Chaplaincy at the Coalface
By Jim Meighan, Chaplain, Royal Hospital for Children in Glasgow
Working and supporting doctors and nurses on the coalface at the beginning of the pandemic was incredibly inspirational. They talked about compassion, care, dignity in tones that stirred the heart and made you feel proud and privileged to share that space with them. They had resolved to be everything they needed to be to get through the day and they displayed no outward sign of fear or hesitation and during those first months, for that moment in time, they were one. They were supported by consultancy teams and senior management who did everything possible to protect them from the ravages that lay ahead.
However, as the weeks added multiple death scenarios to their experience that energy changed. The heavy weight of weariness and inevitability descended upon them and it was only sheer will power, not to let each other down, that propelled them forward. There was a fatigue setting in and a stress building up inside each one of them. Some were able to articulate it but others found it difficult to verbalise it and tears were often shed in the attempt.
My role was to listen and often I followed these conversations up by visiting them during breaks on the wards. The purpose was to let them vent and hear and understand what was actually going on behind those closed doors. In some cases it was feelings of helplessness that ate into their soul. They had reached the point when they each knew the signs, understood the protocols and thus were acutely aware of who would live and who would die on their shift. At that time only 1 in 5 made it out of ICU and those figures robbed them of any hope that they could overcome the devastating effects of this virus. On a regular basis I relayed my concerns to senior management and key individuals and when required they applied appropriate actions and support.
Many who worked through the worst of the 1st wave have had little in the way of rest and recuperation and they were now more fearful of what lay ahead. At that point, in some ways we were in a better place and lessons learned from the frontline are now guiding us during this 2nd wave. Over these past months they have worked, rehearsed, reshaped and fine-tuned new treatment options and developed new protocols to save more lives. However the ‘good will’ support we once received from the public has all but disappeared and the same lockdown protocols that allowed the NHS to cope are now being openly flouted and disregarded. Exhausted and disillusioned we are now haemorrhaging staff to stress, illness, and PTSD. Some, this time around, are certainly less willing to put their lives on the line. I plan to hang around and again take my place in the R&R hubs if necessary, but I also share their reluctance. To keep risking your life when so many are flouting the rules by being careless and thoughtless does impact on your ability to keep going.
Being part of these final goodbye moments for Covid patients and their families is exhausting and heart-breaking. For the families it is ‘Hell on Earth’ and completely and utterly devastating. For the staff it is a daily catalogue of loss that they must bear every hour of every day. Every shift starts with a roll call of who is still in the present and each shift they somehow manage to pour love from empty vessels and find words to soothe and calm troubled souls. They are truly remarkable. For my part, like every member of that team, you have to resolve to be all you can be in those precious moments. It’s almost as if time stands still and those images of bereft and grief stricken families often threatens to overwhelm. You realise though that this is their time, not yours, and as such, you determine to help them explore their own beautiful thoughts and memories of their time together on this earth.
At this moment in time I can only provide best guesses on what lies ahead. With new rules coming into force across the country the only thing I can say for certain is that the Christmas we knew and enjoyed will be very different from previous years. The idea of a virtual family meal and celebration is something we are all dreading to differing degrees. For those of us with relatively good health being separated from our loved ones is something we have reluctantly become used to and in many cases we have found new ways to celebrate family and demonstrate our love to the people we miss most.
We see that same helpless heartache of separation being played out in our hospitals every day. The beautiful reality and result of every painful moment that has led us to this point, is that we have evolved as human beings to see beyond our own worldview. We have learned to treat each patient with the same kindness and concern we would have wished for our own loved ones. Covid could have crushed us into submission but through the tears and hell of loss something precious has been discovered. We found strength in each other, and realised we were not alone. Christmas this year may not be as we hope or expect it to be, but many of us have a new found perspective on what we consider to be valuable and maybe this year we will fully understand this gift of love we all have to share.