Continuing the conversation on the use of volunteer chaplains

Volunteer Chaplains –The Discussion Continues

Editor's note: More responses to the two articles about volunteer chaplains warrant the continuing of this discussion within the context of Advocacy. The original articles were in the August 16 (vol. 3, no. 14) and November 1 (vol. 3, no. 19) issues in case you missed them.

The discussion about the role of volunteers has been interesting and important. However, in my opinion, what volunteers should and shouldn’t do in a pastoral care program misses the real issue, which as Marshall Scott and Neville Kirkwood have noted, is the continuing lack of understanding about the role of professional pastoral care.

In almost all of our consulting engagements with hospitals around the county, we see sophisticated hospital administrators who do not understand the contributions that professional chaplains should be making in their hospitals. Again and again, we see hospital administrators, and even their chaplains, who do not understand that the chaplains can be fully integrated into the strategic directions of the hospital. All too often, the chaplains are working very hard, but their work goes unnoticed – they are, to use an old line, “doing things right, but not doing the right things right” – “right” being those activities that have been established by their hospital’s leadership as directly connected with the hospital’s mission and path to success, and assigned to the responsibility of pastoral care.

Most hospital administrators in the United States struggle every day with communications breakdowns causing patient-staff and staff-staff conflicts, lapses in patient safety, gaps in patient-centered care or cultural competence, and other issues that lower their patient satisfaction, increase their staff turnover, increase the likelihood of litigation, and eventually cost them real money. They all too often don’t hear the voices of their clinical staff – particularly their nurses – who are feeling the stress from dealing with disruptive families and tragedies that could have been addressed by their chaplains.

Professional certified chaplains (but not volunteers) can make significant contributions to all of these everyday hospital problems. However, when most administrators look for solutions to these problems, chaplains rarely come to mind. Worse, we are often seen as irrelevant to these concerns – because we are irrelevant if we aren’t integrated into the accountability and responsibility for patient care! However, when these same administrators learn to understand the substantial contributions professional chaplains can make to issues that are central to their everyday practice, they are often enthusiastic about maintaining even increasing their pastoral care resources.

Thus, the task before professional pastoral care is to clearly and convincingly demonstrate the real contributions we can make to our hospitals’ mission and margin, and then insist on being held accountable for the results of our efforts. When we are successful, our efforts will be recognized. Then we can let the potential contributions of volunteers find their own level of success.

Rev. George Handzo
Associate Vice President, Strategic Development
The HealthCare Chaplaincy
New York, NY

While I understand that Chaplain Donovan's concern about volunteer chaplaincy is a real-world anxiety occasioned by the quickness of some hospitals to go for spiritual care on the cheap, I want to propose that he and others who are defending the world of professional chaplaincy from the incursions of voluntarism are, in fact, barking up the wrong tree. I think the premise of Barry Glasner's The Culture of Fear: Why American’s Fear the Wrong Things fits very neatly into the reasoning that says volunteers are a threat to health care chaplaincy.

What we chaplains ought to fear is our poor record in demonstrating the effectiveness of comprehensive programs of spiritual care. With all due respect to the anxiety that arises when some health care institutions seek the absolute minimum in spiritual care, I really believe we are violating our noblest selves when we duplicate the curious and sadly mistaken human propensity to protect one's position by blaming those in our midst who don't have the "proper papers."

I'm the director of pastoral care in a large, faith-based health care system in which spiritual care volunteers have increased the reach AND the quality of pastoral care that our chaplains provide to the patients and family members served by the 16 hospitals in our health care system. Furthermore, repeated research in the a wide variety of helping disciplines that offer services MOST like those which chaplains offer has demonstrated conclusively that, for about 80% of individuals in need of care, nonprofessional helpers are as effective as professional helpers.

I cite this statistic to every new group of volunteers who train in our system – as I did when I developed a large volunteer program in a regional public hospital in the East.

I do so for two reasons – one is to affirm their capacity to successfully carry out the divine call we share with them – to offer themselves in compassionate service to the spiritual needs of others. The second is to stress to them how MUCH they assist our chaplains to increase the effectiveness of their ministry by focusing on the approximately 20% of individuals who desperately need the services of a professional chaplain. Volunteers cover ground our chaplains should NOT be covering, and they help us more quickly to find the people who can most benefit from our care. While they are doing so, they become the most passionate and effective advocates of professional chaplaincy precisely because they see first-hand the difference professional chaplains can make.

