St. George
Serbian Orthodox Church
Carmichaels, PA

Thoughts on Pastoral Care
by Fr. Rodney Torbic
Adult Class - July 8/21, 2005

Pastoral care is an important part of the ministry of an Orthodox parish. Parishioners reasonably expect to be visited and supported by the parish priest when they are homebound, hospitalized, in rehabilitation, nursing or care homes, jails or prisons.

The parish priest must exercise judgement, discretion and weigh the use of time in meeting the needs of parishioners. Each priest has a limited amount of time and resources in meeting the needs of parishioners.

Pastoral care is part of a continuum of work of the parish priest. Among other responsibilities, the parish priest must perform liturgical services, counsel parishioners, oversee and participate in the parish religious education program, work with various parish organizations and the parish Executive Board.

The St. George Serbian Orthodox Church in Carmichaels, Pennsylvania is located in rural Greene County, Pennsylvania, adjacent to Fayette County and nearby West Virginia.

The parish priest of St. George Serbian Orthodox Church in addition to serving the parish, serves as administrator for Holy Trinity Serbian Orthodox Mission in Fairmont, West Virginia.

The geography of the area served by the St. George Church and Holy Trinity Mission is more than 150 miles, north and south and perhaps seventy miles wide. The number of active parishioners actually attending church are a hundred or less. The number of people in the area of the two parishes showing interest in the two parishes is well over a hundred.

Friends of the parish and family members of active parishioners also may require the attention and support of the priest. This increases the number of people the priest must consider.

From January 1999 until mid-July 2005, parishioners and friends of the parishes have gone to a wide range of hospitals. In West Virginia, individuals necessitating visits have been hospitalized in local hospitals in Grafton and Fairmont.

Also in West Virginia, parishioners have been hospitalized at Ruby Memorial Hospital, Chestnut Ridge and Mon General in Morgantown.

In Pennsylvania, parishioners have used Greene County Memorial Hospital in Waynesburg and Uniontown Hospital in Fayette County.

Fairmont General Hospital is close to fifty miles distant. Grafton is somewhat further. The hospitals in Morgantown are a little more than twenty miles away. The Waynesburg and Uniontown Hospital are about 12-15 miles distant.

Brownsville Hospital, Fayette County is regularly used by parishioners and is about 12 miles away.

Distance is an important factor because it takes time for the priest to travel to and from. More than one parishioner may be hospitalized at a given time and not in the same location.

Other hospitals in Pennsylvania used by parishioners are as follows: Washington Hospital, Washington; Mon Valley Hospital, Monongahela; Jefferson Hospital, Jefferson Borough; These three hospitals are approximately forty five minutes or more drive, all in different directions.

Hospitals in the Pittsburgh area that have been used by parishioners are these: University of Pittsburgh Medical Center-Presbyterian, Montefiore, Magee-Womens and Shadyside Hospital.

Parishioners have also used these Pittsburgh Hospitals: Allegheny General, Mercy, St. Margaret's, and the Veterans' Hospital. All of the Pittsburgh hospitals are more than hour drive from the parish church.

Since January 1999, parishioners have been in two different residential rehabilitation centers in Morgantown, West Virginia, one in Canonsburg, Pennsylvania and one in Pittsburgh, Pennsylvania. The Canonsburg facility is about forty five miles from the parish church.

In addition to hospitals and rehab centers, parishioners have needed the use of two different nursing homes in Waynesburg and a nursing home in Uniontown.

Parishioners have resided in personal care homes in Buckannon, West Virginia(about a hundred miles south of the parish church) and in the vicinity of Worthington, West Virginia (about 60 miles away). One parishioner resides in an assisted living facility in Morgantown.

In Pennsylvania, parishioners have resided in personal care homes in Masontown, Carmichaels, Brownsville, Isabella, Merritstown, New Salem, two facilities in Uniontown, and Fayette City. With the exception of the home in Fayette City which is about forty-five minutes drive, the rest are a half hour or less in distance.

Parishioners living in assisted living and personal care homes are regularly sent copies of the parish weekly bulletin that includes the weekly sermon. Some live or have lived within range of the weekly Sunday radio broadcast and can listen to it.

