Pastoral Care Before Surgery

What is it like for my Congregation member?
The single, most prominent emotion present in patients prior to undergoing surgery is fear (anxiety). Typically this takes two forms: physical and psychological. Physical fear has to do with perceived threats of bodily harm. Psychological fear has to do with perceived threats to ones sense of self-esteem. These may manifest themselves in a variety of ways.

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1. Fear of separation - Probably touches the separation anxiety experienced in childhood. Going to surgery is an act I must do alone. No one can be present in that experience with me. I am most profoundly alone.
2. Fear of change - Most commonly a fear of change in lifestyle including:
• loss of mobility
• loss of bodily functions (having to go home on oxygen, tube feeding, colostomy)
• loss of independence (having to depend on others for basic needs, bringing the threat of a nursing home even closer)
3. Fear of pain - Will I be able to handle it? Will I be embarrassed by my inability to handle it? Will the pain go on indefinitely beyond surgery?
4. Fear of being out of control - Have to give up my own clothing, eat when and what the hospital says, share my room with a stranger, have help to go to the bathroom. I lose all my privacy. Everyone enters the room without my permission. What will I be like under anesthesia? I have to surrender the most vital functions that I have to others, allowing them to breathe for me and stop and start my heart.
5. Fear of death - Tillich's fear of non-being. Even though there is a low mortality rate for this surgery, will I become one of the statistics? Where am I when I am under anesthesia?

What can I do to help?

1. Listen carefully for the patient's feelings and accept them.
• Allow the patient to express and own negative feelings: "Yes it is depressing"
• Facilitate the expression of as much feeling as the patient wants.
• Remember denial is a survival mechanism. Don't try to take it away from patients in the short run, but be aware if it persists after surgery.
• Don't deny the patient's feelings: "Oh, you don't have to worry about that!" The patient has the right to his or her own emotions.
• Don't minimize the operation: "Oh they do hundreds of these operations all the time. I'm sure it will go just fine"
2. Accept the patient's emotional needs and minister to them.
• Confession is good for the soul -- and for the body!
• Communion can be a powerful means of incarnating God's forgiveness and acceptance.
• Prayer, used carefully, can help express a patient's feelings and invite God's grace to touch a patient at the point of need.
3. Be responsive, not directive. Not everyone will want or need your care. Compelling someone to accept your care reflects your needs rather than theirs. Learn the art of being gracefully dismissed.
4. If possible, without taking away that patient's feelings, help him or her reflect on ways they got through difficulties in the past and articulate resources they currently have.