Hospital chaplains direct the spiritual healing of end

On his first day of training as a chaplain at UC San Diego Health, the Rev. Matthew Valdez joined the hospice team. His first patient died.

Shaken by the experience, Valdez was nonetheless inspired as he prayed with the patient’s daughter. Although he didn’t know much about the role of a hospital chaplain before, he became convinced at that time that he was meant for this work of helping the sick, dying, and those suffering from trauma of all kinds.

“Being with people in crisis, at any stage of illness or crisis, speaks to me,” recalls the Protestant minister. “It fills me with energy to help people in difficult situations.”

Valdez is part of a team of board-certified chaplains from various faith traditions who work in UC San Diego Health departments and facilities. The team cares for patients, their families, and medical and administrative staff.

He and his colleagues are also representatives of the chaplain teams at hospitals and medical centers throughout the San Diego area, says Allison Kestenbaum, certified educator and supervisor of Spiritual Care and Clinical Pastoral Education at UC San Diego Health.

Although chaplains are often integral members of hospital care teams, their role is not well understood even by hospital staff. It is often assumed that chaplains serve only openly religious patients and families, but chaplains say they are there for everyone, regardless of religious background, even if they have no faith.

“Chaplains are spiritual advisors,” explains Kestenbaum, who is Jewish. He points out that the kind of specialized pastoral care that chaplains offer is only minimally taught in seminaries and religious institutions. “Although all chaplains are associated with certain religious or spiritual traditions, not all clergy or religious are chaplains.”

“The range of human experiences and suffering is imminent in healthcare,” he continues. “We dominate the healthcare system, so one of the things we do is act as interpreters: we understand the things that we can offer patients because of our long experience, and we want patients and their families to understand what is happening.”

And while patients and their families may not specifically request religious advice, chaplains can offer the most important service they need: a listening ear. Chaplains provide patients and their families—regardless of their age—an important opportunity to reflect on their fear of dying, their loss of dreams and expectations, and the chance to explore their spirituality, he notes.

“We feel very comfortable with silence,” he says. “That’s where the pain comes out. There aren’t many places where you’re celebrated for sharing your losses. We allow people to express themselves and heal themselves.”

Kestenbaum oversees a team of seven chaplains, four of whom are full-time. “Chaplains are non-anxious, non-judgmental people who have the ability to be still, especially in a place like this, which is not a still place. Chaplaincy is not for everyone, but these qualities can be cultivated.”

His board-certified training program requires 1,600 hours of instruction, many of which were spent working under the close supervision of chaplains.

“I am proud and admire how my team consults with each other when difficulties arise,” she says. “We have a culture of consultation and support.”

For the Rev. Ryan Sey, the only full-time chaplain at Rady Children’s Hospital, it is the variety, immediacy and importance of his work that he finds especially satisfying.

“There’s this idea that chaplains are only for the religious,” says Sey. “We’re really here to offer spiritual support to everyone, and that support is defined as anything that helps us make sense of our lives.

“For some people that can be a religion or a belief in a higher power,” he continues. “For others it may be their job or what they do in the world; can be anything. A lot of what we do is listen. We help families find meaning in what is happening to them.”

As soon as a chaplain walks into a room, Sey says, they assess what the patient and their family need, regardless of their religious tradition. “We are here for everyone,” he says. “Chaplains come from all traditions. We ask ourselves ‘how can we support this family?

“Most days we work on crisis intervention, trauma and end-of-life situations,” he adds. “My friends who are church pastors think I have a difficult job. But my work is specialized and brief: once I pick up a family spiritually and send them out into the world, they return to their own faith communities, where the long-term healing work is done.”

The COVID-19 pandemic meant relentless end-of-life care for chaplains, including the newly released Valdez, who learned how to express his emotion while fully clothed and masked.

“Back then I was a new chaplain and I felt challenged by the number of deaths I had to attend to on a daily basis,” he recalls. “Currently, we are in a new normal. We see COVID all the time, but we have adapted to it.”

The pandemic, in fact, helped him in his training.

“It made me a better chaplain,” he declares. “I think getting through 2020 forced me to return to my church community and forced me to lean more into my own spiritual practice. It can be motivating for someone who has to offer spiritual care to so many people in so many crises.

“I can’t sit idly by in my own spiritual practice,” he says. “I must be intentional.”

Surprisingly, chaplains have one of the lowest burnout rates in healthcare, Kestenbaum says.

“It has to do with our view of the world, which helps us make sense of what we experience,” he observes. Effective chaplains are often tied to contemplative traditions and communities, praying, meditating, or making pilgrimages to recharge.

Kestenbaum says that chaplains are integral members of healthcare teams. They can participate in hospital rounds and advise hospital staff in a crisis, as well as care for patients and their families.

At their locations in La Jolla, Encinitas, Chula Vista, and San Diego, Scripps Hospital chaplains, of various faiths and denominations, provide a wide range of services, including caring for and accompanying patients in last hours of his life and spiritual resources, such as devotional material or the daily communion of Eucharistic ministers.

Also the team of chaplains at Sharp Grossmont Hospital works “to promote harmony and healing of mind, body and spirit,” says its website.

Achieving that harmony is difficult for those in crisis, but helping patients and their families achieve it offers immediate results, Sey says. In parish ministry, ministers do not always experience the immediate effects of their work.

“It can be a long time before you see the fruits of your labor,” he says. “Here at the hospital, as soon as I walk out of a room, I can see the benefits.

“We immediately see how things have changed,” he continues. “Not only do we work with a team whose members are incredibly diverse in terms of religious tradition and cultures, beliefs and specialties, but we work side by side to support families in all facets of their healing.

“It’s what I like the most: At the end of the day, we do what’s best for families and patients.”