NACC: Vision Online

Dream job’ achieved:

outpatient ministry among the poor

By Sr. Andre Dembowski, RSM, BCC

Let us follow the example of Jesus who testified on all occasions a tender love for the poor. – Morning and Evening Prayer of the Sisters of Mercy

Every Sunday after being certified I’d chat with retired health care workers from my parish, St. Vincent’s, near Baltimore’s Inner Harbor, about the hunt for my “dream job” -- outpatient ministry. Responses ran the gamut: from “Never happen! A chaplain for outpatients is a luxury” to “If you ask me it’s on the cutting edge of health care today. Patients are in and out ASAP; stick with your dream!” After a few sterile interviews at local hospitals in Baltimore, my mentor for certification encouraged me to “trust and wait,” the openings will come. “The openings” turned out to be quite singular -- St. Francis Hospital in Wilmington, DE.

When the director of pastoral care called with a job offer, my already discerned response came easily, “It’s taken a long time to live and work among the poor in Southwest Baltimore in an 1831 House, a project sponsored by the Institute of the Sisters of Mercy.” Emphatically I continued: “First, I’m not moving. Second, if I’m traveling to Delaware (preferring public transportation, the train came immediately to mind), it’ll have to be for my “dream job.” An empty silence followed. I spelled out what a dream job meant: “outpatient ministry!!!” More silence, followed by a pregnant possibility. I was told, “That’s not exactly what we had in mind but don’t take a job until we get back to you; we have to return to the drawing board.”

Every question on the table during that first interview focused on the poor. “Is there a sincere in-your-face commitment to the poor at St. Francis? The underinsured? The uninsured? Is the mission I’d naturally connect with the saint, Francis, “alive and well?” The mission statement, core values and dynamic witness of the two women across the table assured me I was scouting the right team, plus St. Francis was in a comparable neighborhood to southwest Baltimore, culturally and racially diverse with a high crime rate. I was in the right ballpark.

As an extended student in CPE training I studied with five culturally and religiously diverse supervisors and worked in four different hospitals. My last two units at St. Mary’s, an acute care hospital in Langhorne, PA, excelled in offering opportunities for pastoral outreach. Sites in the four hospitals included: a skilled nursing home; a permanent home for 16 mentally ill women otherwise homeless; a cancer center; and an at-home hospice. I soon realized I‘d come to the table with the bases loaded. Cleats dug in, weight shifting side-to-side; focused with a prayer, I was poised for the pitch. A grand slam! One more interview for clarification and I had a part-time position beginning in July 2006. “Just one person can bring new life into a stress-filled world.” -- Margaret Silf

St. Francis was my first job as a Board Certified Chaplain. Continuing with a few baseball metaphors, Same Day Surgery (SDS) had a few coaches and signals I had to master before really qualifying as a team member. I was green as grass. Collaboration with the nurse manager of the unit alerted me to the boundaries necessary when scheduling back-to-back surgeries. If not attentive, instead of bringing “new life” I could add to the stress of a team that ran like clockwork. We shared succinctly the nature of my ministry, i.e. identify and relieve any anxiety or disturbing or futile feelings with pastoral conversation and prayer. I assured the nurse manager that when the patient was needed, just a tap on the shoulder or a nod of the head would do to end my conversation with the patient. I wanted to help not hinder. In time I would learn their signals and respond in kind. Once she relayed the plan, we were on the same page. “Having a chaplain on the team added to patient satisfaction on the NRC Picker evaluation mailed to each patient,” I was later informed by the nurse manager of SDS Unit.

Within a week in SDS, I realized time was of the essence. Instead of 8:30 a.m., my day needed to begin at 7 a.m. St. Francis has two waiting rooms: a rather small, sterile room where you register with chairs against the wall on all four sides (about 16) and an additional, well-orchestrated, comfortable room where family and friends wait during the day. A plus for children and others waiting is a huge fish tank, floor to ceiling.

