Chaplain Dick Millspaugh writes from experience on the importance of initial verbal and non-verbal communication with patients.

A Voice of Experience II

Chaplains have a voice of experience learned over their years of clinical work. I will share one example of my learning below, and hope, in return, you will share your learnings with other readers.

When introducing myself to a patient, I used to say, “Hello. Mr. Smith?” The patient would then nod his head or say, “Yes?” Then I would say, “I am the hospital chaplain,” or “I am the chaplain on this unit.”

I have changed this introduction in three ways. Now I say, “Hello, Mr. Smith. I am Dick Millspaugh, your chaplain.” The “Hello Mr. Smith” is said with a bit of an exclamation, not quite deserving of an ‘exclamation point’, yet with a sense of warmth and anticipation deserving more than a period. I intend to move the greeting from “I am not sure who you are, I want to verify your identity,” to “I have taken the time to learn your name before meeting you, and I trust that if I am not correct you will let me know.”

Secondly, I now say “I am your chaplain.” I recently changed jobs from serving as a chaplain in a county hospital to a Veteran’s Administration hospital. I noticed that the patients in the VA hospital have a particular respect and expectation of the role of chaplain. From their years of military service, they expect a chaplain to be available. Thus, without realizing it, the patients taught me to claim my role more fully, more directly and more personally with them: “Hello Mr. Smith. I am your chaplain.”

The third change in my introduction is more subtle, and I believe more profound. This change comes from a meditative practice of opening one’s heart and one’s mind to the indwelling love of G-d. For me, this practice results in an actual sense of my heart opening and filling with a love that is from beyond me. At my best, before I go to sleep at night, I imagine seeing patients the next day with this expanded sense of love.

How is the sense of love communicated in my introduction? I reach out in four ways.

1. Eye contact. Chaplains have heard since their first unit of CPE that it is important to establish eye contact. This can be so rote in our guidelines for practice that we forget its importance. One might learn much from making eye contact with five or six different patients in one day. What do you learn in the first 10 seconds about who the person is? The aware chaplain will learn a lot about the patient through being open to the response of the patient’s eyes. Eye contact is only the beginning of a descriptive interchange with the patient.

As we become more culturally aware, we may also recognize that for some cultures and some individuals eye contact is invasive or threatening or rude. As with any guidelines, there are no hard and fast rules.

2. Love from an expanded heart, communicated through the eyes. Said metaphorically and yet literally, this love from the heart flows from eyes of the chaplain to the eyes of the patient.. This love says, "I am here for you. Without knowing you, I care for you. I am willing to be here with you to the degree you would like me to be here." One may actually experience a "warmth" - an energetic flow of love which one allows, rather than manufactures - that makes contact through one's eyes to the eyes of the other.

3. Handshake/holding hands. I often will extend my hand to the patient as a part of my introduction. Writing this article helps me be aware that I offer my hand when I read the patient’s non-verbal behavior as being neutral to receptive, or when the patient has already started to extend a handshake to me as I approach the bed. As in making eye contact, I am aware of my heart opening to the patient as I extend my hand, so it could be said that I am extending my heart through my words, my eyes and my hands. There is much we can learn from patients as they respond to their hand being held?: do they passively let their hands be held ; are their hands sweaty or cold?; are they reluctant to let go of the chaplain’s hand?; do they squirm or express other signs or discomfort with touch?; do they move to seek an embrace?

4. Awareness. Finally, I extend my openhearted love through my awareness of an open heart. Through my awareness I believe I communicate a spirit of care that is larger than any specific acts or words. I believe that on some level the patient senses this. More over as I am able to stay in touch with this openhearted love, it informs me as to next steps in the patient encounter. Remaining openhearted helps me read the patient’s interest or disinterest in pursuing the next steps of a relationship beyond an introduction.