The multiple roles of emergency department pastors

The multiple roles of emergency department pastors

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“Active shooting, multiple casualties” scrolled on my big screen TV. I put everything down, grabbed my documents, and walked towards the hospital. When I approached the entrance, my phone rang. The emergency department coordinator blurted out, “Doctor Tom, can you come now? We need you.” I replied, “I’m already on my way. I’ll be there soon.”

The mission of the hospital chaplain is to provide spiritual care to patients, their families and staff. Some pastors are embedded in the patient service process of a typical hospital and become part of the medical team, acknowledging that they support primary medical services.

The staff like to call me “Dr. Tom”. It is professional and friendly. “Rev. Dr. Tom” is official. “Pastor Tom” is more suitable for contact with patients, because the title of the priest immediately reminds people of a particular religious belief, and I prefer to be universal and serve all patients, regardless of their religious beliefs, if any. Theologically speaking, all people are children of God. My goal is to strengthen the connection between patients and their families and their God, and to instill confidence in the medical care they receive. The result is in the hands of God.

During traumatic times, my task is to escort my family to the family room. I also assist non-medical patients with care and even make beds from time to time, especially when the staff is under pressure.

On Christmas a few years ago, first responders transferred an unconscious woman to a trauma bed. Liquid and waste fell on the floor. The deputy medical director exclaimed: “Will it be too much to ask for a pair of boots to protect my new shoes on the day we celebrate the birth of the Lord?” After a quick replenishment, I handed a pair to an assistant. He put them on the doctor’s feet. I started to leave the room, but the head nurse shouted: “We need two more, Dr. Tom.” The medical staff spared no effort to treat them in time.

The close working relationship with the medical staff provides the pastor with an additional way to understand patient care. When doctors reveal their diagnosis to patients, they often ask me to accompany them. The nurse greeted me, “The patient in Room X needs you.” Whenever a traumatic situation arises, they will call without hesitation.

With the exception of obvious exceptions that pose a danger to oneself or others, patient confidentiality is of the utmost importance. I saw a patient take a pill from the bottle, put the bottle back in her wallet, and immediately reported it to the attending nurse. Establishing this level of confidence with caregivers opens up feedback, which is valuable for mental counseling with patients.

When COVID-19 hit, non-essential staff were taken on leave, but I was quickly recalled to serve the entire hospital. Half of emergency beds are dedicated to COVID patients. I was stopped by a physician in the lobby. He said, “We need to upgrade you to a level 3 mask at least. You are too valuable.” When N95 masks were on the market, I got a few. When medical staff can use the COVID vaccine, it is an honor to receive a call and be told to line up.

Burnout exhausted many nurses. When all COVID patients are intubated, receive multiple intravenous medications, and lose consciousness, it is very laborious. Need to be monitored frequently. The unit director of the largest COVID intensive care unit asked me to pray for her nurse. I pray on the work public address system so that the nurse does not have to leave the patient’s bedside. Every time a passing nurse says “Thank you for your prayers”, my heart twitches.

There are occasional special events. When paramedics dress up for Halloween and Christmas, I like to be a costume judge. This is indeed a special event when I was asked to preside over a wedding for a female patient who had to cancel the scheduled wedding due to necessary surgery. The bride wants to get married anyway. The surgeon approved a ceremony in the hospital chapel the day before the operation. The attending nurse made all the arrangements. This is a complete family ceremony, with recorded music, scaled down to avoid too much stress.

Recently, I was about to enter the ward, and the medical director of the ward had just arrived. I started to move away, but he said, “You first, Dr. Tom. They need you more.”

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