Category Archives: Training

On the difference or Equivalence of Pastor/Chaplain

Is There a Distinction that Needs to be Drawn Between a Practitioner’s Playing the Role of Pastor or that of Chaplain?

I was a bit bemused by the persistence of the tendency to Bible-thump one’s way through any such discussion

I recently engaged several colleagues on the question of chaplaincy or pastoring. I was a bit bemused by the persistence of the tendency to Bible-thump one’s way through any such discussion, while advocating an interfaith approach as advanced by the adherents of the CPE agenda. I thought I’d share my contribution to the discussion.

listen-with-heartIt is my contention that we should not advance the notion of a “versus” or “as opposed to” when discussing chaplaincy or pastoring. While it is true that some traditions, the Hebrew and Islamic, for example, eschew the notion of “pastor” or “shepherd” for cultural or traditional, even ethical reasons, in the broader sense all chaplains are in fact “pastors,” while all pastors (in the conventional sense) are not necessarily “chaplains” (or critically speaking, even pastors!). In fact, I object in principal to the biased terminology we so frequently use in our vocations, “pastoral care” department, because it tends to be exclusive. I personally prefer spriritual care provider (although in my professional materials I do use pastoral care). Moreover, most people, even those in the vocation, tend to associate pastoral with pastors and thus with some sort of clergy or ordained service provider (usually with no questions asked and we all know about the profanation of ordination); that in itself is a misfortune for all concerned. But the much-touted CPE doesn’t do much to clarify the issues for interns or residents, and we still see chaplains “certified” by the self-proclaimed arbitors of chaplaincy who are just as ignorant after several years of “education” as they were before.

A case in point is taken from the scenario presented by the initiator of the discussion who describes walking into a Jewish patient’s room with a Christian clerical collar, which I characterized as benign “ignorance” but in reality was outright insensitive and would indicate that the “chaplain” in question did not do any initial preparation before launching out on rounds or visitations.clerical collar pc I might fraternally suggest that in future, whether you are a chaplain or a pastoral care associate, to check the chart briefly or dialogue with the nurse assigned to that patient before you visit. The offending chaplain actually says that he was aware that the patient was dying and had no family, so it seems rather odd that the chaplain did not appreciate the patient’s faith tradition and, if it wasn’t in the chart, that he didn’t consult with the immediate caregiver (nurse or LPN).

I also questioned the fact that the visiting chaplain was aware that the man was “Jewish”. Being Jewish immediately identifies one as being associated with a certain cultural, socio-religious tradition, after all, one does not call one’s self “Jewish” except to identify one’s self as a Jew.  So this also raises the question of whether the chaplain in question was indifferent to the possibility that this dying man might have welcomed a visit by a rabbi, or that the chaplain did not make or offer to make a referral. Such sensitivity may have been a great comfort to the man, who might have found great refuge in his tradition and prayers. So I identify a boundary issue in this behavior, too; an issue of knowing one’s limits.

This situation also sends up red flags in that it clearly indicates that the institution did not do a spiritual assessment of this patient, much less a spiritual evaluation or history, which also reveals a glaring ignorance of the now widely inaugurated JCAHO and HIPA scoring categories relating to patient spiritual care.

The scenario I describe above should be instructive to us all and I thank the so-called chaplain for the inadvertent teaching/learning moment he has provided.

Finally, in the dying process I don’t feel there’s a heck of a lot of “pastoring” left to be done, unless it’s for the survivors. In my experience, in end-of-life situations I am more of a presence and spiritual guide/companion. While that may arguably be part of pastoring in a general sense, I feel that the actual mission of pastoring contrasts in praxis with the mission of spiritual accompaniment at end-of-life or in an existential crisis.

plant in handIt’s rather like the difference between evangelization and catechesis, if you have that in your tradition. One takes care of the basics and gets the seed started (evangelization), the other (catechesis) ends in the care and nurturing to harvest time.

