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Texas Health Huguley
CLINICAL PASTORAL EDUCATION
Pastoral Encounter & Reflection
Chaplain Jose Escamilla
Patient name: L Age 60 Race Caucasian Sex Male
Religion: UnknownRoom? Unit 3300
Date of call 10/3/2016 Length of call 30 minutes
Frame Work for Pastoral Care
Background Information (Reason for call, previous visits made, etc.): Patient was not on my list. I was visiting others patients on the same unit. I was ready to leave the unit when The nurse asked me to visit him. Yes, what can I do for you? We have this patient he is mad with us. Can you visit him?
Observation Upon entering room and describe nonverbal communications from, patient, staff and family (describe the setting, who was present chaplain, patient any nonverbal communications which occurred.) When I walked in the room the door was open, the curtain was open I could see him and hear him (because he was screaming).
Personal feelings upon entering the room: This was the first time I enter a room without asking. The patient was not aware of me. When I walked to the room I saw that patient was very anxious and nervous he was screaming and he moved up and down his back. I really didn’t know what to do with him
Verbatim Conversation: Patient=P Nurse=N Chaplain=C
N 1 Are you the chaplain?
C 1 Yes What can I do for you?
N 2 We have this patient; he is mad with us. Can you visit him?
C 2 Yes let me go. (I was in front of the room)
N 3 But before you go let me tell you something, he is little of in his mind (I hear him before I see him)
C 3 (I walk inside the room and stand to his left side) Hello I’m the chaplain, (No answer) Hello
P 1 I’m in pain.
(He was loud)
C 4 You have a lot of pain?
P 2 I’m in pain.
C 5 What can I do for you? Can I pray for you?
P 3 I’m in pain.
C 6 Can I ask the nurse to give you some pain medicine? Let me ask him. (I left the room)
C 7 (I see him in the nurse station) Hey he says he is in pain can you give him something?
N 4 I know, but his doctor is not here, I cannot give him any drugs without the doctor’s permission.
C 8 Okay.
N 5 All I can do is give him Tylenol, I can do that.
C 9 That’s fine with me.
N 6 Okay.
C 10 (When I go back in to the Room he still screaming) Hey the nurse is coming with the pain killer.
P 4 I’m in pain.
C 11 I know, he is coming.
N 7 Okay buddy this is your medicine; open your mouth this is your water.
C 12 (The nurse left the Room) thank you.
P 5 I’m in pain! (He is screaming)
C 13 I know you are just take the medicine and wait little bit.
P 6 I’m in pain.
C 14 (I stand in the left side) Hey listen to me.
P 6 I’m in pain. (He is loud)
C 15 I know, listen, look at me (he finally stop screaming) listen to me, look in my eyes. (silent)
C 16 Lay down your head on the pillow, feel how soft it is, it’s the best pillow you ever felt (he nodded his head up and down saying yes). Now let your shoulders rest in the bed, (he slowly settled back into the bed). You are really tired, (his head moves up and down saying yes) now your arms feel heavy, let them rest, you can feel the bed under your arms is soft, very soft, now your legs are very tired let them rest, (his head move very slow saying yes). Now you are resting in the best bed, now you can feel the mattress in your whole body, it’s really good, it’s very soft, now your whole body is totally resting. (The patient starts snoring).
(I leave the Room with the patient sleeping like a baby)
N 8 What did you do with him? He is sleeping?
C 17 Yes
N 8 Thank you chaplain.
C 18 You’re welcome God bless you.
A What are your feelings in your relationship encounter with self, the patient, staff or family member? Me: I felt connected very well with the situation; I connected with the staff helping him with the patient. PATIENT: I felt sadness when I saw the patient out of control. I help the patient giving him the attention and pastoral care.
B: Description of the Dialogical process: At first I felt like I was talking with myself, looking at his body language expressing pain but he started answering my questions (C 14)
C. Using the 7x7 spiritual assessment expand on your assessment of the patient’s spiritual needs by evaluating the patient’s:
1. Belief and Meaning
2.Vocation and Obligations
3.Experiences and Emotions: The patient was suffering from pain, he was out of control that made me feel sad, and reminded me of people in my past.
4.Courage and Growth: I think he was courageous letting the staff know he was in pain.
5.Ritual and practice:
6.Community: I don’t see any community in the patient’s life, I the chaplain in the visit became his community of help.
7.Authority and Guidance: I used my pastoral authority to guide the patient to relax.
8.What is your assessment of the patient’s need: He needed to stop suffering from pain. I can see his spirit and soul was suffering for the pain. He needed to put his body, mind, spirit, and soul to rest. I don’t know his situation, but I know he most likely had a hard life.
D. In your own words, articulate central themes of your religious heritage, theological/Dharma understanding, life events and relationships that you utilized in your pastoral care. In reflections, what themes have you become aware of in this pastoral/priestly encounter.
My pastoral presence was outstanding when I told him to listen and look at me (C13)
I was his only help during this time. I used my pastoral theology (reconnecting people with the goodness of life) to give him the peace and rest in the midst of his suffering.
E. Introspection by Chaplain-What issues of transference/encounter transference were at work here? What identifications and projections were in play?
In the visit I was aware of my struggle whose people life’s out of control. I see myself helping people with mental problems, that surprise me. This patient reminds me of people on the streets with mental problems and hopelessness.
F. Give a critique of your pastoral\priestly care? List three strengths and three growth areas.
1.Critique: I feel I was there at the right time when the staff and patient needed me I just don’t know if I could have done better
2.Strenghts: I Listened to the patient and I was open to do something for him.
3.Growth Areas: I think I’m growing in my pastoral care. Providing love for the patient, supporting helping the staff being present when they need me (as the book in living color presented in page 63 as pastoral care)
G.What Learnings issues emerge for you in this pastoral care encounter? How do they relate to the learnings goals you have set for yourself this unit? My biggest learning issue is to shape and form myself to the different types of patients. This patient really gave me the opportunity to integrate my personal theology reconnecting people w/ the goodness of life when I guided him to sleep providing an escape from his reality, at least for the moment
H. Feedback I need from peers& Staff. Be specific as possible! I would like my peer’s opinion on the way I address this situation.ed). You are really tired, (his head moves up and down saying yes) now your arms feel heavy, let them rest, you can feel the bed under your arms is soft, very soft, now your legs are very tired let them rest, (his head move very slow saying yes). Now you are resting in the best bed, now you can feel the mattress in your whole body, it’s really good, it’s very soft, now your whole body is totally resting. (The patient starts snoring).
B: Description of the Dialogical process: At first I felt like I was talking with myself, looking at