14 Paperwork

Keeping records is maintaining care

Chaplains take care of paperwork.

When someone arrives at the hospital without a name, we help find their name. And fill out the paperwork to document it. When someone arrives unconscious and their valuables need to be secured, we inventory the belongings and take them to the security lockup. And fill out the paperwork. When someone is interested in advanced directives, like the appointment of a health care representative, we explain the forms. And fill out the paperwork. When someone dies, we fill out the paperwork. When we visit with a patient or family, we make a note of it on the clipboard we carry.

And then, after all those conversations and interactions, we fill out the electronic paperwork in two places. It can take a long time. I’ve had eight-hour shifts where I’ve spent more than two hours on paperwork.

If you are unwilling to fill out paperwork, don’t become a hospital chaplain.

But I don’t see it as paperwork. I see it as one way we provide continuity of care.

“Continuity of care” is a healthcare phrase. It means that a person gets consistent healthcare across time. It used to mean that there was one person who knew you and your family and everything that was right and wrong with you. Now there isn’t just one person. There are primary care physicians and specialists. There are offices and clinics and hospitals. And so, everyone in healthcare keeps records on interactions with patients. Conversations, diagnoses, prescriptions, tests, vital signs. Everything is noted so that anyone involved in care for that patient doesn’t have to start over with every contact.

And it’s not just on the medical side of health care. There can be many chaplains, too. At one of our hospitals, we have 248 hours of coverage every week: a chaplain 24/7, an additional one during the day, and another working with palliative care. At another, we have 42.5 hours in person and 125.5 on call. To provide care for all this time, chaplains take turns. One chaplain may visit a patient when he or she arrives, another may visit in the middle of the night, a third may be present when a ventilator is removed, and a fourth may be there after a death. The way we make sure we are providing consistent conversations and care is paperwork.

In my previous work as a pastor, I could have conversations with the same family for years. I could provide the continuity myself. Now, for the sake of our patients, I work with colleagues to give that care. I take careful notes. I document the conversations and the decisions and the concerns. I pass on what will help the next person serve well.

Sometimes it feels like a paper trail. But mostly it feels like a life line.

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Before You Walk In Copyright © 2019 by Jon Charles Swanson. All Rights Reserved.

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