Ask a friend or family member if they know what health care chaplains do, and you are likely to draw a blank stare or shrug. Or, perhaps one will describe a chaplain as a religious professional who will say a prayer over the patient, or help the family prepare for funeral arrangements.
Most Americans are not familiar with professionally trained, board certified health care chaplains who undergo intensive academic and clinical training to bring comfort and meaning to patients and their families. While doctors and nurses can heal the body, caring for the spirit takes a different kind of training and skill.
The word "chaplain" is part of the confusion. Webster defines chaplain as a priest or other Christian religious leader who performs religious services for a military group or for a prison, hospital, etc.
This does not define health care chaplains who come from all denominations, provide support regardless of a person's religion or belief, or no religion or belief, and are trained to listen to people in their time of crisis as well as to hear what is unsaid. For example, when a patient is afraid, perhaps facing risky surgery, he or she may not want to express that fear in front of a loved one. The health care chaplain knows how to ease that patient's distress.
While the chaplain's focus is spiritual rather than religious, religions often come into play. Multi-faith chaplains are often called upon for conversations related to end-of-life decisions or rituals related to death or grief.
Chaplain services are clearly an essential component of quality whole person care -- body, mind and spirit -- a concept that is increasingly becoming a fundamental part of health care, especially in palliative care for the chronically ill. However, it is often an undiscovered asset by those receiving health care. In fact, studies show, many more inpatients desire conversations about religion/spirituality than have them.
So, the first challenge is that patients and their families need to become familiar with the concept; they need to know that they can request a chaplain, if they so desire, just like they might ask to see a social worker, a physical therapist, or a disease specialist. They need to become their own advocates for spiritual care.
In addition, there's even greater challenges in our health care system. Medicare only covers chaplain services in hospice. Not all interdisciplinary health care teams include chaplains. Those that do are more likely to understand the role and recognize the value. They see that a chaplain's presence provides an opportunity to communicate findings/recommendations into a treatment plan, and increases the likelihood of considering the patient as a whole.
As well, physicians, nurses and other interdisciplinary team members have marginal exposure to spiritual care training. Yes, chaplains are the spiritual care specialists, but spiritual care cannot be their domain alone. We've got to teach people from all types of medical disciplines how to listen and engage people comfortably and care for them spiritually and emotionally.
Such training could help them identify those who might benefit from a chaplaincy referral, and work it into patient care plans. So these professionals, too, need to advocate for spiritual care training within their scope of practice, and for inclusion of chaplains on interdisciplinary teams at their institutions.
Education and advocacy by consumers and professionals alike can make a real difference here. It all boils down to quality of life -- at a time when patients and their families need it most.
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