Wait, is that allowed?

So on call in the ED recently, I had an experience that cause me a lot of turmoil. I feel the need to post a warning to this post: it pertains to religion, and I’m not sure how I feel about that. I will tolerate no Bible-bashing or ANY kind of bashing in the comments, but fair comment is most welcome (and sought).

So, it was night shift in the Trauma unit and it was insane. It had recently been pay-day, translating directly to loads of drunks, loads of MVAs, and loads of assaults. In addition to the many injuries (e.g. paediatric fractures) that occur during all times of the months.

Anyway, it was rough. The narrow corridors of the emergency wing were packed with gurneys. Patients were holding their IV bags above their heads because there were not enough IV stands. I took to wearing gloves all night long because on a night like this you can’t trust any surface to be clean. I also wore my N95 mask all night long. It was a hot-zone.

And in the midst of this, while I was rushing to find large-bore IV cannulae (because it’s a great idea to run out of those), I almost slammed into three people who were praying vociferously over a patient sitting in a wheelchair in the corridor. The group looked like a husband, wife and small daughter, all wearing black T-shirts with JESUS emblazoned on the front – and some other words that I never got around to reading. There were more of them there – many little groups, many with children.

I almost slammed into them because they were standing in the middle of a narrow corridor with way too many people in it, and they did not move out of the way. They did not move out of the way because they were praying. Eyes closed. The patient seemed pretty confused. He was also pretty drunk.

I felt annoyed. I’m still not sure why I felt so annoyed, but I have some theories.

Having grown up with the so-called very progressive South African constitution, I’m all for freedom from discrimination. So the practising of religion is really not what bothered me here.

What bothered me was

1. It’s an emergency area. Doctors and nurses are LITERALLY trying to save lives. The place is over-full and doesn’t need any bodies there that aren’t ill and in need of healthcare. When I’m walking from one room to another with a used sharp, looking for a sharps bin that ISN’T overflowing, the fewer people I can possible bump into, the better. When I’m rushing down the corridor with a gurney, the fewer people I have to BEG to get out of the damn way, the better. I’m not suggesting that we don’t need all the help we can get. I’m just pretty sure that an omnipotent being is able to hear your prayer even if you are not standing in the hot-zone.

2. It is a public hospital in South Africa. Probably half of the people in there are coughing up TB Bacillus. WHY would you want to expose your child to that, all in the name of a prayer they could very well be saying in their bedroom before bed? Why would you want to expose their fragile immune system to that any more than it needs to? Or your own, for that matter? Repeat #1.

3. Patients in the ED are in pain and are vulnerable. They are in a crazy and unfamiliar environment. Strange people come to them to stick needles in their veins and gloved fingers in all orifices. It is uncomfortable, violating and patients are out of their element. Many don’t know that they have the option to refuse certain procedures, or to refuse being treated by a student. And in their vulnerable state, they may not know that “no” is an alright answer when you ask them, “may I pray for you?” Even if the patient is Christian, it does not mean that they want someone to pray for them right then and there. They needn’t be made more vulnerable than they already are.

4. Maybe this is unkind of me, but in this country, there is room for more than prayer. When our patients leave hospital, they need to convince their employer not to fire them. Many of them need to learn to deal with new disabilities. Many of them will continue their alcohol and drug habits. Many of them have children. Many of their teenage children have children. Pray for that. Or better yet, DO SOMETHING ABOUT IT.

An anecdote: There is a volunteer group of friendly people who come into our stable inpatient wards a few days every week. They are dressed in bright yellow aprons and come to the wards offering haircuts, washes and manicures for the inpatients. I am told they are a Christian volunteer group, but I have never heard them proselytize to patients. They simply smile and offer their free service, chatting quietly to the patients and leaving the ward with big smiles – both ways.

That, in my mind, does a whole load more good.

All I’m wondering is… was the former group-in-black ALLOWED? Shouldn’t security have escorted them out (theoretically, I mean – our hospital’s security is pretty useless)? They weren’t visiting anyone they knew, it was busy, and they were a nuisance. Most importantly, to my mind they were taking advantage of my patients’ vulnerable states, and I don’t like that.

But: is there a side to this that I am missing?

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21 thoughts on “Wait, is that allowed?”

  1. I’m a (Christian) pastoral counsellor (in training). Next week I’m attending a workshop in clinical counselling where we’ll be working in ICUs, terminal wards and the like. I’ve received training in this setting before. From what I’ve been taught this is totally unacceptable for several reasons:

    1. You do not start counselling a patient without that patient’s consent. If the patient is unable to give consent you don’t start praying for him/her anyway.

    2. You don’t enter any ward or other area of a hospital without the explicit permission of the nurse or doctor in charge of that area.

    3. I know of hospitals where the counsellors work in the trauma ward and have a very good relationship with the trauma staff, but their work is to support the families of patients who often don’t have a clue what’s going on. The only time they’ll get near a patient there is when an extra pair of hands are needed to hold someone down. I’ve also known these counsellors to grab a mop and clean up blood/vomit so a nurse doesn’t have to.

    4. A child does not, under any circumstances, belong in a trauma ward, unless he/she’s a patient. Those parents are in fact not just risking the child contracting TB or something else, they run the very real risk of emotionally traumatising that child and it can even lead to that child developing PTSD at a later stage.

    5. There’s a time for prayer. There’s a place for evangelism. The trauma ward is not that time or place. In fact, as a theologian, counsellor, and simply my own conviction as a Christian, I don’t believe one may pray (out loud) for anyone or share the gospel with them unless they ask you to or give you permission.