The importance of the weekly bulletin being sent was best expressed by a parishioner who could not hold and read the bulletin because of the physical condition of her hands. Even though the parishioner could not read the bulletin, she said her receiving it made her look important in the eyes of the staff.

It is important to note the bulletin is mailed each week by parishioners who do the work voluntarily. This is a valuable service. At least one parishioner living in a person care home is a regular listener to the parish radio program.

The need to go to the hospital is not always predictable. Accidents happen. Emergencies arise. The priest is expected or should go regardless of the time of day or night.

One parishioner was involved a serious auto accident. Another was hit by a vehicle while a pedestrian. Both incurred serious injuries. Prayer was needed. Physical presence was needed.

Parishioners have experienced strokes, heart attacks, and falls resulting in injury. Cancer has afflicted several parishioners. A number of parishioners have had scheduled surgery.

Surgery is always a concern because of the anesthetic involved. Family members and the patient need prayer and support during these times.

Prayers for the sick and the Akathist to St. Panteleimon are useful for individuals having surgery. Prayers to St. Nectarios are useful for individuals with cancer. Anointing with Holy Oil is also beneficial to the hospitalized.

Hospitalized individuals are at various stages of life. For some, recovery and return to good health is the distinct possibility. For others, earthly life is coming to an end. The priest must be ready to deal with the questions, the emotions, the concerns that arise.

Each hospital is different. Each unit on the hospital is different. The hospitals in Pittsburgh are large facilities. Going to a hospital, particularly a large facility in a strange community can be overwhelming or threatening to a patient or a patient's family.

Being with the family at the time of surgery or while emergency care is being given can provide support in addressing the level of concern experienced.

The Lord Jesus Christ established hope for many ill and afflicted. He healed and continues to heal.The Lord Jesus Christ also suffered on the Cross and resurrected bringing hope to those falling asleep in the faith.

Saints such as Sts. Cosmas and Damian, St. Panteleimon and St. Nectarios offer hope and serve as intercessors for the hospitalized.

The prayers of parishioners for other parishioners are of immeasurable value.

In the St. George Church it is a regular practice to pray daily for those known to be ill or injured. It is a regular practice to do Akathists to St. Panteleimon when surgery is scheduled and when serious illness arises in a parishioner.

Names are included on the prayer list of the church upon request or when the condition of a person becomes known.

At times parishioners may not want to be cooperative with suggested medical treatment and the priest may be asked by family members to discuss this with the patient. It is always a time for great care.

Most medical facilities welcome the priest even when the patient is in intensive care. It is important to keep in mind the condition of the patient and not stay too long and not be disruptive to medical care.

Hospitalized patients, particularly with serious illness or immediately following surgery or heavy rehab exercise need rest.

When possible it is best to visit during scheduled visit hours. At times this is not possible. Avoiding visits during change of shift times is wise because delayed approval to enter may occur.

Coming to visit a patient in serious condition requires a certain composure. The priest must be sensitive to his demeanor, facial expression, tone of voice and content of words.

The confidentiality of a patient's condition must be maintained as requested. The priest needs to deal with inquiries in ways that respect the patient's wishes. At the same time, interested family members and friends have an interest in the patient's condition and this must be addressed.

Hospital personnel have difficult jobs. The priest needs to respect the work done. The priest's presence, at the same time, underscores the importance of the patient and the care the patient receives.

Since 1999 a relatively number of residential admissions from the given parish have been made for emotional, psychiatric or psychological problems. Mental illness is an illness requiring treatment. Depression, schizophrenia, emotional disorders, thoughts of suicide require attention.

The priest has a part in addressing the issue of mental illness in a parishioner. The priest must know his limits in this regard. He must also be familiar with the laws and the various rights afforded him and the parishioner.

Bedside manner, physical presence in a room, the appropriate use of prayers and consultation with hospital personnel are matters of interest to the priest. At times a patient may be in intensive care, unable to speak, with various machines operating. It may be a time for silence...but presence. It may be a time for prayers but not questions. It may be a time simply to hold the hand or to anoint with oil or to place an icon in view.

Calls can come late at night when the priest is asleep. Requests for prayer for a loved one having surgery can come at any given time. The priest must be conscious of his words.

