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Palliative Care Series - Chaplaincy and Palliative Care

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Summary

This evening's on-demand teaching session will focus on the role of chaplains in palliative care and how spirituality can be a powerful tool to comfort and empower people during end-of-life care. Our chaplain, based at a hospital, will discuss what spiritual care is, how to recognize and respond to a person's spiritual needs, and the importance of understanding and embracing each person's unique perspective. We will also look at how chaplaincy works within the NHS and learn how the medical and religious perspectives can come together to ensure all patients' needs are met.
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Description

Join Mind the Bleep for our 12 week webinar series focussing on Palliative Care. From symptom management and career planning to conversations at the end of life, our weekly webinars will explore a variety of topics integral to working in healthcare. Bringing together speakers from a range of disciplines and perspectives, we hope the coming weeks will give an insight into an area of medicine which is as thought-provoking as it is clinically relevant.

For Week 8, we were joined by Ruquvva, a chaplain working in North East London, who shared her unique perspective on the role of faith in palliative care.

Learning objectives

Learning Objectives: 1. Explain the role of a chaplain when attending to a patient's spiritual needs. 2. Describe different life situations where a chaplaincy service may be appropriate. 3. Identify key elements of spiritual care such as hope, strength, trust and meaning. 4. Summarize key differences between religious beliefs and practices and the chaplaincy service. 5. Discuss the importance of respecting the individual's personal beliefs and values.
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The following transcript was generated automatically from the content and has not been checked or corrected manually.

Okay. Okay. Hi, everybody. Welcome to this evening's talk as part of our palliative care something. And this evening, we've got to talk about the role of the chaplains. He said at the end of life, so required I'll let you dress yourself and get started on your body. Hi. This is okay. I'm one of the chaplains based at which cross hospital. But otherwise I do work across the side. Um, it is uploading my slides. So when that uploads, I will just we will start. And then once they're uploaded, that should be fine. So we'll start anyway. And then we can Yeah. It's still staying up, loading properly. That should happen very soon. Uploading like that. Um, apologize for the delay. Um, that is one of the key things about chaplaincy. We never know what will happen when it happens, and we do need to just run off sometimes last minute and say Okay, end up like something's happening. Um, yeah. So that was a very fast introduction to chaplaincy in its full full. So, yeah, it's still uploading. So we'll wait for that to upload in terms of, uh, chaplaincy. So I'll just switch from the public side is coming up. And then when they already they already, um, in terms of chaplaincy. So what? Um, and it's interesting. Often when a patient is like, Do you have any spiritual needs? What? What do you feel? Do you need a chaplain, then often say No nothing to do with me. We don't have any spiritual needs. We don't know or they'll assume that chaplaincy means Oh, no. Are we dying? Is something serious happening? And they will not want to respond at that moment. You know, when you hear the word respiratory itself, just listening to that spirit, just listening to that word spirit itself. If you listen to the center of the word, it has the word spirit, in their spirit is in every one of us. It's what breathes life into us. It's our respiratory system that breathes life into us, and that's what keeps us going. And then if we look at, um, spiritual care definition, what is the definition of spiritual care? It's that care which recognizes and responds to the need of the human spirit when faces, trauma, ill health, sadness and it can include the need the meaning, um, self worth to express oneself for faith, support, perhaps rights or prayers or sacraments Or just, you know, sometimes just a sensitive listener. Spiritual care begins with encouraging human contact in a compassionate relationship and moves in whatever direction the need requires so again by spirituality. So if we look at some keywords, what is spirituality? Spirituality is about hope and strength. It's about trust. It's about meaning and purpose, forgiveness, belief and faith in oneself, people's values, love and relationships, morality, creativity and self expression. All these things come into, um, spirituality, finding out what's happening. There is somebody. What do they do? What it isn't. And this is often where sometimes, you know, we can get mistaken and somebody said, Would you like a chaplain? Often the thought is okay. They're asking if we want a chaplain. It must be about religious beliefs and practices. Full stop, and somebody says, I'm not that religious. I