Listening to hearAnother colleague mentioned in a rather cliché fashion with which we are all familiar when listening to the CPE crowd, that CPE trains one to listen. I disagree with such responses such as “CPE “teaches” one to listen.” I’m not quite sure how that works but in my divinity training and three years of supervised pastoral formation, and my participation in and disappointment with a rather popular CPE program in a large trauma center in Albany, New York, which fell far short of even my minimum aspirations, I don’t think that people can be “taught to listen” they may listen, but they don’t listen deeply. I know that from experience the deep listening skill comes from deep within one’s self, once one is comfortable with one’s self, and can leave one’s self for the time it takes to absorb and process the patient’s narrative. It’s that kind of listening that might be part of qualifying an aspirant to be spiritual care provider but it certainly isn’t the be all and end all.

The serene face of the large Buddha his long wise curvaceous ears at once loving and open to the woes of the world: Compassionate.

The serene face of the Buddha, his long wise curvaceous ears at once loving and open to the woes of the world: Compassionate.

Deep listening is the act of sinking into a serene quiet place, and awakening a receptive awareness of the other. By entering quiet and becoming aware of the other, we move out of and beyond our ego-driven chaos to become open to the divine messages within us and shared with us by the other. Imagine the irony here is that we so often complain of the pain of not having been heard, but we are so guilty ourselves of being deaf to, not hearing the innate wisdom from within ourselves and shared with us by others. When we learn to accept emptiness, when quiet, we instinctively trust in the guidance of sacred voices far more profoundly than what our bullying brains and the busy buzz of life would have us hear. And we listen, respond with silence.

In fact, having examined quite a number of CPE curricula and having developed continuing quality improvement curricula for the healthcare chaplaincy department, I find that the current CPE programs and their associated certification elements serve only to promote a burocratic and very branded form of “pastoral” care, and that branded product falls short of most suffering persons’ real needs. helpingIt’s the proprietary nature and standardization (viz. uniformization, homogenization) of the learning that deals the death blow to an appreciation (1) of the universal truths and values shared by all human beings, (2) the beauty in the diversity of traditions and how to appreciate and be enriched by a certain mutuality, (3) the possible pitfalls of an interfaith approach to faith traditions that may adhere very loyally to their dogmas. There are other reasons I could enumerate but regrettably (or fortunately for the readers) space is limited.

I think that an overwhelming majority, too, of CPE students come with excess baggage and too little self-death–I’ve observed interns, residents, even certified chaplains who have a great potential to do considerable damage…and do. The situation is not unlike seminary, you can do much to scrutinize, to form, to standardize but Whoa! when you turn them loose on the world, watch out! (A Roman Catholic diocesan priest, who also serves in the chancery tribunal, remarked ironically to me one day, “They’ll ordain anybody these days.” Which is probably true given the shortage of priests today.)

The so-called supervisors of the CPE programs almost invariable have their own biases and agendas, and these tend to impair good formation.
In some, not all instances, too, CPE programs have become “pay-to-work” programs in which minimally screened individuals, wet behind the ears and green, are turned loose on the floors to deal with sophisticated staff and human beings in existential crisis. I don’t feel that’s right. And I have also observed that interns are exposed to the same curriculum content for three or four years, and unless they have the academic predisposition to independently advance their armamentarium of experience through narrative and study, many don’t build their foundations. Some interns do not have theology or pastoral studies to help them through the necessary processing, and almost all have a depraved Western bias to their spirituality that tends to act as a speed bump when offering care to Non-western recipients. These programs tend to be “chaplain mills.” CPE does not fit the bill on its own to form professional, well-rounded spiritual care providers, but does excel in churning out multitudes of volunteers for greedy institutions. That may be one of the reasons it has survived this long.

