TalkBack on volunteer chaplains – the conversation continues

Continuing the Discussion: Volunteer Chaplains – Yes or No

Editor's note: Because the responses to the two articles about volunteer chaplains are raising some major issues for chaplains, we have chosen to place these comments in the context of Advocacy, since some believe that the number of chaplaincy jobs are affected by the increased use of volunteer chaplains.

I am glad that Chaplain Donovan has continued the discussion on Volunteer Chaplains. The situation in Australia causes me deep concern. Many denominations are not seeing chaplaincy as part of their "Missional" (the in-word) programs. It does not put many more sitting in their pews. Increasingly they are reducing the number of paid chaplains and appointing volunteer chaplains for one or two days a week who are nothing more than denominational visitors. Unfortunately the institutions are putting them into the same basket as chaplains. The new privacy laws do not allow them to see patient’s lists. Some hospitals are legalistically insisting that pastoral visits may be made only to those who request it.

As a consequence, applications for membership to the Australian College of Chaplains, (the equivalent to Board Certification) have dropped considerably. The Registrar reports show a drop in active membership due to retirements, with minimal interest by the volunteers. This type of addition to the Chaplaincy Departments means that fewer chaplains are able to become and be recognized as members of the unit's clinical teams in the hospital.

Perhaps we should be more stringent in our classification of Chaplaincy department members identifying them as Lay Visitors, Lay Pastoral Visitors, Clergy Visitors and Chaplains as set out in my "Pastoral Care in Hospitals". Perhaps then hospitals will be able to identify and cooperate more with the professional chaplains in the department. Professional chaplains must be able to walk tall alongside the professionals of other disciplines in the unit and institution as a whole.

My own involvement as a professional chaplain resulted in being issued with invitations to present papers at three Post-Graduate Medical Conferences with the following titles: "Organ Donations as an Aid to Grief", "Team Work in the Emergency Room" and "Terminal Illness in Teenagers". The first was the result of being summons to the ICU each time life support systems were to be stopped. I sat with the relatives as the Medico spoke to them of the possibility of the donation of their loved one's organs. About 80% denied the request saying that they did not want their family member's body to be mutilated. The doctor left the room. I sat with the relatives and discussed the pros and the cons of donation. Within a short time and without pressure half of those who refused changed their minds.

The ICU Director presented a paper at a National Conference of Intensivists showing how the Chaplain's presence resulted in more than a doubling of the years' donations of organs from the Unit. The present report is that the Chaplain is no longer involved in this process and the donations have dropped.

Churches must be made aware of the value, the practice and the importance of full-time (in one hospital) professional chaplaincy and that part-time volunteers are at best little more than pastoral visitors.

Once again thank you for this opportunity to respond to articles in PlainViews.

Neville A. Kirkwood
Queensland, Australia

The article by Chaplain D W Donovan on A RESPONSE TO VOLUNTEER CHAPLAINCY was excellent. I am aware of an organization that provides hospital/nursing home visitation by lay men and women who refer to themselves as "chaplains." At first, I was shocked, but got over it because they really just do not understand that there is a "difference." I tried to explain, but got nowhere. The organization has been ministering for YEARS. I am grateful that these men and women who take their "gift of visitation" seriously for Jesus' sake. Please thank Chaplain D W Donovan for me.

Louise M. Hutchinson, Chaplain
Fall River, MA

Here’s another thought about the question of using volunteer chaplains. It was suggested that chaplains are “an extension of the church”. While I belong to a church and am endorsed for ministry (ordained) by that church, in my professional role I am the Interfaith Chaplain (emphasis added). There is even some discussion about whether “chaplain” is the best title for one engaged in interfaith spiritual care, since it is rooted so firmly in Christian history. I minister to people of all faith traditions and none, for the experience of illness affects the spiritual health of all people. I operate from a theological conviction that the Creator wills and intends for us to become whole persons – physically, mentally, spiritually, and emotionally. The resources of one’s own and other traditions can assist in that journey to wholeness. Some patients and families will indeed want – and they get – the ministry of the church, through prayer, sacred readings, sacraments and other rites, and connection with their tradition and its representatives. There are a lot of people, though, who do not belong to any organized faith group and do not intend to form this kind of connection. I seek to bring the conviction and hope that healing and wholeness are possible, rather than “the church” in an official sense.

On the other hand, (trained) volunteer pastoral visitors can and should be an extension of their own church to their own members. That kind of support and connection is extremely important in the journey of recovery and navigating the changes that may be happening in the person’s and family’s life.

Rev. Mary Holmen
Chaplain Selkirk Mental Health Center
Selkirk, Manitoba

A response from the originating author (PlainViews Vol. 3, No. 14):

I’m happy to see Chaplain Donovan’s response to my article. I appreciate that he is approaching this question from a perspective of bringing together spiritual needs and the capacities of the clinically trained chaplain.

I believe that Chaplain Donovan has confused specifics of function with the parameters of practice. These days passing water, etc, are not commonly done by RN’s or LPN/LVN’s. That does not remove them from nursing functions. Professional nurses coordinate these interventions, and determine how they will be delegated. So, while not commonly carried out by RN’s or LPN’s, they remain part of the professional practice of nursing. Nurses have worked hard to express a practice and body of knowledge for nursing. In doing so, they have not repudiated the basics of hands-on care. Instead, they have delegated some of those functions to others who function under supervision. Those activities may be poor use of a professional nurse’s time, but are within professional nursing’s and purview.

In the same way, the fact that some interventions might fall within our professional purview does not require that only we provide them. I may – sometimes I must – delegate or refer out a spiritual intervention. That does not suggest that those interventions have ceased to be within our professional expertise. I cannot provide all the spiritual care that happens in my hospital. I can, however, oversee a program to reach throughout the hospital. I can educate staff in addressing spiritual needs. I can collaborate with local faith communities for specific needs. I “assess needs and determine interventions,” and am uniquely trained for that. However, I can delegate some activities of spiritual support to properly supervised students or trained volunteers.

We are certainly integral to the health care team. We are integral, but we are not “medical” practitioners, or “nursing” or “pharmacy” practitioners. We are those on the team with expertise in spiritual care; and, indeed, spiritual care is why they want us there. Thus, I continue to see the definitive context for our work as ministry, as spiritual work.

Administrators do want those who “cook the best vegetables.” To follow that metaphor, we need to be clear that we are trained as chefs. To feed more people, it is poor use of our professional time to mop floors when we need to be at the fresh market. Our professional training prepares us to implement a broader vision of spiritual care for our institutions. Appropriate leadership of students and volunteers can be part of that implementation. It extends our ministries, rather than diluting or diminishing them. Providing caring presence and information about spiritual care are within our professional purview, but don’t always require our highest expertise. To delegate those functions does not make them less our responsibility, or make us less chaplains; but it can mean more patients have access to compassionate spiritual care.

Marshall Scott, BCC
Saint Luke's South Hospital
Overland Park, Kansas