VERBATIM REPORT Level 2 CPE

Educator: Beatriz Pacheco

CPE Student: Hong Phuc Pham
Interviewer’s Name: Hong Phuc Pham
Date of Visit: 09/12/2022
Initials of Patient: AT
Hospital & Station: Methodist Richardson - L&D
Length of Visit: 30 mins
Part I: Known Facts
Mrs. AT is a 31. y.o. African American 22.1week pregnant woman who presented to the hospital
after her ultrasound clinic confirmed with her that they found no fetal heart tones. I was called by L&D
nurse to assist with “finding a funeral home.” Pt was just transported on the floor 2 hours before I
received the call. AT has a 7yo. son who is at home. RN stated that pt’s father is not in the picture. And
lastly, plan is to induce labor and when born, the baby will be over 350g without taking a breath.

Part II: Observations

Before entering the room, I made sure to check first with our nurse. In talking to her, I realized
that she has not had many fetal demise cases and her anxiety was to make sure the process from the nurse
point of view goes smoothly. The RN wanted to cover her ground on autopsy questions and funeral home
arrangements. She had prepared the fetal demise packet and started to fill out the pink card. I reminded
myself to provide a calming presence, tone, and be as informative as I could be to ease the RN’s anxiety.
Walking in the room, I noticed two family members present. AT was laying on her bed, covered
herself in a blanket and turned towards her family members. The blinds were down. Family members
were silent. The atmosphere seems noiseless but was not deadly.

Part III: Assumptions From Observation and

Your Feelings Going Into the Interview
Given the age of the family members, I assumed they were the patient’s parents. With the nurse’s
main concern in mind, one of my objectives was to find the answer for her. I have kept in mind for this
visit that everything is moving very quickly for the patient. Not only that, but all that has befallen on the
patient is very recent; therefore, sensitivity is important. I felt nervous in ministering to this mother
because all the factors are stacked against her, that, in turn, could affect how she will receive my presence.

IV. Purpose / Focus

I want to use this verbatim to reflect on providing spiritual care for moms & families in fetal
demise situations. The grief in fetal demise is different; therefore, the chaplain needs to be mindful to
provide a space for moms & families to cope with the loss in their own way while also being mindful to
provide pastoral interventions that will help them cope more healthily. Through this verbatim, I hope that
my CPE peers, supervisors, and I can share with one another our experiences with fetal demise so as to
explore the chaplain’s role & goal in moments of vulnerability for the moms & families.
 V. Dialogue
AT= The patient
HP= Chaplain
() = non-verbals, self-talk

HP1: (knock) Good afternoon, Mrs. AT? (I called her Mrs. with an intention other than because she has a
7yo. son at home)

AT1: (turned to look at me)

HP2: Hi, Mrs. AT. (glanced eye contact over to the 2 family members present) Hi. (gesturing handwave,
taking a step in the door) I’m chaplain Hong from the pastoral care department; I know you just got here,
but I wanted to come by and check in on you.

AT2: Okay.

HP3: Is this a good time? I know everything is happening very quickly, so… (gesturing that it is okay to
say no)

AT4: Yes, it’s okay. (She turns toward me, and I started walking toward bedside)

HP5: How are you, AT?

AT5: I’m okay. (brief silence. I took a sigh)

HP6: I heard from our nurse that you got bad news this morning. (brief silence) How are you feeling
about what’s going on?

AT6: I’m okay.

HP7: Uhm, okay. Good… good… (Turned to the family members) Sorry I never asked. How are you
related to AT?

Family members: We’re her parents.

HP8: Wonderful. Thank you for being here… This is a very sacred moment for AT and for you, so we do
want to honor that. (I now intentionally choose to be frank in vocabulary) Especially now that your baby
does not have a heartbeat, AT, you might experience many emotions that come with her death (patient
politely fixed me his)... his death. It’s a boy. I’m sorry… But anyway, I want to let you know that you
have all our support; our nurses, doctors, chaplains, and your family members here. (Patient looks deep in
her thoughts) Things will be moving very quickly and it might be very overwhelming, but know that you
can take as much time as you need to; tell us to slow down when you need us to, okay?... Whatever you
need in this hard time, okay AT? (The patient and family seems stoic)

AT7: Yes. Thank you.

HP8: Sorry I didn’t ask. How old is he? And is he your first kid?

AT8: No. I have a 7 y.o. son. He’s at home. I’m 22 weeks in with this one.

HP9: Ah, so he’s your second son. 22 weeks old (I smile). Have you thought of a name for him?

AT9: No. Not really.

