hospital chaplaincy beyond religious control

HospitalChaplaincybeyondreligiouscontrol:acompellingpilgrimageSandeRamage:WorkshopforCommonDreams,[email protected]@gmail.comwww.spiritedcrone.co.nz

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AsaNewZealandhospitalchaplain,I’vefoundmyselfcaughtinareligiousandspiritualtimewarp.Thispresentationtellssomeofthestoryofmypilgrimagetounderstandthatandthinkabouthowitcouldbedifferent.Althoughspiritualwell-beingisafundamentalhumanright,hospitalchaplaincyinNewZealandgrewoutofaChristianparish-visitingmodel.OvertheyearsithasdevelopedintoaprofessionalpastoralcareserviceunderpinnedthroughClinicalPastoralEducation(CPE)training.Theworkforceisamixtureofprofessionalchaplainsandasignificantnumberofvolunteers.Underthegovernmentcontractwe’reemployedtoprovidespiritualsupporttopeopleofallfaithsandnone.However,weallhavetobeChristianministers.Wecan’tbeMuslim,Buddhist,Hindu,Jewish,Pagan,HumanistorAtheist.Itfeelsasthoughthere’sanelephantintheroomandit’scalledChristian.


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WhenItalkaboutthissituation,acommonresponseistosuggestthatweneedmoreelephants.Thatis,morechaplainsfromvaryingfaithtraditions.I’mnotsosurethatthisisthebestpathway.BeforeIgoanyfurther,it’simportanttosaythatmycommentsarenotacriticismofmyemployer,theICHC,orPalmerstonNorthhospitalwhereIworkasahospitalchaplain.Noraretheyacriticismofmychaplaincycolleaguesinthishospitaloranyother.Myreflectionscomefrommyownministrypilgrimageinaworldthathasshiftedbeyondrecognitionanddemandsaresponse.WhenIbeganatPalmerstonNorthhospitaltherewerethreechaplaincymodelsinoperation.Denominationalvisiting,whichislessdominantnowwithmoreecumenicalchaplainsandfewerpeoplenamingareligionordenomination.Loiteringwithintent,randomwanderinglookingforpastoralneed.Neitherofthesemodelstakechaplainstoprioritypatientsbutneitherdoesrelyingonstaffreferralsasthesemostlyfallintothe‘religious’category.


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Abouttwoyearsagothechaplaincyteamdecidedtostartnotingtrendsinamoredeliberateway.Althoughoneofourcontractualprioritieswastoattendtodeathanddyinginthehospital,wefoundourselvesmoreoftentendingtotheemptyroomwithnopatientinsight.Toputthisincontext,blessingroomsafterdeathisapracticeconsistentwithMaorispiritualityandisavailableinmostNewZealandhospitals.Stafftoldusthatmostpatientsweren’treligiousanddidn’twantchaplains.That’snotsurprisinggiventhediminishingnumbersofpeopleassociatedwithchurchgoinginNewZealand.However,aschaplainsaremeanttobethereforpeopleofallfaithandnone,wecouldseetherewasahugegapinunderstanding.ForalthoughKiwisarenotbigchurchgoers,thevastmajorityconsiderspiritualitytobeimportant.ThisisconsistentwithmyexperienceandtheconversationsIhavewithpeoplewhenIcangetpastthereligiousanxietypresentinoursocietyandconsequentlyourhospitals.


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Wethoughtwe’dbetterstartaskingstaffwhattheythoughtaboutallthissoweconductedasmallsurveyattheendof2012.Oneofthethingsweaskedwashowtheythoughtwesupportedpatientsandfamilies.Overwhelmingly,staffthoughtweofferedsupportatdeathanddyingeventhoughtheyweren’tcallingustoassist.Thatjustaddedtotheconfusion.Whenweaskedwhatwasgettingintheway,itwasabitdispiritingbutalsorevealingtofindthatstaffdidn’treallyknowwhatchaplainscouldoffer.Thechallengewastobeclearaboutwhatexactlywewereoffering,andtoexplainthatinlanguagethatcrossedmultipleboundaries.Therewaslotsofroomforfreetextinthissurveysothatwecouldgetasenseofwhatstaffreallythought.Tofindthatspiritualitywasscarierforsomeofthemthanaskingaboutsexstartedtoputthewholethinginsomekindofperspective.Youcangetacopyofthesurvey:[email protected]


