Hospital visitation: What pastors should know

Ten ways to increase the effectiveness of pastoral ministry to those hospitalized.

Delmar Smolinski is a hospital chaplain at St. Mary's Medical Center in Saginaw, Michigan.
William Rabior is a hospital chaplain at St. Mary's Medical Center in Saginaw, Michigan.

Visiting the sick in hospitals is an important mandate of pastoral ministry. It provides an opportunity to minister to people who are vulnerable and needy and, in the process, become an instrument of God's healing touch. However, in carrying out this ministry, it is essential that pastors remember some useful pointers that will enhance their visitation ministry. Here are ten of them.

1. Be aware of basic assumptions in pastoral care. Every person's life has a spiritual dimension. For some this spiritual aspect may be clearly defined in terms of religious beliefs, worship rites, and denominational affiliation. For others it may not be so defined. Nonetheless, this spiritual dimension affects the course of life a person takes. Consequently, every human being has a story to tell and needs someone to tell it to.

Another assumption is that it is both God's will and basic to the human instinct that we be without sickness—that we be whole persons. Psalm 34 expresses this by reminding us that God wishes to be close to the broken-hearted and extend His healing power for those crushed in spirit. Indeed, Jesus came to this world that we might have life to the full (John 10:10).

Wholeness is never fully attained in this life but is an ongoing process of transformation and growth that reaches and is finally accomplished beyond this life. In the words of one recent visitor to our hospital: "All healing is not on this side." Another person, a patient, said that whether there was a physical recovery or not, either way she was going home/Home.

A third assumption is that prayer is a genuine source of power in striving for wholeness, promoting health, and keeping patients and their families positively focused on healing. Recent medical research has acknowledged the complementary power of prayer in the treatment of patients.

Finally, an array of religious leaders from various traditions have served as exemplary sources of inspiration and healing throughout history. No one has a monopoly on God's Spirit. For Christians, of course, the Master Healer is Jesus who, as the Gospels tell us, spoke with authority and accomplished numerous faith-filled healings of body, mind, and spirit. When a pastor visits the sick and injured, the recovering and the dying, he or she visits in the name and under the commission of Jesus Himself.

2. Be aware of the consequences of being hospitalized. First, separation is one consequence. A patient gets separated from home, family, friends, work, and the security of normal, daily routines; and anxiety begins to set in.

Second, disintegration. The patient experiences a feeling of falling apart and losing control of life and self. Questions about one's goodness and worth may arise. Concerns about one's personal identity, family relation ships, employment, and mortality may surface as well.

Third, psycho-spiritual paralysis. A sense of helplessness and hopelessness may creep in and overwhelm the patient, leaving the per son unable to adjust to illness and the limitations thereof. It may prevent them from seeing any or enough light at the end of the tunnel. However, these consequences of hospitalizations can be countered and overcome by significant doses of faith, hope, and love— qualities that endure and make life meaningful (1 Cor. 13:13).

3. Be aware of your attitude toward death. What has your experience been regarding the death and loss of loved ones? Was it a painful or a blessed event? Are there still unresolved relational matters? Are you still grieving? Have you discussed your own advance directives (durable Power of Attorney for Health Care or Living Will)? Does anyone know your preferences about organ donation? These and other questions may be very significant in the setting of the terminally ill person.

Increasing your own personal death awareness can enable you to break free from the unspeakableness of death and allow you to live life more intentionally and more in tune with the end-of-life questions patients and their families may be struggling with at the time of your visits. It is a matter of recognizing, as psychologist Carl Rogers has suggested, that facts may be painful at times, but they are always friendly. In other words, painful as some subjects may be, they are nevertheless a means of discovering the truth.

4. Pay attention to the stress level in your own life. Stress is at the foundation of much sickness in today's fast-paced world, particularly in the areas of cardiac, neurological, onco logical, and abdominal suffering and pain. A certain amount of stress is normal in life and often is the catalyst for positive development and growth.

However, too much stress can lead to the harmful depletion of physical, emotional, and spiritual energies, leading to burnout.

Visiting the hospitalized requires that you be in relatively good health yourself, if your pastoral care of others is to be effective and fruitful. Having an appropriate sense of humor about yourself and the foibles and vicissitudes of life is one way of checking the pulse of your own stress level.

5. Pray for and with patients and families. Along with medicine and surgery, prayer and Scripture are integral parts of the treatment and healing of patients, be it formal or informal prayer, ritualized or spontaneous prayer, spoken or silent prayer.