Soon I launched into a Trinitarian (I like thinking in threes) schema: control, compassion and co-union. I remembered that knowing the lay-of-the-land soothes most. As I entered the smaller room I’d begin: introduce myself as chaplain to the patients and their loved ones, question if anyone had been here before, if so, I‘d tell them, fill in if I leave something out. Then I’d brief them on what was to come: Phase I, the patient gets the most beautiful gown and crown then returns; Phase II, nurse comes for the patient; they leave and a series of confidential questions are asked. It’s the only time aside from surgery itself that loved ones are separated from the patient. When the confidential questions are completed, you are then invited to join them again and sit by the bed until the patient is wheeled out; you then exit through the corridor you came in, turn right and go to the “fish tank” room where you’ll find TVs, lounge chairs, complimentary coffee and tea. By 9 a.m. a volunteer in a peach smock and a nurse will be at the registration desk to your left as you enter. Give them your name and who you came with; the nurse is your go-between, keeping you informed throughout the day. Don’t worry if you forget; they’ll come to you for any information they need and keep you informed. You will see someone from the surgical team before you leave the hospital today. They’ll come to the waiting room or invite you to come to the backroom of SDS. Where they meet you usually depends on how tight their schedules are. Once I forgot to add the last instruction and one distraught woman thought they were calling her to the backroom because a crisis occurred. Knowing is a comfort to loved ones and gives them control of their day. I try to interject some humor as well; it’s good medicine for whatever ails you.

The privilege of our ministry is to invite people to pray. I then invite anyone who would like to pray not only for their loved one but in solidarity for all the sick here in the hospital and around the world to please join me in the center of the room. As I walk toward the center with outstretched hands, I add that if you’re not comfortable, stay where you are. We’ll still be praying with you. Once in the circle I draw attention to our held hands, “No matter what color, culture or religion when someone we love is ill we all feel the same.” I ask them, wanting to be politically correct and respectful of all religions, Muslims? Hindus? Christian or Jewish? Mormons or Jehovah Witnesses? Seventh Day Adventists? When we’re all Christian I pray in the name of Jesus ending with the Our Father. If not, I address God as the Creator of us all and all respond with an “Amen.” In the two years plus that I’ve been doing this in SDS, I can count on one hand those who have remained seated. Though not sharing bread as in Communion, I feel such a co-union as we, a roomful of total strangers, share prayer with a deep sense of compassion one for the other. Nurses slip in quietly and with a gentle touch to the shoulder direct a patient out of the circle when necessary. Later you often see families talking to each other in the “fish tank” room.

They return to their seats as I quietly approach each group and ask the patient’s name, checking them off my daily printout, adding only the first names of family and friends. Some choose to talk at that time. Others ask me to see them in the back of the room before they go in to surgery. Following are two vignettes of incomplete pastoral conversations where I feel no one could deny the need for chaplains in outpatient ministry.

Patient was waiting alone for her procedure. She and her husband had prayed in the circle. “I’m so glad you came and prayed with all of us. I’ve never seen that done before. I sent my husband down for some breakfast. He’s such a good man but he doesn’t handle sickness very well. I’m so worried about him. We’ve been married almost 56 years now, and I’ve always prayed he’d go before me. They’re doing a biopsy today. Would you look for him in the waiting room; I know he’s very anxious; maybe he’d open up to you? We’re not Catholic, but he’s a very religious man.” This stream of concern trickled from her without taking a breath or waiting for a response. More than words she wanted “ears” to hear her heart. Tomorrow I’d look on the new admit list for her name. I prayed it wouldn’t be there.

For comfort, some patients sit in a recliner as they wait. Our eyes locked as I turned from another patient across the room. I remember he opted to pray in the circle as I walked toward him. “I really didn’t want to come today, but my wife was determined this not be put off. I’m not complaining. It’s just too much time to think. (Slight pause, I waited,) Almost three years ago today, my teen-age twins (a boy and a girl) were murdered in our home by a family friend. Often he came over for dinner; sometimes he just hung out and watched a DVD with us. He was always welcome; only this day he was high. My wife and I were grocery shopping.” We have forgiven him but the pain recurs like a wave. Holding hands I prayed for the grace of “one day at a time.” He was about 40. We never saw each other again.

SDS at St. Francis has doubled its patients in the last year. I think of outpatient ministry as imperative -- “Good News” in Catholic healthcare.

Sr. Andre Dembowski is a chaplain at St. Francis Hospital in Wilmington, DE, and resides at the 1831 House, in Baltimore, MD, one of approximately 10 such houses in the United States that are sponsored by the Sisters of Mercy to be a presence to the poor, living and working with them as their neighbors.

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