January 8, 2013 in Features, Health

Chaplain’s call

Internship reveals valuable lessons for living, dying
By The Spokesman-Review
 

Rebecca Nappi poses in the chaplain’s on-call room in the 644-bed Rush University Medical Center in Chicago.
(Full-size photo)

Modern chaplaincy

• To be a certified health care chaplain requires a theology master’s degree, a faith group endorsement and/or ordination and four “units” of clinical pastoral education at an accredited institution.

• Chaplains, trained non-denominationally, visit patients from all religious traditions, as well as patients who hold humanist beliefs.

• Most U.S. hospitals employ chaplains. The Joint Commission, the country’s main hospital accrediting organization, requires medical centers to accommodate patients’ cultural, religious and spiritual values and practices.

• About 450 health care institutions in the United States offer accredited clinical pastoral education. The closest program to Spokane and North Idaho is in the Tri-Cities.

• Demand for chaplains is expected to grow in coming decades due to hospital stays by aging baby boomers and increased use of hospice care; chaplains are part of hospice-care teams.

Source: The Association for Clinical Pastoral Education and staff research

From September to December, I took a sabbatical from The Spokesman-Review, moved to Chicago and completed a 12-week internship in chaplaincy at Rush University Medical Center.

Aging experts predict that some baby boomers now in their 50s will work at “encore careers” in their 60s and 70s, lured there by financial necessity and/or unfulfilled callings.

In the mid-1990s, I first heard a subtle call to chaplaincy. My brother-in-law and father died within two years of one another, and family members gathered for weeklong vigils at their death beds. It was sacred time, and in an editorial board meeting at the newspaper 17 years ago, I blurted out: “I’m going to be a hospital chaplain someday.”

I finished the theology master’s degree required for it in 2003, and this fall completed one of four required “units” of clinical pastoral education, the units combine class work and practical experience.

I’ll complete the other units in the future. Unlike most professions, age is a plus in chaplaincy work.

The second week at Rush, a cab driver, noting my chaplain ID, inquired about the program. I explained the requirements. He seemed surprised. “Why does it take so much education and training just to be a chaplain?”

“It’s harder than it looks,” I said.

In my 12 weeks at Rush, I learned a lot about dying and living, including:

• Our bodies need to last a lifetime

Newborns should be given a car with the understanding that the car, the only one they’ll ever own, is the outward sign of their bodies. They need to use the proper fuel, get regular tune-ups and drive sensibly.

Some of the illness I saw at Rush resulted from people neglecting and trashing their bodies. Obesity, alcohol and drug addiction, untreated mental illness were just a few of the “car crashes” I witnessed.

• That said, many patients were at Rush because of random occurrences.

I met patients with unrelenting seizures because they fell or got hit by cars and buses. I met people whose brains exploded due to aneurysms. I learned from them that lives change dramatically – and sometimes forever – in just a few minutes. Any illusion we have of control is just that.

• Still, it’s impossible to live life always counting blessings

Every moment of life is a gift. Even the sickest people I met – those rescued from the brink of death – complained about something. Hospital food, family members who failed to visit, the long wait to go home.

I learned that complaining, especially during recovery, is a fist against death. We complain because we’re alive.

• Code blues are dramatic in real life, too

When patients require immediate resuscitation, dozens of doctors, nurses and other health-care professionals rush to their rooms. To bring people back is messy, scary and often more violent than depicted in TV and the movies.

Chaplains at Rush are summoned to every code blue to support family members, and our presence sometimes added to the trauma, as if angels of death had appeared on the scene.

So we always said: “We’re here to support you. It doesn’t mean your loved one is going to die.”

• Inland Northwest hospitals should aggressively market the region’s stress-relieving activities

In the middle of the night during those code blues, I marveled at the doctors and nurses who worked hours to save a patient’s life. It sometimes took me days to recover emotionally after my 24-hour on-call shifts, and no one’s life hung in the balance of my work.

To blow off the stress, docs and nurses either would have to drink or engage in extreme sports, I concluded.

Inland Northwest hospitals already market the region to docs and nurses by touting the outdoors, but they should really pump up our mountains, lakes, rivers and running/biking/hiking culture. And mention our cool bars, too.

• True listening can be truly healing

We were trained as chaplains not to ask a lot of questions in patient rooms, or give advice, or talk too much about ourselves. We were there as a “non-anxious presence.” We helped patients identify strengths they possessed, despite their hospitalization and illness. And when asked, we prayed with them.

So patients were free to talk and talk and talk, and many did. Listening well is a discipline that requires intense practice. That’s one reason it’s so hard to be a chaplain.

• You can’t take it with you

I worked an on-call shift on Black Friday. In patient rooms, commercials and newscasts hyped the country’s biggest shopping day. The hype seemed ludicrous while visiting patients who wore simple hospital gowns. When patients died, nurses gathered up their belongings into one bag. It offered perspective on our cultural obsessions, including fiscal cliffs.

• Denial is OK

I met several family members who believed their loved ones would go home in a day or two, despite doctors and nurses explaining that their loved ones had just hours or days to live.

These family members were in big-time denial. But when their loved ones finally died, the denial died, too. And they seemed to handle the reality as well as better-prepared folks.

• People are not their roles

I left Spokane a journalist. The next week, I was Chaplain Becky. Moving from journalist to chaplain to journalist once again feels disconcerting, but I am heartened by the wisdom of Clayton Thomason, the chairman of the religion, health and human values department at Rush. He spoke eloquently in class one day about the difference between roles and vocations.

“The theologian Frederick Buechner defines vocation as ‘the place where your deep gladness meets the world’s deep need,’ ” Thomason summarized in a recent email. “A vocation is that path in life which calls us out of ourselves, to that place where our gladness meets the world’s need.”

Some people express their vocations in their careers. Others through roles they play in people’s lives as family members and friends.

Speaking of family and friends, keep in touch with yours. You’ll need them when you’re sick or dying. Patient rooms were often crowded with loved ones and close friends, but I rarely saw their coworkers or bosses.

• Push yourself in 2013

Years before I knew Rush was in my future, I read every mountain climbing and Antarctica adventure book I could find. I was never going to climb the world’s tallest peaks, or live in Antarctica, and the attraction puzzled me.

During my grueling on-calls at Rush – 24 hours carrying a pager that rarely stopped paging – I finally understood.

During on-calls, chaplains can walk 10 miles or more in Rush’s sprawling medical complex, responding to patient requests throughout the night. Sleep in the on-call room is rare and fitful.

Awakened in the middle of the night, I wondered where I’d find enough stamina to answer the page, and I drew upon those stories of women and men in Antarctica and on mountain peaks who pushed their bodies and minds to extreme. We’re all tougher than we know.

At the end of their lives, men and women often regret not taking more personal and professional risks. So this year, climb that impossibly high mountain – real or metaphoric. You’ll return to your old life in a new way.

And that’s what I learned in chaplain school.

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