On another level, some practitioners involved in the discussion advocated that the “Gospel” or, by extension, holy scriptures, has no firm place in chaplaincy. I do differ in that the fundamental ethics of the “Gospel” (not as understood principally by the evangelicals or fundamentalist among us) is a major part of chaplaincy. servant leadershipI cite particularly the beatitudes and the teaching of discipleship and servant leadership (chaplaincy is certainly not limited to the sick and dying but to the suffering generally). While I abhor the notion, and even more so the practice of proselytizing to captive audiences, and would hasten to emphasize that evangelization and catechization is not a fundamental role of the chaplain, ethics, discipleship, and servant leadership all play a special role in the myriad activities of the professional chaplain. (Note also that I do distinguish between the “professional chaplain”, the pastoral/spiritual care associate, and the visitor providing spiritual support.) To advocate that the truths and values espoused by the “Gospel”, the holy scriptures of any faith or spiritual tradition might have no place in chaplaincy is to advocate a position, I believe, of a chaplaincy practice devoid of ethics (and religion) (I do realize that this is a particularly “Christian” approach and my Judaic, Islamic and Buddhist colleagues may not necessarily agree with the religion-ethics statement, but I make the statement here somewhat loosely for convenience sake).

I’m not judging colleagues in chaplaincy or Clinical Pastoral Education too severely at all. In fact, I’m simply sharing my own observations and opinions based on personal experience. I am not a bit surprised when some readers tend to take these observations personally, as if they were meant to make an ad hominem stab at the straw[wo]men of CPE; I usually anticipate that persons in our line of work have a bit more self-awareness not to take every facially severe remark as a lancet thrust to the heart, however.

Rather than play an offended person’s role, perhaps we all would benefit by admitting that we may have learnt something about one’s self as through another’s eyes.

We Respond, We don't React.

We Respond, We don’t React.

Our role is to humbly respond, not to knee-jerk react. After all, to paraphrase the prophet Martin Luther King, Jr.: ‘We are all wrapped in the same cloth…when we directly hurt another we indirectly hurt ourselves.” (I do hope I did that statement justice!). So, when one party to the conversation called such a response arrogant, and a failure to simply accept some responsibility in relationship to colleagues’ responses, I merely responded, “My point indeed. The mouth loves the feel of words.” Instead we minimize, rationalize and justify our behavior, making certain to protect one’s self. This particular correspondent insists that “our patients have thick enough skins to handle a collar.”panda overload My response was tantamount to the fact that I don’t think that we have any right to expect patients to have “thick skins.” Some practitioners in pastoral care seem to admit patients’ strengths but underestimate their sensitivity and vulnerability. Many of the patients I see have lost their thick skins and in fact are pretty bruised in terms of dignity, autonomy, fortitude, patience, etc. I see no reason to add another straw to the pile. And Yes! It’s not about us, it’s about patient-centered, family-focused, inter- and multi-disciplinary care.

bedside prayerWhen we adopt such an approach we appreciate that, whereas many of our colleagues practice their spiritual care ministry in acute care settings or in crisis settings, many colleagues may find themselves–particularly in the scenario of the long-term care setting–in the position of playing both the role of chaplain and pastor to some residents in those longer-term care facilities. Regrettably, many of these residents lived their lives unchurched or churched with infrequent interaction with their faith community; more regrettably, some faith communities have disappeared or simply no longer continue a ministry of visitation of the sick and homebound who were once part of their faith community. It’s in such situations that the chaplain may very well become the pastor, and have to function in both roles. I don’t feel that this should be a major stumbling block nor even a concern to the well-formed spiritual care provider, who is responding to a true call to spiritual care ministry.

We're all wrapped in the same cloth...

We’re all wrapped in the same cloth…

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Where Have They Been for the Past 20 Years?!?

After Having Made More than 200 Written Inquiries to Healthcare Facilities in 4 counties in Central New York, My Conversations with Persons in Charge of Pastoral Care in Their Institutions Have Been…SHOCKING!

OMG!!!

Since the late 80’s volumes have been published on the subject of the importance of spiritual and emotional care to patients in crisis, patients with chronic conditions, patients and residents in long-term care facilities. Much has been written about the positive effect of competent pastoral care and emotional/spiritual support palliative care and the hospice movement. Surveys, empirical and evidence-based studies and research have provided the methodological and statistical and scientific support showing that pastoral care, spiritual and emotional support is sought by patients, has positive effects on outcomes, complements the medical/technological/physical care and treatment provided, and is an integral part of multidisciplinary, interprofessional, holistic health care. The data’s there, the vangards are promoting the good news, but healthcare administrators, CEOs, COOs seem to be missing the bus on this issue. Where have they been for the past 20+ years, one has to ask?