    People like these probably mean well, but they not only make your job more difficult, they make medical professionals negative against people like us who are actually trained to do the job and who follow the proper channels and procedures. In my opinion, if they want to pray, by all means let them. Outside the doors where they’re not in anyone’s way (and their prayer will be just as effective). But unless you are a patient, visiting a patient or have the permission of the hospital management to offer spiritual support to patients, you don’t belong there.

    1. Thanks for your excellent input! I didn’t even think about kids getting PTSD, but you’re absolutely right. The kind of things that happen in casualty are NOT for kids’ eyes. I’m sure there are counsellors who are really helpful and professional – probably because they’ve been trained.
      You’re right, these people probably did mean well. I think healthcare workers should probably be given a similar course – in what is acceptable and what is not, and how to deal with unacceptable instances.

      1. I shared what you wrote with my fellow students and course presenters when we were doing orientation for our visit to the trauma ward and they were all in full agreement that something like this should not be allowed to happen.

        What’s interesting is to see how it can work if done right. The man who presented this module works as trauma counsellor in a private hospital in Johannesburg. He is seen as a full and vital member of the emergency room team and actually got several pages on incoming emergencies even as he was presenting to us.

  2. I think KokkieH summed it up pretty well. I agree with your post, with your annoyance, and the fact that it hindered your job. You are literally saving lives; faith and prayer may work for some but at that point in time, YOU were the one saving lives. I also don’t like discussing religion as it can turn very nasty, and in fact I wrote a similar piece (I’m not in the medical industry thought) last year – here’s the link if you’re interested – http://wannabepoet.wordpress.com/2013/04/16/where-to-draw-the-line/

    Really enjoyed reading your post – thank-you 🙂

  3. You have every right to be annoyed. It isn’t really a religion thing either. I think you would have been just as annoyed if a stringed quartet was playing soothing music and got in your way. Although the quartet probably wouldn’t have been as brazen. Seeing how a higher power wasn’t telling them to do it.

    ED in South Africa must be quite the experience.

    1. Hah! Good point. I’d like the music but I’m sure they would be in the way. And make me feel a little awkward, like their music demands me to have more grace, or something.

      ED in ZA is quite the experience – but this is the first I’ve ever experienced anything like THIS. Generally we have other very shocking experiences.

  4. With my mother being a very strict nursing sister, I think you needed a dangerous matron to keep order in the hospital, and firmly but friendly guided them out of there. Like our Good Book says, there is a time AND A PLACE for everything. (Ecclesiastes 3). People doing that mean well, but are a danger to themselves and patients needing medical care. Most South African hospitals do have a chapel or a waiting room nearby. It is just not appropriate to be in the way of the people doing their medical jobs. .

    I say this with a lot of love, as a pastor! People like these make it very difficult for us to visit our church members in a professional way in some wards like ICU’s, because nursing staff have experienced problems with religious people hindering them in their duty. And yes, there is good reason why there are normally not more than 2 people allowed to visit a patient at any moment.

    1. Exactly! We definitely have a problem in casualty in that nurses are just too busy with the needs of patients to enforce strict visitors’ rules. Our hospital does also have a chapel, so you’re correct in that they could go there if absolutely necessary.
      I can see how it can become difficult for you to do your job when people make a nuisance of themselves. It would be awful if a patient actually requested a visit from their religious leader and the nurses wouldn’t give him access…

  5. I’m in full agreement with KokkieH. In the first case, it is common sense that persons who are not performing a specific function (medical, patient, support person) in the emergency room should not be allowed access. I am surprised that the little trio even managed to gain access, considering how they stuck out like a sore thumb. You do describe it as a hectic scene though, so perhaps they took advantage of a moment of distraction. The fact that they irresponsibly exposed their child to this situations says more about their own questionable judgement than anything else.

    Just as patients sometimes feel medical personnel are dismissive of their religious concerns, surely the reverse is true! I do believe that there is absolutely a time and place religion in medical care– it should come at a time when it can offer true support and hope, in the comfort of a hospital room, when it means something to the patient. That time and place is not the casualty department

    As a person who is Hindu and does not consider myself easily offended, I nevertheless imagine that if I awoke from a drunken stupor or was lying there in and out of pain to find someone praying for my soul I would be quite annoyed. And offended. What about me makes you think I’m going to die and need your assistance in gaining salvation?

  6. I should also say, that as Hindu person, I would not be averse to people reaching out to me in a compassionate manner, offering the strength of their religion on my behalf. I would just be irritated if it was done without my consent.

  7. Wow, I totally echo everything that has been said so far. Between the risking people’s lives getting in the way, the risking their children’s lives by being there and the absence of consent from all involved parties, this is not okay.
    There are more effective ways to love and serve.

  8. I am a nursing student at a catholic college with many sisters as my professors and instructors. Everything that we have talked about in class pertaining to faith and prayer in the hospital has to do with the PATIENT’s preferences, the PATIENT’s faith, not the faith of those “serving” them. Every reason you gave for them to not be there was valid. I cannot come up with a reason that those people should have been there at all… A concern of mine is that if they got in to the hospital and the delicate unit that the Trauma unit is, who else is wandering the halls of your hospital, accessing areas they shouldn’t be? These people were in some ways preventing you from doing your job, but what if they weren’t there to pray, what if they were there to steal medical records or supplies, would it be just that easy? I feel like you may have a bigger problem stewing… Best of luck!

    1. Thanks for your input! Yeah, our public hospitals are not at all secure. It is not uncommon for rival gang members to come into hospitals and threaten doctors and nurses who treat people they have just injured in shoot-outs. It’s pretty scary. Apart from that, we haven’t ever really had problems with members of the public coming in to steal records or supplies, but frankly, they probably would be successful if they tried.

  9. Unrelated to the above post…all the best for your upcoming exam week, you got this! The end is in site 🙂

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