don't need a chaplain or it's about imposing your own beliefs and values and none of us. So I'm a Muslim chaplain and I will. I have studied it, and there's certain rules that I know, but it's not about what I know. It's about the patient that I'm going to see. They lived experience of faith. It's about what they need. It's also a bit about using my position to convert just because somebody's sick, ill. They're questioning their life. It doesn't mean I then turn up and say, Hey, I have all the answers And the Muslim Let's all become Muslims or a Christian chaplain doing the same or a Jewish or seek. It's not about that. It's about listening to the person and being there for the person for that moment in full entity. It's not a specialist activity sometimes, and it's definitely not the sole responsibility of a chaplain paying attention to somebody's spiritual care, listening to their needs, wanting to know what is that we can help. It's not just the chaplain that can do that. We can all take some time and do that. Practicing spiritual care, what is practicing spiritual care? In RCN survey for the Royal College of Nursing, a member said spiritual care is a fundamental part of nursing, currently much neglected through ignorance and misunderstanding, and that's literally it. Sometimes it's misunderstood or it's neglected and it's one of the key things that we have to do. We can't neglect a person's spiritual care. When somebody comes in to a hospital, they're coming into the whole person, the medical side, the medicine. That's really, really crucial that we treat them. But we can't ignore their inner self, the spiritual self, the thing that keeps them taking. Because one thing to remember is when you come into the hospital, everything stripped of you. You're in a hospital gown, your identity stripped of you. You've got a you know, an identity tag on. There's nothing that you normally do. And often it says that people are given a gift of time, and it's a gift that is really, really hard to take, you know, suddenly being an award and not knowing what time, the time, change and only working things. And it's really, really hard to just ignore that. The practice of spiritual care. What is it? It's about meeting people at a point of the deepest need. It's not about just doing, but it's about being with them, being with a person in the full entity, the thoughts, everything it's about our attitude behaviors are personal qualities, how we are with people. It's about treating spiritual needs with the same attention as physical needs, and that is a really, really key thing. And often I know in medicine, especially working in hospital, the physical need does come first, and that makes sense. But it's not neglecting the mental need as well, not neglecting the inner self. So what's needed for me, you know, as people were all here together with one goal in mind to help the person. We're all here to make sure we do the best for this person that come in. So what is it we can do? Adopt a caring attitude and disposition, recognizing and responding appropriately to people's needs? You think observation to be identified? Clues like sometimes when I go to see someone, you'll notice little things. Here. The desk. You'll notice a urine or a bee or rosary beads or something close. And you think, Okay, this person's religious. Okay, this is what you know means a lot to them, giving time to listen and attend to each individual person needs. We can't group everyone to give them one bracket and say they're a Muslim. They'll need this receipt. They'll need this. There are Muslim. They'll need this because our faces individuals, it's our lived experience of faith and being aware when it's appropriate to refer to a chaplain. So what is chaplaincy again? Which bring it here? Because I'm saying to You don't know when is it appropriate to refer to a chaplain? So the next question that follows on is what is chaplaincy? And in all honesty, chaplaincy is anything the patient may require. They all lived experiences, anything they may require. We'll give some examples after as well, so one thing to remember. One key thing to remember every single person is an individual, and we all see things from a different perspective is to really important things. Every single person is an individual, and we all see things from a different perspective. And if we just think about even within our own family siblings, the same situation could happen. But yet every sibling will have a slight, different take on it. A mother and father will have a slight different take on it are husband and wife will have a different take on it, and that's the key thing to remember that even though we're all experiencing it together, we all have a different perspective, and we need to work with that. So what is happening in the context of the NHS now so chaplaincy in the context of the N. H s is guidance that is not affiliated to anyone. Religion or belief system and modern healthcare chaplaincy is often focused on ensuring that all people, whether they be religious or not their needs are met. They must have the opportunity to access act all spiritual, religious support when they need it and how they need