Well, there are a number of reasons for the failure of administrators and executives to have missed the message. Yes, they claim to attend conferences and workshops and seminars on every conceivable subject, but they are worlds apart from the wards, the dramas that play out on a moment-to-moment basis, the writing and sealing of living, human documents. These executives rarely, if ever, seek the honest inputs from those in the trenches, and are highly unlikely to be aware of complaints when they are made. Seems they’re too important, too busy taking care of business and relegating human care to the foot soldiers.

That’s the impression I have gotten from two rounds of inquiry with almost 200 hospitals, nursing and rehabilitation centers, and funeral homes. Yes, funeral homes. You’d think that with the hospitals and nursing homes dropping the spiritual care ball, the funeral homes would pick up the pieces. But not at all. The funeral director is in the business of selling services, too, and once the remains are out of sight, Job’s done! Pay up and go forth and grieve!

The bottom line is: The preliminary findings is that most healthcare institutions do not have a pastoral care program or even anything close. They continue to bring in visiting clergy, questionably fit lay ministers, untrained inexperienced volunteers and put an untrained unqualified person in charge of the “pastoral care services.” It’s pitiable but it’s true!

The saying goes: “You can lead a horse to water but you can’t make it drink.” But what’s mind-boggling is that the horse knows it’s thirsty and when offered water still refuses to drink. Go figure!

An Illustrative Case

I received a call today from a large healthcare system and had the opportunity to discuss pastoral care, spiritual/emotional care with the VP, marketing and public relations. That may seem like a real opportunity but I found it a bit odd that the hospital administrator directed my letter regarding continuing quality improvement and pastoral care to marketing and public affairs. Nevertheless, I ran with it. I wanted to see where this was going to go.

What did you say? (OMG! Why me?)

What I learned from the conversation with the VP, a woman who admitted not only to being VP for marketing and public relations but also to being supervisor of volunteer services, including what she thought was the pastoral care program, as well as overseeing several other ancillary services. Red flags went up. These people don’t have a clue!

This was no small fish. CMH is a general medical and surgical hospital in central NY, with 258 beds. Survey data for the latest year available shows that 32,764 patients visited the hospital’s emergency room. The hospital had a total of 6,755 admissions. Its physicians performed 1,206 inpatient and 2,776 outpatient surgeries. Outpatient visits: 309,767, Births: 518. In fact, with its satellite outpatient and long-term care facilities it is likely one of the largest healthcare institutions in at least two central New York counties.

The conversation got off to a rather deplorable start when she assumed I was ignorant of the healthcare setting and commenced to describe how when a patient is registered s/he is asked about religious preference. “If the patient wants to give that information s/he can but if they don’t, well, they don’t.” (That’s the extent of their spiritual screening, assessment, etc.) She proceeded to tell me that the information they do harvest goes into a list … Here I had to interrupt her and tell her that I am familiar with the usual hospital routine and the hospital census as well as HIPAA provisions regarding access to the hospital directory. Shall we move on, please?

I’d rather not describe the entire discussion. Suffice it to say that it was rather typical for most institutions: abominable ignorance about what a pastoral care program is or should be, reliance on unqualified or poorly qualified, part-time staff who provide spiritual care (for example, the spiritual care coordinator is an English teacher, but she “does have a MA in English.” And her spiritual qualification? She’s married to a pastor. That’s like having my physician’s wife, who has a MA in Art, do my colonoscopy! Breathtaking!)

This organization also has a pastoral care coordinator who “contacts and follows up with commuity [visiting] providers.”

And what training or inservices to you provide to staff and providers? “Rabbi F. from the large local Hassidic community comes in and talks to staff about religion, diet, etc.” Well, that’s a comprehensive program if I ever heard of one!

I mention HIPAA, the Joint Commission scoring categories for pastoral care and spiritual and emotional support, and the Title 10 NY code regarding spiritual and emotional support to customers. “We’re not accredited; we do what NY law requires.” Appears that CMH is not JCAHO accredited and the VP, Public Relations & Marketing didn’t seem to think that incorporating or applying industry standards was important. Au contraire, mon amie!