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Whatwasequallyfascinatingwasthatevenalthoughstaffsaidtheydidn’tunderstandspirituality,theywereabletooffertheirown,oftenerudite,definitions.Mostdidn’tmentionGod,Jesus,theBuddhaorMohammedbutinsteadusedmorecontemporarywordstodescribethesacred.Onepersongaveusthisstunninglist:Aboutthistime,asaresultofaspectacularlyunsuccessfulattempttogetbetterreferralsfromstaff,thechaplainsbegantogetinvitationstoattendmulti-disciplinarymeetings.Yippee,wethought.UnfortunatelytheprogresswasshortlivedduetoalegalinterpretationofaPrivacyCommissionerruling,whichmeantthatouraccesswasdenied.Thiswasdespitesigningthesameconfidentialityagreementsthatallstaffsignanddespiteourcontractsstatingthatwearepartofthemulti-disciplinaryteam.Backtosquareone.Wedecidedwehadtohelpbridgetheunderstandinggap.IdevelopedtheSpiritualityinHealthcareseminarforstaffandtookeveryopportunitytoattendstaffbriefingsandunitmeetingstotalkaboutspiritualityUsingthismethodI’vebeenabletospeakdirectlytoover200staff.Adropinthebucketwithastaffofnearly3000buttheysayadrippingtapgetsresults!


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Wetakeaverybroadapproachtospirituality,acknowledgingthatthisisadevelopingjourney.Recognizingthatevenhavingalabelisnotsofamiliaranymore.Weincludewide-rangingresearchthatpointstotheseismicshiftaroundspirituality,thegrowingdisconnectwithreligioustraditionsandthemovementtowardsspiritualindependence.Thisapproachinstantlyresonateswithstaff.


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Weredefinesomereligiousterms,connectspiritualwriterswiththehealthcareliteratureandbuildlanguagebridgesfromoneworldtoanother.Connectingiskey.WeencouragearangeofdefinitionsforspiritualityandaresoblessedtohavethisNewZealandresearchtoreferto.Youcanseemoreaboutthisonwww.spiritualityandwellbeing.co.nzWerefertoMaorispirituality,whichalsoholdsconnectivityascentral.


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Wetalkagreatdealabouthowspiritandsoultendtobehidden.HowinourKiwicontextwetalkaroundtheseissuespreferringtonatteronaboutsheepdogs,andfamilies.Butwepointoutthatthesethingsarepartofthespiritualdimensiontoo.Andsomehowitallconnectsuparoundthevulnerabilityofourmortality.Everyonegetsthatinaninstant!Usingtheacademicliteratureisvitalsothatwecanexplainhowdiversespiritualityis.It’snotlikegivingtwopanadolasneeded!Insteadit’sexploredandexpressedindifferentwaysindifferentplaces,oftenemergingthroughourlanguage.Hencetheimportanceofconversationaboutsheepdogs,rugbyandsailinginacountrylikeNewZealand.


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Butthepathwaytotalkingaboutspiritualityisstillabitproblematic.Idevelopedawayofexplainingthisthroughtheimageryofdoorwaysorportals,inpartbecausemanyofushavetravelledtodifferentlandsorwaysofbeingthroughtheliteratureormoviesofourchildhood.MydoorwaywasNarniasoIusethatasanexample.Fortunately,ProfessorElizabethMacKinlayhascomeupwithausefulspiritualitymodelinherbookPalliativeCareandAgeing.Iaminherdebtforthisimagethathashelpedsomanystaffunderstandhowreligioncanbepartofspiritualitybutnottheonlydoorwaytoultimatemeaning.

http://www.jkp.com/catalogue/book/9781849052900/review/Werecognisetheproblemofspiritualityasabsence.Notbecauseindividualstaffmembersarelackingincompassion.Farfromit,forIseetheevidenceofdedicatedcareeveryday.Instead,economicsandscientificrationalismsometimesdominateandpushotherlanguagestotheside,makingithardtoembedspiritualityintothesystem.


