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CPE: 24hr On-Call in a Trauma 1 Hospital

June 7, 2007 Adam Walker Cleaveland

Part of our job description for the summer entails being the On-Call Chaplain 7 times throughout the summer. It’s a 24-hr on-call, and after 5pm, the On-Call Chaplain is the only chaplain in the 600-bed hospital. So, it can be a little intimidating – especially your first time. It’s hard to describe what being On-Call for 24-hrs is like. And it’s also hard because each night is different at the hospital. Some evenings might be relatively quiet. Others might be much busier. If I had to pick a phrase to describe my first 24hr on-call experience, it would probably be trial by fire. When I walked into the Pastoral Care Office today, one of the staff chaplains was reading through the log-book. When I walked in, she stopped, looked up at me and said, “Are you okay? Do you need a hug?” Perhaps that gives you an idea of the intensity of my evening. I received a fairly steady stream of pages throughout the day, but things really kicked into high gear around 7.30pm.

I had just finished dinner, and was starting to make rounds when I received my second Code 40. A Code 40 is a trauma being brought to the hospital – they can come by ground or air, and a Trauma Team is called down to the Emergency Department (ED). The Trauma Team consists of doctors, nurses, radiologists and many other sorts of specialized doctors, hospital staff and the On-Call Chaplain. My first Code 40 of the evening was a motor vehicle accident (MVA) which ended up with the patient becoming paralyzed. This second Code 40 was a shooting – and a pretty high-profile case because it was a 22-yr old New Brunswick Police Officer who was shot (but in stable condition now). Because of the nature of the case, and the fact that it was a police officer who was shot, this brought out the “suit patrol” (President and Assnt. Vice-President of the hospital, among many other very important people in the hospital).

This must have gotten things going, because from 7.30pm – 8.30am the following morning, I only got 1 hour of sleep and I was on my feet in the ED for most of the on-call. We had 4 more Code 40s for MVAS, one for a pedestrian who was struck and one for a burn victim whose body was 90% covered with 2nd & 3rd degree burns. During all of these Codes, I also spent time providing Emotional/Spiritual Support (ESS is Chaplain lingo) to other patients who were in the ED, and to some other pages I received. One of those was for a young couple who were going to have to deliver a 22 week still-birth. I met with the couple both before and after the delivery and gave a blessing over the baby’s body once it was delivered.

There were some other visits throughout the evening but all of the Code 40s and the stillbirth were some of the hardest parts of the evening. Sometimes I was interacting with the trauma patients who came in, sometimes trying to provide ESS to their families and sometimes, we are told, our presence helps the staff feel better. For the most part, the doctors, nurses, EMTs and others on the Trauma Team work really well with the Chaplains and help us play an integral part in the care of patients that come into the ED.

I had a few conversations with some of the trauma patients, and the one thing that struck me the most was how in just a split second, their lives were dramatically altered. The burn victim was a young man in his early 20s, just about ready to head home after work when there was a chemical accident, and he was burned…90% of his body, burned extremely badly. And just like that – his life will never be the same. Plans are abruptly changed. And this was just in one hospital in one city in one state…you get the idea. It’s pretty sobering to think about how many people’s lives are dramatically changed just like that.

I was told that this was probably the most intense on-call experience I’ll have. In some ways, it was good to get it out of the way – perhaps it will make all the others seem easier. I’ve always wondered how people can do night-shifts. But it’s pretty easy in a hospital, specifically the Emergency Department; by around 2 or 3am, I was running on pure adrenaline. There were definitely parts of the evening when I was really enjoying the work I was doing, the chance to provide ESS to patients and families. Who knows – maybe hospital chaplaincy is in my future?

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Filed Under: Ministry Tagged With: Clinical-Pastoral-Education, CPE, hospital, on-call, Pastoral Care

Adam is an artist, entrepreneur, pastor, husband and father. He lives in Skokie, Illinois with his wife Sarah (who is also a pastor), their son Caleb, and their dog, Sadie. Read More…

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