This is where my conversation partner starts to get defensive: I ask whether any of these people have any training in theology, pastoral care, divinity. “No.”

This ain’t gonna work!

But this raises not only the question of what on earth are these off-the-street amateurs offering to patients in spiritual and emotional crisis but also the question of the ethics of offering healthcare (Yes! Mabel, pastoral care is healtcare and the professional chaplain is considered to be a healthcare provider. Read the regs!) by untrained, incompetent persons. This question follows on the heels of my VP friend responding to my question about ethics training for pastoral care associates by telling me, “We have an ethicist on staff. And we have an Ethics Committee of about 20 people, I’m one of them.” Omigod! We’re doomed!

By this time I realize that this woman’s defensiveness is escalating and she’s not hearing, not listening, and is begging to get off the hook. Finally, I opt for mercy and suggest that I send her some extracts from my Continuing Quality Improvement and my Standards of Practice for Pastoral Care, and that she  review them and get back to me when convenient. (The relief on the other end of the line is audible, almost palpable.) So, I thought I saved us both the agony on continuing the conversation in a language one of us didn’t understand.

My initial reaction was sadness that such ignorance would prevail in the institution and, by extension, to its satellite and affiliated healthcare facilities. (In fact, I did a year of supervised pastoral formation at one of their nursing homes and can attest that the problems are system-wide in this organization. There pastoral care (religious/spiritual/emotional support) was run by the activities department!)

As soon as I mention that I have observed that CMH is in the same boat as most other institutions in the area: No clue what pastoral care is nor the impact on quality that such a service deficit might have, I hear the tone and the mood change. I ask myself, “Why are you contacting me? Is it just to tell your CEO you spoke to me as requested? You’re not interested one iota in pastoral care nor in what your customers need!” Yes! That’s the impression that was made on me.

Do you have similar experiences? Please share them with us. In the meantime, I’ll keep pluggin’ on. Remember: We are sometimes the only advocates for those suffering and we have a sacred duty to be a voice for them. Peace!

Does Interfaith Require a Denial of Faith?

Hear with your eyes; see with your ears!

Hear with your eyes; see with your ears!

A colleague recently raised a very relevant and poignant question, one which I think we in pastoral and spiritual care care ministry to the sick and dying have had to face and which, and in my experience, receives only marginal and very inadequate attention in divinity formation–naturally because most divinity formation is denominationally oriented–and clinical pastoral formation–because in the programs to which students are farmed out the supervisors are of one denomination supervising a variety of denominations (and generally ignorant of the philosophy, theology, tradition of most of the students’ traditions because the program is “interfaith”). There may be several reasons for the “neglect,” the first being ignorance of and opposition to alternative or conflicting traditions. Most of us have been inculcated very early in our faith formation, and certainly in the context of some agendas inherent in divinity programs, by the notion that we are the “elect” and the “others” just haven’t yet gotten it right. I personally deplore that exclusionist attitude as much as I abhor Marcionism or supercessionism. But it’s there, and what it brings to those who have occasion to be in regular contact with other faiths and traditions is the gnawing anxiety that somehow, by ministering to the “others,” we may be injuring our own faith or, as my colleague stated it, “does interfaith ministry require me to deny my own faith?” or to deny something essential to or in our own spirituality or faith life.

My response to the question was and continues to be that “interfaith” doesn’t require the minister to “deny” anything at all but invites us to participation and relationship.

This is where, I think, good formation, training, seasoned with generous life experience, helps a lot. We are most uncertain, feeling we’re on thin ice, as it were, where we are poorly prepared, unsure of our own feelings or potential responses, or where we expect we should have an answer or a fix-it. We as pastoral care providers need to give ourselves permission–as part of that self-care thing–to be uncertain, to be insecure, to ask probing questions of ourselves about what we believe and how we believe, to go dry once in a while. Every great saint (read “saint as in moral model of living” in any tradition) has experienced this.

