Hospital visitation 101

A registered nurse shares practical advice with those who will spend time visiting ill church members in hospitals.

Kathy McMillan, M.A., has worked as a registered nurse and is now the director of Employee Spiritual Care at Loma Linda University Medical Center, Loma Linda, California, United States.

 

 

 

A church member of yours has just been admitted to the hospital, having suffered a heart attack. You discover this at three-thirty on a Friday afternoon when his wife calls to inform you—and she, with desperation in her voice, pleads with you to visit him.

 

You haven’t finished your sermon, and you promised your wife that you would help clean the house. Nevertheless, duty calls, and you leave for the hospital.

 

While driving to the hospital, you remember your last hospital visit with displeasure. A nurse told you to leave because it wasn’t visiting hours. You ended up being pushier than you would have liked in order to have a chance to visit your church member.

 

Many clergy feel out of place in the hospital. The environment can seem rather harsh and uninviting; the staff sometimes seems too hurried to be helpful; and the patients are often so sick that you aren’t sure if your visit mattered.

 

Hospital etiquette

 

You can do several things to make hospital visitation more beneficial for all who are impacted by it, including yourself.

 

Identify yourself. Once you arrive at the nurses’ station, identify yourself as a pastor and ask the nurses on call if this is a good time to visit. For many reasons, clergy often arrive outside of visiting hours. Most hospitals will allow pastors to visit at any time—especially if the patient or their family has requested your presence. Pastors should always carry their ministerial license or credentials. This proof of ministry is recognized by hospital staffs as a legitimate form of identification that allows pastoral access to patients who need to be visited—even outside of normal visiting hours.

 

Don’t be intrusive. Do not ask the attending nurse for a report on the patient’s condition. Due to privacy laws (often referred to as HIPAA1 by medical personnel), staff members cannot provide any information unless the patient has specifically given them permission to talk with you.

 

Be aware of sanitary rules. If the patient is in isolation, you may still visit, but make sure you understand what precautions need to be taken. Patients who are in respiratory isolation may need you to don only a mask, while other visits may require a gown, gloves, and a mask. These precautions are for your safety as well as that of the patient.

 

Before entering the room or touching the patient, wash your hands well. Germs are often passed by hand contact, and you can help prevent further infections. Wash again as you leave.

 

Don’t overstay your welcome. Even if you were invited to visit, remember that when someone is ill or in pain, their attention span is very short. If the patient wants you to stay longer, he or she will let you know. But even if the patient wants you to stay longer, it may not be best to do so. In such situations, you might wish to tactfully say, “I really do want to spend more time here with you; but I think it will be better if you focus your energies on getting healthy right now. I promise you that I will stay in touch with you.”

 

Spiritual care

 

While spiritual care-giving may seem like a pastor’s specialty, for some reason it often seems harder in a medical setting. In unfamiliar surroundings, the pastor can feel out of place. There are several things to keep in mind.

 

Hospital ministry is a journey. Spiritual care does not come in a neatly wrapped package provided by a person who has “arrived” and given to a poor soul in distress. It may be more helpful to think in terms of a spiritual journey. You are on a journey, as is the person you are visiting. In the way that you listen—and through words you share—you will provide something that will help the patient on their spiritual journey. And they, in turn, will likely say something that will help you on yours. By viewing it as a mutual experience, it takes the pressure off trying to find the perfect thing to say.

 

Assess the situation. Try to determine how the patient feels, both physically and emotionally. One cannot assume that people waiting for biopsy results are frightened. They may be full of anger or guilt, or they may be very sad.

 

Listen. Western society tends to be uncomfortable with silence. Stop and absorb what the patient is saying without feeling the need to respond. In Chinese Mandarin language, the character for listen is a combination of the characters for eye, ear, and heart. What a powerful illustration of the multifaceted concept of listening! Anyone can hear words and repeat them. It takes discernment to read between the lines, to interpret the body language and discover the real message. Don’t feel that you have to respond verbally to everything. Sometimes the most powerful response is, “I’m really sad to hear your story. I don’t have any words that seem appropriate, but I want you to know that I care.”

