Brent Peery, D. Min.

Chaplaincy 101: Show Up. Shut Up. Offer Help.

A few decades ago I played on a pretty good high school basketball team. Looking back, I see we were good not because we possessed any extraordinary athleticism. I think we were good because we had been trained for six years in a program that consistently drilled into us the fundamentals of basketball. We did the basics well.

I have given some thought over the last few years to the question of what are the fundamentals of good chaplaincy care. What are the basics that when done well will lead to care that makes a positive difference for patients, families and the healthcare team? One way of summarizing them might be: Show up; shut up; and offer help.

Chaplaincy care is intensely personal work carried out through the medium of relationships. Showing up is the first step toward building an effective helping relationship. In our department we stress proactive chaplaincy. This is in contrast to reactive chaplaincy, responding to the initiative of others. There is a certain amount of this in any chaplain’s work. But, there is real danger in others defining our work for us if this is our primary approach. Proactive chaplaincy care involves making rounds in assigned clinical areas and attending multidisciplinary rounds meetings for the purpose of initiating relationships with patients, families and the healthcare team. It is hard to be of much help if we do not first show up.

Frequently the foundation of relationship is laid by explaining who a chaplain is and how we can help. Though simplistic, in most cases it is sufficient to say, “We are specially trained clergy who offer spiritual and emotional support in the hospital.” Longer explanations can be provided as needed. There is typically some introductory conversation. This is often relatively shallow in content, but valuable as a means of establishing trust that leads to the possibility of more substantive interaction.

It is then that we shut up. We move into a primary mode of eliciting the other’s story and listening. We listen with trained ears, eyes, heart, and mind. What is the medical narrative and how does it relate to a larger life narrative? What does all of this mean? What are this person’s needs? Hopes? Resources? What is her concept of the Holy? What is the shape and quality of community in her life?[1] All of our listening, combined with our training and experience, provides the material out of which we form an assessment.

It is based on our assessment that we offer help.[2] We identify the chaplaincy care interventions we deem to offer the greatest potential for assisting this person. If he grants us the privilege of being his helper, he can expect to benefit from both our personal concern and professional capability. Accepting and benefiting from our help does not require a person to even begin to comprehend all of the years of education, clinical training, personal growth, and life experience that contribute to it. He just needs to know we care.

These are the fundamentals of what we do. Day in and day out. With person after person. We show up. We shut up. We offer help. On the surface, these rudiments are no more impressive than the innumerable hours my high school team spent in dribbling and passing drills or in running through offensive and defensive sets ad nauseum in practice. To the ignorant it is about as exciting as a musician practicing scales. But, to those of us who have trained to master the essentials, this is the stuff out of which grows some of the most meaningful work a person could ever hope to invest a life in. When we get it right, patients, their families and the whole healthcare team wins.

Footnotes

[1] VandeCreek, Larry and Lucas, Arthur. Eds. The Discipline for Pastoral Care Giving: Foundations for Outcome Oriented Chaplaincy. New York: Haworth Press, 2001. 8-18.

[2] We offer; we do not impose. To do the latter would risk violating the medical ethics principle of patient autonomy, not to mention the inherent dignity of another human.

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