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Health care chaplains can be underutilized unless other members of the health care team understand their role. To help doctors, nurses, and other caregivers know when and how a pastoral care professional can help a patient or family, Margaret McClaskey, MDiv, director of pastoral care and ethics consultation at Rush Northshore Medical Center in Skokie, IL, devised a list of reasons to call pastoral care, along with a short description of pastoral care. She distributes the list at medical staff meetings and nursing and resident orientations.
Here are her 11 reasons. You may want to add your own:
1. When a patient is anxious or fearful of surgery, therapy, or medical procedures. A chaplain can help patients and families identify the sources of their fears and find strength to face their circumstances through their faith, other meaningful ideas or value systems, or spiritual resources from the community.
2. When a patient needs comfort. Nursing staff can provide comfort and consolation to patients and families. When these needs become an increasing concern for staff, however, a chaplain can provide a comforting presence. A chaplain also can contact a patient’s place of worship for additional support.
3. When for no known reason a patient doesn’t respond to medical treatment. A chaplain can help patients identify the meanings they assign to their condition or pain. A chaplain also can help patients resolve fear or guilt that may be working against the physician’s efforts to treat physical symptoms.
4. When patients and/or families have major health care and treatment decisions to make. Surgery/no surgery; code/no code; treatment/no treatment; respirator/no respirator. These are examples of the many decisions that can be influenced by unspoken and spoken beliefs. A chaplain can help the doctor, patient, and family members consider the meanings they give to various health care options and make decisions they can accept.
5. When a patient’s way of life must change following an illness. Heart attacks, debilitating illness, amputation, loss of a child at birth, and many other circumstances require changes in a patient’s way of life. A chaplain can offer patients and families the stabilizing influence of spirituality, resources for hope, and an opportunity to find meaning in their changed lifestyle.
6. When a patient has a long-term or terminal illness. A chaplain may be able to help the physician decide what to tell patients or family members, as well as when and how to tell them. A chaplain can work with patients and families as they try to understand and accept the prognosis.
7. When a patient is dying. A chaplain can help families deal with the news, begin to accept the impending death, and find a source of strength, hope, and comfort. A chaplain also can ask a patient’s faith community to be an additional source of comfort and support.
8. When a patient is admitted in a traumatic or emergency situation. A chaplain can keep the family members advised about the patient’s condition, surgery, and admission. A chaplain also can give emotional support while families wait for news.
9. When a patient has died. A chaplain can provide ministry, support, and comfort for families during bereavement.
10. When it is time for a family to consider organ or tissue donation. A chaplain can provide information about organ donation choices while helping families explore spoken and unspoken beliefs that may affect their decisions.
11. When hospital staff are having difficulty with the circumstances surrounding a particular case. Patient circumstances often affect the staff, especially when staff become attached to a patient and family, when difficult ethical decisions need to be made, or when staff are reminded of their own life circumstances. A chaplain can help staff express their feelings, identify the meanings they have given to a situation, provide support and comfort, and, if necessary, refer them to the employee assistance program for additional help.