By Denice Foose and Theodore H. Smith
Jeff (a pseudonym) is a Caucasian Roman Catholic layperson, who serves as a trained pastoral visitor in the Department of Spiritual Care at Baylor St. Luke’s Medical Center in Houston. On his weekly visit to his assigned clinical unit, Jeff met Juan, a 65-year-old Hispanic patient from a small town in south Texas. Earlier that day, Juan received a potentially fatal cardiac diagnosis, requiring a heart transplant. With his family still in their hometown, Juan suddenly faced emotional and spiritual distress alone. Jeff entered Juan’s room knowing only his name, age and religious affiliation. His effort to establish an empathic presence with Juan became more challenging when he realized that neither spoke the other’s language well.
However, through his genuine investment in making a pastoral connection, Jeff learned the broad outline of Juan’s medical condition. More importantly, he felt some of Juan’s understandable fear and the religious overtones of Juan’s self-presentation. Jeff realized the potential meaning of his visit and had the courage to tolerate his own anxiety. A decisive moment in their conversation came when Jeff offered to read – from a Spanish edition – selected prayers from Pastoral Care of the Sick. While Jeff felt embarrassed by his stumbling Spanish, Juan was nonetheless moved to tears, literally, by the transcendent assurance of God’s faithful outreach of pure, unbounded love to all God’s children. To complete this visit, Jeff made a referral to the staff chaplain assigned to that unit for her follow-up ministry.
Jeff drew upon his training as a pastoral visitor, especially in the art of empathic listening, along with the traditional resources of ritualistic prayers of the Catholic faith. The combination enabled him to conduct a truly effective initial visit to a lonely, frightened man in a foreign setting. Moreover, Jeff’s commitment to serve, while possessing a solid identity as lay caregiver, significantly enhanced the mission of the Spiritual Care Department.
This vignette illustrates how a lay ministry program can enhance a department of pastoral care. Such a program does not simply add to but improves the ministry of a department. Jeff’s interaction with Juan was more than a greeting visit; it was an in-depth encounter, offered by a trained layperson giving expression to his life of Christian discipleship. This type of ministry creates a powerful middle ground, between the contributions of a sensitive volunteer and the professional expertise of a board-certified chaplain.
Of course, an effective lay program requires work. Administrative authorization, departmental support, educational opportunities, and personalized consultation are essential, and each has a distinctive function.
Administrative authorization at departmental and executive levels is a requisite first step, but it must be followed by meaningful support, especially at the departmental level. All members of the chaplains department, few or many, should be committed to the program’s success, welcoming prospective members with genuine enthusiasm. Occasionally, ordained clergy feel threatened by gifted laypeople or underestimate their capacity to develop pastoral skills and acquire core knowledge. Neither response is healthy or professional. Finally, the title for the participant in the lay ministry program is vital. In our program, we avoid the word “volunteer” and use the title “pastoral visitors,” to emphasize their distinctive identity as laypeople who have a heartfelt call to serve God and the Church in this capacity.
Another indispensable element is training. Over many years and working with scores of participants, we have found that laypeople want to be challenged in order to grow intellectually, relationally, emotionally and spiritually. The verbatim continues to be the single most effective teaching tool to equip people for pastoral care ministry – including laypeople. Difficult at first (as for all of us), writing verbatims generally become less onerous as laypeople increase their capacity to recall larger portions of the conversation. While never anxiety-free, these discussions help students grasp the fundamentals of pastoral presence, empathic listening, facilitating a person’s expression, and tracking a person’s story, plus limiting interrogatives and personal disclosure. An initial six-session, biweekly training program can provide a solid foundation to develop their ministry. Supplementing that introductory program with quarterly continuing education forums will keep them challenged and on a growth trajectory.
Personal attention also is integral. Hearing their name as they enter the department, receiving a personalized folder containing their patient list, reading a few instructional comments from their assigned staff chaplain, and finding a note of personal greeting in the folder are all powerful messages to the lay minister. They say, “You are important to us, and your ministry is vital to the mission of the hospital and department.” Occasionally, the lay minister will require something extra – a time of personal consultation. Meeting that need lets them express their thoughts and feelings about an emotionally and spiritually demanding encounter.
“I’m a better spouse, friend, and caregiver because of the training through our Pastor Visitor program. I listen better and am better able to connect.” This was Helen’s comment in the concluding session of the program’s five-part, three-month introductory training series. It reflects the breadth of the program’s impact; it is a form of spiritual renewal for Helen as she continues to invest in ministry as a pastoral visitor.
Jeff and Helen’s experience, or something like it, can be replicated with a commitment to an elevated vision of lay ministry. Concurrent with that effort, professional chaplaincy also is strengthened.
Denice Foose, BCC, is director of mission integration for acute care and the Rev. Dr. Theodore Smith is director of clinical pastoral education at CHI St. Luke’s Health at Baylor St. Luke’s Medical Center in Houston, TX.
