The Rev. John Olsen on building bridges of trust

Offering Pastoral Care to Hospital Staff after a Sudden Loss

Spiritual care to a bereaved staff

Recently I led a prayer gathering with hospital clinical information staff. One of their co-workers was vacationing with her husband in the Caribbean when they both drowned in a diving accident. The staff was devastated, and had also lost other highly regarded co-workers in the recent past.

In the gathering, 40 staff members (including the chief of staff, administrators, and co-workers) shared remembrances, feelings and a time of prayer. I read from the Psalms, and led the group in a prayer that incorporated phrases from remembrances shared by the staff, as well as offering prayers for her family and loved ones.

Following the gathering, I mingled among the staff, and spoke with co-workers who needed to process her loss. They found my interventions comforting and thanked me for coming to offer my prayers and presence. I left materials with the supervisor for the staff, including Care Notes, pamphlets and prayer booklets we had prepared for our grief groups.

Memorializing the deceased staff member

I worked with staff to plan a memorial service, and to invite the deceased co-worker’s family. Due to the nature of the deaths, the bodies were delayed in returning for burial. Her manager wanted to wait until the family had held their services. That is what we did.

Several colleagues shared helpful insights in the wake of this tragedy. One spoke of the importance of listening for how the loss has affected their sense of hope for the future, and attending to their despair. Another had a prominent physician die suddenly and mentioned the importance of “companioning”staff that had experienced the loss.

Journeying with hospital staff after a loss

Often in chaplaincy, we minister to a patient and family during intense crises and then do not have the opportunity to journey with them afterward. I seek to make myself available as a supportive presence to people experiencing a crisis of health. They often return to their daily lives and are not heard from until their next visit to the hospital –save the occasional thank you card.

Hospital staff are a constant presence in the hospital amidst all the turnover of patients and crises. After a loss or crisis, we as chaplains have a unique opportunity to journey with staff as a supportive presence. Sometimes this involves being a sounding board for intense emotions of grief, loss, or anger. At other times this involves facilitating resources to help with coping. It may also mean working with supervisors to facilitate times of sharing or remembrance. Such a crisis is a time of great need that we as chaplains must be ready and equipped to respond to proactively. After the tragedy, I rounded through the department on a daily basis. I made myself available to any staff struggling to cope with losing their co-worker and friend.

Pastoral opportunities

When we respond to a staff crisis compassionately, it builds bridges of trust and creates new pastoral opportunities. After the memorial, I began receiving more referrals for pastoral care. I also found several new “go to”people to keep me updated on staff morale so I can respond effectively to their needs.

Better staff satisfaction = Better patient satisfaction

Patient satisfaction surveys, such as Press Ganey, show that higher staff satisfaction is very highly correlated to improved patient satisfaction scores. The time and energy we spend ministering to staff helps improve the care and ministry that patients receive. Offering effective pastoral care to hospital staff in crisis is one of the most important, but often overlooked opportunities for ministry that we as chaplains can engage in.

Resources:
Lindemann, Erich. "Symptamatology of Acute Grief." American Journal of Psychiatry. 151:6, June 1994. (reprint of 1944 article).
Kenneth Mitchell, Herbert Anderson. All Our Losses, All Our Griefs: Resources for Pastoral Care. Louisville: Westminster John Knox Press, 1983.
Press Ganey Associates. "Undeniable: Patient and Employee Satisfaction Linked." October 30, 2003.
Worden, J. William. Grief Counseling and Grief Therapy. New York: Springer Publishing Co., 1991.

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

Christopher De Bono on being spiritual but not religious

More on Harding: Identity and the Contemporary Chaplain

Rev. Stephen Harding’s recent pieces in PlainViews on “making a case for”and “continuing a discussion”on theology (v2, no.10 and v2, no.14) have certainly touched a sensitive, and I would argue critical, nerve for contemporary chaplaincy. This nerve has a lot to do with identity, specifically the value of the religious and theological identity for the contemporary chaplain.

Harding uses words like “giving away authority,”he notices the multi-disciplinary team’s perception that there is an apparent “overlap”of chaplain’s work with other disciplines, and he describes a “system where anyone can have a conversation about spirituality.”When I hear these descriptors, I hear identity issues. For some reason, there is some question as to the value of a chaplain rooted in and representative of a faith-based theological tradition when it comes to talking about spirituality.