If we have “faith” we have it. It may not always and at all times be as strong as at others and there are crests and troughs–anyone who truly believes in anything has questioned it at one time or another–and we, rather speaking for myself now, I have sometimes asked myself “What’s the use!?!” only to turn around and remember that I am creature! I am the bearer only of the message–and that message may only be one of silent presence–, the receiver has the decoding book in his/her heart that will reveal his/her Truth, the meaning.

Unity in Diversity!

The recent (by “recent” I mean in the past 5 decades versus the past 5 centuries) efforts and movement towards interfaith dialogue and communion/unity speak volumes to us in pastoral care, and allow us to be more open to other faiths and traditions, recognizing the shared and appreciating, respecting, tolerating the perhaps conflicting aspects. Our personal faith is al lthe richer for appreciating and accepting others’ perspectives and how what for Christians is the Holy Spirit reveals the Godhead thru those perspectives. As in the case of science and Holy Scripture there’s no conflict at all–it is only human beings who inject conflict–and here I’d like to refer to Calvin’s theory of the two books. Science and Holy Scripture complement, buttress, affirm each other as revelation. So, too, do other faiths and traditions and we as pastoral and spiritual care providers are in the unique position to tap these resources, to adopt and adapt some of them,  but we must do so without anxiety for what we fear we might have to lose but anticipation at what we have to gain. This requires an open and receptive heart and mind.

And a generous dose of humility and charity wouldn’t hurt.

Finally, the interfaith symbol is a good focus for reflecting on what I’d like to call the circumincession or perichoresis of interfaith ministry; it’s a dynamic movement within and into the various faiths and traditions, denying nothing, incorporating everything.

Addendum: A collegue just commented on my posting: “You made me smile there. There is a line toward the end of the movie “The Polar Express”, where Know-it-all Boy is going on at Santa about the first gift of Christmas. Santa looks at him says “Young man, patience. And a smidgen of humility might also serve you well.” How true!

I’ve found that the Chaplains group on Linked In has some very worthwhile discussions.

Interfaith? Supervision?

What’s Interfaith? While the notion of holistic care that supports mind, body, psyche, soul is nothing radically new, it has attained some level of vogue in recent years. But it has not been made clear what exactly institutions mean when they throw the term around, as they are wont to do, however. Seems like it’s the new trendy word that has supplanted the notion of “non-denominational” but is much more arrogant. Non-denominational at least meant that it didn’t cater for any particular denomination (presumably of Christianity but could conceivably be extended to any religion, if understood broadly as a denomination). Interfaith, on the other hand, is much bolder, more arrogant, and flies in the face of any meaninful signification. In fact, interfaith could mean “in between faiths” or “catering for all faiths.” Either the one or the other is wholly illogical, and that’s why both the patient and patient families and the pastoral care provider have to be very cautious when approached by anything “interfaith.”
Even the emblems used by “interfaith” providers appears a bit exaggerated and gives the impression that interfaith can do it all. It can’t.

Here’s an illustration: In many of today’s non-denominational or secular care facilities, whether the secular hospital or nursing care facility, if it has a pastoral care or religious services presence, will usually characterize itself as “interfaith,” and its chaplains as “interfaith chaplains.” Total rubbish. And it’s more self-aggrandizing and misleading than it is comforting to those receiving the “care” from such departments. First of all, it doesn’t take into sufficient consideration the uniqueness of each faith’s tradition and spirituality. Second of all, it presumes that a Buddhist can provide adequate care to a Lutheran, and that’s simply not so. Or a mainstream protestant can provide adequate care to a Buddhist or a Hindu. The Jewish and Moslem traditions have caught on and pretty much take care of their own, preferring a rabbi or an imam. That’s very understandable under the circumstances. But what about those religions that are pretty rare, like Buddhists, or those suffering shortages of clergy like many Christian denominations?

Someone saying, “I’m the chaplain,” can mean many things. Moreover, many of the chaplains most patients and patients’ families see in most institutions are actually interns or so-called residents, trainees. Many of these people have little or no formal training in ministry, pastoral care, spirituality, theology, ethics, much less education and training in comparative religion or religious ethics. I even worked with persons who had never even been to a funeral let alone accompany a family in an end-of-life situation, or counsel a family when making a withdrawal of life support decision! It’s embarrassing!

