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Comfort Care

Comfort Care.  This is hospital "speak" that someone is nearing death.  In this instance regarding me, a patient was being taken off life support and a chaplain was needed.  The comfort of care to be offered is certainly for the dying, but is more likely for the loved ones present, and maybe also for the staff who tend to those departing, and to those who remain.

Today I experienced my first death at WHC.  It was peaceful, and I was grateful.  The patient was non-responsive, appeared to be comfortable, and the family present was quietly coming to grips with the reality of the situation.  I said God was already tending to K, and that I was there for the family.  There was evidence of head trauma which had required surgery.  By the time I arrived, the means of support had been discontinued.  His breathing was even but labored, and there was a rattle to it as his chest heaved.  We all saw the monitors reflect that the life and spirit of this "former choir-boy, later rebel and rabble-rouser" was slowly ebbing away. 
Sensing he was Catholic, I asked if a priest had already visited.  The sister thought yes, but seemed to look to me to be with them right then and there.  I turned slowly in the Book of Common Prayer to Ministration at the Time of Death, seeking prayers which would guide me and hopefully comfort them, and then placed my hand on the man's shoulder:

"Into your hands, O merciful Saviour, we commend your servant K.  Acknowledge, we humbly beseech you, a sheep of your own fold, a lamb of your own flock, a sinner of your own redeeming.  Receive him into the arms of your mercy, into the blessed rest of everlasting peace, and into the glorious company of the saints in light.  Amen."

I was not there long before the heart monitor flat-lined and the RN who had called me mercifully came in to turn off the equipment.  As gently tears flowed down the sister's face, I continued: 

"Almighty God, look with pity upon the sorrows of your servants for whom we pray.  Remember them, Lord, in mercy; nourish them with patience; comfort them with a sense of your goodness; lift up your countenance upon them, and give them peace; through Jesus Christ our Lord.  Amen."

Moments after, the doctor stepped in to pronounce, "His heart has just stopped."  He paused for a second, then turned and left.  (I had been warned that some MDs seeing a chaplain present wll operate within the parameters of 'do and go'.)  Well, he 'did' and he 'went.'  It struck me as odd for a moment, but later seemed inconsequential in the scheme of things.
There was a distinct and holy stillness during which no words were necessary.  Not mine, anyway.  The sister continued to talk to her brother, and all the while, her husband sat behind her with his hand rubbing her back.  She mentioned various family members long since past who were gathering to greet him now.  He would be reunited with his Dad on Father's Day.  I appreciated her words telling me that she had a sense of life changing, but not ending.    

After a little while longer, I offered to stay, but the family was good, and they no longer needed me.  Stepping out of the room into the ICU, the RN quietly slid the door closed behind me, leaving the family for their time alone.  I stopped to check in with the nurse to see how he was faring.  He seemed surprised that I even asked.  As I began my charting under Progress Notes (wondering if my note would be the last in that section), I overheard the nurse asking another RN if a chaplain had ever followed up with them about their well-being after "Comfort Care."

"No" was the answer.

I think I left feeling a bit more saddened by that than I did because of this man's passing. 


( 1 comment — Leave a comment )
Jun. 29th, 2010 10:35 pm (UTC)
I am impressed with your work at the hospital. When your Mom was in the hospital at Mary Hitchcock for her radiation /cemo treatments I would spend some time in the intensive care unit as a Chaplain and I found that frequently I was spending as much time with the staff, both doctors and nurses as I did with the families of the patients. Most of the time the staff knew that the patients they were treating were terminal whereas in other parts of the hospital most patients would eventually recover. Sometimes I felt that the staff was hurting maybe even a little more than the families since many were asking themselves, "What should I have done that I didn't which would have saved this patient of mine". I always tried to help them by reminding them that they used the talent and education that God had given them to the best of their ability, and to remind them that all of us one day will be called "home" by our Father in heaven. I think it helped them some, but it takes a very special group to face this problem day after day in the oncology department's intensive care wards.

So I am delighted that you felt called to speak to the nurse and maybe with the doctor in attendance if he/she has the time to share with you.

Keep up the good work.

( 1 comment — Leave a comment )