In some ways, pastoral identity is not a new question. It is well within the history of pastoral care to ask how religious or faith-based identities fit into who we are as chaplains. A brief survey of current literature on the modern clinical pastoral education movement reveals deep tensions in this area.[1] More than a generation ago, as pastors learned more about psychological methods and language, an ever-increasing tension developed in the relationship between Christian theology and psychology.

Although the Christian theologians engaged in pastoral care at the time agreed that the psychological “tools for analysis and interpretation must be brought to bear on the pastoral task,”[2] there was a growing concern by some that the discipline of Christian theology was losing out to psychology. The debate concerned whether pastoral care could find, or needed to find, a way to remain “rooted in the Christian tradition and language”[3] while engaging new psychological tools or methodologies.

What is new about contemporary pastoral identity is the changing workplace milieu. This emerging milieu is increasingly non-religious. Most Canadian institutions have “non-denominational”chaplains who are no longer designated representatives of particular religions and these chaplains often facilitate multi-faith needs. This new milieu includes a clientele –and staff –who increasingly profess to be spiritual in a way that is not necessarily connected to a religious tradition; and includes, perhaps more importantly, chaplains who themselves are more inclined toward a wider spirituality rather than a specific religious tradition. It is this last point that really concerns me: what was once a tension between pastoral care identity and the role of psychology has now developed into a similar tension between pastoral care identity and a movement to non-religious spirituality.

This last point is best summarized by the expression popular in Canada, “I’m spiritual but not religious.”The “spiritual but not religious”distinction raises important questions for pastoral care, and its relationship with other disciplines.[4] Are the spiritual and the religious related? If so, how? Are they opposites, different realities altogether, or integral to one another? Or, are they really the same? Whatever the answer may be –and Harding raises the importance of clarifying terms in his second article –the larger question is “How can the chaplain, historically a representative of a faith tradition, assist or support people within these parameters?”If the answer is “not at all”or that “others can do this”then the writing is on the wall.

Much of the modern popular discourse on this relationship sees spirituality and religion as opposites. My understanding is that this is not so. Nor are they synonymous, but they are potentially related. I agree with Saundra Schneiders’definition of spirituality: “The experience of consciously striving to integrate one’s life in terms not of isolation but of self-transcendence toward the ultimate value one perceives.”[5] I agree that, from a client’s perspective, the ultimate value may be religious but then again it may not be. I also believe that chaplains need to be able to present spirituality in a way that includes the religious.

I take up Harding’s excellent observations because chaplains must engage our changing health care landscape; or else we will be left behind. Harding has encouraged us to ask who we are.

As an invitation, I encourage you to reply to this question: how important is it that you, an institutional chaplain, are rooted in and representative of a faith-based tradition?

Footnotes:
[1] A brief survey of some of the literature points to this concern: In 1981, Allistair Campbell called for a “rediscovery”of pastoral care because of “a contemporary confusion about the true nature of Christian caring and by a feeling of alienation from traditional understandings of the pastoral task.”See Allistair Campbell, Rediscovering Pastoral Care (London:Darton, Longman & Todd, 1981). Around this time, Thomas Oden called for a return to classical theological language and practice. He took issue, among other things, with “an anti-theological style of pastoral care.”See Thomas Oden, Care of Souls in the Classic Tradition (Philadelphia: Fortress Press, 1984, p. 130.) In 1984, Charles V. Gerkin looked for a middle way through this tension seeing both aspects of the debate as “tools of interpretation.”Calling this a “re-visioning”in a “hermeneutic model,”he proposed a “process of interpretation and re-interpretation of human experience within the framework of a primary orientation towards the Christian mode of interpretation in dialogue with contemporary psychological modes of interpretation.”See Charles V. Gerkin, The Living Human Document: Re-Visioning Pastoral Counselling in a Hermeneutical Mode (Nashville: Abingdon Press, 1984 p. 20.)
[2] Gerkin, p.14
[3] Ibid., p 21.
[4] Even a cursory literature review indicates that most health care disciplines (medicine, nursing, social work, occupational therapy, etc.) are studying and publishing on spirituality. In fact, beyond health care, spirituality is alive and well in other places: see for example "spirituality at work" seminars.
[5] Saundra Schneiders, “Spirituality in the Academy,”in Theological Studies Vol 50, 1989, p. 684.

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

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