But it gets worse! In a supervision conference during my own training, one so-called “chaplain intern” was relating an encounter with one of the patients in my care, whom he had seen during the night while acting as on-call “chaplain.” The parents asked about baptism for their dying son, an adult, and my colleague went on about what he explained to them about infant baptism–the patient was 37years old!–and adult baptism.

Pseudo-Theologian

The intern’s theology was total rubbish and all he proved was that he knew absolutely nothing about the theology of baptism (and he was studying divinity at a leading school). Ultimately–thanks to the intern’s catechesis–the parents opted not to have their son baptized. The man died unbaptized, the parents got an “edu-muck-ation” of sorts, and I had an opportunity to practice extreme humility…and deep prayer! The pitiful part of this is that the so-called supervisor said nothing at all, despite being an ordained RCA minister! At times, on direct inquiry by patient or family, we must respond with pastoral guidance based on life-experience, formation, training, interreligious/interfaith/intertradion respect and appreciation, and much extracurricular study; this was a regrettable example of putting the ignorant in a position of immense gravitas and having him drop the pastoral ball.
Another travesty: In my same group of interns (Albany Medical Center, Summer 2011) there was a Canadian female professor, allegedly teaching “theology” (but her description looks more like an excerpt from a feminazi catalogue). She came from humble and abusive stock, had a number of really shoulda-been-disqualifying psychosocial issues, was totally unprepared for ministry…BUT…was apparently an “Anglican deacon” and soon to be “priested.”

The “curette” or is it “curate.”

But even as a case-worth-further-study she was turned loose on patients and families. She attended a patient and her family on one of my units during night on-call. When I visited the patient and her family the next day they behaved rather bizarrely. We had a relationship so they soon told me what was bothering them. The parents were reserved in their description of this “Anglican deacon” or “that woman” as they put it; the daughter (the patient was less kind, calling the intern a “hovering freak”). I brought this up to the supervisor who did nothing. On several occasions I found her “ministering” to families of patients on my units in the waiting areas. She even “introduced” me to families to whom I was ministering for days. I regret not being able to reproduce for you the looks the people gave her, and their comments on the Vicar of Dilby that followed. On another occasion, the family of a young African-American patient on one of her units flatly refused to have her in the room; the family insisted that I minister to the dying young man. Staff thanked me for being there instead of the other intern. The unit paged me to attend to the family, who requested me specifically, since it was expected the young man would die within the hour. Out of courtesy I contacted the lead chaplain for the unit, my colleague the “Anglican deacon,” who forbade (which was her prerogative) me to continue ministering to “her patient and family” on her unit; the young man died that same day. In personal supervision I related the case to the supervisor (who was already made aware of the situation), and noted that the incident was tragic but foreseeable. The intern had no clue about the family, their needs, their desires; it was all about property rights. The so-called “supervisor” cast a blind eye to all of this. The outcome was far from “interfaith” and much less pastoral care.

And then there’s the sundry “digruntled” Cathlick. This is apparently a new variety of Catholic who had to announce at every didactic session to each new speaker not that she is just a Catholic but invariably a “disgruntled Catholic,” as if that made her something special in the eyes of those present. She invariably had to distinguish herself from the apparently run-of-the-mill “gruntled Catholic.” She had to identify herself as a species of Catholic or a Cathlick, CINO (Catholic In Name Only). Invariably a middle-aged female, needful, dragging her baggage from bedside to bedside. And because of her needfulness, requires special attention and gets it; while putting everyone else on edge with her neurotic idiosyncrasies. (We had one of these in my group and she was allowed to complete her CPE unit apart from the group, receiving special personal supervision from the so-called supervisor). She could play a part as “interfaith” pastoral care-giver that she could not licitly play in real life, that is, outside of the hospital. A travesty.

