A spiritual care consult order came in from a unit I was covering.  Annie, a nurse on the unit, noted that Ingrid, an elderly woman in her care, seemed lonely and anxious; Annie thought she might benefit from someone to talk to.  Annie is delighted when I arrive and takes me in to see Ingrid.

“Hello, Ingrid!” she announces brightly.  “The chaplain is here to see you.”

“I didn’t ask to see a chaplain,” protests Ingrid.  “Why would I want to see a chaplain?”

“When we talked this morning,” Annie replies, “you agreed it might be helpful to have someone to talk with.  That’s why Chaplain Greg is here.”

“Yes, I did say that, but I didn’t say I wanted to talk to a chaplain.”

“Oh, don’t worry, Ingrid,” Annie smiles.  “He’s not THAT kind of chaplain.  Trust me, you want to talk to our chaplains—they’re the best!”

“If you say so …” Ingrid relents feebly.  Annie executes a quick about-face and heads out the door.

“Greetings, Ingrid,” I begin.  “Annie’s right, I don’t have any agenda, I’m just here to offer you company.  You don’t have to talk to me at all if you don’t want to, it won’t hurt my feelings.  It’s entirely up to you.”

“OK … but I don’t even know where to begin.”

“Well, you’ve clearly lived a long life, and I’m sure you’ve got stories to tell.  What would you like me to know about you?”

“I was born 94 years ago in a small town in Norway, north of the Arctic Circle,” Ingrid begins, and she is off and running with what we call “life review”—including positive memories of her Lutheran upbringing, a faith that fell by the wayside when she married and moved to the U.S.  It was amazing and heartwarming.  Acknowledging that her life is now nearing its end, she accepts this with equanimity and gratitude.

“I realize I’ve talked your ear off,” Ingrid concludes as she begins to fade, “but I do feel much better now.  So this is what you do, listen to people like me?”

“We do many things,” I reply, “but listening is the most important.  If people have religious or spiritual concerns, we are certainly there for that.  Often, though, people just need to talk to someone who really wants to listen.  It can be healing for them, and in return we get to meet wonderful people like you.”

“So now I know.  If that’s what chaplains do, you can come by any time.”

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Ingrid’s reluctance to visit with a chaplain was not at all unusual.  I once had a man shout “OUT!” the moment the word “chaplain” left my lips.  More often, people smile nervously and say, “No, thanks, I’m fine” when they sense religion might be on the agenda.  It’s unfortunate, but I can’t say I blame them.

Our children were born almost 40 years ago in a Catholic hospital, with a crucifix displayed prominently in each room.  The care we received was wonderful, but each time before discharge a nun, calling herself a chaplain, came by to perform a blessing on our babies.  She didn’t ask about our beliefs, and her agenda, not the desires of the newly expanded family, was the focus of the encounter.  We told her, “No, thanks, we’re fine.”

I know of many chaplains who struggle in workplaces where the other chaplains celebrate the number of souls they save for Jesus, despite training that emphasizes the need for respecting the faith traditions—including no tradition—of those they serve.  Even worse, a movement has recently emerged to place “volunteer chaplains” with no formal training in schools and other public institutions, with an explicit goal of proselytizing.^[1]  No wonder the word “chaplain” sparks trepidation in many who hear it.

I’m happy to say I’m not that kind of chaplain, and neither are my colleagues.  We seek to put the patient (and/or family) and their needs at the center, and let them guide us toward the type of care that will be healing for them.  That begins with helping them feel safe to speak from their heart, without fear of judgment, much less a religious pitch.

Patients who want prayer or other religious care are usually direct about it, and we are always delighted to inquire about their faith and practices and offer care aligned with their preferences.  More often than not, though, the patient’s needs and wants are less obvious, so we try to approach in a way that is open and inviting.  Often, as with Ingrid, a patient may have no issue with religion, it’s just not what they need or want at that time. 

But many patients have a difficult relationship with religion, whether from being judged or abused in the past, or from feelings of shame regarding things they have done.  In such cases an explicit religious association can shut down a conversation before it ever gets started.  Once a patient feels safe, though, it’s not unusual for them to steer the conversation toward religion or spirituality, and to take a step or two toward healing their own religious trauma.

If one searches online for “chaplain images,” the vast majority of what pops up is explicitly religious and overwhelmingly Christian; while I am very much a Christian, I’m just not that kind of chaplain.  I selected the photo that opens this post because it represents the kind of chaplain that I seek to be:  down in the mess of life with my patients and my fellow care providers, meeting people where they are and offering them a distinctive kind of care they just might really need, even if they didn’t know it.

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[1] “Some state lawmakers want school chaplains as part of a ‘rescue mission’ for public education,” AP News, March 29, 2024