Hospital Visits

I notice that that the Rockbridge students have several threads of thought about the length of a hospital visit, about whether to pray or not to pray, and thoughts on the book and the Pastor's Tips.

I want to give you some tips based on my experience. They don't differ greatly from what has already been presented, but they may give you some encouragment.

As always, in any situation in ministry, we want to be sensitive to the leading of the Holy Spirit. We also want to observe what happens when we enter into a new situation, and learn from our experiences.

One experience I am grateful is that of working as a hospital chaplain for the V.A. Medical Center in our local area. When I started, I was somewhat apprehensive about what I was supposed to do. I soon found, though, that the main chaplain was overloaded with a need to do administrative work along with the "visiting" work. It turned out, that I would end up doing about 80% of the visits. I was not given too many guidlines. A lot of this was like the "cold calling" several of you mentioned.

Our practice was to visit each new patient that entered the hospital, and to visit every paitent who was put on the seriously ill list. We would visit other patients more often if they indicated they wanted those visits.

After a couple of weeks of doing this, I came up with the following plan that was acceptable to my supervisor (the main chaplain) also: Basically, a visit would go like this. I would enter the room and introduce myself to the patient. I said something like, "I am here from the chaplain's office, and we just wanted you to know that we would be glad to come by and have prayer with you sometime." Then I would be quiet. Like one of you said, the ball was then in their court. From there, I just responded to the patient. Sometimes they were talkative, and I would stay and talk. Sometimes they would just say, "O.K." or "Thank you," and I could tell the visit was over. Many times (most), I was quite comfortable asking, "Would you like me to have prayer for you today?" Almost always they would say, "yes," but on a few occasions they would say "no." Since I had included the word, "today," the tension over a refusal was diffused. Another way to handle that would be to use the word, "now." "Would you like me to have prayer with you now?" This works well if earlier in the conversation you have said something like that you would be glad to have prayer with them sometime.

On an average day, we would visit anywhere from 15 to 20 patients, so a lot of them got the "five-minute" type of visit. On the other hand, there would be those (usually two or three) who were open to talking about spiritual things or who just wanted to talk in general. Often I figured out that those two or three patients were really the reason why I was there--why God had placed me there for that time. Still, those longer visits seldom ran longer than 20 minutes.

Another thing I did was to ask the question, "What are the doctors telling you?" Then I would listen carefully to what they had to say. When I first came on board, when a doctor entered the room, he or she often just brushed right on past and ignored me. This didn't happen every time, but it did happen enough to be noticeable. At that time, we had access to the patient's charts, and we wrote notes in them ourselves. When I first started, our goal was to document ten percent of our visits in the charts. Then we set a goal to go to twenty-five percent. The hopital made a change to electronic documentation, so we started putting our comments into the computer. I was fairly computer literate, so I started documenting all of my visits. I say all of that to come to this. Since I always asked the patient, "what are the doctors telling you," I always put their answer into the electronic chart. I think others also transferred thses over to the paper charts--or maybe we printed them out and put them in there too. Anyway, the doctors began to notice that I had asked that question, so many of them began to read our comments because they wanted to see if the patient really understood what they were telling him or her. Since they were reading our comments, they soon began to occasionally consult with us too. (I'm sure they already did that some with the main chaplain since he was established, but I thought the progression from being ignored to being consulted was interesting in my own case.)

My own preference for a hosptital visit for member of my own congregation, or their family members that they ask me to visit, is to be comfortable with leaving after about five minutes if it seems natural, but to go twenty minutes if the patient seems alert enough for this and if conversation, either from the patient or the family members, seems to be flowing well enough to warrant that length of stay. I do usually, but not always, ask if they would like for me to pray with them today. If it seems "forced" to get that question in, I don't worry about not asking it. If it is a person I know very well and who attends church regularly, I will often ask them if they would like me to read Scripture too (before asking about prayer,) They usually will like that too. Contrary to what some may say about picking out a very appropriate passage, I don't necessarily worry about that either. I just try make sure the passage I read does not raise troubling questions, bring up bad memories, or things like that. I have several verses from Roman chapter 8 underlined. Sometimes I will just read some of those. In our area, regular church-goers will appreciate the reading and prayer. In all of these situations, though, I don't try to force anything.

My take on what to do when the doctor enters the room is to do what we did as chaplains. When the doctor came in, we would get up or move away from the bed so as not to be in the way. After I was established, someimes the doctor thought I was leaving, and he or she would often say, "You don't have to leave." So, now my policy has to do with how well I know the patient. Many patientes would prefer that I be in the room, so they could ask me questions to make sure they heard correctly what the doctor said. Many times a doctor visit is very routine, and it is not necessary to leave in those cases.

They way I do it now when a hospital staff member comes into the room is to start to move so as not to be in the way of whatever they have to do. Many times a nurse will simply say, "You don't have to move," or "You're O.K." Then I stay put (unless I need this as sort of an excuse to leave.) When a doctor comes in, I get up and move away from the bed and move closer to the door. If his or her visit seems very routine and not sensitive or confidential in any way, I stay in the room. The key is to watch the patient, the patient's family members, or the doctor. If any of them seem to want to speak confidentially, I quickly excuse myself (or just slip out without saying anything.) Many times the patient or family member will introduce me to the doctor. Then leaving may seem a little strange. I think in this regard, to be sensitive to the Holy Spirit, to be aware of what seems natural, and to closely observe the patient, doctor, or family member, will allow you to receive the wisdom to know what to do. I am not saying there is anything wrong with always excusing yourself when a doctor comes in, I am just giving you my take on what to do in these situations.

Outside of the hospital room, staying quite a while in a visiting room with the family often gives some good relationship-building opportunities. Often, I just "play it by ear" as to how long to make those visits.

I hope some of these things can perhaps be helpful to some of you.

I do enjoy learning from your insights.