Hospital chaplains aim to offer patients a hope for the holidays

Cheer leaves some patients isolated

The business of living and dying, hospital chaplains say, doesn't stop during the holidays.

Like police departments, airports and Waffle Houses, hospitals are open 365 days a year, tending to people who are sick or near death. And at health care systems across Arkansas, chaplains say their work intensifies in the period between Thanksgiving and the new year.

They are busy ministering to patients and families whose feelings about hospitalization are magnified by expectations and memories tied to the season.

"This is supposed to be the time of candy canes, and every family getting together, and everyone happy, laughing, fire going, et cetera. ... [for patients], I think it just brings an added dimension of sorrow," says Chad Raith, vice president of mission and ethics at Mercy. "What we've created oftentimes in our culture is that the holiday season is supposed to be cut off from suffering."

Chaplains' role -- variously described as a healer, a witness, an interpreter of narratives or a "fellow pilgrim" -- is to come to the aid of patients, families and hospital staff members who are feeling discomfort, processing bad news or experiencing grief after a death.

A chaplain could be called to hold an elderly woman's hand, visit with a family whose baby has died, or sit in a narrow emergency room bay with a patient who may not survive -- often all in the same evening.

Around the holidays, chaplains' day-to-day work is both the same as usual and also "more so," says University of Arkansas for Medical Sciences associate director of pastoral care Susan McDougal, as hospital visitors' feelings "become more poignant."

"The memories that we have of our early childhood Christmases and Hannukahs and Kwanzaas, and all the different holidays that we celebrate ... we always hold them up as really seminal to who we are," she says. "There's a sense of wanting to talk about that, needing someone who will just listen and understand."

At UAMS, chaplains' seasonal preparations begin before Thanksgiving, when condolence and acknowledgement letters go out to family members of patients who have died during the year.

Vice-president of mission services and director of pastoral care Sister Maria Christi Cavanaugh says chaplains in the St. Bernards Healthcare system prepare special prayers and have holiday-themed literature on hand to help patients who are struggling with a "feeling of longing" around Christmastime.

"Here I am, in a hospital setting, away from family and friends, so it creates probably a deeper sense of separation," Cavanaugh says. "We try and be open and sensitive to that and to listen."

People working in chaplaincy also need to be mindful of their own holiday memories, and any major events that happened in their own lives during the year, adds Kay Hardin, senior staff chaplain at Baptist Health. A recent loss, or thoughts of a family member who is now absent, can weigh heavily on both caretakers and patients.

If not recognized and managed, she says such feelings can both hinder the chaplain's work and complicate a patient's recovery.

Many health systems in Arkansas employ just a handful of staff chaplains, with a more robust network of trainees and part-time chaplains to provide 24-hour coverage. They are often priests, pastors, deacons or rabbis who have been board-certified after completing a clinical pastoral education program, which includes at least 1,600 hours of training.

Though they are often very immersed in their own faith, area chaplains stress that no matter the season, their role is not to proselytize to people who come into the hospital. Professional standards require "spiritual care that respects diversity and differences including, but not limited to culture, gender, sexual orientation and spiritual/religious practices," according to a fact sheet from the Board of Chaplaincy Certification.

With patients, "we're not going in there to save their soul, or to do anything dramatic like that," says Michael Millard, a chaplain at CHI St. Vincent Hot Springs. "I'll answer their questions. But I'm certainly not going to try to drive them someplace, or take them someplace that they don't want to go."

"When we're talking about health and sickness, life and death, disease and prognosis ... these are human issues. They transcend cultures and religious preferences," UAMS Director of pastoral care and clinical pastoral education George Hankins-Hull says.

When patients do ask to discuss religion, chaplains can have those conversations, but another key part of their work is connecting patients who've asked to see someone from their faith community. Most chaplaincy departments maintain contact lists of leaders from local churches, temples and mosques, as well as personal relationships with clergy.

Roman Catholic priests, Jehovah's Witnesses and members of the Church of Jesus Christ of Latter-day Saints are regular visitors to UAMS, where chaplains work to facilitate the "inreach" of faith leaders, Hankins-Hull says. UAMS chaplains also make note of staff members -- for example, doctors who identify as Muslim -- who've volunteered to discuss faith issues with patients.

That leaves chaplains with what Hankins-Hull calls an "agnostic" approach as they're faced bigger, harder questions about illness or injury: patients and families who want to know "Why is this happening to me?" or "What does this mean?"

But even for chaplains, those questions don't come with easy answers.

"I say, you know what? I'm not sure that I can answer that question. I don't know," says Millard.

"I think sometimes people think we have a closer connection [with God] or we're going to be able to solve this great dilemma of terminal illness, and we're going to make it all better," Cavanaugh says. "I may not be able to make it all better, but I can help you journey through the difficulty."

Much of the time, chaplains say, patients and families don't want advice or wise words as much as they want someone to listen without judgment. And sometimes the work can be even simpler, McDougal adds -- finding a Bible, meeting frantic relatives at the door of a vast hospital campus, or helping people use the phone after a shooting to let relatives know they're OK.

It's part of chaplains' compassionate practice, both during the holidays and throughout the year.

"I hope that folks know whenever they come to the hospital, that they have a resource in us. If it's something deep and troubling that they are dealing with, that they are facing, we're here," Millard says. "We're there with people, when they need us the most."

Metro on 01/01/2019

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