HP10: Oh! What a good time to name him then! He might not have the life we hoped for, but he is your
son, and after your delivery, if you would like, our chaplains can do a small naming ceremony. Only if
you want okay? You’re the boss. (I smiled) He is your son even when there’s no more life in him right
now, and we want to honor his life.
(Patient looks as if something had finally hit her. Patient starts to tear up and her mother came close to
console her. Her dad also starts to cry while sitting on the couch. I went to look for tissue paper and
respectfully acknowledged the tears of each person)
Hmm… (I stayed silent while consoling the pt’s; I felt that barriers were broken through our tears; I
rubbed the pt’s arm). This is too hard. (I did not mind holding in my emotions - I sobbed, cracked my
voice talking, and wiped my tears with the family. As part of self-disclosure, it was in my imagination that
in the future I could lose my own child in a similar situation) I am so sorry… AT, I wish I can tell you it
will get better. It probably won’t, but don’t forget the people who are here with you. It might not get
better, but know that you don’t have to go through it alone. You have your mom, your dad, and a whole
lot of people to support and pray for you. (We cried for another 3-5minutes. I picked up the conversation
again after noticing AT trying to compose herself) How are you feeling right now, AT?

AT10: I… I don’t know…

HP11: Maybe overwhelmed. Mixed of emotions?

AT11: Yes.
HP12: Maybe sad. Angry?

AT12: I’m hurt. I try not to be angry. I know everything is in God’s hands. But it hurts… my baby… (she
starts to cry more)

HP13: It hurts… a lot… (I sighed) Don’t worry though, okay? If you do have to be angry at God, I think
he can take it. (She and everyone in the room chuckled) I’m glad that we shared our tears here. For me it
means we are accepting our reality, and that we are willing to express our grief. So, don’t be afraid of
crying it out, AT… and talk to someone about it. We will remember your baby boy!

AT13: (Patient and her family expressed gratitude) Thanks for being here.

HP14: You’re welcome. And it’s not the end of it. (I handed them my card) We have a team of chaplains
here to walk with you, so tomorrow morning Chaplain Staci will follow-up with you. (I walked with them
through resources on grief for MEND, funeral home arrangements, the memories that our staff will
provide for her to bring home, and most importantly, instructions to request to see her baby whenever she
wants to. We ended the visit with a prayer and that brought a lot of comfort to the patient and her family)

(I walked outside to update the nurse that the family needs time to process this loss, and we do not need a
funeral home arrangement until the pt is discharged. She was barely induced and so time is not going
against us. I was quite proud of myself for handling the situation, and it affirmed my training that “it is
good to make mothers cry.” The world sees crying as a sign of weakness, but the eyes of faith see inner
strength and healing)

Part IV: Analysis

1. The Person(s):
Going through a fetal demise is surreal; the death of this 22wk old baby is the death of the dreams
that AT and her family members had hoped to see in person. This death paralyzed them. While
there are many thoughts going through the patient’s mind (anger with God, absence of baby’s
father, 7 y.o. son at home and telling him about the loss of his brother, funeral home
arrangements…), I chose to address her grief and she responded very well to it. She accepted that
she needed to express her emotions, name her baby, and remember the baby in order to heal
herself.

2. The Chaplain
I connected myself to the patient’s situation and I was comfortable with doing that. I am engaged
and hoped to have children of my own. I can’t imagine how numb I would be upon receiving the
news of my baby’s death. Knowing that God controls life and death does not suffice as an answer
to this loss. So what I did in this visit was what I hoped I would receive. I hope to have someone
 there to help me name my emotions, tell me that it is okay to experience the pain and emotions,
someone to hug and console me, and finally, someone whom I know I can depend on at my worst.

3. Interpersonal Dynamics:
My experience is that fetal demise cases are (typically) paralyzingly silent. The patient and family
would not like to talk much, and that is uncharted territory for me (I prefer that the pt talks more
than I do). In this visit, I did most of the talking, and I was not confident with myself. I was
asking for God’s grace throughout the visit because I know that one of my weaknesses is long
impromptu-speech. I felt a great deal of relief whenever someone shared something so that I
could have time to plan on what to say next.
Despite my weakness, the chaplain-patient-family dynamics worked out perfectly thanks to
empathy. The pt and family affirms with me multiple times that the visit helped them. I was also
reflecting on

4. Theological Implications:
The question on the existence of suffering in the world is a million dollars question. Although the
Book of Jobs attempted at answering this question, the answer remains a mystery. Those going
through grief are tempted to find answers to the question: Why did God allow this evil to happen
to me? Sometimes they find success, and (more often than not) they fail at it miserably. The
“mystery” here, however, is that: God knows our sufferings - in fact, he may know our sufferings
5480 times more than we know our own (5480 times is the number of scourging Jesus received
throughout the Passion). And so in fetal demises, I generally will not explore the million dollars
question but opted to be the companion who knows another’s sufferings.

5. Future Goals for learning/ministry

Once we were past the “screening” process (HP1=>AT9), I was back in my comfort zone. In my
comfort zone, I am able to connect with patients on a deeper level; however, I would also like to
develop my “screening skills” specifically for fetal demise when the atmosphere is covered with
nothing but darkness. I hope to come up with a list of priorities that pertain to spiritual care for
mothers losing their babies. Such as: father of the baby, baby’s gender and name, funeral home
arrangements…