Verbatim U2 Er.docx

Background Data: Patient information: Diagnosis: Pulminary Age & Sex: 2 Months/Male Marital Status: NA Faith Tradition: Chatholic Race: White Ethnicity: Hispanic Physician: Admission Date: 11/05/2018 Sexual Orientation:

Ministry Context: Peer Group Presentation: Seminar Resident’s Name: Arnold Torres Unit of Training: Fall 2018 Unit II Center Location: VB.B, ED Verbatim Submitted: 12/20/2018 Referral By: Page Type of Visit: Code Blue Date of Visit: 10/15/2018

1. Background Introduction:

This visit deals with a loss of an infant, and a grieving mother, which she seemed to have a hard time verbalizing. I did sense a lot of openness from her to explore and to tell me more on what had happen. However I would like the group to explore areas that I could have touched on and didn’t, and also to see about next steps with him to use in further visits.

2. Body of the Visit:

I received a Code Blue in the ED, thru the intercom. I arrived at the ED and asked for the Code Blue room, and the security guard guided me to room 15. Patient is a 2 month male, who had previous been discharged from VRMC, from a pulmonary disease. I enter the room where the mom of baby was at; there was a Police Officer with her.

Micro Skills Used

Legend: C-Chaplain M-Mom D-Doctor Conversation and what happen in the visit. (knock on the door) Hello I’m chaplain Arnold.

C1:

Hi – how are you? What happen?

M: I’m ok, I don’t I was asleep, and someone knocked at my door and I woke up. Then I saw the

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Result

baby and he wasn’t moving. Its my fault. C2: No it’s not you fault. (I stand next to her) C3: I will go check on the baby. ( I walk across the hall) C3: They are working very hard to help your child. M: Have you seen cases like this? Will the baby make do they survive? (making a lot of eye contact, looking very afraid) C4: There are two Doctors in that room so I know they are doing there best to help your child. D1: Please call the Pastor, Chaplain. (I hear the Dr. so I go acroos the room again) C: Yes Doctor? D: Please prepare the mom, talk to her and tell her her son was already dead when he arrived, that we are doing everything to bring him back. But don’t give her hope. C6: I will talk to her Doctor. ( I go back to the room with baby mother) C: Stephanie, the doctor is saying that the baby arrived dead here to the hospital that they are doing there best to bring him back, but he may not make it. M: Can I see him? I want to see him!

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C: Yes you can see him from here. (I pointed at the door) C8: (An investigator walks in and questions Baby Mother) D: Chaplain please come. (doctor explains to me that baby did not make it) I will go with you and talk to the mom. C: Stepahine the doctor is here. D: Mija, we did all we could with your baby but he didn’t make. (talking in a soft voice) M: NOOO!! Do more Do more I know you can do more for my baby? Please do more! D: We did, Stephaie we did all we could. M: No please do more bring my baby back, its my fault, I felt asleep, if I wouldn’t had fallen asleep, he wouldn’t had died!: She’s at a home too. She doesn’t come see me either. Neither does my grandson. C: Its not your fault, don’t blame yourself. M: He was sick, why did the other hospital released him? If he was sick? D: Do you have any family members we can call?

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M: NO, I have no one here. My mom is Houston. I’m alone here C15: Where is your baby father? You mentioned? I wheel him back inside. He’s quieter now. C16: He is probably outside, (screaming and trying to hurt herself) I want to die, I don’t want to live. C: You cant hurt yourself, you have to be strong. M: I want to see my baby. I want to be with him, please. C: I think we can go in now. M: Camilo, levantate, wake up. (as she walks inside the room, she scream the baby name) wake up Camilo, please. I need you. I need you. You were the pride of the family. No one had met you yet. Please get up!! (crying and screaming) O: There is someone outside saying they are family. C. Stephanie do you have a brother her? M: Yes who is it, let him in, please. O: Ok I will bring him. M: Hermanito, mi hijo se murio, brother my baby died (as the sibling wlked in, she started crying again) no one had met him, brother. Why Why? Its my fault I felt asleep.