Requests to visit can come at any given time. The priest can be needed at the hospital for the prayer before surgery at 5:00 AM. He may need to see an accident victim at 1:00 AM.

When the phone rings the priest does not know what the call is for but it must be answered. He may be just returning from a long trip and be told of a parishioner in a hospital requiring immediate attention.

When visiting patients in the hospital, the priest will hear a range of medical terminology. He will need to deal with the terms to understand the patient's condition.

When in a patient's room, another patient, unrelated to the parishioner may be nearby. Sensitivity to the condition of the other person is required. In visiting a parishioner, the priest may come in contact the one or more doctors, one or more nurses, perhaps a social worker or chaplain.

It is good to know the resources of a hospital. The hospital chaplain or social worker can be of help at certain times.

In the case of the St. George Church and the Holy Trinity Mission, certain parishioners work in professional medical capacities. They have been definite resources in providing important support to parishioners coming to the facilities where they work. Their contributions must be acknowledged.

The St. George Church has an established Parish Nurse's Office staffed by an experienced Nurse Practioner. The Nurse Practioner has given educational talks as part of the parish outdoor religious programs. She has been available for consultation to the parish priest, giving advice and assistance in meeting the needs of parishioners as they arise. She has been directly accessible to parishioners for consultation, checking of blood pressure and discussing healthcare concerns. The Nurse Practioner has addressed healthcare concern regarding the local power plant at important times during the past several years.

One nurse has been particularly helpful in one of the larger hospitals in providing support to patients using the facility. Nurses from one facility used regularly by parishioners have an important presence in the facility in developing a healthy atmosphere.

One nurse assisted in accumulating data on mining deaths and injuries. Several parishioners have been employed in medical service agencies. Their presence has added to the quality of service rendered the community. Their participation in the life of the Holy Orthodox Church increases their value to the community.

Several doctors have a certain connection with the St. George Church and at least one doctor is active with Holy Trinity Mission. Their Orthodox identity in relationship to their work in the community is of immeasurable value.

Beginning in 1999, the St. George Church recognized the important work of emergency medical providers. A Service of Thanksgiving was held in connection with the commemoration of St.Panteleimon in appreciation of the contribution of emergency medical providers. Ambulance servers in the area were asked to send their ambulances to the church to be blessed. This was done with the Archpastoral Blessing of His Grace Bishop Dr. MITROPHAN, the Diocesan Bishop.

The ambulance blessing continued each year including 2004. The annual observance was extended a few years ago to include all individuals in the field of healthcare because of the importance of their contributions. The Parish Nurse's Office took St. Panteleimon as the patronal feast. In 2004, a program was held which included a dinner and reading of the lives of healing saints.

When one member of the parish is sick or injured, all parishioners are affected. The prayers of all parishioners contribute to the wellness and desired wellness of parishioners.

During the Divine Liturgy and during the daily services of the Church, prayers for the sick and suffering are offered. Names of known sick, ill or injured parishioners and friends of the parish are read one or more times daily.

An interesting anecdote worth sharing occurred at the Fairmont General Hospital. A parishioner from Holy Trinity Mission was scheduled for surgery. He was already in operating room when the priest arrived. Knowing of the priest's presence and interest in praying before the operation, an operating room nurse had the patient taken from the operating room to a nearby area and gave the opportunity for prayer. The nurse said "We must take care of the important things first, meaning prayer, before we operate."

The power of prayer is important. Prayer helps in recovery. Prayer helps in managing pain. Prayer helps in dealing with illness. Prayer helps in understanding illness.

It is the rare family that does not have someone in the hospital at sometime during the life cycle. The parish church offers support during these periods. The parish church offers prayers during these periods. The parish church offers interest during these periods.

Parishioners learning about the prayers of the Church and using these prayers during times of good physical health practice good preventive care. Parishioners living the life of the Church, honoring the fasts and living according to the teachings of the Church, practice good healthcare.

When a parishioner cares for his or her soul and treats his or her body as the temple of the Holy Spirit, he or she practices good healthcare. (I Cor. 6:19)

In the twenty-fifth chapter of the Gospel of St. Matthew, the Lord Jesus Christ speaks about caring for the sick, the suffering and imprisoned as criteria for admission to His Kingdom. Christ is identified with the sick, the suffering and the imprisoned.