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ItwouldbeeasytopointacriticalfingerattheelephantsayingthatChristianityhastakenallthespaceintheroomwhenothersshouldbegettingachancetoofferspiritualcareinNewZealandhospitals.Ononehandthat’struebutifyoulookcloselyyouwillseethattheroomisverytatty.Thehealthcaresystemhasnotpaidattentiontohowtoembedspiritualityinasystemicway.Chaplainsdohavearesponsibilitytonametheabsencesandtopointtothestateoftheroom.Butlikeallpropheticworkthat’seasiersaidthandoneandtobefair,thefingermustn’tonlypointoneway.Chaplaincyalsohasaresponsibilitytothinkdeeplyaboutourownfearsforthefuture.Toseekoutresearchaboutthechangingscenesothattherearehonestconversationswithfundersaboutwhatthefutureofspiritualityinhealthcarecouldlooklikeinthebroadestsense.Forinstance,Christianityhasastronghistoryofmission.WhilsttheChristianchurchesmaynotharborlingeringhopesofthehospitalasmissionfield,plentyofpatientsholdthemistakenideathatChristianchaplainsaretheretoconvertthem.It’swhatappearstodrivesomeoftheresistancetochaplaincyinhospitals.There’sanuncomfortableconversationtobehadabouthowchaplaincyispresentedinthefuture.Languagematters.


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Andthenthere’sthebigquestionaboutwhocanofferspiritualcareintheNewZealandhealthcaresystem.JohnFigdoristhehighlyeducatedandvaluedchaplainatStanfordUniversity.He’sgotawaybetterdivinitydegreethanmineyethewouldnotgetahospitalchaplainsjobinNewZealandbecausehe’saHumanistandnotaChristian.JasonHeapwouldn’tgetajobeithereventhoughhe’sbeenaChristianministerbefore.HetooidentifiesasaHumanist.ButthinkbacktoallthematerialthatIpresentinourSpiritualityinHealthcareseminarsandalltheresearchthatIdrawfrom.Allofitpointstodiversewaysofunderstandingspirituality,beyondbutnotexcludingreligioustraditions.Andtherealityisthatsomeexistingchaplainsarecaughtinadescriptivebind,havingmovedbeyondaclearlydefinedChristianlabelbutunabletoexpressthatbecausetheirjobdependsonoffering‘Christianministry’.ChaplainXislikethis.Hedespairsthatthisoutmodedlabelingsystemunderminesthedevelopmentofauniversalspiritualhealthcareservicetothe88%flyingsoloinNewZealand,outsideofanyreligioustradition.


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Wehavetogopastwhatwe’vealwaysunderstoodanddonenomatterhowuncomfortablethechangeis.Let’sfaceit;courageisneededtoaskhardquestionsaboutwhatchaplaincyisachieving.Todosomein-depthresearch,nottojustifyourexistencebuttounderstandexactlywhatspiritualcareisneededforKiwistoday,howthatcanbedeliveredandwhowecouldpartnerwithtomakethatareality.Tobehonest,Ithinkwe’vealreadygonepastthechurchand/orparticularreligionmodelforchaplaincyinNewZealand.However,thereispotential.We’refortunatetohaveTeWhareTapaWha,awell-developedMaorimodelofhealththatholdsspiritualityascentraltoourexistenceandwellbeing.Butthisisonlythestartingpoint.Weneedthecombinedinputofawidevarietyoftraditions,religious,wisdom,philosophical,scientificandcultural,sothatspiritualityisnotanaddedextrabutacentralanddynamicpartofhowhealthcareworks.


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Wealsoneedasharedlanguageandanumbrellathatcanholditalltogether.IthinkKarenArmstrong’sCharterforCompassionframeworkprovidesthiswhenitsays:Theprincipleofcompassionliesattheheartofallreligious,ethicalandspiritualtraditions,callingusalwaystotreatallothersaswewishtobetreatedourselves.Compassionimpelsustoworktirelesslytoalleviatethesufferingofourfellowcreatures,todethroneourselvesfromthecentreofourworldandputanotherthere,andtohonourtheinviolablesanctityofeverysinglehumanbeingtreatingeverybody,withoutexception,withabsolutejustice,equityandrespect.WhenthegreatgodZeustoldhisdaughterPandoranottoopenthebox,hemusthavebeenwellawarethathernaturalcuriositymeantshewouldcompletelyignorehisgoodadvice.Andthankgoodnessshedid.Although,atfirst,alltheillsoftheworldthreatenedtooverwhelmher,hopeandanewwayofbeingwereeventuallyabletoflyfree.Pandoraisadelightfulrolemodel.Anychangetothestatusquobringsfear.However,toignoretherealitiesofthissituationis,Ithink,toendangerthedevelopmentofspiritualityinhealthcare,understoodtobeafundamentalhumanright.Andwhat’smore,everyelephantdeservestorunfree!

hospital chaplaincy beyond religious control

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