In session 4 we discussed the issues of grief that come to the patient and the family during the time of terminal illness. I began the session by asking them to write down an instance where they had lost a loved one and to consider their own grief process.
The assigned reading for this session was On Grief and Grieving, by Elisabeth Kubler-
Ross and David Kessler.4 In reading the text, the chaplains discovered that the stages of grief, according the text, were the same as the stages of death. The overview of the stages of grief seemed to be helpful in their own experiences of grieving. They were able to recall feelings and emotions during their times of loss. This overview of the stages of grief, again, was an emotional time in the training for all the chaplains. Three of the chaplains shared a story of loss with the group. One of the chaplains shared about the loss of a child. Even though the loss had been some time in the past, the chaplain was able to talk about how this study was helpful for her to understand the grief process and how it was still a process she was experiencing.
Two of the chaplains talked about the illness of their spouses and how they were in a grieving process for their loved ones who had chronic illnesses. They talked about their anticipatory grief. Another assigned text was Wayne Oates’ book Your Particular Grief. In this text, anticipatory grief was explained as, “the severe time- limiting of life by such a disease commits your loved one and you to a long but
nevertheless patterned process of grief.”5 With both chaplains there was a real feeling of anticipatory grief for their loved ones who had been told they were terminal. The process of daily caring and watching their spouses brought grieving emotions for them.
These two events opened the door for the chaplains to discuss their understanding of how patients and their families experience grief in death and dying situations. We shifted to the experience of the patient and their family and how these stages were like the stages of dying. We talked about the grief-work cycle of bereavement.
This grief-cycle for the loved ones is explained in Death and Ministry, by J. Donald Bane,
4Elizabeth Kubler-Ross and David Kessler, On Grief and Grieving (New York:
Scribner, 2005).
5Wayne Oates, Your Particular Grief (Philadelphia: Westminster, 1981), 23.
Austin H. Kutscher, Robert E. Neal, and Robert B. Reeves, Jr.6 The grief cycle can be explained in two steps. The first step is the realization the loved one is gone. The second step is when the mourner gradually begins to form ties with the living and with the things of life. There are new adjustments to their environment and the life tasks they face.
The remainder of this session consisted of orienting the group to the areas of the hospital where grief ministry might possibly take place. Each member of the group was one of our volunteer chaplains and was familiar with the hospital setting. The purpose of the tour was to give the group a feel for the areas where they would be called upon to minister to patients and families who would experience grief in their hospital experience. The tour consisted of the Emergency Department waiting room, the critical care unit waiting rooms, and the surgery waiting rooms to discuss patients who received news of death and dying patients from emergency situations. We then visited the units themselves to talk about how we minister to patients who are in the units and have been given the news of their impending demise.
We then visited patients in the Oncology unit and the medical-surgical units to make ourselves aware of areas where we would be apt to talk with patients and families who have received the news of eminent death. We then saw two patients, who were on ventilators, whose families had made each of them a DNR. The DNR means to “do not resuscitate” in case the heart stops beating and the patient stops breathing. The families of these patients were planning on removing the ventilator the next morning. We talked about what it was like to visit a patient on life support and how the patient may be able to hear conversations from the chaplain and the family. Prayer and reading Scripture is important to these patients during this stage of their lives. The chaplains were taught to take families to the waiting rooms to discuss issues about grief for their loved ones unless the family knew the patient would want to hear the discussion. Most importantly,
6J. Donald Bane, et al, Death and Ministry, Pastoral Care of the Dying and Bereaved (New York: Seabury, 1975), 110-11.
chaplains must knock on the door before they enter a patient’s room and obey any sign that is on the door.
Chaplains at Western Baptist can go at any time to minister to patients. The chaplains were taught to be respectful of other health care providers in the process of their visit. They were taught to respond to the pager they would be wearing when they were on call and how they would be a welcomed part of the healthcare team in these kinds of situations. After the tour the chaplains were told there would be more touring of other areas in the hospital in the next session. We had prayer and were dismissed.
Session 6: Principles for Pastoral Care