A Pastor's Guide to Hospital Visitation
Here's a short list of things this chaplain wishes pastors knew about hospital visitation. Trigger and Content Warning: Hospital and Hospital Related Care
Trigger and Content Warning: This post talks about different aspects of the hospital and has depictions of types of medical interventions.
I have been a hospital chaplain for 51 weeks. In the almost one year I’ve been doing this, I recognize there are a lot of things that happen in a patient’s room that I had no clue about before becoming a chaplain. This guide is written to pastors by a pastor-turned-chaplain.
In my limited experience, my estimation is that very few folks have ever been to the hospital because something is going well. Even in the midst of giving birth, there are challenges and risks and the potential for complications. For the most part, folks go to the hospital because they are sick, and we go to visit people in the hospital because they are sick.
In my work with pastors, I have found that there are individual challenges to going to see congregants in the hospital. It may be because they have had difficult or traumatic experiences either for themselves or for another. It may be because of how hospitals are portrayed on TV. It may even be for more theologically charged reasons. Being at the hospital can feel icky, scary, and difficult.
Intuitively, I think we know that there are different areas of the hospital but as part of this guide I want to explain a few. We are likely familiar with clinics (family practice, pediatrics, OB, etc.). These are where our primary care doctors are. Then there are specialists (heart, cancer, urology, etc.). There is the walk-in which is designed for non-life-threatening illness or injury (like a tick bite). Then there is the emergency department which is for bigger injuries (like a bear bite).
(this is a photo of a billboard outside a hospital in Montana)
There are lots of different areas such as labs for blood work, diagnostic imaging (xray, MRI, etc.) operating rooms, and some hospitals even have a chapel.
Then we have my main area of service, the medical floor. Sometimes called MedSurg (Medical Surgical) this is where folks who have an illness that need more care. Really sick folks are admitted to the ICU (intensive care unit) which has a smaller nurse-to-patient ratio. And then there are specialties in these areas in well-resources hospitals such as a NICU (intensive care for really little babies) and the PICU (for pediatric intensive care).
In my facility, my primary work is with the MedSurg, the emergency department, and the cancer clinic. I meet with patients, family members, community clergy, and other caregivers in these halls and rooms. There are plenty of studies that demonstrate how meaningful spiritual care is when folks are in the hospital. Caring for the spiritual and emotional wellbeing of your congregants is powerful, important, and has higher healing results.
And hospitals can feel sterile. There are different smells (I know it’s cancer clinic day because the stairwell smells different on those days), sounds, and sights. It is important to be aware of those things as to be supportive to those in our care.
The Sights, Sounds, and Smells:
Hoses and Tubes: There are hoses and tubes that go everywhere. And when I say everywhere, I mean everywhere. If there is a natural (or unnatural) opening, there’s a tube for that. Some are mean to help get medication or nutrition in. Some are meant to help get things out.
Sounds: There are things that beep, chirp, and sound the alarm. From IV pumps, blood pressure monitors, and oxygen saturation, lots of things make noise. Outside of patient rooms at our hospital we have LED lights that alert us to different things. One white light means a call light (patient needs assistance), the disco ball is a bed alarm (patient who needs help getting out of bed is feeling adventurous), and the double red light which I have come to call the “poop alert” is just the bathroom call button meaning someone might be done with a shower.
Smells: Fairly self-explanatory. But certain medications, treatments, and interventions can also have smells. Not all are gross, but some of them are. But those are not the only ones. Infections and wounds that require treatment can be unpleasant.
There was a young family who had just received news that their kid had a serious but treatable medical diagnosis. Because it was a kid, the church they were part of sent out the kid’s pastor to minister to the family. He tried his best and meant well. He offered prayers and scriptures and then wanted to meet a practical need and offered to bring the family a pizza. Searching his pants he realized he left his wallet at home and then asked the family if he could borrow money to go get them a pizza. Thankfully, the family was generous with both the money and also reserved judgement for this young pastor. But I think that points to pressure pastors put on themselves to perform all the extras. It is powerful to enter the room, offer supportive care, and just allow your attuned presence to be the gift.
As much as we, the visitor, might feel uncomfortable being around these things for a few minutes or hours, these are the lived reality for patients. They don’t always get the reprieve from the poking and prodding and so we muster our compassion to attend to care.
When I enter the room, I try not to ask the cultured question, “How are you?” They are in the hospital, that should tell you what you need to know. I like to ask, “How is your spirit today?”
This question does a few things for me as a chaplain. First, I give my name and my title, and then I state my intention: I am here to care for your spirit, if you spirit needs tending to. I have seen people with significant illness in wonderful spirits. I have seen people who are medically ready to go but emotionally stagnant. We don’t need to assume the worst, but we need to be ready to attend to the spiritual and emotional state of those we are seeing.
Share how you are experiencing the situation. Our cultural default is to apologize to someone when they are hospitalized. But unless you caused the electrolyte imbalance (or other reason they are admitted) there isn’t a need to say, “I’m sorry you are here.” I think that phrase is trying to get at how we feel sad, upset, or concerned. So use those words. Often times when I meet a family member of a patient in crisis I’ll say, “Hi, I am AJ, one of the chaplains here and I am saddened that we are meeting like this.” With the right delivery and empathetic approach, this is a sharing of compassion and empathy.
Most of the time a pastor is visiting a congregant because they have relationship. So lean into your relationship. You don’t need to ask a whole lot of questions, simply being present and attentive to the patient’s needs are enough. There are some situations and conditions that might mean a patient doesn’t quite feel themselves, so be supportive of where they are at and share in their hope.
A few other considerations:
Some hospitals have clergy parking. Use it.
Hospitals have visitation hours. Some are more flexible around clergy visiting but it’s good to call ahead to see if you can visit. Sometimes units will close down in the afternoon so the medical staff can provide the cares and interventions.
Sometimes doctors or medical staff will ask you if you’d like to step out for a few moments. This usually means a patient needs to be cleaned up.
Pray and offer support. Various religious traditions have rituals that are supportive of a person’s spirit. In the Christian tradition, we lean on prayer, communion, reading Scripture, and other rituals that support our connection with God and with each other. I’ve seen pastors bring guitars. I’ve seen native spiritual leaders offer smudging (burning incense). Hospitals want to accommodate religious and spiritual needs as we recognize our spiritual wellbeing can influence our physical health.
It’s okay to not know. There are a lot of times I do not know what the medical conditions are that patients are going through. And I don’t need to know. I am there to offer the emotional and spiritual support, and I hope the medical jargon doesn’t get in the way of how you offer care to those in your community.
The hospital setting can be challenging for a lot of reasons. I hope you’ll take on the task of going in to offer supportive care.