"I was sick and you visited me.".Matt 25:36
"O LORD my God, I cried to You for help, and You healed me" Psalms 30:2
Hospital chaplaincy is primarily concerned for the ill, including the mentally ill, the dying and incapacitated people.
Human beings can find it difficult to make sense of suffering and illness. When we experience illness, pain and despair, we come face to face with a mystery we do not fully understand. We, then, are challenged to re-assess our priorities in life.
From a Christian perspective the experiences of illness and despair can be opportunities for personal growth, and a time of being drawn even more deeply into union with God. Illness and despair can put us in touch with our own frailty, and challenge us to draw strength from the spiritual and pastoral resources within and around us. This is where the role of the chaplain comes into the picture.
Chaplains include four major areas of Pastoral Care in their ministry. They are:
Guiding means giving advice and helping people explore the questions they ask. When people are ill they often ask questions about the meaning of many things in their lives. Sometimes there are often difficult decisions to make about their health or about their future. Sometimes there are faith questions about death, forgiveness etc.
People often need someone to sustain them, to support them; a person who will listen to them.
A person may need reconciliation with themselves, with God, or with family. Again, listening, guiding and praying with people can help the processes of reconciliation to begin.
The chaplain can set up an emotional climate of peace so the body can do its own healing work more effectively. A chaplain may help people open up possibilities in their lives so they can receive strength from God, and from other people.
Australia and New Zealand
Within Australia and New Zealand some small case studies have been conducted on the role and work of hospital chaplains. Some basic descriptive research exploring the ‘sources of satisfaction and stress’ among New Zealand (NZ) Hospital chaplains noted that the main source of stress for chaplains was that of ‘carrying a heavy load of too many patients’ (Tisch, 1997). Other research has explored the involvement of NZ chaplaincy personnel in helping patients, families and staff to make bioethical decisions (Carey, Aroni, Gronlund, 1998). This research is still on going. Thus far however there has been no empirical research published in NZ to cross evaluate and assess chaplaincy roles with the type of institution or type of pastoral care to particular patients (eg, aged care patients). The NZ ‘Inter-Church Council on Hospital Chaplaincy’ is currently exploring the possibility of conducting empirical research among its contracted chaplaincy personnel.
The ‘AUS.CUR’ research conducted at the RCH Melbourne (mentioned earlier) explored the role of chaplains similar to that of US ‘Pastoral Care Survey’ (Carey, 1972). The ‘AUS.CUR’ research however included not only nurses and doctors but all allied health professionals totalling some 390 respondents (Carey, Aroni, Edwards, 1997). This research found that the majority of clinical staff affirmed all the roles of hospital chaplains as being appropriate within a medical setting but emphasized that there needed to be extensions to the chaplains’ role in terms:
(i) increasing their public profile beyond the traditional stereotypes, (ii) to assist staff with more productive teamwork,
(iii) to have a greater input on ethics committees and ethical decision making,
(iv) to be more forthright in personal presentation and
(v) to increase the number of chaplains to patient/staff ratio.
An additional issue arising from data derived from staff indepth interviews, was the need for ‘outpatient chaplaincy’ and home visits by chaplains – thus enabling follow-up pastoral care for recent or early discharged patients. The concept of ‘parish nurses’ and chaplains working together is also currently being explored to consider such a ministry (Van Loon, Carey & Newell, In Press 2000).
Other Australian research has also started to note the important input of chaplains. Preliminary findings from the ‘Liver Transplant And Pastoral Care’ research, conducted within three Australian Hospitals in different states (Queensland, New South Wales and Victoria), suggested that where chaplains are liaising and drawing patients, relatives and staff members together, the patients are more content and are being discharged at a faster rate than otherwise (Elliot & Carey, 1996). This research has not yet been completed. If the findings are fully substantiated the cost saving of having effective chaplaincy and pastoral care services could be very advantageous to all concerned and would clearly help to prove the cost efficiency of hospital chaplaincy (Carey & Newell, 1999).
The Westmead Brain Injury Rehabilitation Unit and Pastoral Care Department pilot research (Ireland, Carey, et al, 1999) which surveyed patients, relatives and visitors over a 12 month period indicated that ‘irrespective of gender, age, category status, or religious belief the majority of respondents believed the chaplaincy services provided were ‘very good’ or ‘good’ (96.3%)’. Also pilot research conducted at the ‘OLOC’ Aged Care Facility in New South Wales, likewise suggests that the majority of patients were very affirming of the provision of pastoral care services (Mulder & Carey, 1999). However, as indicated by such pilot research, there is a long way for health care chaplaincy research to progress in terms of research protocols, method, construction and testing of measurable instruments both descriptive and experimental.
Currently a national research project is being conducted under the auspices of the School of Public Health, La Trobe University, on the involvement of chaplains in bioethical decision making. This descriptive research, involving over 400 chaplains across Australia and New Zealand, will explore issues affecting both acute patients and aged care personnel such as the ‘withdrawal of life support’ (WLS), ‘not for resuscitation’ or ‘do not resuscitate orders’ (NFR / DNR) and ‘euthanasia’. The project was due for completion in 2000 or 2001. Like other chaplaincy research, progress is hampered by a lack of funding.