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‘We were not just called on to tend sick bodies, but troubled minds and souls, too’

by
22 May 2020

Lisa Opala describes her work as a chaplain on a Covid-19 ward

lisa opala

Lisa Opala on a ward of a hospital in the north-east of England, where she has been working as a chaplain

Lisa Opala on a ward of a hospital in the north-east of England, where she has been working as a chaplain

PART of my mixed-mode contextual training for ordained ministry as a priest in the Church of England takes me into a major trauma hospital in the north-east of England, where I have ministered in the hospital chaplaincy team for the past three years.

On 26 March, at 1.30 p.m., I was fit-tested for an FFP3 mask (FFP stands for “filtering facepiece”; the higher the number, the better the protection). As I put on the large white hood, I called to mind the armour of God in Ephesians 6.10-18.

One hour later, I was called to my first Covid-19-positive patient. Suddenly, the donning and doffing training I had just received was being put to the test as I prepared to enter the patient’s room in full PPE.

The patient was being taken off a machine that pumps air through a mask, and the medics were not sure how the patient would manage with nasal oxygen. I was warned that the patient might struggle, and it would be good if I stayed with the spouse. To my surprise, I did not feel any fear: my only anxiety was trying to keep the visor from slipping down my forehead.

Nobody knew when the patient would die: the doctors presumed that it would be within the hour. I stayed for four hours, until the patient lost consciousness through sedation and pain relief. I was on call again the next day; so I eventually left and promised to return in the morning. As I drove home to our quiet rural village nestled in front of the Cleveland Hills, I knew that this was just the beginning.

Since that first encounter with Covid-19, every day I have seen about six to eight people infected by the coronavirus, of whom more than half were on an end-of-life pathway.

 

I WILL never forget that first call-out. I was told that the spouse left the hospital alone in the early hours of the morning, to self-isolate; they now faced the reality of living alone, relying on others to get shopping and prescriptions. This particular couple had no children, and had been together for more than 50 years. Life had changed beyond recognition: no visitors, and no leaving the house; not only grief, but loneliness.

Imagine, every time you hear the news, another statistic: your spouse is now “one” of 23,000 — or more. The personal, the individual is lost in the collective grief. There is no proper funeral, no visit to a funeral parlour to view the body for one last time. You cannot sit down with the funeral director and family members and plan a meaningful liturgy. I was beginning to see the emotional and psychological trauma that people would inevitably face in this new situation.

Some days, after the first wave of patients to the hospital, all visits from families were suspended. Every day, the face of chaplaincy was changing, and what made it more difficult was that, for those first two weeks, I was the only chaplain compliant with PPE testing and training to visit the Covid-19 wards. I was later joined by two Roman Catholic priests who were also fit-tested for FFP3 masks.

A wonderful team of clinical psychologists set up a “wobble room” in the Covid-19 section for staff to process and take time out. As I began to meet and speak with more and more nursing staff, it became evident that I was not the only one feeling that I was way out of my depths.

Nurses had been drafted in from other medical departments to fill shift rotas, some of whom had never seen death or dealt with the dying before, and certainly not on this scale. I worked closely with our colleagues in palliative care to discuss ways of using technology, or encouraging families to connect with loved ones in innovative ways. It began to be evident that we were not just called on to tend sick bodies, but troubled minds and souls, too.

As for me, it is my usual duty as a chaplain to visit those on an end-of-life pathway: on a normal day, I visited about three or four patients who were diagnosed to receive no more treatment. Despite what we saw on our television screens from around the world, I never saw anyone suffer in agony. Any distress or anxiety a patient suffered through breathlessness was carefully monitored with medication.

In many ways, my experience of working and seeing patients who were dying was not new to me. What was different was the loneliness of death, the social distancing, the protective equipment that I was obliged to wear. I struggled with the fact that, each time I entered a bay, I looked like something from an apocalyptic film set, and I had to approach dying patients with dementia and create for them a warm and safe atmosphere.

It was not easy. They heard only a gentle reassuring voice from behind a mask and visor, and the hand that tried to reach out to hold theirs was a cold blue rubber glove. I had to allow my eyes to speak and to convey a smile; and my voice, which I had to raise for those hard of hearing through the mask and visor, to offer a reassuring presence.

 

IT WILL become for me a significant memory from this time: the ice-cold hands of so many dying patients gripping mine, through a latex glove. How was I to put some human warmth into the clinical coldness of this unprecedented situation? How was I to show a smile, some love, some human compassion and presence in a side room where a patient is waiting for death? These were my daily tasks — not only for the patient, but also to honour their family, the hospital trust, and the mental health and resilience of the many young nurses and cleaning staff who watched me enter those side rooms day after day.

