C-Force: Where Religion and Medicine Meet
At University Health hospital in Kansas City, Missouri, COVID hospitalizations had been running high in January, notes Gina Kaufmann, a locally based NPR correspondent. Medical teams once again had to keep in-person contact to a minimum. For hospital chaplains, this means that their only direct contact with patients can be through in-room telephones. Doing this makes it hard to make a connection, let alone address a patient's spiritual needs. In a medical team, a chaplain represents that person they can "talk to, someone to cry with, someone who knows how hospitals work," Kaufmann writes. For family members and loved ones, they are there to listen and help them decide what to do while in a state of stress and confusion.
To give a picture of how these interactions can work, Kaufmann shares a story told to her by Ramona Winfield, a chaplain on the palliative care team at University Health.
Winfield tells her of being called to a room where a non-COVID patient had died. As she entered the room, she saw that a grieving relative had climbed into bed beside the deceased. The relative was unresponsive to what the nurse standing bedside was saying to him. Winfield immediately stepped into the relative's line of vision, and the nurse moved aside. She made some quiet attempts to start a conversation with no results. She decided to change her approach. After standing there quietly for a moment, she began to sing a peaceful song. The family member began to cry.
"He just lay there and cried. And I got some tissue, and I wiped the tears away as I was singing. And then the family member began to talk," Winfield tells Kaufmann. He spoke to his deceased relative, not Winfield, and said his goodbyes.
Next, she calmly explained to the grieving relative that soon someone from security would be coming to take the body to the morgue and that he had just a few more minutes to be with the body of his pasted away relative. The family member responded "okay." As Winfield stood in the background continuing to hum her song, the man took a towel and wiped the patient's face, hands and feet.
"As he was doing this, the family member would say, 'You've done so much with these hands, taking care of your family. You worked hard,'" Winfield told Kaufmann. "And as he wiped the feet, he would say, 'Those feet have walked so many miles just to make sure that your children had all that they needed.'"
"After being immobilized with grief when Winfield arrived, the relative left the room in peace, on his own terms," says Kaufmann.
In a June 2020 article, during the early days of the COVID outbreak, when so much media coverage was being rightly focused on our remarkable hospital first responders, I mentioned how one important service rendered was being overlooked: the role of the hospital chaplain. Mentioned at the time was Father Radu Titonea, a hospital chaplain at Long Island Jewish Forest Hills hospital. Given the overwhelming stress heaped upon doctors, nurses, tech workers and those responsible in keeping the hospital clean and functional, Father Titonea admitted to having to often shift his attention to checking in on the mental well-being of staff. As to dealing with death and grief caused by a raging pandemic, he pointed out how hospital chaplains are well-experienced in dealing with uncertainty. "We live in that world, of people not knowing what's going to happen to them," he said.
"Chaplains are non-anxious, non-judgmental people who have the ability to be still, especially in a place ... that's not a still place," Allison Kestenbaum, a certified educator and supervisor of University of California, San Diego Health's Spiritual Care & Clinical Pastoral Education, describes a chaplain's role in a recent story in the San Diego Union Tribune. They try to recognize the humanity of each person they encounter.
While much has changed since 2020, what remains is a lack of recognition of the contribution these spiritual counselors have made and are making as integral members of a hospital health care team. According to Zippia, a career data website, there are more than 9,600 chaplains currently employed in the United States. Clearly, not all hospitals provide specialized pastoral care. It is said to be taught only minimally at seminaries and religious institutions. Chaplains are generally board-certified by one of several bodies such as the Board of Chaplaincy Certification, a national, not-for-profit 501(c)(6) affiliate of the Association of Professional Chaplains. According to Kestenbaum, despite the job they face daily, chaplains have some of the lowest rates of burnout in the health care field.
"While chaplains often are integral members of hospital care teams, their role isn't widely understood even by the hospital's staff," reports the San Diego Union Tribune's Cathi Douglas. "Many times it's assumed that chaplains minister only to overtly religious patients and families, but chaplains say that they are there for everyone, no matter their faith tradition -- even if they have no faith whatsoever ... And while patients and their families may not specifically request religious counseling, chaplains can offer them the most critical service they need -- a listening ear."
Jonathan Rudnick is a rabbi and community chaplain at Jewish Family Services who visits patients at various hospitals within the Kansas City metropolitan area. "People come to hospitals, almost always, for the physical," he explains to NPR. "They've got a problem and they need/want to have it fixed ... The unintended consequence is: Things get very imbalanced with all this focus on the physical. Something needs to heal physically. At the same time, it's like, 'What about the rest of me?' We are multidimensional creatures and when one dimension is being related to so intensively, the other ones can get lost."
Tracy Balboni is a senior physician at the Dana-Farber/Brigham and Women's Cancer Center and professor of radiation oncology at Harvard Medical School. She is also the lead author of a newly released study by researchers at Harvard on the role of spirituality in healthcare. "Our findings indicate that attention to spirituality in serious illness and in health should be a vital part of future whole person-centered care," she says.
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