Hospital chaplains adjust to the new normal with COVID-19

COVID-19 has forced hospital chaplains to revamp how they do their jobs, including a greater reliance on technology.

Credit: Ralph Barrera

Credit: Ralph Barrera

COVID-19 has forced hospital chaplains to revamp how they do their jobs, including a greater reliance on technology.

The Rev. Beth Jackson-Jordan listened intently as the older man spoke about his dying wife of more than five decades.

His wife was in the ICU at Emory Decatur Hospital — but he was at home — unable to hold his wife’s hand, touch her face, or kiss her one last time.

In normal times, Jackson-Jordan, chaplain of Emory Decatur Hospital, would pray side by side with sick patients or with grieving family members, clasp their hands, wipe tears, and be a voice of solace.

But in the wake of a global pandemic, there is no normal for hospital chaplains like Jackson-Jordan, who are having to adjust to new ways of ministering to isolated, vulnerable and, sometimes, scared patients and their family members, as well as swelling ranks of medical personnel who are traumatized by a stealth enemy — COVID-19.

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The spread of the COVID-19 pandemic has affected all aspects of life, even for those whose calling it is to provide spiritual comfort. That’s meant prayers by phone, last goodbyes to dying loved ones by tablets and using other technology to bridge the forced, but necessary physical distance between patients and families and friends.

Chaplains also have to navigate seeing non-COVID-19 patients who need their support as well as those with the disease.

The Rev. Beth Jackson-Jordan, a health care chaplain at Emory Decatur Hospital, is finding the COVID-19 disease has changed the way she does her job.

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“This is happening all over. We’re trying to create a sacred space for important moments in life like end of life or the change in status of one’s health, but it’s gone from being in-person to being virtual,” she said. “We can still do it, but we have to look at ways to do it creatively.”

For the man whose wife lay dying, Jackson-Jordan prayed with him over the phone. She encouraged him to talk about what made his wife special to him.

His wife was very active in her church, he said. She had a strong faith.

The hospital staff had helped him use Facetime so he could be with her — at least virtually — before she died.

“It was very emotional,” said Jackson-Jordan, director of spiritual health for the hospital and the married mother of three adult children. “I imagined what that would be like for me.”

There have been many more COVID-19 patients she’s talked with and prayed over who were hospitalized and treated, and recovered.

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She’s had to introduce herself to novel coronavirus patients without any face-to-face contact. Before, a chaplain would meet a patient by request or a nurse’s referral, or the chaplain would visit and explain what they had to offer.

These days, though, she introduces herself by telephone in the patient’s room. Emory has developed a script to put patients at ease “so it doesn’t scare the person. It can be spiritually and emotionally challenging to be in the hospital and not be allowed any visitors.”

Jackson-Jordan, a Missouri native, grew up Baptist. She left a more conservative tradition because they didn’t allow women ministers, and she joined the more progressive Alliance of Baptists.

She was led to ministry after spending two years working with youths in a church in Guam while in college.

After seminary, she did a clinical pastoral education chaplain residency in a psychiatric hospital in Washington, D.C.

“I learned so much about spiritual care for those who are suffering with chronic mental illness and felt I came to know God in a deeper way through my relationships with the patients there,” she said.

Nothing, though, prepared her and other chaplains for the highly contagious disease that is filling hospital beds across across the nation.

The Rev. Amani Legagneur, manager of spiritual health and education for the Northside Hospital System. CONTRIBUTED

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Trace Haythorn cannot think of a time when the field had experienced such challenges.

“We’re paving this road as we’re walking it,” said Haythorn, executive director and CEO of the Atlanta-based nonprofit accrediting body, the Association for Clinical Pastoral Education.

Some parallels have been drawn with the early days of the HIV/AIDS epidemic, another mysterious illness that wrought devastation in various communities. Still, “that was very small in comparison to this,” Haythorn said.

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Chaplains have long had a presence in health care settings — from hospitals, to long-term care and hospice and in the military.

Haythorn co-founded the Chaplaincy Innovation Lab at Brandeis University with Professor Wendy Cadge. A 2019 survey found that 21% of U.S. residents had contact with a chaplain in the previous two years. More than half of those had the contact in a health care setting.

Recently, the lab and ACPE sent out a national call for volunteer chaplains, and more than 1,500 people responded. The call was in response to COVID-19, “because we heard from chaplains working in some of the hardest-hit hospitals in New York that they didn’t have the bandwidth,” said Cadge.

The Rev. Dr. George H. Grant, executive director of Spiritual Health, Woodruff Health Sciences Center, Emory University, said COVID-19 has forced hospital chaplains all over the world to rethink and retool how they do their jobs, and that sometimes means a greater reliance on technology.

