A Florida Hospital
program encourages patients to discuss emotional and spiritual health with a chaplain, nurse and social worker.
After Sarah Register had two lost pregnancies, her son Bodhi was born last August, 16 weeks early. It was an emotional time as she worried about her preemie and mourned the fact that her pregnancy didn’t go as planned.
Then her doctor at Florida Hospital Orlando’s Neonatal Intensive Care Unit told her about Compassion Rounds: a doctor, a chaplain, a nurse and a social worker would sit down with the Registers and talk about emotional and spiritual health. If the Registers wanted, the group would pray with them. The only topic that would be off-limits during the session was medicine.
“The first time we did it, I really let loose,” Register recalled. “I expressed how I had always wanted a big belly and stretch marks. I wanted a real baby shower. And I didn’t get any of that. I had just started showing before he was born, and I skipped out of the whole experience. It was hard for me to come to terms with it all. It was a weight off of our shoulders to freely talk about everything.”
Dr. Reina Mayor, a neonatologist at Florida Hospital, created the Compassion Rounds in 2016 in collaboration with a hospital chaplain because the families’ well-being is as much a part of the babies’ healing process as is medicine.
“The the ability for how the mom and the dad are coping has a direct impact on the bonding with the baby,” Mayor said. “Even cognitive and neural development can be affected when they get older if that bond is impaired.”
Meanwhile, studies show NICU moms are twice as likely to suffer postpartum depression than moms of term babies, and as many as 70 percent of moms at some point during the NICU stay will experience some symptoms of post-traumatic stress disorder.
Mayor got the idea from Dr. John Guarneri, chair of Florida Hospital Department of Healthcare and Spirituality, who started the rounds in 2012 at Florida Hospital Altamonte at the neuro-oncology unit.
“We saw this black hole, where physicians were taking care of the body, occasionally the mind, but not so much the spirit. Compassion Rounds filled that gap,” Guarneri said.
Mayor thought the rounds could fill a similar gap at the NICU.
“Even though the parents are not our patients, how the mom and the dad are coping has a direct impact on the bonding with the baby,” Mayor said.
Together with Jocelyn Shaw, the senior chaplain at Florida Hospital Orlando, along with a nurse and social worker, the four started making rounds once a month to families of NICU babies.
They sat together in the baby’s room and instead of talking about medicine, they asked parents how they were coping. They listened to them. They offered to pray with them. There were hugs and lots of tears.
“It’s changed my perspective as a physician,” Mayor said.
Until that first round two years ago, Mayor thought she already knew the parents of the tiny preemies. She had seen them and talked to them week after week. And despite being aware of studies and statistics, what she learned at the rounds surprised her.
Parents wept because they couldn’t hold and bathe their baby like they had expected. They felt guilty — maybe it was
something they had done to cause the early delivery.
“During the medical rounds, they would ask all the appropriate medical questions, but it’s like inside, they were dying. They were breaking down,” Mayor said.
Although there’s recognition that addressing patients’ emotional and spiritual health may play a role in better health outcomes, there’s a dearth of research in the field.
But working for Adventist Health System, which is committed to extending the Healing Ministry of Christ and whole-person care, when Guarneri pitched the idea of Compassion Rounds to his bosses in 2012, he didn’t need medical research to make the case.
“I challenged them and said, ‘If you believe that we have a body, mind and spirit, shouldn’t we have all three on our radar when we take care of people?’” he recalled.
The health system has collaborated with Duke University’s Center for Spirituality, Theology and Health on studies that show training providers to engage patients on spirituality makes them more likely to conduct spiritual assessments.
“I feel like a third of physicians are interested in spiritual aspects of care,” Guarneri said. “About onethird are neutral and can be won over. And one-third think it’s a lot of baloney. So if we get the two-thirds, that plenty.”
The health system, which is changing its name to AdventHealth in January, is also adding new questions to its outpatient intake forms to assess patients’ emotional well-being.
“We’re not here to promote a certain type of religion, even though this hospital is faith-based,” said Shaw. “We’re here to support [patients] in whatever their faith is or the lack thereof.”
Mayor is planning two research studies to quantify the impact on Compassion Rounds on NICU parents. In one, she’s planning to interview families after the rounds to pick out common themes and develop a structure to the program.
In another study, she aims to find out whether there’s a connection between the rounds and the moms’ postpartum depression and anxiety score.
The rounds are already spreading to other units of the hospital, including the pediatric ICU. Other Adventist Health System hospitals have expressed interest in replicating the model, Mayor said.
She has been giving talks about the initiative and when she talks about it to her peers, she calls it “Chicken Soup for the Physician Soul,” because the rounds have helped her too.
“You know, you have those days, like when we started Compassion Rounds, I had three deaths in three weeks and I had babies that weren’t doing well and I just felt like I didn’t have any more to give and after that first compassion rounds, I was like, ‘Oh my gosh’. I was walking on clouds. I felt like I could give again, you know. It’s so important because that’s why doctors go into medicine.”
Register said she’s participated in several Compassion Rounds since that first time a year ago. Bodhi, who spent a year in the hospital because of breathing problems, is finally heading home today.
“If you were to have the chance to do the Compassion Rounds, I would say do it,” she advised other parents. “My husband works long hours and when he comes here we talk about medicine and it’s not so much about how are you feeling. The rounds help us have a 20- or 30-minute break from the whole world of medicine.”