it. Apologies. The slides are not opening for you, but right now what you would have seen. And I'm sure you've seen that often. Sometimes when you have a picture and some people see it as, um, old lady and some people see the young lady and I've actually used the same picture with the nurses and we've had life and sessions and it's amazing how, because I see it so often I can see both. But within the team, some people can only see the old lady, and some people can only see the young girls. And it's amazing how that's us. Our perception. When we look at a patient, sometimes someone will only see one thing and somebody else will come in and say no, completely different. And I'm sure you've experienced times when somebody will say, Oh, that old lady, Yeah, she's a lovely old lady, isn't it? Someone will say no, she's terrible. She's always shouting at the start and always complaining, and it's the same person. But it's a different perspective of each person. And often people should have been perspective. So you know, as it happens, often were called in. And we asked, You know, can you please help? And we'll just go from scenarios of different patients. So if it's a Muslim patient, often I'll be called in to say, You know, we have somebody there on the back. It actually happened today. Um, and the family have tried every single thing they can, and they're still fighting and saying there should be more treatment. And what they're saying is, if we withdraw treatment, you'll be killing our loved one and you're not allowed to kill in Islam. It goes against our faith, and sometimes and what happened today was one of the doctors called me and said, You know, can you tell me what could I say? And sometimes That's the very thing that doesn't help when a doctor or a medical practitioner survey the family. Sometimes they're not open to listening because they're thinking I get what you're saying but you're coming at me From a medical point of view, we are answerable a lot. We need the answer. From an Islamic point of view, I can say the exact same thing and yet they'll listen. I've often had times when there's a family meeting and the family are refusing and they're refusing to budget. They're saying you're killing my loved one. What are you doing? And then I'll come in and say no Islamic Lee to medical experts say something. The ruling it, you can accept that you're not killing. And then they look at me and say, So are you going to take the answer like on the day of judgment? Asked, Will you take the answer? Yes, I will. I'd be happy to because I know as an Islamic scholar I know what I'm saying is correct. I know this is the ruling, and I know it's okay. And at that moment, it's like a dam breaks down in the leg. Okay, Well, except that okay, we'll do that. And one thing to always remember. As chaplain, I'll go through the other Facebook for Muslim chaplain. One thing that comes forward a lot is when before someone dies. Often, you know, there's all these fighting and challenges and family members and different members. For once they die, the sense of can take over. And it's a case of Okay, this was the time that was written for them to die because we have a belief that when you're born, the time of your death is written and that calm kicks in. But that's the moment when they say we want to bury our loved one as soon as possible. Can you please help us? And that's the thing that somebody can do the most is get that medical cause of death signed and hand it to them in the plant manager of the procedure, whatever the process is so that they can have a face burial. It's the same with Judaism as well, because that face burial is where they get the comfort from. That's where they're able to gather themselves, and it's not just treating the patient while they were. They're treating them holistically that. Okay, we did everything for you while you're alive. Now you have died. We need to do everything for you and have you get to your creator. And that's one of the most crucial things. And that helps anybody and often often and family members will say, you know, they're taking forever. We can't breathe, were in limbo. No way to remember that. Another thing that is really beneficial. Um, and again, it's a It's a double edged coin. Sometimes someone who will say We don't want the money, we have our own. We don't want the Chaplain were Okay, refer them Regardless, the champions are thick skinned enough to turn up themselves. And, you know, say, you know, listen to me, this is my card. These are my details. If you want me to call me if you don't let me, don't call me. It's fine and walk away. You can often afterwards, questions come up and they want to question life. Or they want to speak about what had happened and make sense of things, and often that's the point. When, as the chaplain were able to do that, we're able to comfort them. It's also this word chaplain. When it comes to Muslim patients, the word doesn't exist in Islam, A chaplain or, for myself, a female chaplain. The word doesn't exist completely. So when someone told you know, would you like us to call the female chaplain or No, Would you like us to call the female exam? I guarantee you, and it