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Urgent (Spiritual) Care

Hospitals are places of change, and often, places of crisis. In a hospital, a person experiencing a medical crisis may need support and their families may need help coping.

One of the most common misconceptions is that hospital chaplains are there to evangelize—they are not. They are trained specifically to give patients and families what they need, in the way that they need it.  

Chaplain Roy Foster is part of a rotating team of chaplains at Riverside Tappahannock Hospital, in Tappahannock, Virginia, and he says that he often introduces himself by saying “I’m here to support you in whatever you need, faith or no faith.”

“We are trained to personally connect with the patient. Doctors and nurses don’t have the training or the time for some of these matters. We are there to be present to the specific needs of the person,” he says.

To become a hospital chaplain, four units of Clinical Pastoral Education are required, including peer feedback groups and residency. This training prepares people who already have a master’s in divinity or a seminary degree for the specifics of working in a hospital.

Patients often wrestle with questions like “Why is this happening?” and “What did I do to deserve this?” in the hospital and it can be a place of high anxiety. Chaplains offer a confidential person to talk with, and sometimes their objectivity is reassuring.

But many people don’t know they can ask for a chaplain or when they should do so. Chaplains are available to be present for patients and family members in the hospital in all kinds of situations, including death, receiving bad news, stress over making decisions, family issues and unfinished business.

“People in crisis are more willing to talk, especially to a chaplain,” says Foster. “It’s our job to be present, and to offer compassion and awareness of the critical life event they are experiencing.”

Often people who have a sudden illness, such as a heart attack or stroke, have a hard time coping.

“It’s a surprise and your head is swirling with fear and terror. Those things you worry about in the back of your head, you are suddenly experiencing it now,” says Chaplain Barbara Shefelton, staff chaplain at Bon Secours Mary Immaculate Hospital in Newport News, Virgnia.

Another reason people may be reluctant to call for a hospital chaplain is that they may not be religious or worried about proselytization from the chaplain. Although chaplains may have backgrounds as congregational pastors, or act as one when they are not at the hospital, these are very different roles.

“We meet them where they are. Whether Wiccan, Baha’i, Jewish or Muslim, we are available,” says Shefelton, an ordained Presbyterian minister.

“It’s not about evangelism. It’s about being present and helping them talk about what they really need,” Foster says.

Chaplains also act as a liaison for other faith leaders, calling them if one of their congregants is admitted, if they want to receive a visit or receive a sacrament.

Although people admitted to the hospital are asked about their religious affiliation, the label on their medical chart after religion is only a starting point for chaplains. Particularly with the growing number of people who consider themselves “non-religious,” chaplains may enter a patient room not knowing what to expect. But they contend that people in crisis are in need of spiritual care and listening, so they are there to meet those needs and are trained to be open to what the patient or family needs.

In addition, hospital chaplains help people working in the high stress environment of hospitals. Foster says that more than half of his job is to be present for the staff, who experience loss and emotional stress frequently in their jobs.

Shefelton said that at first, the shift from a congregation to the hospital was a big change.

“I was worried about having no sense of congregation, but the staff becomes that,” she says.

Acting as a chaplain varies from place to place. Foster says that in a rural hospital in a small town, one of the differences is that everyone knows each other. “It’s not uncommon that people being treated are known by the hospital staff. This can be both a stress and a comfort,” he says.

It would make chaplain’s jobs so much easier if everyone arriving at the hospital had already written down their wishes. Chaplain Shefelton says, “It’s absolutely one of the most important conversations we can have with anyone: our parent, spouse or children. It’s so difficult, but it’s a gift to give your children.”

Allison DeLaney, chaplain for Hospice House and Support Care of Williamsburg, Virginia, says it’s never too early to have this conversation. “You honor your life by talking about end of life wishes with your family,” she says.

DeLaney suggests using a workbook or guide that covers three topics: your wishes for medical care near the end of your life (often called your advanced directive), your wishes for your funeral and burial or cremation and your will. Your advanced directive and will should be legal documents, including designating someone you trust to make decisions for you if you can’t. An advanced directive includes deciding who will speak for you if there are medical decisions to be made, and what kind of medical treatment you want if you are not expected to recover.

Before you document it, spend time thinking about what it is that you want. Think about your values, your favorite music, who you’d like to get your precious items or to care for your pets. “You don’t have to talk about it all the time. Just have one concentrated conversation about it and keep it updated,” DeLaney says.

Even if you feel uncomfortable, think of your loved ones and how it may help them. DeLaney recommends everyone do something to acknowledge life has changed after a loved one dies.

“Admitting you might die doesn’t make you die sooner. We are all going to die—there’s a 100 percent mortality rate—so we might as well deal with it,” says DeLaney.

End of Life Conversations

• Put documents with the right people—your doctor, your friends, your children and your spouse. If you put items in a safety deposit box or safe, make sure the right people know where the keys are.
• Don’t forget about your digital assets. Do you want your Facebook and Twitter accounts deleted immediately? Who has passwords for your online accounts?
• If you own a business, consider creating a letter of instruction for your family on who to call upon your death such as your accountant, colleagues and clients.
• Don’t forget that you are more than your stuff. Write down stories to share with your loved ones about your life and your values. What do you want them to remember about you?

About the author

Natalie Miller Moore

Natalie runs Moore than Words, a health communications consulting firm in Williamsburg. She loves to learn and write about health, particularly relating to patient experience and research.