Monday, October 31, 2011

clinical pastoral experience week 5

CPE REFLECTION WEEK 5

What’s concerned me most this week is the newest development—that one of my residents is convinced that I tried to kill him while visiting him in the hospital. I’m not worried about legal or ethical repercussions from the accusation—that I didn’t do anything resembling what he remembers, pulling off his nose tube, is pretty clear to me and to others—but I am worried about how this will affect our relationship once he’s been discharged from the hospital and returns to the facility.

It’s possible he won’t remember the incident at all, that it’s a memory caused by his pain medication and just as ephemeral. It’s possible that he’ll return and his first words to me will be, “Isn’t that funny, that I thought you tried to kill me?” But it’s possible too that he’ll become more convinced of the reality of that memory and it will adversely affect the relationship we have and that’s the biggest concern I have. How do I move both him and me beyond that, especially if he remains convinced of it?

The Nurse Manager for my floor has pointed out to me that this experience is good in a sense, as it gives me an idea of what it feels like to the aides and nurses when the residents call them bitches and niggers or accuse them of ignoring them or trying to kill them, and she’s right. From the perspective of ministering to the staff this is an invaluable situation. If anything good could be said to come out of the situation this would be it. I thought I’d had nearly every experience in my group home years but this one is new and I don’t like the feeling much.

Otherwise this has been a good week. I think that as a group our CPE cohort is coming together better, seeing one another as individuals with needs and concerns and less as other people who simply do much the same things as we do, only not as well or in a different way. The conflicts that strained our initial coming together--one person's perceived distance because of his new illness, a threeway misunderstanding—have been addressed and I don’t see any new ones on the horizon.

My relationships with my residents are becoming more solid. Another, older resident has also been hospitalized this week and my visits to him have proved beneficial I think to him and me. After conversation with my floor social worker I’ve determined a way of connecting with two residents in vegetative states that involves simply sitting quietly with them, much the same way as I’d already been sitting with another. I’ve begun to have positive interactions with still a third who’s so self-isolating that I almost never see her, but who I’m certain to approach whenever I see her out. She remains distant but encouraging: she hasn’t yelled or called me a fucker which I take as positive signs. I’ve sat with her only as long as she seems to want, which is usually about four or five minutes, and I think something she likes is that I don’t have any demands of her: one of her first comments to me was, “What do you want?”

I’m concerned about the development of another resident's abscess. Or not his abscess itself but its effect on the staff and to a lesser extent on him. That he’s going to die from it is a given and that it’s probably going to happen sooner than later is something everyone, including the resident, has known, but while he seems to be resigned to it, I think staff members are realizing that the time has come for the actual process to play out. The floor nurse manager very nearly cried when she told me he has bone showing and the consequences of that. I’m watching this development closely and picking my way carefully.

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