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C: Stephanie don’t blame yourself, it is not your fault. C” let us pray for the blessing of your baby and you. M: ok, (as I start praying, she starts crying) no, no, I didn’t want this kind of blessing for him (referring to been dead). C: please try to calm down a bit. You need the strength to go on! M: I don’t want to live I want to die. ( she is looking around to hurt herself. I gice a sign to the security Guard to keep is eye on her.) I want to kill myself, I want to be with my son. ( she finds a plastic door, from a pushcart, and trys to cut her arm)

IV. CONCLUSION 1. The patient, family members, etc. (assessment of the Spiritual/Emotional implications)

I went in to the visit expecting more of a formal “pastoral” visit, given that he had specifically asked for a chaplain. This was also confirmed for me in P3. Given his desire to die I expected him to have questions about God and faith, perhaps express 5

fear of dying, confess, want to accept Christ – I wasn’t sure. However when I opened up the door to conversation, religious discussion was not on his mind. This surprised me, and I felt myself switching from a pastoral to more of a diagnostic role in order to see what was happening. I wondered for a minute during the conversation why he had wanted a chaplain. I realized that he probably didn’t even know what to ask, and that he may just have needed pastoral presence in his life. He asked for me because I had shown up before. I decided not to press too hard in terms of his suicidal thoughts, religious themes or theological questions as I felt it would be better to let him bring them up. I felt that taking Francisco outside would change the situation, make him feel a bit more free and open, and help him to talk about his losses and inner experience. I also wanted to show him acceptance and companionship as I felt that he probably expected to be rejected, just as he has been rejected by his family and probably feels rejected by God as well. I also came in to this visit with a bit of uneasiness, because I was not sure exactly how much religious power he was going to give me. I’ve been more comfortable in my role as chaplain than I have in my prior role as a more formal minister, and even much less so as an evangelist. I wonder if he is going to expect me to be an evangelist or confessor of some sort. In terms of my own authority provided to me by my position, it pushes my comfort boundaries because I’m not comfortable pushing people or confronting them to make decisions. I feel that building the relationship and witnessing through that relationship is more beneficial in this situation. I could have gone in with the intent to witness to him, given his terminal prognosis and need for an understanding of Christ. But I took the path that seemed the most natural. Relationally I think he may see me as a son. I know very little of his family except to know that they aren’t involved in his life. He sees himself as alone, though he seems to interact with the other residents there, especially some of the men and his roommate. He seems helpless and hopeless. His abandonment defines him. Our social worker stated that she has been frustrated talking with him in that whenever she has tried to point out positives to him he ignores them and remains fixated on his losses. She expressed this as “he just doesn’t want to do anything for himself”. I believe he doesn’t because he doesn’t see any reason to do anything for himself – his “self” is gone. He has lost everything that has given him meaning in the past. I’m not sure what he holds on to or what is keeping him going. It may be that this reaching out to others and trying to rebuild relationships in the time he has left (which he thinks is short) is his purpose right now. This desire to connect with me is evidence of that. Presence was very important to him. The fact that I visited him before, however briefly, was an important starting point. The fact that he sought out that presence again shows he trusts that and me he felt supported while I was there. 6

While I felt sadness, I overall felt peace during the visit. Moving the visit outside helped me as well, as I tend to feel less pressure and more comfortable with silence when I’m outside. I also switched from a more active role to a more passive role. This opened him up quite a bit I believe, as he moved more from the negatives of his present to more positive aspects – fishing, going outside, and the other residents. He also visited with me much longer than I expected. My first visit with him was rather short, as have most of his other visits with our staff. I feel that he trusts me and I feel that I need to reinforce that trust. Spiritually I felt as if I were an incarnational presence to Francisco. I don’t know what spiritual or religious questions he has, but I know that he needed more of a presence in his life at that time. He may be dealing with a lot of guilt and shame from this event that ended up in his being committed, and I’m sure that he feels that life isn’t just or right. Being gracious to him will, I hope, make him more open to forgiving himself and releasing the shame that makes him want to die.

2. You as a Chaplain 3. Theological Reflection There are many unanswered questions when it comes to death. 4. Plan of Care 6. Learning Goals Pastoral Formation: Learning Objective Pastoral Competence: Learning Objective

Pastoral Reflection: Learning Objective 7.

Level I or Level II Learning Outcome(s) Addressed in the Verbatim

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Interface with Curriculum Content (current or past) Ministry in the (ED) didactic and verbatim, how did it helped me. 7

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