NACC member Julianne Dickelman, BCC, a chaplain educator at Providence Healthcare in Spokane, WA, asked members of her interdisciplinary team to share their thoughts about how they use chaplains to care for patients. Their responses follow.
The case manager
In my role as a RN Care Navigator, I see not only medical challenges working with patients following their hospitalizations, but a great need for their emotional and spiritual health.
I refer one or two patients daily to chaplain outpatient services. I explain their role to the patient so they understand what they can provide. I almost always receive a call from the patient later expressing gratitude for the call, stating how much they appreciated the support and time given to their needs. If needed, a chaplain home visit may be offered.
The circumstances that I refer have ranged from an overwhelmed wife caring for her husband after his cancer diagnosis, to a chronically depressed widower who cannot control his diabetes because food has become his drug. Some patients resisted seeking behavioral health services, but after speaking with the chaplain reconsidered or returned to their church family for additional support.
One 80-year-old woman lost both her adult children to a rare genetic disease that had required her 24/7 care since their birth. After the second child died, she became suicidal, since her world had fallen to pieces. She lost her home, was listed incorrectly as deceased by Medicaid, and was unable to get her prescriptions. The chaplain contacts were imperative for this woman to move forward in her life. She has her insurance and medications back, and lives in assisted living surrounded with others to bring her back to life.
The two chaplains I primarily work with are approachable and positive. Every patient has been treated professionally with respect and caring. The chaplains’ work reflects the Providence mission and values we all strive to follow. Our medical providers have been extremely positive toward this program, and we look forward to increasing our partnership with the chaplain team.
— Debra Breckenridge, RNCN
The registered nurse
As a registered nurse with an internal medicine practice, I have had several opportunities to refer patients to outpatient chaplains. I appreciate their presence on the care team because they have different resources than I do as a RN, and they bring a different perspective to the care of the patient. Often, they may have more time to spend with the patient than the primary care team, and they can address needs that cannot be treated with traditional medical care.
On one occasion, a patient’s son had recently committed suicide in a very public way. The patient had worked through some of her grief, and did not feel she was ready to attempt therapy. But she wanted some type of support. I felt the intervention of a chaplain would be a positive resource for her
Another patient had experienced a traumatic illness with new physical disabilities, and long-term recovery with uncertain prognosis for regaining previous functions. In addition, she and her husband had recently lost their home. Because of her new disabilities and the location of her new apartment, she was homebound for several months. The chaplains worked with the patient through multiple home visits and provided resources to support both the patient and her husband.
A third example is a man who was admitted to the hospital for alcoholism. His wife had left him because of his drinking, and he lives in a very isolated area with several animals to care for. He was very upset by his potential divorce, and was having great difficulty caring for himself after returning home. He had home health care assigned for PT, OT, & RN. But he was also referred to the chaplain, who arranged to visit in person once weekly, and to follow up by telephone once weekly to help him navigate his newly sober lifestyle. This is not the type of support that a primary care physician could offer.
I am very thankful to have chaplains on our team, as it fills several gaps in primary care, and a chaplain referral is often the perfect solution to a patient situation.
— Deb Baldwin, RN