Friday, 3 February 2017

Journal: Palliative care and beyond

I find myself engaged with end of life situations on a regular, almost daily at times, basis and each is as individual as the people involved with it. The blessing is that few die alone, the curse is the pain and guilt, the missed opportunities, the leaving others behind as only one person goes through the turnstile at the end of it all!

Recently I chatted to a lovely lady who has been working in a hospice 'up North' for a number of years; and it was an enabling and inspiring thing as she told me of her working life and the people she worked with. The shock came in the comment that whilst it was a great environment to work in, there were days when she would gladly swap her well-funded, well-equipped, workplace for the other end of the scale NHS just to see a patient walk out having been mended rather than ended! This was something that hit home as I generally get to visit loads of people and expect just that - not that I don't get my fair share of terminal bedside hours.

It was also a bit of an eye-opener to be told that whilst everyone in the place she worked was committed to the job they were doing, it was - all things considered - a job. She spoke of how the volunteers and the environment gave people some idea that everyone in her workplace were some sort of saintly people, "But I work with people who are there because it's a good job with good hours, pay and environment. To paraphrase her comments, "We have our good days and bad, the days when we clock in and can't wait to clock off again, and days when we are the people the customers like to think we are. We are human!"

There are times when we all need to be able to step back and 'just do the job' without placing all of ourselves on the roulette wheel. It's something I'm rubbish at and I wonder if it's something I need to learn. That said, like the nurse in the hospice context, people have this image of the kindly, compassionate and caring cleric: Totally committed and willing to walk the extra mile, giving all of themselves and more to their role. And they are disappointed when their expectations prove to be fals.

The task is to be true to ourselves whilst also maintaining an integrity. To minister God's Grace whilst  living in it ourselves. To do what is needed without destroying ourselves or our families or denying the care others need whilst perhaps denying their expectations. Whilst denying our own expectations and the excesses they might create in us and others.

The knock at the door on a day off because the person knows you'll be at home combatted by telling people that the vicarage is not a workplace but a home and they aren't welcome; something that living over the shop, and the person I am, could never do. The denial of the expectation of others because, like the nurse said, "It's just a job at the end of the day!"

I work alongside someone who is available on a 7*24*365 basis and whilst I recognise that I'm not able to keep those hours, I also realise that stuff happens in that timeframe too - and that means that I'm 'on call' to meet those needs - providing triage and when necessary being out of the door - because we deal with life (and death) in all its richness.

The observation that 'things can usually wait until the morning," and the idea that there are few emergencies that can't wait until the morning, whilst perhaps reasonably true in the final analysis, is a bit flawed in my opinion. Tell that to the mentally ill parishoner who calls at 02:00 in a flat spin and panicking. What they need is a voice at the other end - it might take five minutes, it could take two hours  (and it does some days) but an answerphone and office hours don't just deny expectations (which apparently I have wrongly created) but create something weak and destructive too!

Now that's an invitation to a punch up - isn't it?

Lord, today has been a tricky and challenging day - the people before me .have been a blessing; a fragile and fragrant flower found in a shell scrape of sucking mud amidst the carnage of combat - the  demands and the skirmishes taking their toll. But you have been with me, my rod and my staff, my comforter, my guide and friend. Your love has fed me, forgiven me and encouraged me to press on.

For those in end of life situations - the terminal and the bereaved - may I shine your light of hope and love.

For the mentally ill, may I be their rock and anchor - that those in the storms may be held fast whilst those in the quicksand might find their feet on safe ground - as you are for me.

For the homeless, may I have the wisdom to act, and to hold fast, that needs are met and the right things done in the right way.

Lord, for a challenging day, with pain. Sadness, loss and triumphs too - what can I do but thank and bless you for all You as in, for and too me?

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