I finally started my first big-person job as a hospital chaplain resident at a large hospital in the Twin Cities. People usually have one of three reactions. The first reaction is overwhelmingly positive. The second reaction is generally uninformed but curious. The final reaction is more negative or misinformed. There's an episode of Scrubs where Dr. Cox's super-Christian sister comes to the hospital and ends up ministering to a patient, much to his chagrin. They stand around all night praying and lo, and behold, a miracle! The impression is that chaplains are there because we think we'll be able to call healing miracles down Benny Hinn style or because we want to convert people. Having been met with a number of these reactions ranging from curious to confused, I have decided to write up a post. I strongly encourage people to take advantage of a chaplain's presence if they ever find themselves in the hospital, hospice, or other care setting, because it never hurts to have another person on your team.
So now that we've cleared up what a chaplain doesn't do, what exactly is it we actually DO do?
1.) Provide holistic care of the patient.
Being in the hospital, or even another type of care setting (assisted living, inpatient addiction treatment, etc) often feels like you are being looked at as a collection of body parts or as a "problem" rather than a human being. Doctors are great and gifted but sometimes look at people as if they are a liver with a side of intestines instead of a person who is 31 and unexpectedly ended up in the hospital with mysterious symptoms and a possibly really bad diagnosis. In my health system, we are considered "spiritual care" not because we necessarily deal with religious topics but because we see patients as whole people whose beliefs, values, sense of self and purpose also suffer because of medical diagnoses and, conversely, whose diagnoses can be worsened by these more spiritual concerns. There are scientific studies that show that patients who have their spiritual needs attended while in the hospital have better outcomes (are less likely to die) than those who don't! That's because the feelings of fear and dread that come up around illness and death can and do have a physiological impact. Sometimes these feelings and thoughts are mediated by organized belief systems, and sometimes they are not. Patients benefit from having a person who can help them integrate their current situation with their life philosophy and/or beliefs.
2.) Provide emotional and spiritual support for patients, families, and staff in crisis.
Being in the hospital is hard on patients, but it's also hard for family members and for staff. Medical and ancillary staff who work on ICUs or a hematology-oncology unit usually see more bad outcomes than good ones. There is a lot of pain, suffering, and death in these situations, and regardless of the spiritual or philosophical concerns, all of these people need somebody who is willing to delve into the emotions of the situation and address them. Usually this just looks like 'yeah, this is really hard, I'm so sorry' but you'd be amazed how helpful it can be to just feel heard when the world is going crazy around you and you feel totally powerless. I once ministered to a family of a different faith from mine during a terminal extubation (pulling life support). I didn't have the same traditions but I was able to draw from their traditions and mostly just sit with them, bring coffee and extra chairs, and help them talk about some happy memories as their love one died. What we do is walk into a house of sorrow and accept the pain and journey with them in it. It sounds simple, but when you just kissed your baby on the head for the first and last time, or when your wife isn't going to wake up again, it means a lot.
3.) Provide rituals and ceremonies, prayer, or facilitate contact with those who can.
My staff and resident group has several Lutherans, a couple Catholic priests, some Unitarian Universalists, Muslims, Mormons, Baptists and a few other types of Christians. People form their lives around stories and often part of our story is the story of a group of people who came before us and believe like us. Believing in something bigger than us either as a Christian, Muslim, or a Humanist or whatever is almost a biological imperative. We make meaning. Even if your meaning is that 'there is no meaning' you are still writing your life story according to an interpretation. Feeling connected to something broader is important for many people, and as a chaplain my job is to understand people's religious, spiritual, or philosophical needs and help them be met. If that means finding a Jehovah's Witness to minister to a patient, then I call their central office. If that means locating a Qu'ran or getting a priest to do an anointing, then I do that. If it means praying with patients, I will do that in any way they feel comfortable with me doing it (depending on their beliefs and their understanding of mine). Often the difference between total anxiety and a sense of peace is a thirty second prayer with a chaplain, or maybe just a five minute conversation. My job is to assess the need and meet it to the best of my ability.
4.) Give patients a chance to vent their feelings or take a break from getting poked and prodded.
Sometimes I have a visit that is nothing but talking about all the places the patient has visited, or all of their 80 grand-children and what they're up to, or maybe the latest movies we've seen. Hospitals aren't fun places to be stuck if you're not getting paid (worse if you're paying an arm and a leg), and sometimes the best thing for a patient's healing is to not be bored and frustrated. That means sometimes we talk about nothing at all. They ask about me, I ask about them; we chat. Or maybe they're really frustrated that the nurse keeps waking them up and just need to be grumpy with somebody. There are medical staff members and social workers and nutrition workers and occupational therapy and physical therapy, etc etc etc and they poke and prod patients non-stop. I come in and ask nothing of the patient but what THEY need and want right now. Sometimes feeling like you have a little bit of control, even if that means kicking the chaplain out, is everything.
5.) Work on interdisciplinary teams to advocate for, listen to, and care for the patient.
Believe it or not, religious or spiritual issues come up more than you would think for patients. Should a Muslim patient be undressed by opposite sex staff members? How do we handle the patient's beliefs there? What if a Jehovah's Witness opts for a life saving blood transfusion but is feeling extremely anxious about that medical decision? Maybe a patient is in a vegetative state and the medical power of attorney is unclear? There are ethics boards, care teams, palliative teams, and a slew of other teams that are there to care for the patient. As chaplains, we sit in on many of these and make sure that the patient's emotional/spiritual needs are being accounted for in such situations. Chaplains are there to really hear and understand patients, and we work side by side with doctors, social workers, therapists, etc to ensure that the patient is receiving the best care possible that accounts for as many needs as possible. This includes treatment decisions, end of life decisions, or even pregnancy termination decisions. We put on a lot of different hats, but our job is to see the whole person and do whatever we can to see that their values and spiritual health are taken care of.
Ultimately, you want a chaplain in the room because professional chaplains are trained to be on your side. They are there to listen, to advocate, to mediate, and most importantly to love the patients. Sometimes we have our hearts broken by the tragedy we walk beside. I remember these stories sometimes as if they were my own. But for me it's an amazing, fulfilling opportunity to be the hands and feet of Christ to serve all people (of all faiths, beliefs (or not), and backgrounds). My personal belief is that Jesus and the promise of new life in the midst of all this crap that we trudge through day after day shows up through those of us dedicating our lives to serving the world. So I will continue letting the light of love shine in my hospital and wherever else I can for as long as I can.
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