But think of it this way: The departments providing the “training” get paid, the institution gets reimbursed by Medicare or Medicaid, the trainees get a unique experience, the department managers and staff get big heads. Everyone wins…well, almost everyone. But it’s really about the reimbursement and the prestige of having a chaplain training program on site–but that’s all that counts, isn’t it? There’s something dishonest, unethical about this. Don’t you think? Therefore…

You must always be skeptical. It’s a shame but it’s true. Things are not always what they seem and it is in your best interest to ask questions and insist on transparency. If someone appears at your or your loved one’s bedside, find out who they are. Ask questions like what is your religion? Where did you study? What do you expect to do for me, my loved one? How do your expect to help us?
I realize it’s difficult to have the presence of mind and the wherewithall to ask such questions in such a stressful situation but why accept an amateur for pastoral or spiritual care when you’d expect a specialist for medical or nursing care. Is you earthly well-being more important than your eternal essence?
Pastoral and spiritual care is one of the most important support services available to patients and families in critical situations. It would be foolish to refuse it or not to make the best of it. You deserve the spiritual and emotional care a good chaplain can provide; so does your loved one. Whether it’s prayer and teaching or simply silent presence; whether it’s performing a complex religious ritual or simply holding hands, it’s good medicine and even science has shown that it works in positive ways. Accept it if offered, but make certain it’s authentic and can provide what you need.

Read about my own interfaith internship experience.

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The Interfaith CPE Experience

Interfaith Intern Receives 1 CPE Unit

I’ve been reading a number of interesting comments on Interfaith chaplaincy on the professional blogs. I’ve reproduced my own experience of my Interfaith Internship at Interfaith. Read about the travesty of interfaith CPE at a mid-sized acute care facility, and some of my experiences of so-called “supervision” and some questionable interns.

My CPE Group & Supervisor

Nutty History

CPE Co-Founder?

In the mid 1920s, the new form of theological education known as Clinical Pastoral Education developed out of the risk-taking of Dr. William A. Bryan, Superintendent of the Worcester State Hospital, Worcester, MA when he employed Rev. Anton T. Boisen, a former mental patient, to become the hospital chaplain. Thus the research interests of this Congregational /Presbyterian (he called himself Presbygational) minister became the motivation that initiated clinical pastoral education. Anton Boisen had been hospitalized for psychotic breaks from 1920 to 1922, and during the hospitalization, he felt a calling to “break down the dividing wall between religion and medicine.” He believed that certain types of schizophrenia could be understood as attempts to solve problems of the soul. He invited four students, to spend the summer of 1925 with him at the hospital. One of the four, Helen Flanders Dunbar, subsequent a pioneer in the field of psychosomatic medicine, came as a research assistant. Dr. Flanders Dunbar later became the Medical Director of the organization of clinical programs called the Council for Clinical Pastoral Training of Theological Students in New York City.

Read more at CPE History.

Pay to Work?!?

Silly me. Having finished up an MDiv at a Roman Catholic school of theology and ministry and having completed two years of supervised pastoral formation (SPF), I decided to do a third year of SPF on my own and participated in a remarkably rewarding 10-week intensive unit of clinical pastoral education in a local hospital. It was the crown and the epitome of pastoring.

As I mentioned, the experience was unparalleled. (Although the supervision part left a great deal to be desired and the colleagiality of my fellow chaplains was a bit bizarre, to say the very least, but I thought of their sociopathologies as part of the training.)

I was generally setting up my day by about 7:30 a.m. and generally didn’t leave until after 5:00 p.m. in order to finish my charting and referrals. Sometimes, I’d put in 12-hours and more just to ensure that the patient or the family were not left in the lurch and to ensure continuity of care.

Then I came across the article The “Great American Internship Swindle” in Newsweek. It’s an article specifically on interns and intern abuse. Only then did I give a thought to the $750.00 I dished out to work as a chaplain intern.  I also learned that the hospital was paid or reimbursed for providing spiritual care. I made some inquiries with several agencies, including the hospital, to verify that they received reimbursement or payment of some sort for chaplain services but no one seemed to want to answer my question.

It comes rather as a surprise that given the “training” content of the internship, the pastoral care work that was done, and the fact that residents and other pastoral care staff were all paid to do what I was actually doing, that we should still have had to subsidize the opportunity to work for the hospital.

Any thoughts or shared experiences would certainly be of interest to me and our readers.