happens with me so often 99% of the time, the family would say, No, it's okay. We don't know what sector of Islam that is. It's not the one we follow. We do not want any female. Um, um, so I always say, Let me introduce myself. And if you have a place where you have female chaplains, let me introduce themselves. Let them come aboard because I'm actually recognised within Islam as an Alabama and every family member will recognize that, and they will understand that. So that's not an issue. But it's just let us come along and introduce ourselves, and even for the males, the chaplain, the imam let them come along and introduce themselves, and then they can help from, because that's quite needed. And I don't know if you've seen that there's these little good anti use one. Here. Um, try and get on the camera. Yeah, that way. So we have these little grandkids that were donated, and there, Come on, this is actually a little cute. Um, and what happens is most people this will play the whole a quarter and on the audio. And most people will be very, really appreciative If you say to them, Look, my loved ones, when I see you, can they please have a call on cues and then this will play the corner, and and it means that it's something that can give them comfort. And if you say to a family, look at your loved one. This was on all the time. Um, it really, really does give comfort prayer room a Muslim. You need to play five times a day, and often as a patient, you can't do that, but to know which way the direction is of Mecca or what's the alternative? Because I can't do evolution with water and you can do it with a stone and having a religious person or a chaplain come by and explain that makes all the difference whole death burial matters. As I said, I touched on that the medical cause of death. I think often people are surprised at how fast it happens. If somebody passes away, someone dies before 11 o'clock. 11 AM They're usually buried on the same day, 11 or 12? Yes, they usually buried on that very same day. It's going to get a little bit harder now in winter, because the graveyard 4 30 is the cutoff point and it's easier in summer. But still 11 o'clock. They are on the same day. And if it's afterwards, or if somebody passes away now, UH, 7 26 someone dies. Um, they'll probably be very first thing tomorrow. The registry office will issue a green form by nine o'clock, and they can be buried. So these are all the things that chaplains. We have connections with the registry office manager's with reporters, and we can help the family. And it gives the most comfort and ethical questions. Um, often, it's asked. There's a particular medication that has four cancer. I'm in there and it's the only medication. There's no alternative. Can they have it when the medical start is? Yes, you can be like, No, you don't understand my religion. You don't know. I'm going to get in for for this. When the Muslim chaplain comes along and says, you know, of course you can have that. Okay, this is fine. You sure we're fine. So from a Muslim point of view, these are all questions that can be answered and help from a Christian point of view. You know, often the captain will come along and give the appointment for the last rites or blessings. They'll do a prayer, Um, and that will give them comfort. A holy communion. So often, people have said, we've drifted away from our faith, and now we're at the end. We want the Holy Communion, baptisms and weddings. We've had quite a few weddings here, but within with, uh, last week we had one. And even though it wasn't a Christian wedding, um, it was a civil partnership that I was able to help facilitate in. I see you. Um, they had already been married twice before, and they didn't want a church wedding. Even though they were Roman Catholic. They wanted a civil partnership, and as the chaplain, it was quite an honor to facilitate that. And it surprised me because I called the registry office at 9 a.m. In the morning. We have the paperwork. I wasn't even on site. Um, I had a consultant sign it and send it back, and everything was being done remotely. Um, and by one o'clock, it was confirmed that this burial, I mean, this marriage would take place on the ward at 2. 30 on the same day. And this is a patient that's in I see you. And he, um, palliative care of end of life. So we don't know timescale. So everything was arranged from nine AM to one o'clock. It was confirmed that this is taking place at 2. 