Celebrate Finals Week: Take This Test

When chaplains write down conversations they have with patients to share with other professionals, the dialogue may reveal a heap more about themselves than about their stellar patient care. We like to think we are showing off our expertise and resultant comfort, but as any chaplain in training knows, our own issues can subconsciously leak out, especially when we show the transcript for other chaplains eager to hunt for our rooms for improvement. That is why we write these verbatims: to find out what gets in the way of better care and work to get it out of the way in the future.

I took a portion of the following verbatim from an article in the chaplain literature. Since the article did not allude to what I saw as a problem, partly out of curiosity, and partly as a challenge, I now invite my readers to look through the transcript and identify the issue, or the principal issue. So if you can stand the suspense, read through it, comment if you can, and you will hear my answer in my next post. I will also wait until then to respond to comments, so everyone has a chance to take this “test.” Good luck! Whoever gives a great answer will get honorable mention.

Chaplain: interaction #1   (The hospital patient seemed alert and was sitting up in bed reading a book. The chaplain knocked on the door.)

Patient: interaction #1     Yes, come in.

C2     Mrs. Jones, I’m So and So, the chaplain-on-call.   I understand that you wanted to visit with a chaplain.

P2     (She smiled.)  I like the way you said that…”to visit with a chaplain.” Our minister said that there would be chaplains available to talk to if I wanted to.  (She winced some. I sensed that she might be in some pain.  I waited a moment and then responded).

C2     Indeed, I am here to visit with you, Mrs. Jones.  Am I picking up that you are in some pain right now?

P3    (Smiling but still wincing some.)  You observed accurately, Chaplain. I am having some pain.  Not a lot but some.  By the way, it’s Mary. (A slight pause).  I hate being in the hospital. The nurses are very sweet, and I have a very competent oncologist.  But being here is such a waste of time.

C3    Mary, you sound like a busy person.  It’s no fun just to lie here, especially in some pain, when you could be doing…what?

P4     I’m a manager of a large real estate company…Oh (she winces again).

C4     Mary, are you sure you feel like visiting now?  I could come back another time, say, in the morning.

P5      Chaplain, you don’t need to stay.  I know there’re probably some here worse off than me.

C5     Mary, if you want me to stay, I will.  You’re important, and you did have the nurse page me.

P6     (Smiles slightly).  Thanks, Chaplain.  I would like to talk…I really don’t want to talk about it…But (winces slightly…pauses.)…I know I need to…My family physician came by while my daughter was here earlier… [She then tells her concerns in the rest of this transcript]

 

Write your answer here, under “Comments.” I will give a passing grade to all who try, and an “A” and special mention for the best answer!

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13 thoughts on “Celebrate Finals Week: Take This Test

  1. Nancy Lloyd says:

    Two problems:
    I didn’t like the response to “It’s such a waste of time…”
    Chaplain seemed to ” waste time” by asking about pain..I would have waited until Mary told him/her what her physical situation was.

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  2. Cathy Baird says:

    I’m not sure if “principal issue” refers to Mary’s issue or an issue with how the chaplain handled the beginning of the conversation. Mary’s principal issue may be the transitions from being in control and having a purpose to losing control and wondering what her purpose is (with a possible side issue of finding it difficult to ask for help).

    I believe it would have been fruitful if the chaplain (at “Indeed”) had asked what she would like to talk about instead of asking about pain.

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  3. Leah Recchia says:

    I noticed that the Chaplain thought maybe she was bothering Mary. The Chaplain asked if this was a good time to stay and visit. Maybe the Chaplain was looking for assurance that Mary wanted her there? Mary seemed like she was unsure as well.

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  4. Vicki says:

    I wonder if this woman needs to be in pain. It’s hard to focus on much else when you are. Could the chaplain not find her nurse and report that this woman is clearly in physical pain? I would want to know what’s up with that first.

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  5. Sande Ramage says:

    I think the pivotal moment is after P3 and in the space before C3. The chaplain responds out of her understanding of being busy (probably lots of calls still to do) and what a waste of time might be for her. Maybe Mary was talking about being in hospital as a waste of time because she wanted to be at home doing absolutely nothing but gazing out at her special tree. Who knows. Maybe reflecting back waste of time? might have taken the conversation in another direction.

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  6. Jessica Perez says:

    The chaplain’s approach did not seem very warm. She did not ask the patient how she was feeling. With this question the patient could have time to vent on how she was in pain. In addition, the chaplain assumes that the patient is a very busy women and this is the reason she does not want to be there. As chaplains we must never assume what our patients suffering is. We must let the patient guide us in the conversation, not the other way around. In C4 the Chaplain is also assuming that the patient is not capable (because of her pain) to talk. If the Chaplain was called by the patient of course she has something to say. Because the Chaplain is assuming she almost lost the patient in P5.
    We should never assume we know what our patient needs or why they are suffering. They will always let us know.

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  7. jane hatton says:

    Or maybe being there was a waste of time because she is terminally ill. The chaplain should just have reflected “waste of time?” and waited for what came next. What struck me was that he/she didn’t sound comfortable in their own skin…

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  8. Peg Burbank says:

    I am curious at the italics used for the word “visit” in C2 (there are 2 interactions numbered C2). I agree that P3 is loaded, and C3 seems to redirect rather than scratch into it. This Chaplain seems to want to run from this patient’s pain, rather than enter it – especially problematic for a referral.

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  9. DJ says:

    Is the chaplain uncomfortable with seeing someone else in pain and bringing undue attention to the pain? The patent never mentions the pain. It is the chaplain that focuses on the physical pain. There is something deeper the patient is avoiding and not wanting to talk about. Patient is hoping the chaplain can naturally draw it out of her. . There is a conflict between patients mind and soul. The mind and soul are not in agreement.

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  10. Karen, I must be dense because I have read this transcript carefully about three times and I cannot identify anything I would consider a problem! I shall read your next blog in the hope of enlightenment.

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  11. kevinformal says:

    What DJ and Jane Hatton said! Also, not enough slapstick humor and murders for my taste. 😉

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  12. Gydle says:

    I also got bogged down in the chaplain’s response to “waste of time” — the patient could be referring to the fact that she knows she is going to die and so whatever treatment is happening in the hospital is futile – that is the waste of time, not that she would rather be doing something else or that she is a busy person or that it’s “no fun” to be in the hospital. Time is precious when you know you are near the end of life.

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