The Catholic patient in the emergency depamnent A u t h o r s : Patricia Carroll, RN, CEN, and Colleen Shiraishi, RN, MSN(c), CEN, San Diego, California, and Gas Vegas, Nevada

T here are several sects of Catholicism embod ied in both Eas te rn and Western rites: Roman, Byzan-

tine, Russian, Greek, Slovak, and others. Emergenc y nur ses should be aware of three sac ramen t s tha t all Catholics practice. An e m e r g e n c y nurse may perform only one of these sacraments , Baptism, if a priest is not immedia te ly available and dea th is imminen t .

Baptism Any viable fetus not expec ted to live should be bap t ized immedia te ly at the reques t of a parent . A viable fetus may be def ined as a fetus more than 24 weeks ' ges ta t ion in a facility where neona ta l ser- vices are available and more t han 27 weeks in facili- t ies where neona ta l services are unavailable. 1 Many hospitals have their own defini t ions of viability. If a priest is not available to perform the sacrament , any bapt ized Chris t ian may bapt ize a viable fetus, with any available water. The nurse should pour the water over the in fan t ' s head, saying, "I bapt ize you in the n a m e of the Father, and of the Son, and of the Holy

Spirit." The e m e r g e n c y nurse should notify the Catholic

chapla in or par ish priest as soon as possible so tha t the bap t i sm may be registered. Bapt ism is not ind ica ted for bir ths of nonviab le fetuses or products of abortion, nor is burial i nd ica ted except as reques ted by the family. Documen ta t i on in the nurses ' notes should in- clude the reques t for Baptism, who performed the bapt i sm, and not if icat ion of a priest.

Any unbap t i zed person who is critically ill and r eques t ing Bapt ism may be bapt ized in the same m a n n e r as a n e w b o r n infant. The nurse m u s t have the

pa t i en t ' s permiss ion to notify family m e m b e r s that bap t i sm was performed. The nu r se should d o c u m e n t

the conversa t ion in the nur ses ' notes and notify a priest soon afterward if he is not available to perform the sacrament . Not only does the priest need to register the bapt i sm, but, if the pa t i en t survives,

Ms. Carroll is an emergency nurse and educational facilitator, Vet- erans Affairs Medical Center, San Diego, California. Ms. Shiraishi is a clinical nurse, Emergency Department, University Medical Cen- ter, Las Vegas, Nevada, and a graduate student m the family nurse practitioner program at the University of San Diego, San Diego, California. Ms. Carroll and Ms. Shiraishi are mother and daughter. For reprints, write Patricia Carroll, RN, CEN, 3738 Via del Conquis- tador, San Diego, CA 92117-5741. J EMERG NURS 1995;21:513-4. Copyright �9 1995 by the Emergency Nurses Association. 0099-1767/95 $5.00 + 0 18/1/67451

he can provide further religious educa t ion and other s ac ramen t s such as Ano in t ing of the Sick and

Penance .

Anointing of the Sick A noi n t i ng of the Sick, formerly k n o w n as the Last Rites, is performed for any bapt ized Catholic who is critically ill or injured. It can be reques ted by the pa- t ient or a family member . If the pa t i en t is unab le to speak and the family is not available, anyone may call a priest for a Catholic pat ient . The priest can perform the s ac ramen t du r ing a cardiac arrest s i tuat ion with- out in te r rup t ing medica l care; the s a c r a me n t requires very little space and time. If the pa t i en t is alert, a few m o m e n t s of pr ivacy should be provided so that the pa t i en t may make a last confession.

A n o i n t i n g of t h e Sick, f ormer ly k n o w n as t h e Last Rites , is p e r f o r m e d for any b a p t i z e d Catho l i c w h o is cr i t ical ly ill or injured.

Penance The sac ramen t of P e n a n c e is also k n o w n as Confes- s ion or Reconcil iat ion. Sins are confessed and absolu- t ion is given; hence , the need for privacy. Pat ients do not have to confess their s ins to receive the Anoint- ing of the Sick.

All Catholics are ent i t led to the sac ramen t s of the church; they are no t wi thheld for moral reasons or in s i tua t ions such as suicide, murder , or subs t a nce abuse. Persons in these s i tua t ions are v iewed as menta l ly ill and in need of counsel ing.

There is no fee or donat ion expec ted for the sac- raments . Larger hospi tals usually have a list of priests on call and specific procedures for con tac t ing them. Smaller facilities ma y have to call the local parish di- rectly. Emergency nurses should review procedures for con tac t ing a pr iest before one is needed.

The Catholic Church supports organ donat ion and will assist in counse l ing and comfort ing families in mak ing dona t ion decisions. The church also b e -

December 1995 5 1 3

JOURNAL OF E M E R G E N C Y NURSING/Carroll and Shiraishi

l i e v e s in t h e r i g h t to d i e w i t h o u t a r t i f i c ia l s u p p o r t b u t

d o e s n o t s u p p o r t e u t h a n a s i a or a s s i s t e d s u i c i d e .

If a m o t h e r is fa ta l ly ill or i n j u r e d a n d h e r f e t u s is

a l ive , t h e c h u r c h a p p r o v e s life s u p p o r t u n t i l t h e i n f a n t

c a n b e d e l i v e r e d safe ly .

T h e C a t h o l i c C h u r c h i s w i d e s p r e a d in t h e U n i t e d

S t a t e s , a n d m o s t c o m m u n i t i e s h a v e a c c e s s to C a t h o -

lic r e s o u r c e s . It c a n b e fa i r ly e a s y for a n e m e r g e n c y

n u r s e to m e e t a C a t h o l i c p a t i e n t ' s s p i r i t u a l n e e d s , a n d

i t is c e r t a i n l y we l l w i t h i n ou r s c o p e of p r a c t i c e to d o

so.

We t h a n k J a n e Gorman, PhD, p rogram director for the Insti- tu te of Chr is t ian Ministrids, Religious Studies, Universi ty of San Diego, a n d Pr. Louis Fischer, clinical pastoral educa tor and Catholic chaplain, Sharp Memoria l Hospital, San Diego, for thei r a s s i s t ance wi th th is article.

Reference

1. Gerber -Smi th L. The p r e g n a n t t r a u m a patient . In: Car- dona VD, H u m PD, Mason PJB, Scanlon AM, Veise-Berry SW, eds. T rauma nursing: from resusc i ta t ion th rough reha- bilitation. 2nd ed. Philadelphia: WB Saunders , 1994:677.

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