30. Um, and the family asked me to be one of the witnesses, which was amazing. I see you was really, really happy, and they decorated everything and had it already. And I think these are the kinds of things that sometimes we get so tied down with death and dying and illness and sickness that we forget that there's also happiness with the joy between a wedding and having somebody do that for this particular wedding. Um, as I left, I was embarking, and as I left, my car had a punch up and I thought, Okay, there's no way I'm going to make it. I phoned the roadside assistance A and I said, What do I do? And they said, I will be with you in two hours to explain that somebody's about to get married. Well, some stuff and I need to get to it. You wouldn't believe that from the first phone call to the tire being changed with me being on their way In total, the whole thing took, uh, 30 minutes. That's it. The first phone call was made at one o'clock. I was on my way at 1 30. Sometimes everybody comes in to help, and it's amazing how Roadside Assistance also plays a part of the world has paper chains and cakes and everything ready. He was dressed in his nicest pajamas, and it's beautiful being part of that of chaplains as well. I remember there was another one that again end of life, and this was that she was dying, and her partner, he had rings, but they didn't fit them to their hands had fallen and there was no way they could wear them. So we thought, Okay, what do we do and in which we have a mark. And so I sent him two shots to buy some hair balls because they have some rings and he went and bought them and we stretch them. And I had them already. And this was a Christian wedding and I was helping, and I bought balloons and everything decorated the woman and I gave them their rings. And as he was standing there, he's so nervous he ate the Harry bullrings. He just ate my rings. What do we do now? Luckily, the packet had another one, and we stretch them when we gave him that. And I said, Do not want you to eat my rings. Um, we have all these kind of things that will happen and enjoy your stories. I had another one where I am a rosary beads. I woke up a patient, quite elderly Christian, and I gave her a rosary beads and she looked at me and she thought I was a none. And she died and gone to heaven. And she's like my dad is heaven like, No, I'm not a nun, you know, in heaven. And I made her feel across, and I said, Um one of the chaplains. And then she was like, Thank you, sister. So that would they started laughing, saying, Okay, your sister. Okay. And now, um, so we have you look for human really is. But the point is, you facilitate whatever is needed whenever it's needed, and however it's needed, um, so where it comes to Jewish patients and I'm speaking to the demographics of a lot of patients we have here, um, the majority. And again, um, they are that can things be facilitated? Can things be made easier in terms of Sabbath? So if they have an appointment on the Sabbath, can that be changed? So instead of having on a Saturday or on Friday after midnight, I mean, after sunset, can it be changed? Can it be on Friday earlier? If somebody is booked in for a cesarean, do they have to have it on a Saturday? Or can it be moved to the Friday or either okay to have a delay on Sunday? And it's all these kinds of things that are really important, and they give people comfort. Sometimes, you know, it's small when they give them the most comfortable. Um, sometimes we have patients who are really, really concerned about kosher. And they are, you know, is the food definitely kosher. Is this okay? Um, have you checked the kitchen? Are we able to eat this? And it's all these kind of things that you have to make sure that yes, it is. Yes. We'll help you. Don't worry about anything and just go into the kitchen and taking a picture and bringing it. I've done this often, just taking a picture and bringing it and showing them that look, This was prepared completely separately. It just gets this extra level of comfort to the family. Sometimes I have the rabbi call me and say, I'm not going to make it. These are our holy days and I want you to come in. But we have a patient. Can you please go and see them and I'll go in and sit down? And I'll say, You know, obviously I'm a visible Muslim and, you know, I'm sorry the rabbi had surface, but I'm on my way and they'll be so happy to sit down and they'll have a conversation and they'll recognize that it's okay. We can have this whole conversation. Um, sometimes it's medical staff that are confused. You know, a nurse will say to me, Okay, you know, you're talking to them. They're Jewish. It's like, Yeah, I know they were Jewish. Yes, we're having a very happy conversation. Um, and sometimes it's just someone that they know is a religious figure. She's not going to judge us. She's a religious figure, which means that she's found by ethics and she's not going to judge. She's not going to think anything else of, uh, she's not going to do any. And sometimes that's just the nicest, sweetest thing we can do for someone. And then have the family come back and say, You know what? At this moment in time, when my loved one needed it the most, thank you for being there. I have so many stories that come to mind with different faiths once we have somebody that she was evidently and again Sorry, a lot of my stories to start with, and she was dying. It's really bad, but she was dying and she was a Roman Catholic quite about, and she married a person from Church of England and, you know, they were very happily married and there was no issue there. But as she was dying, she wanted to talk to somebody. Offload plan the funeral put things in place. Now she felt like if she was to call a Roman Catholic priest, she would be dishonoring her husband. And she thought if she was to call a Church of England priest, she would be dishonoring her own beliefs. And she was a dilemma. And