Visiting in Hospital

Visiting in Hospital

www.hospitalchaplain.com- Article Hosted on this site
author- Dr. Simon Harrison
date- Nov 2000 extracted from- Pastoral Care Training Course (UK)

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Guidance for visiting in Hospital

Why am I visiting?
As with home visits- the way you behave depends on who you represent, e.g. representing church, ‘the minister’, just yourself, ‘concerned neighbours’ etc. It is worth taking time to think about this each time before going in.
Why does Mrs Y think I'm visiting?
This is more important- the need to say clearly who are and why you are there. Whatever we may think, the rules are made by the patient, not by the visitor. You are often an uninvited guest. Just because the minister wants to find out if Mrs Y is all right, doesn't mean she wants to speak to you!
Relations with Staff
Staff often know how a patient feels about the visitors they are getting (in a way we cannot). It is good practice to ask staff ‘if it is all right to visit Mrs Y today’, and whether one should stay long. (It is sometimes better to ring in advance) In Exeter, the darker blue the uniform, the more senior the nurse (matron is now ‘ward manager’). Alternatively, ask to speak to the ‘named nurse’. Do not try to pry information out of staff about patients!
In the general ward
People feel vulnerable in a hospital bed. They feel awkward wearing pyjamas’s, but more importantly, they cannot easily break conversation with you- they are a sitting duck, you have to make the break for them- at the right time, and clearly. You may be the 10th visitor that day, but they don't want to be rude. This makes them unlikely to assert their boundaries- to tell you to leave, to ask you not to hold their hand, to move the conversation the way they want it to go. There is also a physical problem of seating. The choice is between a chair facing the wrong way or the edge of the bed. Always ask before sitting on a bed or offer to fetch a chair over.
Be sensitive to the wider ward- if someone is upset, try to avoid banter! Although others will often try to join in your conversation- take the lead from Mrs Y. Also be sensitive to family and other visitors arriving- I normally offer to leave without laying a guilt trip- but stay if they ask me to. The same goes for doctors etc- ask the patient’s permission to leave and ask if they want you to return or not (later or another day).
What can I say? What should I remember?
If you need to wake someone- it is better to ask staff first- do they need sleep more than your visit? If it is OK for you to do it, speak clearly first, then touch lightly on the back of their hand if necessary. If still no response, return to staff. It is normal to begin clearly saying who you are and why you are here. If nothing comes from this, how about a simple question ‘how long have you been in?’ (avoid ‘How are you?’- can be a very invasive question in hospital) Touch- need to asses this carefully. I generally avoid it unless there is a clear hint from the patient that this is wanted or if you normally hold hands/kiss this person outside of the hospital.
Listening-
90% of the reason for being there- allowing someone to tell their story, to speak and know they've been heard, to share their situation with someone not directly affected (unlike family or staff)… and more.
Getting permission.
Always check for permission before:
1) adding someone to a prayer list,
2) letting anyone in the parish know anything (including family and clergy)
You are there for the patient- not for the parish or the church
When appropriate- you might gently offer to pray before you leave. (‘I will remember you in my prayers at home… would you like me to pray with you before I go?) Take a copy of the Lord’s Prayer or a visiting card if this helps. It may sometimes be right to suggest Ward Communion- either yourself (if authorised) your clergy (letting hospital chaplain know beforehand) or contact the chaplaincy through staff. It may also be right to refer-on- eg the hospice team, chaplaincy, clergy, etc. ASK PERSONS PERMISSION FIRST! Do not make promises that you, another or God cannot keep- eg "I will always be here for you" - "the vicar will call soon" - "God will heal you, I just know it."
Visiting the psychiatric ward
These can be distressing sometimes, but are not as scary as people make out. The bottom line is always ‘there but the grace of God go I’ and never ‘poor souls’.
Loneliness is often a key issue and it is right to overcome our fear and visit on a regular basis when appropriate. Remember the long term commitment implied by regular visiting.
It is vital here to liaise with staff (and generally with family too) about visiting- you will often be told ‘not yet’. Check with staff before each visit and on arrival. Apart from medication, words and listening are powerful tools- treat them as such (avoid platitudes)
Wards are safer than you imagine, but check before using a quiet room. Avoid all contact with vulnerable patients in a closed room.
Time
As with home visiting- allow enough time- but be highly sensitive to hints about leaving- only you can leave. A long silence may not be hint to go, but asking about you all the time may be (I don't want to talk to you about me!). If someone is in hospital today they are VERY likely to be quite poorly, even if they look bright. Twenty minutes is often long enough, many would like visitors to stay for about ten. People often complain about visitors (including clergy) outstaying their welcome. What is your visit saying, and how long does it take to say it?

- I've done my bit, Cheerio! (5 mins?)

- We haven't forgotten about you- and do care. (10 mins?)

- You should really be interested in what’s going on (eg church gossip- 3 hours?!)

- If you need something (paper, books)- I will bring it without a fuss (10 mins?)

- Pull yourself together and THINK POSITIVE (30 mins? and a week to recover)

- You can talk about whatever you want, I am listening. (5 mins -1 hour and return call)

Particular problems to think about (group work)
Problems of speech, toilet, visitors, staff, mealtimes, silences, difficult conversation topics.

What to do once I've left.
Spend some time in quiet to offer situation/ conversation to God.
Try to leave the situation behind- don't take someone’s story to the next social gathering (even a housegroup/ prayergroup) and don't let another’s emotions/ situation take over the rest of your day if possible.
Use notes if you are invited back (significant names etc).
Do the things you've said you will- speak to people if requested etc.
Respect the confidence of the conversation- you need express permission to let someone else know a diagnosis (what they have) or prognosis (how things will be). This goes for family. friends and for clergy (even if this is clearly a ‘church’ visit).

Dr. Simon Harrison

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