Pastoral Care Chaplain, Cardiac Unit, St Vincent’s Hospital, Sydney
Told to Helen Signy
“We all have a human need to be connected, liked and respected”
8.30am. My expertise is to provide emotional, spiritual and religious support to patients, staff and families. That means sitting with people, listening, showing compassion and concern and providing them with a safe place to explore whatever it is that’s going on for them.
I work with eight others. We are on call for anybody, regardless of their religious affiliation. We don’t preach and we are not there to convert. If the person doesn’t mention God, I never do.
This morning I greet colleagues, print out my ward list, then we have a meeting to talk about what’s happened overnight and what’s going on. On Wednesday mornings we always have a prayer to remind us that the work we do is sacred work – it’s not about us.
9am. I go onto my ward and meet the patients who have arrived overnight. We often receive people flown in from country NSW in an air ambulance. They usually have multiple heart conditions and are very ill and could die. We’re the only heart and lung transplant hospital for NSW, and we also take patients from WA and SA.
Patients like this are usually in shock and won’t have slept much. Their relatives may be arranging time off work and are now driving to Sydney – I know they’re going to be shell-shocked and make a mental note to come back and talk to them in the afternoon. I tell patients I’m employed by the hospital so they know I’m not from any religious group. Generally speaking, people will say, “No, love, I’m not religious,” – then boom, boom, boom, off they go.
For a lot of men, it’s very hard for them to admit they are frightened. I ask them what scares them. Is it pain? I get them to break it down. I spend 45 minutes with my patients and write in the notes.
9.45am. I bump into a nurse who I didn’t see earlier in the morning. I ask her how it’s going – I can see straight away that something’s not right with her. Intuition is a huge part of my job. She says everything is fine, but she was on duty last night when a woman on her ward died. The nurse is only 23 and the lady was 33, and she had a one-year-old child. A lot of the nurses are mothers; it was very confronting.
In cardiac wards, we don’t like death – it’s not like in palliative care where people have already turned that corner.
With patients, I try very much to be the listening heart. With nurses I do that, too, but I also remind them that everyone dies and sometimes the best thing you can do as a nurse is to help a patient die peacefully and comfortably.
If someone died that the staff knew very well, I would spend time checking up on all involved, particularly the young ones. It can be hard for the staff. There are times when patients can be angry and demanding and critical. The first person they see is often the nurse and that anger spills over, very understandably.
I have a 15-minute talk with the nurse in the corridor. I work at the bedside, in corridors, at the nurses’ station, outside with the smokers, in the chapel. A lot of my work is done over a cup of tea. I tell the nurse, “It sounds to me that you really helped her to die peacefully. It sounds to me like you did a really great job.”
10am. I carry on visiting patients in the Critical Care Unit. It’s a frantic, stressful place. Turnover is higher. People have had heart attacks. There is a lot of tension. I try to be calm in the midst of their storm.
I started here five years ago. It was a mid-life change. I’m 52. I had been a lapsed Catholic, but when my children went to school, it started me thinking about religious and spiritual life. If I was bringing them up in a Catholic school, I couldn’t be a hypocrite – I opted in and started work on my spiritual journey.
I went to uni and completed a theology degree, and trained to be a counsellor. When my oldest was 12, I met a friend who, like me, had four children. She got a small spot on her tongue; her dentist told her to see a surgeon. It was a nasty cancer. She was 46, and she was dead in 18 months.
We were great friends throughout her illness. I was there with her husband and children when she died. It was the most profound experience of my life. Until then, I felt I had been sleepwalking.
12 noon. Ward meeting. The allied health team and nursing unit manager go through the list of patients. I listen for those who are the most vulnerable, isolated or the sickest, or those who have been given bad news. In a ward of 34, I usually see eight to ten people a day.
They range from the very wealthy to people who sleep in the park. Generally, people just want to tell their story. They don’t necessarily ask a lot. When terrible things happen, we all fundamentally have a human need to be connected, liked and respected. When you are in deep shock, there is a desperate need to tell your story.
A lot of them are feeling fear, anxiety, anger or guilt. “I should’ve taken him to the hospital.” “I should’ve given up smoking.” There are lots of “shoulds”. Then there’s sadness, envy – “Look at him. He’s going well with his transplant.”
1pm. Lunchtime. It’s really important when you are working with people to take care of yourself. I sit and eat my lunch, but my pager could go off at any time and I could be called to a death on the ward; I would be there for three hours.
2pm. I give a presentation to a group studying palliative care. The hospice at St Vincent’s is recognised as a place a lot of other professionals aspire to. We often talk to doctors about pastoral care; we conduct sessions on my ward for new nurses.
3pm. I go back onto the ward and find out someone died this morning. I’m often paged when someone is in the active stage of dying. I sit with them, pray if asked. Families are often at a loss what to do next, so I help them with the practicalities. There’s also a full-time Catholic chaplain here and a local parish priest. We also have representatives of Judaism, Islam and all the Christian faiths.
Death is the biggest swear word in our community. Doctors and nurses are as bad as anyone else in not wanting to confront death. We can do a lot to help people to make dying better. The first thing is accepting that you are dying.
A person who is dying is still a living person – just as a living person is a dying person.
Once, I had a man on the ward with a 35-year-old daughter from the country who promised him she wouldn’t let him die alone. She decided to go home because the kids were missing her. The next day, her father died. She was devastated. She came straight back – people need to come.
I organised to have the body laid out.
I don’t put any pressure on people, but I try to lessen the anxiety and calm the situation. She finally went in, sobbing and shaking all over, and immediately broke into a huge smile: “Oh look at him. The old bugger’s got a smile on his face. It’s all right, I think he saw Mum.”
I stay with families the whole time they are with the body. I often read Ecclesiastes 3: “To every thing there is a season, and a time to every purpose under heaven: a time to be born, and a time to die ...”
5pm. I am amazed at the extraordinary that comes from the ordinary. When I leave here, I think to myself every day, I’m not God, it’s not all down to me. Somehow God’s in charge of all this and I don’t understand it. I can only do my bit.
I’m inspired by what I see in the courage of other people, their humour and their dignity. It makes me look at myself and inspires me to live my life better.
Whenever I think about my patients, I say a prayer, and I meditate at the end of the day. But when I walk in the door, it doesn’t matter what’s happened, it’s “Mum, what’s for dinner?”
The Other Side of the Story
Ellena Jee, mother of heart transplant patient John, 20, from Wallacia, west of Sydney.
“John’s been sick since he was 14 – he caught a virus and his heart just stopped. He’s had heart failure four times. The third time we were sent to St Vincent’s from the Children’s Hospital, and he was two years on the transplant list.
“It’s been tough. He spent 40 days in ICU – I don’t know how I survived it. He doesn’t remember it. The night the heart came, he was asleep and I was at home when I got the call. We got to the hospital at 1am. All I could think about was this other mother, this woman somewhere that had given this gift to John.
“Catherine was my rock. Every time I was at my lowest, Catherine appeared. When we thought there were no alternatives left for John, she was there every day. She always put everything in perspective.
“You talk to Catherine for a few minutes and the circumstances don’t change, you don’t change, but the light comes through.”
John returned home and was looking forward to studying for qualifications. He developed rejection and infection problems and died on July 24.
