The National Association of Catholic Chaplains

Menu
  • Membership
      • Apply for Membership
      • Frequently-Asked Questions about Membership
      • Request Retired Membership
      • State Liaisons
      • Newest Members
      • Membership Directory
      • Member map
      • Celebrating Our Members’ 25-year Membership and Certification
      • In Memoriam: deceased NACC members
    • Close
  • Certification
    • Initial Board Certification
      • Board Certified Chaplain (BCC)
      • Certified Associate Chaplain (CAC)
      • Palliative Care and Hospice Advanced Certification (PCHAC)
      • VA Initial Board Certification
      • Recognition of Strategic Partners Board Certification
      • Newly Certified Chaplains
      • Close
    • Renewal of Certification
    • Certification Competencies & Procedures
      • Certification Competencies & Procedures
      • Important Background on NACC Certification Competencies
      • Professional Code of Ethics for Spiritual Care Professionals
      • Certification Commission
      • Certification Appeals Panel
      • Ethics Appeals Panel
      • Close
    • Mentors
    • Recognition of Strategic Partners Board Certification
    • Verifying Certification
    • Maintaining Certification in Retirement
    • Graduate Theological Programs
    • Close
  • Education Resources
      • 2023 Retreat
      • 2023 Webinar Series
      • Recorded webinars (2009-2022)
      • Calendar of Events
      • Graduate Theological Programs
      • CPE Programs
      • NACC Professional Networking Calls
      • Continuing Education Hour Requests – Guidelines and Forms
      • Ongoing Educational Opportunities
      • Local/Regional Gatherings & Events
      • Past Conferences (2004 – 2022)
      • Vision
    • Close
  • Resources
    • Antiracism Resources
    • Administrator Resources
    • Awareness Resources
    • Chaplaincy Care Resources
    • Coronavirus Resources & Updates
    • Job Listings
    • The Journal of Pastoral Care & Counseling
    • Partners in Pastoral Care
    • Research
    • Specialty Care Resources
    • Spirituality and Prayer Resources
    • Spiritual Care Department Resources
    • Vision
    • Close
  • About NACC
    • About the NACC
      • Mission/Vision/Values
      • Constitution and ByLaws
      • Strategic Plan
      • History
      • Close
    • Annual Awards
    • Association Leadership
      • NACC Board of Directors
      • Committees, Commissions, and Panels
      • National Office Staff
      • Episcopal Advisory Council
      • Close
    • Catholic Prison Ministries Coalition (CPMC)
    • Choose Chaplaincy
    • Health Care Collaborators
    • NACC Merchandise
    • NACC Publications and Documents
      • Vision
      • NACC Now
      • Annual Reports & Financial Reviews
      • Documents and publications
      • NACC Blog
      • Close
    • Partners in Pastoral Care
    • Partners for Professional Excellence in Spiritual Care
    • Vision
    • Close
  • Choose Chaplaincy
  • Contact Us
      • This field is for validation purposes and should be left unchanged.

    • Close
  • Donate Now
  • Member Login
Home » Vision » January-February 2021 » As families absorb bad news, chaplains stand in the middle ground

As families absorb bad news, chaplains stand in the middle ground

By Nicholas Perkins
For the third time, the palliative care team physician, two nurses, and I met with the patient’s family members on a Zoom call. The first two meetings had ended abruptly when we attempted to address their loved one’s prognosis.

“We know and understand this is a sad situation,” the nurse began. “But we need to discuss Bill’s condition, and his goals of care.”

There was a pause. Finally, the daughter said, “We appreciate that … but why is my dad’s fever continuing? When will another neurologist see him? Why does it take so long for a nurse to answer the phone when we call? When will he be transferred to another hospital for a second opinion?”

“Those are important concerns,” the physician answered. “But right now, they are not the essential concerns. Your father has suffered a significant brain injury. We understand that you want to transfer him. But wherever he goes, the prognosis will likely be the same.” He paused, gently assessing the faces on the computer screen. “Bill is not recovering like we want him to,” he continued. “I think we need to discuss placement in long-term care.”

