The Struggle for Consistency in Compassionate Care

Monday, March 21, 2022

Ministry Volunteers encounter people who have faced many obstacles – both individually and structurally – in their ministry sites throughout a BSVM year, whether they are in clinical or non-clinical settings. The contexts will vary, but the challenge is the same: show up with compassion, fully present, and open to learning from those we meet. 

Read below for an account written before Covid began from BSVM alum, Jenna Vrable (’19-’20) who served at the Bon Secours Care-A-Van in Richmond, VA.

Jenna with a nurse and patient at Care-A-Van

The Struggle for Consistency in Compassionate Care
By Jenna Vrable, BSVM 2019-2020
A Graduate of Creighton University

For most of us, there are only a few moments in our lives where we have the privilege to accompany others through truly difficult experiences that reveal the broken nature of many of our social structures. These moments can leave even the strongest among us feeling lost, powerless, and scared as we begin to grapple with the human toll bound up in the complexities of issues like poverty, homelessness, immigration, trauma, or racism. Though these despairing feelings may be strong, there is a select few among us who decide to dwell in this discomfort and dedicate their lives to the service and accompaniment of others. These incredible individuals make the conscious choice to wrestle with systematic forms of oppression on a daily basis, extending hospitality to and recognizing the innate human dignity of those they serve, and seeing the fight for justice as a worthy, and even godly cause to live for.

Many of the staff at the Bon Secours Care-A-Van fall within this inspirational group of people committed to accompaniment as they strive to offer healthcare to the uninsured in the Richmond area. These remarkable professionals often find themselves serving a unique population of immigrants and refugees new to the United States, patients who have somehow found their way from the border all the way to Richmond, and who have joined a thriving community of Latino people in Southern Richmond. The introduction of this community into the Richmond area has meant that the staff at the Care-A-Van have needed to learn and adapt their approaches in order to adequately serve a population that holds different cultural norms, speaks a different language, has experienced the trauma of unwilling or unplanned immigration, and does not yet understand U.S. customs and culture. Through these complexities, the Care-A-Van has actually flourished, adding staff members from the Latino community who speak the language and can empathize with some aspects of the struggles their patients face. More importantly though, each and every staff member has made the intentional choice to face these social justice issues every day, learning how to help patients navigate the available social services, and consistently offering each patient a compassionate presence despite how exhausting the often-impenetrable healthcare process can be.

Though the normal day-to-day life of a staff member at the Care-A-Van may seem unassuming, there are incredible moments of hospitality and welcome evident to those who take the time to truly look. Every day is different, and every site the mobile health clinic inhabits can bring a new set of challenges and obstacles. In the chaos of the clinic these moments of hospitality can be difficult to see, but they take place every day in the warm “buenos dias” (“good morning”) of the registration staff who brightly speak with every exhausted patient, some of whom began waiting in line for an appointment at three or four in the morning. These moments of warmth and empathy are clear in those same staff who, after a full day of interacting with and aiding patients, will beg to add just one more to the list to be seen before everyone packs up and goes home. They are evident in the staff who bring in grocery bags filled with food on their day off for a struggling patient who has an appointment that day, and other staff who take the time to carefully walk with another patient who shows signs of domestic abuse.

Hospitality is clear in the staff member who carefully analyzes the foreign vaccine record of every child to save them from as many shots as possible, and the staff member saying, “I’m sorry, I’m sorry,” to the crying children as they receive their vaccines, and the staff giving the children small prizes for bravery that have been purchased with their own funds. Generosity is clear in the outreach and nursing staff who spend day after day filling out application forms for much-needed services, and still find time to go grocery shopping for and visit the home of a young mother whose teenage daughter struggles with epilepsy. A welcoming spirit is evident in the providers who carefully examine each patient, knowing that they have waited many hours for the opportunity to be seen and may be having their first experiences with U.S. healthcare at the Care-A-Van. These same providers wait with a warm smile for interpreters to tell them what each patient is saying, and pull out suitcases filled with books to offer one or two to every child. At the end of a long day, these providers may even return to their own practices at night to see another 10-20 patients before they are finally able to rest.

Though I have surely left out many amazing and memorable moments of compassionate care, I think the point is clear: it is valuable to surround yourself with incredible people who teach you to bravely face the issues that our society would much rather ignore. Even more so, I have been honored to witness those who do this grueling work day after day with a smile while they offer a compassionate presence to people who may feel unwelcome and forgotten. In my short time thus far at the Care-A-Van, I have met people who truly see the opportunity to accompany others in their struggles as a privilege. I am learning from these gracious and inspiring colleagues to seek out these experiences, knowing that life’s hardships can teach us to be just a little bit more human if we pay attention.

In my experiences at the Care-A-Van, one of the most notable lessons I’m learning is the value of the struggle for consistency when offering such compassionate care and accompaniment to the most vulnerable. The incredible displays of generosity and welcome that I have witnessed so often in my coworkers call me every day to deeply examine my own practice of a ministry of presence, and I have become intimately aware of the difficulty in consistency. Each day that I walk into the clinic site, I attempt to absorb and emulate the learned wisdom of my colleagues through my own interactions with our patients, and every day is different. Some days I may be called upon to color with two young brothers, both under the age of five, who are incapable of speaking but instead communicate by holding up their drawings and smiling with blackened teeth, waiting for a warm smile in return. Other days I may be asked to entertain a five-year-old boy for a few minutes while my coworkers speak with his mother about their well-founded concerns of child abuse in the home. I might pull out my crayons, sit on the floor next to him, and “oohhh” and “ahhh” as he colors Pokemon characters in his favorite color, pink, and chants his new favorite English word, “turtle, turtle, turtle!” Still the next day I may read to a young girl from Guatemala who tells me of her longing for her home and the family she and her mother left behind, while simultaneously raving about her new friends at school in the United States and the big open field donde podemos jugar pelota (where we can play ball). Later that same day, I could sit with the vaccine nurse and hold the hands of a child whose vaccine record was lost in the panic of leaving home in a hurry and, in starting the process all over again, now needs six shots today before they can be allowed to enter the U.S. school system. Through their scared screams and tears I tell them mira a mi y respire, (look at me and breathe), and I encourage them to look at our wall of brightly colored stickers to choose as many as they want as a prize for being so courageous.

For those of us who are new to the struggles of privilege and power, injustice and social responsibility, the overwhelming need that comes through the doors every day can be all-encompassing. However, as my BSVM predecessor once said, and the inspiring staff here show me every day: “God’s justice is done one person, one relationship, at a time.” The trick may be to remind ourselves of the value of consistency in the face of ingrained oppression and inequality. More than anything else, the staff at the Care-A-Van have shown me what it looks like to face discomfort and expose yourself to opportunities for human connection consistently, every single day, in the interest of slowly tipping the scales towards justice, one welcoming smile and gracious gesture at a time.

Jenna colors with a child while they wait

Care-A-Van is a mobile health clinic in Richmond, VA