an important question: Where will you find a safe place to process these important moments? Maybe there should be supervision for chaplains....

Heidi Zlamal is current a chaplain resident at the Main Methodist Hospital in the Medical Center of San Antonio, Texas. She is a German Lutheran Deaconess and she is also a Volunteer EMT with the Johanniter Nuermberg (German version of St Johns Ambulance), Germany. She volunteers at the Live Oak Fire Department, Texas, and she is looking forward to her 2nd year Residency in the Level I Trauma WellSpan Hospital in York. She hopes to find a Fire Department in York with opportunities for Pastoral Care in CISM for further volunteering.