As Great Lent approaches, the Holy Orthodox Church sets a Sunday aside to remind believers of the importance of caring for the sick, the suffering and the imprisoned.

During the course of the liturgical year, the Holy Orthodox Church brings to believers the accounts of healing by the Lord Jesus Christ.

Individuals taking time to read the lives of the saints, will learn of miracles that occur in healing. Healings of Soul and Body: Saint Basil of Ostrog The Wonderworker details many miracles attributed to St. Basil of Ostrog.

St. Bishop Nikolai in The Prologue of Ohrid gives a daily rendering of the saints commemorated throughout the liturgical year and miracles attributed to them.

Each illness, each accident, each injury must viewed in the Orthodox Christian context. Each response from priest, family member and professional ideally is in the Orthodox Christian way.

Illness, accidents and injury can be turning points. The presence of God can be more apparent. Interest in God can be more intense. Serious injury or illness can summon greater intensity of prayer from the patient and the patient's family.

The love of Christ is always present. Believers need only open their eyes and hearts to Christ to experience His presence and His love.

Care for the sick and the suffering by family members, friends, healthcare workers, priests and Orthodox Christians is expected by Christ as set forth in the Holy Gospel.

Caring for the sick and suffering is a very important part of parish life. It is important to document what is being done. It is important to document what needs to be done.

The Church has a long history of caring for the sick and suffering. Caring for the sick and the suffering is a responsibility of all believers.

We are best prepared to care for the sick and the suffering when we lead lives true to Christ.

When we are true to Christ, we look to Christ for strength and direction. We look to Christ for the nourishment necessary to do the difficult work. We look to Christ in the way St.Paul did, saying, "I am crucified with Christ: nevertheless I live; yet not I, but Christ liveth in me: and the life which I now live in the flesh I live by the faith of the Son of God, who loved me, and gave himself for me.(Gal.2:20)

Each day we have the opportunity to pray for the sick and the suffering. Each day we have the opportunity to live Orthodox Christian lives. We do well to count these days and make the best of them. We know neither the day nor the hour the Lord is coming.(Mk.13:33) We must be prepared and pray we hear the words:" Come, ye blessed of my Father, inherit the kingdom prepared for you from the foundation of the world..." (Mt. 25:34)

To Consider

· The hospital environment a patient must adapt to.
· The reaction of families members to seeing a loved one in the hospital.
· The change in family life at home while a loved one is hospitalized.
· The additional financial burden on the family while a loved one is ill or injured.
· The stress caused in the family due to illness or injury.
· The disruption of family plans and goals due to change in health of a loved one.
· The distance between the hospital and the patient's home.
· The different daily routine a patient must adapt to in the hospital.
· The different food a patient must adapt to in the hospital.
· The loss of privacy a patient incurs when hospitalized.
· The loss of control a patient endures when hospitalized.
· The absence of personal possessions in a hospital.
· The effect of seeing people in uniforms everywhere in the hospital.
· The technical nature of medical terminology as it affects the patient's family.
· The many different professions involved in medical care.
· Sorting out the differences between nurse practitioner, nurse, practical nurse, health care aid, doctor's assistance, dietician, social worker, psychiatrist, psychologist, chaplain, pastoral care assistant, x-ray technician. lab technician
· Understanding ICU, CCU, CPR, LPN, RN, NP, No Code. Code Red... .
· Viewing the hospital room from the perspective of the patient.
· Being hooked to an I-V unit all day and night.
· Living in a room with another patient not of your choosing.
· Having people enter and leave your room at will.
· Being poked with needles by people you never met.
· Being physically examined by people you never met.
· Having people read your medical history and not knowing who they are.
· Being Orthodox in a non-Orthodox environment.
· Having people treat you who do not know what an Orthodox Christian is.
· Missing church because you are hospitalized.
· Knowing that your illness puts a burden on your loved ones.
· Facing an uncertain future due to a serious illness, disease or accident.
· Regretting not having done certain things differently.
· Planning a radical change in lifestyle due to illness or injury.
· Knowing that God is always available even in the worst of circumstances.
· Being the recipient of good care in the hospital.
· Being the recipient of Christian love from family, friends and unexpected individuals.

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