Respectfully,

Mark Grace
Director, Pastoral Care & Counseling
Baylor Health Care System
3500 Gaston Ave
Dallas, TX

It was interesting to read the various responses to the articles(s) on volunteer chaplains. I have, I believe, a slightly different take on the subject. I am a "second career" endorsed candidate for chaplaincy, a single woman, and will soon be 61. After five years of seminary, including a change of denominations and six units of CPE, I am $70,000 in debt and, it seems, without job prospects. Because I am a member of the United Church of Christ, I cannot be ordained until I am employed (that's polity). It is indeed a rare position posting that asks for less than three years of experience and certification, or being in the process of certification, and ordination. At this point, volunteering with a hospital or hospice looks to be the only way for me to begin my certification process, get at least a year of experience, and, hence, improve my prospects for employment. Frankly, I don't know what else to do, and I wouldn't mind some input.

Let me add that I have used crutches for the last 32 years (I am a bone cancer survivor), and that keeps me on the west coast, which is also where my family is. The preponderance of job postings on the APC site seem to be in the mid-west and north-east, and I cannot negotiate ice and snow. If someone had advised me of the great difficulties I would face in finding employment, I might never have entered seminary, and would never have had the many rewarding experiences I have had working with patients and families during my six units of CPE.

Thanks for giving me an outlet to blow off a little steam.

Gail A. Williams, MAPS, CTS
Willits, CA

I have read the ongoing dialogue regarding Volunteer Chaplains with great interest. I believe the use of volunteers by the healthcare industry is motivated, in part, by budgetary concerns. The Pastoral Care Department is not exempt from these fiscal issues. In fact, I would not be surprised to see a growing trend by healthcare facilities in moving toward a multiple volunteer pastoral care staff overseen by a professional Chaplain-administrator primarily for economic reasons. As professional Chaplains, are we prepared to adjust?

One observation I had regarding the comments on the subject was the apparent consensus that volunteer Chaplains are untrained and unqualified to provide the same quality of pastoral care as a “professional” Chaplain. However, that is not always the case.

I am aware of “volunteer” Chaplains who receive no remuneration for their services (as opposed to a “professional” who gets paid for what he/she does), but they are still highly skilled pastoral caregivers. Many of these individuals have completed 1600 hours of extensive and intensive clinical pastoral education. They have been certified by a professional chaplaincy organization that has established and maintains high competency standards and a code of ethics for their “professional” (here I am using the word to define someone skilled at what they do) Chaplains. However, these Chaplains are not employees of the hospital; they serve as volunteers. Some do so because they feel they have more freedom of ministry and schedule as a volunteer than as an employee. Some do so because they want to focus on providing pastoral care rather than on writing in a patient’s chart, or attending administrative meetings, or completing monthly reports. Some do so because the hospital has no intention of including a Chaplain in their budget and this allows the Chaplains to still provide quality pastoral care to that facility. Some do not need a salary because they are retired and have a pension; others raise support like a missionary to meet their financial needs.

I am also aware of professional Chaplains who have a dynamic volunteer Chaplain Assistant Program. As was indicated by Chaplain Scott, this means the professional Chaplain spends more time in an administrative role: recruiting, training, overseeing and evaluating the volunteers. But it also means that his or her ministry at the hospital is greatly multiplied without overtaxing the budget of the hospital or the Chaplain’s time and energy in trying to meet all the spiritual needs at the facility.

The keys to a competent volunteer Chaplain Assistant program are dependent on several factors:
• The Director. This needs to be a person skilled in doing administrative work, but especially in supervising pastoral caregivers. Not everyone who is already a professional Chaplain is able to or even wants to do this.
• The screening of all candidates. At my former facility, these were all Pastors, who had theological training and pastoral care experience.
• The basic training of all new volunteers. At my facility that involved 400 hours of clinical pastoral training, focused on basic listening and assessment skills, as well as the provision of appropriate pastoral care. In addition, there was continuing education that was required for all volunteers.
• The supervision of the volunteers. In the same way we allow students to visit patients during a unit of CPE, we allow volunteers to visit under the supervision of the professional Chaplain.

Yes, there is often a difference academically and experientially between the professional Chaplain and the volunteer Chaplain. However, let’s not forget that this is a spiritual ministry, even though it is in a specialized setting. And because it is a spiritual ministry, there are people God has gifted and called to this ministry who are highly capable at what they do, yet may lack the “credentials” (like Moses or the New Testament Disciples). The basic training plus supervision adequately qualifies them to provide effective pastoral care at the bedside.

So clarify the difference between the professional and the volunteer by educating the healthcare staff and the religious community, but go ahead and use them to expand the spiritual care ministry at your facility.

Chaplain Jeffrey Funk
Executive Director
Healthcare Chaplains Ministry Association
Anaheim, CA

Do you have thoughts about advocacy you’d like to share with your colleagues? Send an e-mail to info@PlainViews.org.