Working with death while grieving is hard

Another mixture of posts that show staff need to have their grief acknowledged in order to provide an effective service. The only way this is possible is if we get better at talking about death and its impact on us.

Getting back to the day to day life, as a chaplain one of the things I was keen to develop was a teaching role with staff. I have been gradually building these sessions up. Sessions I ran included talks about the role of chaplains and rituals at the time of death. I also ran some domestic violence awareness courses. All this had been good in that it had broken down some of the misconceptions about chaplains amongst the staff. Whenever I get the opportunity I remind staff that we are there for them too and not just the patients and their visitors. I also helped to run the breaking bad news course for new medics.

This has led to several staff members coming to chat to me. The issues have ranged from marital problems, difficulties in offering care to a dispersed family with elderly parents living abroad, bereavement support, complex family relationships and coming to terms with past hurts. Sometimes staff have approached me for support with work related issues. Recently that has become more so with cuts that have been made and the threat of future cuts.

One of the staff support activities that I got into was to acknowledge and support the work of a particular ward. They’d had an unusually rough time with a number of untimely deaths amongst their patients. One of these was a young man in his 20’s who unexpectedly went into cardiac arrest and couldn’t be saved. It deeply affected every member of the team, especially the other young men.

I put together a little ceremony, which happened on the ward. The liturgy needed to contain elements that appealed to all faiths and those of no faith. I used a bowl of salty water to symbolise tears and a central candle and gave each staff member a small candle, which symbolised the light and life of the many patients that they had cared for. The ward manager read out various poems and chose some music. It was only half an hour but it was a very emotional occasion for the staff and gave them an opportunity to stop and think and acknowledge their feelings.

The next day one of the young male nurses told me that he had slept better that night than he had for months. He thanked me for making it possible for him to move on. I think this is important. Many staff don’t get the opportunity of going to patients funerals but they sometimes need a space to say goodbye. That was provided on this occasion and helped. It’s something maybe to think about in future for the whole hospital.

One night I was called to the bedside of an elderly woman, She was dying having had a second stroke. The first one had been 18 months earlier and that had left her unable to speak and walk so she had been in a nursing home. Before that she had been incredibly active and a powerful force in her family’s life. Even though she couldn’t speak after her first stroke she could still communicate what she wanted. The patient’s daughter was an only child and the relationship between the two of them at times had been really difficult. The daughter went on to have three daughters of her own. It seemed to me from what was said that the patient had been an exceptionally good grandmother. It also seemed that she had tried to make up for maybe not being that great a mum by being a fantastic grandma.

As the daughter and granddaughters talked to me over the few days it took for the patient to die, it became clear that there were some deep wounds. I encouraged the daughter to name her hurts and speak them out loud to her mum as she was never going to get another opportunity to do this. I said I felt that her mum had tried to atone by the way she had been with her grandchildren and that she wouldn’t want her daughter to carry that pain any further in her life. Now was the time to lay it down and let it go. Bravely she was able to do this and we were able to have a little ceremony and anoint her mum and begin the process of laying the ghosts of the past to rest.

While all this was going on a very good friend of mine was dying. She was in Maidstone Hospital. I visited when I could and chatted on the phone to the rest of the family when I couldn’t get there. Diana was a hospital chaplain herself and had been very instrumental in shaping the way I approached priesthood and chaplaincy. The last time I saw her in a state where we could communicate I knew I had to take my own advice and say to her all the things that I would never have another chance to say. In this case they were all very positive things. During this conversation I asked Diana if she wanted to be anointed. She smiled and opened herself up to me in a posture that is symbolic of being anointed.

In my short time as a chaplain I have anointed many people. Anointing Diana was the hardest thing I’ve done in a long time. It was a beautiful moment and she was very serene and peaceful and it is a memory that will stay with me forever but it was really hard. Afterwards I got back to my car and wept. It was some time before I was able to drive.

 The next day, back at work, I found out that the family of the elderly patient who had died, wanted me to take the funeral. I agreed to do this as they were all so dispersed around the country.

The funeral was early one Friday morning. I had spoken to Diana’s family the night before and they didn’t expect her to last much longer. I was very heavy hearted as I arrived for work that morning. I put on my professional mode and set off for the funeral. Just before I arrived at the crematorium I realised I didn’t have my robes with me. I was aghast at what I’d done and couldn’t believe I had been so stupid. The chapel attendant at the crem was great and rigged me up in something. It wasn’t perfect but it would do. I then opened my folder only to find that I had put the wrong funeral in it. At that point I almost lost the plot. I went into the chapel to take a moment to try and compose myself before the family arrived.

When the family arrived I confessed that I was not properly dressed and that I had forgotten my notes. I was extremely apologetic and said I wasn’t normally so dis-organised. They were extremely gracious and accepting of what I said. In part, that is due to the relationship I had built with them over the time that I had been visiting, but it is also due to the vulnerable position people are in when attending the funeral service of a loved one.

