Hospital Handbook. James T. Wagner
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your hospital visiting, and have a picture of it before you as you consider your orientation.
Begin by getting to know the people who can help. Cultivate an awareness of different professionals in the hospital system and use them regularly. People to contact are chaplains, social workers, nursing supervisors in particular units or areas, patient services representatives, and information hosts or hostesses.
Getting Oriented
Begin your tour with the information desk. There is generally a separate file for clergy where patients are listed by religious affiliation. Make sure your denomination is listed in a way that is familiar to your congregation. Communicate this listing to the members of your church so they know how to indicate their affiliation when they go to the hospital.
In another chapter we will discuss ways to activate the minister's role in hospital visiting, but here it is important to note that church members need to be made aware of the importance of the clergy file at the hospital. I have had people refuse to fill out a religious preference card at the hospital out of civil liberty convictions. Here I had to point out that filling out this category helps me find them. My denomination, the United Church of Christ, still has people in it who call themselves Congregationalists, from the parent denomination prior to the merger. I alert the hospital to this dual listing and encourage my members to stick with one name or the other, depending on the characteristics of the community.
No matter how good the system, some names never make it to the religious card file. Therefore it is important to have a standing policy whereby members of the church call you when they or other members are in the hospital.
The second item on your tour should be the visiting policy. What are the hospital visiting hours and when does the hospital prefer to have clergy visit? You may have to balance the hospital's preference with your own convictions. Some pastors like to visit in the morning before regular visiting hours. This gives you a certain amount of privacy and freedom from interruptions by other visitors. However, it is also a time that many of the medical procedures are performed and you may be getting in the way of hospital personnel.
Find out when meals are served and avoid them. This is an awkward time for patient and visitor.
There are times, in emergencies and around surgery, that you cannot follow the most convenient schedule for the hospital. Find out in advance how to get in late at night or early in the morning.
The third piece of information you should obtain is how the hospital will get oriented to you. What will you do about identifying yourself? No one really looks like the stereotype of a minister anymore, so you cannot take it for granted that hospital staff will understand why you are walking through their halls. I have met staff who claim they can always spot a minister, but they've never spotted me. Women and younger pastors all have special difficulty being recognized as clergy. But unless you look like Ichabod Crane, even a middle-aged male will not be easily recognized as a minister.
Find out if the hospital requires you to carry or wear some form of official identification. If not, then it will be up to you to identify yourself. If you wear a clerical collar, this is easy. If this is not your denominational tradition, you will have to make clear who you are. It is important to introduce yourself as a minister at the nurse's station at the floor where you visit. Hospitals are concerned about the security of their patients, and personnel appreciate your courtesy in introducing yourself.
It is also important to find out how the hospital expects you to relate to special areas like the intensive care unit or the emergency room. These are areas which have strict prohibitions for general visitors but which allow clergy special privileges. You need to know your rights for these areas, because staff are not always aware of clergy privilege in specific situations. A later chapter describes some of the unique elements of emergency room and intensive care visitation, but you should find out what policies apply to clergy in your first tour.
The Visit
Having completed your tour, you are now ready for visiting hospital patients from your church. We share here a variety of styles offered by pastors and hospital personnel. You need to decide which of these styles you are comfortable with.
Depending on the situation of your community, it may be worth calling before visiting. In a large church there may always be enough patients in the hospital to make calling ahead unnecessary. If the church is small and the hospital some distance, then call to confirm that your patient is in the hospital. Call the room to find out if the patient has tests or therapy scheduled so you can plan the best time to visit. This also helps the patient order the day in a setting where the patient has little control of life.
Stop at the nurse's station at each floor you visit. Identify yourself and find out if there are any precautions you must take before entering your patient's room. You may also explain to those at the nurse's station that you will be visiting and would like a certain period of privacy. Some clergy carry religious “Do Not Disturb” signs they hang on the door. I prefer just to mention my visit at the desk. Realize too that if your patient has any particular difficulties, you can go to the nurse's station for help. Having stopped there first facilitates receiving help later.
Knock at the patient's room and wait to be invited in. Hospital patients suffer many indignities. We need not increase them. A patient may be on a bed pan, in the midst of significant pain, or may have just gotten a chance to nap. Give the patient a chance to express personal needs easily.
Don't feel foolish about introducing yourself, especially if you are from a large church. It is easy for a patient to be disoriented and not recognize you outside the context of the church.
Believe it or not, there is division among the ranks of church professionals as to whether one should sit down in making a hospital visit. One school of thought states steadfastly that the pastor should remain standing. The reason for this is to keep the visit short. Another perspective states just as firmly that one should definitely sit and be at eye level with a patient while visiting. We favor the latter point of view, believing enough personnel enter quickly, stare down at a patient, perform their duties, and then hurry off. In the sit or not to sit debate one more detail remains. If you do sit, remember to return the chair to its original place when you leave. Small details like this make a big difference in a crowded hospital room.
The length of a visit is important. Knowing the tendency of clergy toward longwindedness, many resources encourage short visits. Hospital personnel remind us that patients are weak or they would not be in the hospital. However, there is also the superficiality of the pastor who stands in the doorway, waves a jolly greeting, offers a quick blessing, and then departs. Have in mind an idea of a reasonable period of time for a visit before you enter the room. Take your cues from the patient. If this is a time the patient really needs to talk, then stay, and listen. Otherwise keep the visit brief. Common sense is the key.
Speaking of common sense, there is one rule so basic as to be embarrassing, but which nevertheless deserves a quick mention. Do not visit the hospital if you have a communicable disease or are even at the slightest risk of coming down with one. We all know this, but the workaholic strain in clergy requires this reminder. It has often been the case that a co-worker has had to remind me not to visit the hospital on those days when I was dragging around with a hacking cough or a pre-flu funk. You are no good to anyone, especially someone sick, in this condition. Send a card instead.
With all the preliminaries out of the way, it is time to consider the visit itself. Begin with gentle data gathering. It is important to let the patient share his condition, even if you have already received a report from someone else. Let the patient know you are concerned about him. This means asking more than a conversational “How are you?” without communicating dread or disaster. Queries like “Tell me what brought you here.” “How are you feeling right now?” or “How long do you expect to be here?” give you the information you need to begin your care for this patient. You let the patient speak about herself, which may be a significant