The three family members began to cry, quietly. All of us on the team acknowledged their need for silence. We were being transparent about Bill’s condition, while respecting their questions about second opinions. We were standing in the middle ground with them.

The middle ground avoids binary, all-or-nothing thinking and words like always or never. It challenges me to expand my thoughts and vocabulary so I can be open to different alternatives, ideas, and perspectives. These help me understand why some families choose to pursue aggressive treatment for loved ones with a terminal prognosis. The ability to stand in the middle ground with families means I support them with presence, education, and advocacy, even when they make decisions I may disagree with.

When a family is angry, the choice to stand in the middle is as much a competency as it is an art form. I think of the crucifixion when I confront another person’s anger and my own. Anger, like the crucifixion, can be heavy and rough, while the person who experiences it may feel exposed, naked, wounded, and vulnerable. When and if anger surfaces in a family meeting, it is important for me to be mindful. Sometimes I imagine that I am breathing under water and remaining comfortable in the uncomfortable.

I am learning that successful family meetings depend on my ability to suspend judgment, and the willingness to stand in the breach or the middle ground. When I stand in the breach with another person as a chaplain, I advocate for the individual. A sense of appropriate duty compels me to speak for the person who may not have a voice, and to see for the one whose vision may be obscured by frightening realities.

Brittle, fragile, vulnerable, and worried describe some of the feelings when families meet with palliative care teams. It is even more complicated now because of the isolation and separation that the pandemic has forced upon patients and their loved ones.

The word dignity is central to my chaplaincy; in fact, I mention it when I pray with patients because the stories that some share often depict a lack of dignity. When someone listens to you, how does it feel? What do you sense in your body and spirit? I hope those moments are free of advice or instruction, humorous anecdotes and glib remarks. Standing with anyone – not just in the middle ground – means I acknowledge their dignity. I do not want to be the chaplain who follows up every comment with a comeback, the one who responds to every opinion or story with a rebuttal. It is more important to accompany a person and to listen.

When I was 24, I was on the other side of a family meeting, the night an incredibly kind physician told me that my father had died of an aortic aneurysm. Also, years later, an equally compassionate doctor informed my family that any further treatment for my brother’s liver cancer would only prolong his suffering.

On one hand, those memories are painful, but on the other they are redeemable, since having them allows me to consider another person’s perspective. This means I listen when someone shares how it feels to be alone, or when family members request some time to absorb information. I needed that same time the night my father died. I understand the need for time when bad news makes it seem like time has stopped.

I doubt I will ever discover the middle ground in politics or global events. I do, however, believe that when I stand in it with an angry or frightened family, I give them the very things that an emergency room physician gave me the night my dad died. He put his warm, tender hand on my shoulder. He did not say everything would be okay or tell me my father was in a better place. He stood in the middle ground and offered silence beneath the bright lights of a cold emergency room. I pray I do the same.

Nicholas Perkins, BCC, is a palliative care chaplain at Franciscan Health Dyer in Dyer, IN.

 

The National Association of Catholic Chaplains
Become a Member Would you like to get Certified?

Free Publications

Don’t miss the latest news, subscribe to our newsletter today! You don’t have to be a member to subscribe.

National Association of Catholic Chaplains
4915 S. Howell Avenue, Suite 501
Milwaukee, WI 53207
Get Directions

Phone: (414) 483-4898
Fax: (414) 483-6712
Email: info@nacc.org

Our office hours
Mon-Thur 8:00am – 5:00pm Central Time
Friday 8:00am – 12 Noon
Sat-Sun closed

Job Listings

Current job opportunities for chaplains, priests, CPE residents, supervisors, directors of pastoral care, managers, mission directors, and more.

Job Listings

Free Publications

Don’t miss the latest news, subscribe to our newsletter today! You don’t have to be a member to subscribe.

Donate Now

Learn more about making a tax-deductible donation to NACC.

Donate Now

Connect with us

  • Email
  • Facebook
  • Instagram
  • LinkedIn
  • YouTube
© 1997 - 2023 National Association of Catholic Chaplains - Sitemap

Built by Westwords