it was at that moment I actually went to see her, and she said to me, You know what? You're the Muslim champion. Can you please sit down and go through all this with me? Help plan my funeral and do everything? Because I feel like the Muslim chaplain? You're the perfect compromise. I have neither done a disservice to him by going to the Roman Catholic. And I've never done a disservice to myself by going to the Church of England. You know, you're perfect for me as a Muslim chaplain. Uh, again, it was just amazing that she thought she could trust me. And sometimes we don't think of these things that you know. Where is the middle ground? Where can they gain the help? I've had Hindu patient who again? We also on the wood, that she's not responding. She's not listening. Nothing. And her daughter made a request for a Hindu priest. Abundance, and it was their holy day. And he said he can't come out. But if I was the phone, he would do the Muga the prayers on the camera. So I went to the patient and I put the camera on and I spoke to him and said, Please do the prayers and I honestly thought she was not responding. The nurses said she was not responding to any requests. She's not eating. She was given up. But this was a request from her daughter who couldn't be there as well. But that Could you please do this? And every time the one that read a particular thing I didn't understand it was in Sanskrit. She would actually move her hands and do little actions like that. Um and then I noticed he was doing the same action. It was part of their worship and there were particular actions. So she was responding. She was aware, and she was listening. She just told him not to. She was tired, but this prayer enabled her to start communicating, start talking and it really pleased her. And I remember her daughter actually phoned back and said that was the turning point that gave her the will to open her eyes and talk to people. And again, at that moment when I was doing that, when I was facilitating, I was actually questioning myself. She's not responding. She's not listening. I'm really struggling to find a Hindu priest who is not in prayer because these are the Holy Days. And yet when I found one and I went there, it was the one thing that I know has given them the most comfort. We find it with dementia patients as well. Often everything doesn't make sense. But when you talk about their prayers that they did as a childhood or I start reading some Arabic prayers, I know they have done it in childhood. So finally start reading. Don't know them all. Um and these are all end of life issues that really benefit. They give the family comfort the whole family feels like you know what? Before they died, We're so glad you were There were so glad somebody understood what they needed. We're so glad somebody took that time to let them do their last prayer there. Last rights for the Muslim patients. It's where I'm glad somebody was there to ask for the paperwork, that somebody was able to facilitate the burial, that they were able to be buried the next day or the very same day, often the very same day, because that's the comfort. And sometimes with my Christian colleague. He said to me that even with the grieving take place then because the burial and everything, everyone's which is the auto pilot and then he's now started seeing that grieving takes place straight after the burial. I have family members come back to talk to me and say, You know, how was it? How was my mom? What did she say? How was my dad? How was this? And they really offload and cry, and it's just everything's in limbo until they're buried. Same as Jewish families, where they'll ask, Can we please have the body release? Everything is in limbo. We need them to go back. I've actually, um, sometimes when I sit with a Christian patient and they'll come by and say, you know, my father passed away or something accidentally, I said, So when are you looking at? Very well You're looking at today and they're like, No, you know, What are you saying? I'm so sorry I had my Muslim brain and then I know you're not looking at today. I know it will take some time, and it's also about doing what's best for the person. We've had cases where somebody wants to be cremated. It's not about me, it's about them. It's doing what's best for them. Let them decide. So all other days, everyone you know they need to be catered to tailored to. I've also had people that say to me, I don't believe I'm not a believer. Maybe there's something up there, but I don't believe even then, you know, I said, That's fine. I've not come to you. And I believe I have not said a word to you. Talk to me and often they start opening up and talking and they have something, you know. It may be that the dearest thing to them is their dog, or somebody will say to me, my wardrobe, I don't know what's going to happen with someone. Take care of that and it's it's other things. It doesn't mean that, okay? They don't have, um, a different a mainstream belief. Or they don't believe in God that they off the radar and we can't give them pastoral care or spiritual care. And again, these are misconceptions. In end of life, when somebody thinks okay, they're not