The Rev. George H. Grant wears the blue coat that signals he’s an Emory chaplain. He said the novel coronavirus has put more pressure on hospital staffers, and he’s there to help patients, their families and health care professionals. 

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The current “no visitors” policy in most hospitals has made it very challenging for families and their isolated loved ones. They are using the phone, iPads, email, telechaplaincy and video conferencing platforms like Zoom to link the patients to their families, who can’t visit the patients for safety reasons.

To limit exposure to other patients in the hospitals, the Emory team has sometimes called Covid-19 patients from the hallway just outside their room to reassure them.

“Often our conversation goes like, “’I’m here and I want you to know I’m going to reach out to your family. I’m right here with the people caring for you and they are giving their very best to you,’” Grant said. “We assure patients that we’re doing all we can to care for them. We want to make sure that the patients and their family members are feeling figuratively held in this most challenging time.”

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The Emory Spiritual Health team consists of 46 full-time clinicians across 10 campuses of Emory Healthcare. All spiritual health clinicians are masters-level prepared at a minimum. Grant also has a PhD in psychology.

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They are onsite and in the treatment areas caring for patients who have Covid-19 and of course all those who are suffering from other illnesses.

“Our clinicians are led by the values that are important to our care-seekers. This may mean that a person is not religious but is appreciative of the emotional and spiritual support that we bring. If a certain faith tradition practice is needed that we cannot provide then we make the connection in the community and make sure that it happens,” Grant said. Staff support is the other priority.

Perhaps one of the biggest shifts in the spiritual health work is the increased attention paid to the emotional health of nurses, doctors and all medical personnel, but also food service, environmental workers and other staffers, who are feeling the increased pressure and concerns of the pandemic.

Grant says that this focus began even before COVID-19 as the industry noticed more and more hospital workers are experiencing burnout—a kind of emotional exhaustion. The spiritual health clinicians stand with doctors and nurses during huddles and shift change. “We listen and we encourage and we let our colleagues know that we are always there—24/7.”

Chaplain Michael Barber, left, blesses the hands of patient care technician Edna Knox at St. David's Medical Center on Tuesday May 9, 2017.  As part of National Nurses Week, the chaplains at the hospital blessed the hands of hundreds of nurses.  "It's a reminder that as caregivers at the hospital, their hands touch so many lives.  We're acknowledging the work of their hands," said Chaplain Michael Barber.  JAY JANNER / AMERICAN-STATESMAN

Credit: Jay Janner

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Credit: Jay Janner

Several years ago, the chaplains in the Emory system started donning long sky-blue lab coats that would identify them as clinicians and become a symbol of their presence.

The hope is that when a healthcare worker or patients sees the blue coats, “there’s a sense of calmness, even if we’re not talking directly to that person,” he said.

When walking through a treatment area, the chaplains will often place their hands over their hearts and say “thank you.”

“That’s one way to express to another that you are valued—my heart is with you and we are sharing in the burden of this cause—right now,” Grant said.

Help is also needed for the spiritual health clinicians themselves, who may share in the same anxieties as their healthcare colleagues.

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“We are not immune from the fears and exhaustion that comes from being this close to suffering. Overnight, many treatment areas had to become critical care units-which greatly intensifies the work throughout the whole hospital. During this Covid-19 crisis it has been important to have constant check-ins with our spiritual health team members.

“We cry together, we laugh together and we make space for recovery for another day. Many of us unwind by walks outside or connecting with family and friends on Zoom. We also need to be extra careful when we go back and forth from home. Letting our families share in our anxieties, and we in theirs, keeps us on track.”

Chaplains are an invaluable part of the hospital staff. They have been present after births, illnesses and deaths — whenever they were needed to provide comfort, compassion or encouragement.

“We run towards suffering,” said the Rev. Amani Legagneur, manager of spiritual health and education for the Northside Hospital System. “We want to be there, regardless of how painful what we encounter may be. We’re not averse to really difficult challenges.”

Several weeks ago, Legagneur moved toward more telechaplaincy.

She said some chaplains felt uncomfortable not being able to be with people face-to-face. Eventually, they realized that they were actually being more protective and considerate of staff and other patients.

“We had to step back and look at this strategically. It was more ethical not to be present so as not to bring the battle to the nurses, the doctors and other patients by possibly being vectors for this disease.”

She said in addition to patients, they offer to pray with staffers and really listen to their concerns and anxieties.

“We don’t mince words,” she said. “We realize everything is not roses and sunshine, but we want them to remember that there are roses and sunshine and hope in some areas.”