By Marty Folan, BCC, MPS
Chaplains play an essential role in the healing of patients. But anyone outside the ministry, including administrators, will ask, “What do chaplains do with patients?”
While most other healthcare workers provide meds, take tests and readings, poke, prod, and wheel them around, a chaplain’s primary duty is to enter into the suffering, pain, despair, hopelessness, and, sometimes, joy of a patient’s experience and be with them.
To listen. To feel. To reflect. To spiritually assess. To empower. To pray with. To support.
The healthcare industry is slowly shifting toward measuring the quality of care. Under the Affordable Care Act, the Centers for Medicare and Medicaid Services began reimbursing hospitals based on quality of care delivered – above quantity.
And so it goes with the chaplain profession. We were once required to meet daily quotas for patient visits, distribution of Bibles, rosaries or prayer cards, but the shift to quality outcomes regulates our ministry as well. Quality outcomes are observed and measurable changes in a person’s ability to cope.
Below are four tools for measurable changes.
TOOL 1: A Stool
The University of Kansas Hospital at Kansas City conducted a randomized controlled study of 120 adult post-operative patients. One physician was selected to visit all patients. For 60 of them, he stood by their bedside. For the other 60, he sat down beside them. Patient perceptions on the quality of visits differed significantly.
Patients who got a seated visit believed the doctor remained with them longer than he actually did. They believed he answered all their questions, was not in a hurry, was fully present, concerned, and listened to them.
Patients who met with the doctor who stood over them at the foot of the bed reported opposite results. They believed his visits were shorter. They experienced him as rushed. They felt he did not have time to answer all their questions and that he was not as concerned as they wished (2).
Sitting down beside patients sends spiritual messages: I am with you. I am on your level. I am close with you. I am not rushed. I care.
As a director of spiritual care, I purchased stools for all chaplains to sit on during patient visits.
TOOL 2: An Intervention
An 80-year-old woman fought long and hard against cancer. Her son was her greatest support. Her provider and patient care team admired her courage and persistence, yet they knew the end was near. Day after day, visit after visit, the patient’s son remained with her, as his mother battled back.
A chaplain who had ministered to and supported the patient from the time of admission returned for a visit. The son excused himself from the room. At the end of the visit, after the chaplain departed and the son returned at his mother’s bedside, she passed away.
A measurable outcome? In the son’s own words, The chaplain aided her in letting go.
TOOL 3: Prayer
With resources diminishing in both the Catholic Church and Catholic healthcare, collaboration is more important than ever. When I served as director of spiritual care services at St. Nicholas Hospital in Sheboygan, WI, I reached out to prayer groups at five local Catholic churches, and they offered to pray for patients who requested prayer. Chaplains would inform patients that the prayer groups volunteered to take one day of the week each and pray for them on a first-name basis. Over the course of nearly eight years, the average percentage of patients who asked for prayer ranged from 80 to 99 percent each week.
Did prayer provide a measurable outcome?
Harold Koenig, associate professor of medicine and psychiatry at Duke University School of Medicine and senior author of the Handbook of Religion and Health¸ said traditional religious beliefs have a variety of effects on personal health. Koenig’s book documents roughly 1,200 studies on the effects of prayer on health. The results are mixed and controversial.
However, he said, results of studies show that religious people tend to live healthier lives and people who pray become sick less often. Other results include:
- Hospitalized people who never attended church have an average stay of three times longer than people who attended regularly;
- Heart patients were 14 times more likely to die following surgery if they did not participate in a religion;
- Elderly people who never or rarely attended church had a stroke rate double that of people who attended regularly;
- In Israel, religious people had a 40 percent lower death rate from cardiovascular disease and cancer;
- and, Koenig said, “people who are more religious tend to become depressed less often. And when they do become depressed, they recover more quickly from depression.”
TOOL 4: A Gift
He was a grumpy patient in ICU. Noncompliant. Didn’t say much. No visitors came to see him. After a meeting with the patient care team, Chaplain Bob stopped by and introduced himself. A wave of the hand indicated no interest.
Familiar with the signal, Bob said, “I know you’ve been here a while, so I just wanted to stop by and see how you were doing. But if you’d rather not talk, I understand.”
The patient rolled over and looked up at Bob and motioned for him to stay. Bob sat down and listened. The patient spoke of his love of hunting and a memorable fishing expedition. Bob expressed interest and asked the patient to share memories. The patient recalled his catch of a 300-pound Atlantic bluefin tuna in detail. As the patient told Bob how it took more than three hours to reel in the catch, Bob noticed his patient’s smile grow wider, his eyes beamed, and he relaxed back in his bed.
The patient discovered meaning in sharing his story with someone who cared to listen.
Chaplain Bob returned to the patient’s room before his shift ended. He brought a gift from the hospital gift shop: a plaque with a fisherman on a boat.
Grumpiness was replaced with a smile and kind words for his patient care staff. He expressed appreciation to them and apologized for his bad attitude.
At the next patient care meeting, Bob was asked, “What did you do that helped?”
Bob said, “I sat down. I listened to his story and let him know I cared. His fishing outing was a meaningful experience, and he simply wanted to tell someone. I connected with him, and he appreciated it.”
Marty Folan, BCC, is former director of mission integration and spiritual care at St. Joseph Medical Center in Brainerd, MN.