Muslims. They won't need that or they're not this They won't need that or they're not that That's our judgment. That's our play that we're doing. We're thinking it doesn't fit our norm. They won't need that. We always need to think out of the box and think, What is it the patient needs? What is it they need? There's this real person here. They're coming to the hospital. They're dying. They didn't expect to, you know, be here. They're coming to terms with their lost. Their whole family is coming to terms with their loss. Um, we need to help them. We need to help make sense of this. Um, I would say, you know, when I said the whole family is coming to sense with the law, many of you, you know, we'll be aware of this often when it's an Asian family, whether it's um, India, Pakistan, Bangladesh or something? Um, there's a lot of family members. Um, I had a lot, actually. I'm generalizing. We've had a lot from Somalia in families and other families as well. And sometimes it can be very, very overwhelming for a for a nurse. I mean, for the board to try to think, Wow, there's a good 20. People hear, what do we do? And that's why it takes that often. The chaplain's I last did they say to me when I turn on the crowd control here and it's Yeah, just this birth. You You go, you go, you go. You do that and it's just me giving them jobs. Can you go to a funeral when I know there's nothing to do? Can you go and do this? Can you go and do that? Can you go and pray to buy two? And it helps everyone come to terms because they've all got a job now, Um, there was one marriage that for a Muslim family, we did, um it was in Ramadan, the month of Ramadan, and the mother had come into the hospital and she was, she deteriorated. Suddenly. The daughter's wedding was booked for a month later, just after Ramadan and the mother had deteriorated. And the daughter said, You know, my mom, she was struggling. We know she's dying. We've come to terms with that. We've had the conversation with then the prayers. We've done everything. But it would give my mother the greatest comfort if we could be married. So these were This was during coverted. The second wave, just after the second wave had relaxed a bit, but not relaxed too much. And the war was allowing to two people on. So we had to go and negotiate. So we started from like I said, Can we have 20 and then the next, you know, you can have to Okay. 18. Okay. You can have four and 16. Okay, you can have 16. And we negotiated that way until we hit 12. And then I got the imam in and they were married. They were married on the ward, and it was such a beautiful thing because they stay with their mom overnight. Her husband and wife. That was the first night as a married couple. And the next morning the whole family came again, and at 10 o'clock The mother died peacefully and the family came back and said, Thank you. Um, just that one thing. It gave them so much comfort. It makes it give them comfort to know. And these are all things that chaplains that were involved with in end of life and the things that sometimes we don't think that we would be involved with. So, as I said, we're involved in wedding were involved in birth. The moms get called to give Muslim babies the Amazon and the Obama. So it's a special pray that happens in the ears of the newborn baby. They get to do that. I sometimes just go to maternity to remind myself that there's life there. So you've been dealing with a lot of end of life, and then you go see a beautiful baby. I went to see one today, and it just puts a smile on your plan, and you remember Okay, we deal with death and life religious issues where the CPAP the emotional support is the machine allowed to be switched off? Are they in? I see you. What happens? What's the ruling and just taking the the burden of the family because it's the decision is never the families, but sometimes they feel like it is, and that burden is too great to hold and it's taking the burden of them and saying, You know what? It's medical decision. But even the medical decision Islamic Lee or, you know, whatever face you're okay to take it. It's okay. We do multifaith prayers. We helped, you know, patients plan funerals. We support staff when major incidents occurred. And sometimes that's one thing that is sometimes forgotten when there's a major incident, stabbing or something starts shaking as well. Often when I see you. No, I see you Sorry in a a you when the baby comes in and they died, it's not what the start expected. When we have a cold briefing, they're quite shaken. It's not something that you deal with every day, and we're there to give that support as well. For end of life, we support personal spiritual needs. When an individual isn't able to access the support in the external communities, we support the delivery of the freedom to speak up program. You know, we act as an interface between staph and management, were there. So what is it We do in a nutshell. What is it? Chaplaincy We offer a listening air were present at times of stress and anxiety. Who provides scriptures, holy text, religious material. We help contact local faith communities. We help families reflect upon lost grief. End of life issues. We