Hello In There
No visitors allowed into the hospital. The Care Experience team wrote the letter to patients, then posted flyers throughout the campus. We know loved ones promote emotional and spiritual comfort. They support resilience. Loved ones cultivate healing. They have been a part of medical care since the first patients came to our clinics and hospital. For now, no longer. It is eerie to go from room to room seeing no visitors. We see isolation. We sense loneliness in patients and loved ones we talk to by phone. Their absence is distressing to staff. Necessity is the mother of invention. Seeing a need, creative, caring souls stepped in. The spiritual care team with Claire Bohman, Floyd Trammell and David Stickley started new practices. They phoned patients on the 6th floor. Daily. They called to talk, to pray, to simply say we see you. We know you are here. They called families of patients in the ICU with COVID to provide updates. Families asked the chaplains to write letters, and draw pictures for nurses to place in the room not accessible to them. And the chaplains adjusted to offering blessings without the familiar, essential, caring touch of a hand. Technology, often close to hand, entered. A group of third year medical students, whose clinical rotations were grounded, partnered with residents and interns, to source iPads, to establish video visits with family for hospitalized patients. The initial nine, working with colleagues at Parnassus and the SF VA, developed a process for patients without COVID and their nurses to request a tablet visit. With a growing number of volunteers (now more than fifteen of them), they deployed a student to each room who would connect the patient with their loved ones. Over the last two weeks they have performed 66 visits involving 33 separate patients. Half had multiple visits. Patients had much to say, and many to share it with. A 46 year old mother dying of lung cancer, celebrated her daughter’s 10th birthday. For patients unconscious in the ICU, unable to talk, families asked students to show them images of the ventilator. Show the tubes entering their father’s body. They hoped to build a picture of what he was experiencing. And they hoped to soften it – “Please show me his hands.” “Please touch his shoulder, hold it there for a moment while I say I love you.” Not restricted by borders, on Good Friday a student crafted a three way tablet video call including family in Guam-Manilla-San Francisco-with their mother in the final stages of comfort care. They asked the student to place a rosary in their mother’s hand as they prayed, celebrated her, and sought reconciliation. As they said goodbye.
It’s clear, our patients and their extended circle have technology they will utilize to stay connected. Our palliative care team piloted this work with a Foundation Heart grant in the pre-COVID era. They similarly found the deep desire to connect with loved ones at transition points in peoples’ lives. Recently working with the FIS team, they orchestrated a multi-continental iPad call, through a phone interpreter, to update an end of life directive. The family then used an electronic application to sign the document, finalizing our commitment to respect their wishes for their grandfather in his last days. Among the revelations of our work during the pandemic - we have more tools, more creative approaches, and the will to fulfill a fundamental aspect of our humanity, the need for connection. May we commit to holding on to this reminder.
With great respect for your caring work. With gratitude for your caring self.