The role of a chaplain in healthcare setting

Atsung Imchen
CIHSR Dimapur 

There may be varied ways to explain the role of a chaplain, depending on one's understanding and definition of what or who a chaplain is. While the common understanding of a chaplain, as defined by some of the well-known dictionaries are: "a clergyman in charge of a chapel, or a clergyman attached to a branch of a military or an institution, a person chosen to conduct religious exercises" (Merriam Webster Dictionary), "a priest or other Christian minister who is responsible for the religious needs of people in a prison, hospital, etc. or in the armed forces" (Oxford Advanced American Dictionary), "a chaplain is a member of the Christian clergy who does religious work in a place such as a hospital, school, prison, or in the armed forces." (Collins Dictionary); and while we hold on to these definitions, there are still many others, even including medical and healthcare staff who are unsure of the roles and contributions of a chaplain, and who very narrowly assumes that a chaplain's work is nothing more than going around praying for the sick as an all-time evangelist. 

As such, this short write-up attempts to highlight some of the roles of a chaplain in a healthcare setting from a Christian point of view taking into consideration, more of the experiential and practical aspects rather than the historical-theoretical perspective. 

The World Health Organization (WHO) defines health as "a dynamic state of complete physical, mental, social, and spiritual well-being and not merely the absence of disease or infirmity". While the first three dimensions of health – physical, mental, and social, are addressed by other healthcare professionals, the spiritual dimension is usually taken care of by a chaplain, thereby providing holistic care to the patients. This of course doesn't mean that other healthcare professionals can't provide spiritual care. 

There are numerous areas in a healthcare setup where the role of a chaplain becomes vital. 

1. Pastoral Care and Pastoral Counseling – The task of pastoral care involves everything from healing, guiding, sustaining (nourishing), reconciling (with God, with others, and with self), and nurturing. The healing here pertains to the healing of the inner being. Cure of a disease or a dreaded sickness may not be always possible. But there can be healing even in the most difficult situations. Healing then is being able to accept the reality that one faces, finding meaning and purpose even in that painful situation, and being able to express gratefulness and contentment and be at absolute peace within (especially the terminally ill patients). This is where the role of the chaplain comes – to lead them towards their inner peace and healing, through counseling and prayers. Statements like "I am ready to die", "I long for the day my God will call me home", "I am grateful for this life" etc are pieces of evidence of a person with inner peace and healing. This, I believe, is one of the hallmarks of a chaplain. 

2. Emergency and Trauma Care – The role of a chaplain becomes indispensable in an emergency and trauma care setup, where all the emergency and accident cases are encountered. The chaplain's role is to bring calmness to the situation, reassure the family members and relatives, and provide emotional and spiritual support to the families as well as the healthcare team. 

3. Palliative Home Visits – The chaplain is also a core member of the Palliative team that visits the homes of the patients for whom it becomes very difficult to come to the hospital. These are mostly terminally ill patients like cancer patients or stroke patients etc. The chaplain provides spiritual care and support not just for the patients but also the caregivers as well. Personally, this has been one of the most fruitful and rewarding experiences serving as a chaplain. 

4. ICU and Oncology wards – Most of the patients in ICUs and Oncology (Cancer) wards are patients who are almost dying. The role of a chaplain in such a set-up is to prepare them for a good and peaceful death, and also for their eternal life (Christian patients). Someone has rightly pointed out that chaplains are the ones who stand at the gap between the present and the future, between this life and eternity, between heaven and earth. Chaplains' role in such a context is sacred and should be held with reverence. 

5. Bereavement and Grief Support – Another very important and needed role of a chaplain is bereavement and grief support. As someone mourns and grieves over the death of their loved ones, the chaplain's role is to provide pastoral care and comfort to the grieving family members by conducting special prayers at the mortuary, preparing the coffin together with the family members, and sending them off from the hospital premises with a prayer. At times, the chaplains also help in arranging the coffins as well as the ambulance services. 
Moreover, the role of a chaplain extends even to the community members especially when any staff or staff's relatives expire, by visiting the bereaved families and providing comfort and support. 

6. Ethical Decision Making – The role of a chaplain also becomes crucial, especially in making ethical decisions at the end of life. Let me elaborate here – There was a situation where the healthcare team pronounced that the patient is brain dead (a person who is brain dead is legally confirmed as dead), whereas the patient relatives wanted to continue with the ventilator (artificial life support). So, the chaplain was called to explain the reality. With his intervention, the family finally accepted the reality and fate. All the family members were made to say their final goodbye before taking out the ventilator. Though it was an emotional rollercoaster, it was also comforting that the family members were ready to accept the reality and were very grateful for all the care that was provided to the patient till the very last breath.

7. Reconciliation - The role of a chaplain as a reconciler is three-fold. The first is reconciliation with God, the second – reconciliation with others, and the third, is reconciliation with oneself. As reconciliation with God and reconciliation with self, have been explained in the earlier points, let me elaborate on the second one – There was a girl who attempted to kill herself by drinking poison after she quarreled with her dad. The reason for the quarrel was that her dad didn't agree with her relationship with a boy who was a drunkard. She was admitted to ICU. When the chaplain was called to talk to her, the chaplain played the role of a reconciler by bringing the father and the daughter together and letting the daughter express and apologize to her dad. It was an emotional reconciliation. 

These are some of the roles of a chaplain in a healthcare setting, apart from the other regular activities. While many hospitals and healthcare settings have one or more chaplains, there are still many hospitals that don't have a single chaplain. As such, the spiritual aspect of care seemed to be almost completely ignored in such healthcare settings. However, with so much research being done and published, it is proven that the spiritual aspect of care is as important as any other. Therefore, the need and the role of chaplains become imperative, and as such, it needs a lot of support for this. 

In conclusion, while many view chaplaincy just as a profession or a job, it is much more than that. For me, it is a calling! A calling to partner in the wonderful ministry of God. And in that, there is no greater joy than to help someone find true meaning, joy, peace, healing, and comfort in their times of need.