offer support on ethical and religious questions. We offer religious support through prayer, worship, religion, sacraments and we advise on funeral arrangements and associated matters. And where are we were everywhere were in the hospital. Often I'm asked by five managers often. Can you ever go home? Because as soon as I receive, uh, they in which we have a process Where any space cadet. As soon as they received the medical cause of death, they email it to me as well. And I know. Okay, we need to act now. This family were out of hours. That should be a barrel tomorrow, so I'll call them up or I'll be here. And then do you just look in the corridor? Do you ever go home? But we do go home. We do have life, but yeah, you know, we are here quite often. Um often were called in to family meetings because it help. The family is not responding. We don't know what to do. Can you please help? And often we are just by being in virtue of not in scrubs, not in uniform. So we are here. This is the way I see. And maybe that's why the trust is there, that I'm here. I'm part of the hospital. I have the same I d badge. I wear the same yellow badger with my name on it. So I'm here. I'm a professional that they recognize yet I'm not in the hospital scrubs, so I'm also one of them. And sometimes that helps, Um and it means that, you know, I'll have a family saying You understand, right? They don't get it, You understand, right? And it's just being the bridge between No, no, they do understand as well. No one's here to hurt you. Everybody is here to try and help and do the same thing. We're all on the same page and we can work that way. So again, I do apologize. The slides refuse to upload. But what I will do is they'll send them when they do, and you know, if you want to share them with anybody wants them the slides already, and they have all this information. But I did, um, read it and I did talk to you what was on there. And sometimes I find that's even better because it means it's a person to a person. So when things happen, things messed up. That's the chaplaincy training. You know, this was a message from God. We got to do it directly. Thank you. That was any questions? Um, yeah. Does anybody have any questions? I had a question, Which is? I don't want, you know, Is there a kind of a servant in the community? If you have palliative patients who were at home wanted trapping, the input maybe isn't from their own religious organization. Does that exist? So one of the things that's really interesting question, Uh, anybody that becomes a religious scholar and myself, we studied for seven years. Anyone that becomes back which forever Faith, Um, everyone will do that. So I know for the Islamic faith. We specialize in the section that relates to hospital and palliative care and medicine and ruling because that's separate. And sometimes we have had people within the community that have not studied that specialty and not understood. So when the family in the community, you know, says, Oh, they want to switch off the machine, that particular scholar will say, Oh, no, no, that's wrong. You can't do that. And we've actually had an instance where somebody is actually, um And this happened to one of my colleagues where the family were there and they couldn't get through to the hospital chaplain. So they called the chaplain in Pakistan, and this chaplain said, Keep pumping their chest. Islamic Li. This is the right thing to do, and the family is pumping them, and everyone was a bit shocked and stepping back. So the equivalent is there in terms of their are religious leaders. There are scholars, but it isn't there because they haven't specialized in the medical side and they're different rulings. So even myself, I have to then specialize in even babies. For example, what's the ruling? If somebody wants an abortion, what's the ruling? What's this? What's that? What's the ruling? You need to then study specializes in that field? Yeah, Yeah. Thank you. That's really interesting. Um, yeah. So it's really great to get a kind of non medical perspective. Actually, the chapel service just It's so well with palliative care, which is all about. It's really great to get your perspective. So thank you so much, Thank you. And it's quite nice when everyone work together in the end, be tea or something, and it's it's holistic when it reaches that point and everybody recognizes that and you know, weddings. There isn't a medical reason why this wedding would benefit, but it really lives up a person, and it's what they need. And it gives them closure. And the wedding I was talking about on that day, his heart rate was so fast that they're actually worried it may not take place. And then I was just having a chat with him and laughing, saying, Look, you're a guy about to be married. Of course, your heart rate is going to be fast and a half. And then he calmed down and it was fine. And he was able to be married. You know, someone who's not in uniform just laughing about it sometimes helps. Definitely. Yeah. Okay. Well, thank you very much. Yeah, It's a nice evening. All the best. Thank you very much. Thank you, everyone. Thanks. Bye.

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