There were some special moments of joy and grace: a conversation about faith with a young nurse; the beautiful and peaceful last breath of a lady as I recited the words of the 23rd Psalm; the emotional conversations with those on the road to recovery who felt that they were one of the lucky ones blessed by God. And the clapping, the emotional release, and flow of tears as survivors were wheeled out of the ward and could go home to their loved ones.

Every time I pulled up at the traffic lights outside the hospital and saw the huge banner tied to the railings which read “Those working to protect us THANK YOU”, tears streamed down my face; seven simple words, but they touched my heart every time, in the dark late at night or first thing in the morning.

To process some of the grief and experiences that were very raw and very real, I developed a schedule for spiritual and personal well-being. I changed my working pattern from 1 p.m. to 6 p.m., which meant that I could study or work from home in the morning.

Daily prayer strengthened my resilience and determination to visit every patient at least once, and offer a prayer, whatever their faith background was, before they died.

Because of the danger of cross-infection, I could not take any resource or prayer books into the room with me. So, I had to learn off by heart some short prayerful ceremonies that would be suitable and fitting for each patient in the last moments of their life.

For those whom I was going to anoint with oil, I had a small piece of cotton wool soaked in the oil of chrism, that was discarded after use. The oil became an important ritual in the small ceremony, anointing the patient before or after death with the sign of the cross on their forehead and hands: it was my way of offering something tangible and visual.

Many times, in the intensive care unit, I administered the oil in place of the Roman Catholic priest, who recited the last rites through my phone to the ear of the patient. This was a beautiful ecumenical partnering with God and with one another for those who valued a sacramental anointing at the end of life.

As an ecumenical chaplain, I prayed with Methodist, Baptist, Church of England, and many Roman Catholic patients. I gave out rosaries and miraculous medals to many of them — anything that would bring healing and comfort. If a letter or card from a loved one was at the bedside, these became part of my liturgy as I read out the messages from sons, daughters, and grandchildren.

 

THE experience was rich, painful, and lonely. Analysing the situation each day, I felt I was doing my best in a bad situation with the interior resources I had. The 23rd Psalm became my mantra, together with the Lord’s Prayer and the Nunc Dimittis. Favourite scripture passages that I knew also came in useful as I composed brief liturgies of closure for nurses and any family members who were unable to be present.

This taught me the importance of daily recitation of scripture and psalms to familiarise oneself for use in emergencies. The situation was as it was — there was very little I could do to change it.

After a week into the pandemic, we began using FaceTime with families, so that they could see and say farewell to loved ones. The hospital appealed for notebooks and iPads. In theory, it sounded great, but it was far from perfect. Most families chose to remember their loved one as they were. Internet connection in the ward was poor, and the complexity of showing anguished families a beloved parent wearing an oxygen mask or on a ventilator proved traumatic.

Once, we were successful in connecting a dying mother with her daughter across the Atlantic, but it was very distressing for the nurses and myself to watch someone’s raw emotional grief over a screen as they prayed their goodbyes and thanked their mum for all the love and care she had given them.

 

AS THE PPE became flimsier, and the supply chain was under threat, the nurses never backed away, even those with young families and small children at home. Many of them are being paid very little for their selfless work.

It suddenly seemed ludicrous that, each day, news reports bemoaned the absence of football and sport. Millionaire celebrities were being asked to stay at home and sit on the sofa, while the brave key workers, on the least wages, fought a war on the killer virus. A BBC news report showed a residential care home on the Isle of Wight where the staff were sleeping in tents in the grounds, owing to a “no one in” and “no one out” policy.

I did not have to show up every day to visit those on the daily end of life list; I could have stayed at home, saved lives. What compelled and motivated me to go was, I think, my background and training as a contemplative nun for 23 years. The life we lived was the life we had hidden with Christ in God that was our real life.

In some way, the fearlessness of death, and the strong pull to be with those afraid of dying, enabled me to be brave and to look death in the face without fear, but with hope and trust that death shall not have the final word, and that death is not the end.

I hope that my Christian presence, walking the wards of the hospital, placed Christ at the centre of Covid-19 with the powerful message that, through faith in the power of Christ’s death and resurrection, life is not ended. We read in scripture many times, do not be afraid. “Do not be afraid,” I told the patients, “there is nothing to be afraid of. You are not alone.”

 

Lisa Opala is an ordinand from York diocese, studying at Cranmer Hall, Durham. She is a former member of the Discalced Carmelite Order, founded by St Teresa of Ávila. After 23 years of contemplative life in Carmelite monasteries in Reading, Darlington, and Preston, she married, and works as a hospital chaplain.

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