The service went smoothly and fortunately I remembered most of what I had written in the funeral address.

I had never done that before and I hope I’ll never do it again. My own grief over Diana was having much more of an impact on me than I had anticipated. That bit of forgetfulness was a warning sign to me to take care of myself.

Over the next couple of weeks I felt very fragile and my colleagues shielded me from some of the more traumatic situations in the hospital. The problem of a hospital chaplain grieving is that they can’t not be involved in other people’s death or grief as that is part of the daily work. One of the impacts of the strain of trying to remain professional whist feeling so vulnerable was that the forgetfulness continued. This came to a head when I had forgotten to tell my colleague about two occasions that I would be out of the hospital all day. On one of the days she had to come in on her day off. It was a trying situation all round.

Fortunately I had a weeks A/L booked already. The holiday really helped and gave me some space to just be myself. The forgetfulness has lessened but the effects of Diana’s death will be felt for some time I’m sure.

Diana was my soul mate and I really grieved her death and the loss that it brought to my life. Whenever people have died that I’ve been connected with, I’ve always been able to carry on chatting with them. I believe they are in heaven and that they can hear me. It has always helped me still feel some sort of closeness. With Diana all I felt was an enormous void! We were very often in contact via phone or text message. All of a sudden there was just nothing. It was an awful pain. At times I felt overwhelmed and could feel myself becoming tearful with patients or staff. I never did break down in front of anyone but I came close. It’s not that I think crying is wrong but when it’s your own stuff it has no place in someone else’s pain or trauma.

The work of the hospital continued. Despite my grief I had to be alongside the dead and dying and the bereaved. Eventually my pain lessened and became part of my experience. In fact now I find it has been a useful experience because I more readily understand the void that someone’s death can leave. From my woundedness I’ve been able to be a more effective healer because of that deeper understanding.

A teenage girl had an impact on me shortly after the last encounter. She had been suffering from bone cancer for many years. Her family had taken her home to die but at the last minute had panicked and called an ambulance. The crew found the situation difficult, as did the A&E staff. The resus attempt was futile and the young woman was allowed to die with her family around her.

I was wandering through the department late that evening, as there had been a staff BBQ. A member of staff called me over and said they had just been trying to contact the chaplain and filled me in on the family situation. I went in and chatted with the mum and dad and the other siblings. They were all very upset. Dad told me he wasn’t religious and wouldn’t take part, I told him that wasn’t a problem, that as a Church of England chaplain I was there for people of all faiths and none. Mum told me she was Roman Catholic. I asked if she wanted a RC priest and she told me she had asked for that. I double checked with staff and they apologised for shoving me in with the family and that they had called for the RC chaplain. I went back in and explained to the family that the priest was on his way. Dad asked me to stay and mum said she’d like me to say some

prayers. I did a little ceremony with them getting them all to anoint their daughter/sister in their own way. They all participated. I was talking to dad afterwards. I gave him this Native American quote:

“When you were born you cried and the world rejoiced. Live your life so that when you die the world cries and you rejoice”

I said I could tell his daughter had lived her life well by the tears flowing for her and that was a good thing.

The RC priest arrived shortly after this and I left them to it. I wrote to the family and invited them back to the “Remember Me” event. This is a non-religious service to remember all those who have died in the previous year. They all came. The dad spoke to me and said he had found our chat helpful and that he had used the quote I gave him during his eulogy to his daughter at her funeral. To me that showed me, what I already hold as a deep conviction, all people have a spirituality and need to be embraced at those awful moments in their lives. That father found a meaningful encounter with me because I allowed him to express his spirituality how he wanted and didn’t make him fit into a prescribed religious formula.

The same night as the awful situation of non-acceptance of the teenagers impending death, I was also called to a family whose elderly mother was dying. The daughter wanted me to pray for her mum but wanted me to wait until her mum was asleep in case seeing me worried her. I did as the family asked but I must confess it made me feel a little awkward.

While I’m in the hospital I never wear all black. I often have a brightly coloured jumper on, or a different coloured clerical shirt or trousers. The reason for this is so I don’t look like the “grim reaper” I do think it’s my job to put people at their ease and break down any barriers they may have. People will always make assumptions and have stereotypes about priests. Once people get to know me I know I challenge those misconceptions.

Getting back to this family I think the issue was more that they didn’t want their mum to know she was dying. She probably knew anyway and may have wanted some comfort for what she was facing. I had to abide by the families wishes but promised I would also look in the next day.

I did pop back several times before mum died. Mum’s impending death was never openly discussed. I think that is so sad. We need to get better about talking about death. We are all terminal. It will happen to all of us so why don’t we embrace it? I have planned my funeral and made my wishes known. It always helps families if the person dying has said whether they want burial or cremation and what kind of service. It’s much better to have a personal send off than one that could be for anyone, for example one where only the name is familiar.

If this blog helps anyone talk about their wishes with loved ones then it is worth reposting it.