 

Reassurance is usually not helpful. Can you recall school days when you took a very difficult exam? Was there a time when you wondered if you might have actually failed? Imagine coming home to your family and telling them the bad news. What would be the most likely response that you got from them? “Oh, don’t be silly. Of course you passed!” Did you feel any better? Probably not. In the same way, if a patient voices fear concerning the future, it won’t likely be helpful to say, “Everything will turn out for the best.” Acknowledge the pain. Several years ago while I was preparing supper one evening, my children were in the backyard playing. My daughter fell and skinned her knee. She came crying to me, asking for a Band-Aid.

 

Being rather task-oriented by nature, and not seeing any blood, I assured her that I thought she would be OK and sent her on her way. Several minutes later, my mother’s heart was pierced by a sobbing girl on the sofa. I dried my hands, got a Band-Aid, and went and sat beside her. “I’m so sorry!” I said. “I’ve had scrapes before and I know they can hurt really badly—even when they aren’t bleeding.” With that, I put the Band-Aid on, and she was immediately healed! That Band-Aid was a powerful symbol of the fact that I had acknowledged her pain. It’s no different with people’s hearts. They need someone to come beside them and say, “Wow! This must be so difficult.”

 

Don’t try to fix it. Let’s face it. Pastors like to fix things. It makes us feel good to know that we were able to help. We sometimes need to be needed. But too often we jump ahead of ourselves and get into trouble by not allowing others to find their own solutions.

 

I arrived home from work one evening about five-thirty and saw my neighbor’s son out by the mailbox. I greeted him and asked how he was doing. “We just got back from the emergency room,” he replied. His youngest sister had been jumping in the yard that morning and had fallen, breaking her arm. They spent nearly eight hours in the emergency room of a local hospital. Hearing about the situation, and knowing that my neighbor had five children and it was dinner time, I figured I could fix a problem. I told Donald to go tell his mom that I would make dinner. He said I didn’t need to do that, but I insisted. He again refused. Finally, realizing I was going to need to assert my adult power, I told him firmly, “Donald, your mom is always doing nice things for me and I want to do this. Please go tell her that I will make dinner.” His legs started to shake as he stammered, “Mrs. McMillan, my grandparents are coming and they are bringing dinner!” This was a powerful lesson in not getting ahead of the issue. When we allow patients to problem solve on their own, the solutions will be much more appropriate to the problem and will more likely be carried out.

 

Be aware of your nonverbal communication. Glancing at your watch while you stand next to the bed sends a powerful message. Even if your time is short, you can give the patient all of your attention while you are there. By sitting down, making eye contact, and speaking slowly, you can convey you care.

 

Use prayer carefully. Prayer should not be used to end an uncomfortable situation. Early in my nursing career while working on an oncology unit, there was a pastor who often came to visit his parishioners. It seemed that whenever a patient started to voice doubts or anger or fear, the pastor’s response was “Let’s pray.” While his intent was good, he effectively cut off any further conversation. Because of his own discomfort with exploring negative feelings, he never allowed his ailing church members to voice them. Prayer became the end point that snuffed out further conversation.

 

Never assume that someone wants to pray. While most people expect a pastor to pray with them, sometimes they are not ready for it. A simple statement and question like the following can assess the situation. “When I’m feeling afraid, one of the things that really helps me is to pray. Would you like me to pray with you?” Also, ask the patient for what you should pray. It’s easy to assume that someone who has just received a terminal diagnosis wants healing. But they may ask you to pray for acceptance, for peace, or for forgiveness.

 

Conclusion

 

By five o’clock—ninety minutes later—you leave the hospital parking lot. Surprisingly, your sermon became a bit further along than expected— due to some wonderful insights you gained from your hospital ministry that afternoon.

 

 

 

1 HIPAA stands for the Health Insurance Portability and Accountability Act, which was established by the United States Congress in 1996 for the purposes of guaranteeing a seamless transition of insurance coverage for employees from one job to the next (portability) and maintaining privacy and security of health records (accountability).

 

 

 

 


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Kathy McMillan, M.A., has worked as a registered nurse and is now the director of Employee Spiritual Care at Loma Linda University Medical Center, Loma Linda, California, United States.

September 2006

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