Copyright 2016 by Brian Williamson

(NOTE: Brian Williamson is an experienced hospital chaplain, but recently he experienced the other side of ministry, spending many hours in the waiting room of the Intensive Care Unit –ICU– as his own father died. In this post, he shares his observations, in hopes that it can help those of us who visit the sick and their families, especially those in ICU.)

These are some notes I prepared from my experiences in the ICU waiting room as a family member when my father was dying. Since I work extensively in this area as a hospital chaplain, the new experience from a personal perspective has given me insights into how I can better minister to folks going through something like this. Since my observations are filled with my own feelings, they could be negatively or positively impacted by what I’m feeling and/or experiencing. I’ve offered them to my friend and co-worker, Bob Rogers to share with others. My hope is that they will be insightful and helpful to others. So, take them for what you think they’re worth.
1. ICU family members (yes, I was guilty!)  are pivoting/hinging on every little idea of their loved one getting better. You want your loved one to “be” better, so if something is “a little better” (such as a lab result, an O2 sat, blood gas, etc.) then you accentuate that and project it to everything else. This may not be the case… (“He squeezed my hand, so I know he’s getting better!” “The kidneys are looking good.” Some nurses might say, “the numbers are a little better today,” or “We turned the O2 down to 60%, so that’s a little better…” {never mind the tea-colored urine, the 9 medicines in the IV bags, the ventilator set on “C-full control” and the doctor is just hoping that you won’t have to turn it back up, etc., etc.})

2. People in the waiting room—family members, staff, pastors, etc.—tell you what to believe and what to say; and you’re usually polite enough to not slap them when they do; or to argue with them, because you know they won’t understand.

3. There is no shortage of people who want to tell you what it’s like for them. They ask you what’s going on with your loved one, but then they interrupt you to tell you “their story.” When they finish, they usually have forgotten that they haven’t heard your story.

4. Very few people really want to hear your story or talk about your memories; or what’s important to you. Fallacious clichés such as, “I know how you feel” and “I know what that’s like” are the status quo. The reality is that people in the ICU waiting room have their own pain and struggles to deal with. You feel connected to them; but, when your story starts to “go south,” they distance from you as if what you’re experiencing is contagious. If you’re loved one begins to worsen, they leave you alone and whisper to other waiting room people about what’s happening with your patient.

5. Many preachers, ministers, etc., form circles with families that block traffic in the middle of the aisles, then pray loudly—and pray, and pray and pray. Most of them leave after the prayer, and then it’s very interesting what people talk about after the minister leaves.

6. When someone is on the ventilator they have to be sedated (usually). The sedation helps keep the person relaxed so the machine can be beneficial. BUT…what I didn’t know is that every 12 hrs, the sedation has to be turned off in order to “let the person wake up a little bit.” This test helps the hospital be aware of mental changes. During the time the sedation is off, the nurse assesses the patient’s ability to respond to instructions like “squeeze my fingers,” “blink your eyes,” “wiggle your toes,” etc. In other words, you awake every 12 hrs to a tube down your throat that makes you cough and gag, you become just awake enough to know you’re not able to breathe. This can be quite punishing to the patient.

7. Silence is golden. Nurses work hard at saying the right thing and “keeping you company,” which is very special and sometimes greatly appreciated; but, I think that being quiet while being with someone is usually more valuable as their loved one is dying. One of the best questions I heard a nurse ask was, “Would you like some privacy or would you like me to stay with you a little longer?” The worst question I heard was asked by a nurse as I sat in a chair in the pod outside my dad’s room, just after his death… “Uh, you’re the chaplain, right? Well, I was wondering, “How do you feel about monogamy in marriage?”

8. Always visiting during visiting hours may not be the best idea for clergy members. Families get precious few minutes every few hours that could end up being the last minutes they have with their loved one alive. Experiment with waiting room visits followed by in-room visits. I suggest taking someone for a walk around the building, to the canteen, to the coffee shop or somewhere outside. If they ask you to “go back” with them, then go. If not, don’t.

9. There’s lots of praying going on, even though you can’t hear it.

(This is Bob again. From reading Brian’s observations, five lessons come to mind for ministry to families in ICU waiting rooms: 1. Be quiet and really listen, 2. Don’t offer pat answers, 3. Keep vocal prayers soft and short,  4. Don’t be afraid of silence, and 5. Don’t abandon them when they hurt the most. What are your thoughts? Feel free to comment below.)