For my clinical pastoral education, I am serving as a chaplain in a hospital that is a major trauma center, which means that ours is a crisis-driven department of pastoral care. As chaplains, we prioritize our calls as follows: (1) deaths; (2) traumas; (3) codes (generally called when someone’s heart or breathing stops); (4) urgent support; and (5) routine support.
During nights and weekends, when there is only one chaplain to cover the entire hospital complex (some 800 beds), we rarely have time to do anything but respond to deaths, traumas and codes. At these times, literally everything with which we are dealing is a crisis.
And what are we charged with doing during crises? Several things:
1. Be the calmest person in the room. Or perhaps it would be more accurate to say *seem to be* the calmest person in the room. Simply having an apparently non-anxious presence can be a real gift to people in the middle of a situation that is wholly and madly chaotic. Being such a calm presence is certainly easier said than done, of course—especially when there is so much screaming of orders on the part of the medical staff and wailing pain and grief on the part of patients and their families. Still, I have found that at least the pretense of a calm demeanor is actually possible in most cases, and it gets easier as one gains experience in these situations.
2. Serve and advocate on behalf of patients and their families. In our trauma bays, chaplains are the ones who draw the privacy curtains, trying to maintain some semblance of dignity for those who are laid out on the examination table, often bruised and bleeding, with their clothes cut from their bodies. And we are the ones who often remind medical staff that there are family members in the waiting room who need to know what is going on with their loved one. And we are the ones who fetch the doctor when the answers they have given to family members are confusing, misleading or incomplete. We are the ones who take the family from the emergency waiting area to the intensive care unit, who show them where the restrooms and cafeteria are, who ask them if there’s anyone else who needs to be called.
3. Pray when requested and as needed. I’ve had to learn how to pray with people as I never have before. As chaplains, we are asked to pray in nearly every imaginable situation in the hospital—at births, deaths, just before surgeries, at times of great despair and loneliness, at times of confusion and misunderstanding, at the times when life-and-death decisions are being made, and—every now and then—at times of joy. I have changed from being a person who almost never prays (unless you count the many times I’ve said, “Please, God!” sotto voce over the years) to being a person who is praying all the time—both at the hospital and when I’m away from the hospital.So, during on-call shifts (and much of the rest of the time) we get to see a lot of blood, raw pain, unedited grief and, occasionally, astonishing moments of grace. These last moments often come about only after hanging in there through all the other stuff.
There’s a reason why these “crisis shifts” at major trauma centers are mostly staffed by intern and resident chaplains who are serving for fixed periods of time. The intensity of the experience can be a source of awe and can also be thoroughly exhausting. Over time, such work takes its toll, even if one is the best self-nurturer in the world. As for me, I am grateful for my CPE experience and for the work of the many people who minister to those who are in the midst of crisis.
