***Update*** Additional resources added below: 2/7/18

I recently read a fantastic article by Tom Becraft on managing the seemingly unmanageable barrage of stress and grief that can come in heathcare chaplaincy. He begins with the summary of the first hour of one day:

• 6:30 a.m.   The morning shift is just starting. I have just entered the office and am taking off my coat. The desk phone rings. It is from the nighttime hospital supervisor regarding an unfolding situation in Room 1040. A 34 year-old mother of four small children has had a massive stroke apparently caused by a sudden dissecting carotid artery. Brain death is likely. Considerations: how to emotionally and spiritually support this large non-English speaking family; how to facilitate the organ donor requester process; how staff, some of whom are young mothers, might experience this death; how to prioritize. I clip my cell phone and pager to my belt and head out.

• 6:40 a.m.  A patient is about to undergo open-heart surgery. Twice I will meet with the patient’s family to provide progress reports from the cardio-vascular operating room. I give the patient and his family a brief pre-op orientation regarding how, when, and where I will deliver information to the family.

• 6:50 a.m.  The Organ Procurement Agency (OPA) phones, seeking my assessment of how the organ requesting process should proceed for the woman in 1040.

• 7:00 a.m.  I consult with ICU staff about the patient in 1040 and then call the OPA back, telling them that we will be having a Family Care Conference later after a second assessment confirms the brain death. I hang up and immediately feel the phone vibrating again, alerting me to a message that has entered my voice mailbox while I’ve been talking. I access it.

• 7:15 a.m.  An ICU nurse tells me that the wife of a patient in 1030 is distraught and wants a chaplain to come see her as soon as possible. As I approach the room, I pass by 1028 where a patient and his wife gesture for me to come in. Our visit is brief, with expressions of mutual gratitude for the success of yesterday’s open-heart surgery. I move on and am visiting with the patient who’s requested my visit when my cell phone vibrates.

• 7:25 a.m.  The ICU manager tells me that a patient in 1006 is in crisis. Again, it is a young mother in her 30s. Her brain has experienced a traumatic injury following surgery to remove a foreign object left accidentally in her body three years earlier during surgery in a developing country. Like the young mother in 1040, this intubated mother of four will also die soon, perhaps today, if a miracle does not occur. I check in with her nurse. The family has left to get breakfast while staff does bedside assessments and testing. I inform the nurse that I will return later when family is present.

Just reading this makes my stomach drop. While this isn’t typical, it happens. It marks the many targets of care in these contexts: the patient, the family, the caregivers and staff, and the self. That’s a lot. Our tendency as caregivers is to take care of all the other needs first before we tend to ourselves. However when we fail to care for ourselves, the whole system collapses. As the flight attendant says, put on your mask first before putting on anyone else’s, even if you think they need it more.

Becraft notes how he manages to maintain a sense of calm and peace in these moments of crisis and chaos.

When I am moving toward a crisis, I intentionally pause to remember where God says He’ll meet me. For me, Sabbath is that place. While the Sabbath is described in the Bible as “the Seventh Day of each week, and is marked from sunset to sunset, it transcends boundaries. It permeates ALL time, drawing unto the Eternal. It therefore has infinite possibilities for stress management. The Sabbath benefit can be in every moment.

The notion of a constant Sabbath presence of God provides a grounding for release from the need to “do” all the time. It reminds us that God is present at all times and seeks to redeem and restore us at all times.

The need to “do” and “fix” often confront chaplains. Yesterday in my CPSP chapter meeting we discussed some difficult cases, one of which was a woman who seemed to hold everything together so tightly and orderly that it seemed that there were no issues to deal with. The Chaplain felt frustrated in that she felt she couldn’t do her job. In reflection we noted how we can second-guess ourselves into looking for problems and then, finding none, think we’ve failed. We occasionally need to be reminded we must take things – and people – as they are, not as we think or wish they could be. The challenge became not getting through this person’s defenses, but sitting with our own frustration and uncertainty.

Becraft writes, “The Lord of the Sabbath invites us to discipline ourselves to let go of our exhausting work-oriented, production mentality in favor of a God-directed way of being. He invites us to give up our “gotta-fix-this” mindset by yielding control to a trustworthy companion who is both Most High God and Most Nigh God.” As Chaplains and ministers we can forget to rely on God for our own needs, and also forget that God is holding us in the same way that He holds the other.

Tom is the author of “A Bamboo Grove for the Soul: A Storybook of Spiritual Resources for Caregivers” which is available through Amazon.com.

***Update***

One of my readers passed along her own writing on burnout also: thanks Anna! https://doublewoodsupplements.com/pages/fireproof-your-life-how-to-recognize-burnout-and-escape-your-own-personal-inferno

Mathew Bojerski passed along some other resources that are helpful as well. Thanks Mat!

How Mindfulness Can Prevent a Caregiver Burnout
http://homecareassistance.com/blog/how-mindfulness-can-help-prevent-caregiver-burnout

Long Distance Caregiving, When to Move
http://homecareassistance.com/blog/long-distance-caregiving-make-move-closer-loved-one

The Toll of Caring for Someone With Dementia
http://www.prescottenews.com/index.php/features/columnists/in-home-care/item/30129-the-toll-of-dementia-caregiving

A Closer Look at In-Home Senior Care
http://ijpr.org/post/behind-closed-doors-closer-look-home-senior-care#stream/0

Caregiving Tips From the Foundation for Peripheral Neuropathy
https://www.foundationforpn.org/living-well/lifestyle/caregiver-tips/

Study Reveals Toll of Dementia Care on Caregivers
https://www.homecaremag.com/news/study-reveals-toll-dementia-care-caregivers

Expected Increase in Demand for Remote Health Monitoring
https://www.darkdaily.com/expected-increase-in-demand-for-remote-health-monitoring-of-americas-elderly-presents-opportunities-for-clinical-laboratories-to-provide-services-628

How to Balance Care Between Aging Parents and Grandchildren
http://www.grandmagazine.com/2011/04/how-to-balance-care-between-aging-parents-and-grandchildren/