Prayer is God's way for humans to invite God's power and grace to meet the pastoral needs of patients and to build vital, positive relational structures. Prayer opens the doors of hope and healing. However, while visiting the patient, if the person is asleep or unconscious and the family is not present, leave a written note, your calling card, or your church bulletin to let them know that you visited. And then, pray by yourself. Let God do the rest.

6. Be aware of the patient in the next bed and his or her family. Like the parishioner you have come to visit, the patient in the next bed also has spiritual needs, and occasionally you may be able to address at least some of them. Persons who share a hospital room often listen longingly as a visiting minister prays for their roommate, wishing that someone would visit with them and that prayer would be offered for them as well.

It is perfectly fine to ask the patient in the next bed, "Would you like to pray along with us, or would you mind if I offered this prayer for you, too?" Many times that patient and his or her family will be open and receptive to prayer and will be grateful that you included him or her in your praying.

Prayer is often appropriate; proselytizing rarely is. If the patient in the next bed asks for information about your church or denomination, you certainly can provide that information. But deliberately trying to win that patient over to your faith without an invitation to do so is inappropriate in that setting and may create bad feelings which can in turn make future visits uncomfortable for everyone.

7. Practice the practical. Every hospital adheres to its own standards: precautions for the well-being of everyone in the hospital. Visiting clergy would do well to adhere to them too. For example, to prevent passing on any infection to the patient you are going to visit, washing hands is always a good practice before seeing a patient. This is particularly imperative if you have been in contact with blood or other body fluids.

You might be asked to wear a mask, a gown, and gloves, especially if you are called to a sterile area such as an operating room, or are entering a room in which the patient is in isolation. Remember this is to protect both the patient and you.

Don't visit patients if you have flu or a cold. Be careful about what you touch while in the patient's room. If you see something that concerns you, for example, a soiled hospital gown on the patient or dirty linen, inform the hospital staff.

Many clergy who regularly visit hospitals make it a point to get an annual flu shot as well as other inoculations such as those which protect against Hepatitis B or pneumonia in order to increase their immunity.

Behind all this is the matter of helping the patient get well and also keeping us clergy healthy.

8. Make use of the hospital chaplain. Many hospitals employ well-trained chaplains. These can be valuable allies when you visit your sick parishioners.

Chaplains are there to assist and not interfere, so don't hesitate to contact the chaplain during the time your parishioner is hospitalized. They know full well that a person's faith and faith community can play a vital role in the recovery process. Their goal is to harness the power of both for healing.

Chaplains recognize that collaboration with community clergy is some thing good and desirable. They are there as colleagues, not competitors. The hospital chaplain is in a position to visit your sick patient during times you are unable to be there. In addition, as part of the interdisciplinary team treating patients, the chaplain can become an advocate for addressing their needs and also a liaison to both the family and the community clergy.

As hospital chaplains we regularly join clergy in prayer for their sick parishioners, and strive to assist them as best we can. For example, the visiting clergy person may have questions or concerns which we are often able to address and sometimes rapidly resolve. Chaplains are there to serve, and are always glad to have community clergy contact us and draw upon our expertise for the benefit of sick parishioners.

9. Maximize your ministry. You go to the hospital primarily to minister to sick parishioners, but God may send other people to you who are also in need of your services. We have already mentioned the patient in the next bed. In addition, the family members of the person you are visiting in the hospital may actually be in greater need of your ministry than the patient you have come to visit.

The illness of one family member may overstress the rest of the family. Physical, emotional, and spiritual exhaustion can set in. You may be able to nurture and nourish them spiritually.

Your ministry during crisis times such as a serious illness can be instrumental in helping a family cope. Illness often brings feelings of helplessness and hopelessness, and a pastor can help both patients and families draw upon spiritual resources, so they are empowered to face what ever happens.

We also cannot forget the hospital staff. Everyone from a physician to the person cleaning the floors can benefit from a pastor's kind words, a smile, or a willingness to really listen. When we allow God to work in and through us, we may be pleasantly surprised at how many people are touched, blessed, and helped through a simple hospital visit.

10. Maintain confidentiality. Protecting the privacy of patients and the confidential information related to them has always been important. Patients have the right to release or prohibit the release of information about themselves. Their decisions must be respected.

The hospital will generally disclose to clergy that a certain person is a patient and where they are in the hospital. They will also usually provide basic information about the patient's general condition without going into specific medical issues. If the patient chooses to restrict even this amount of information, then nothing can be divulged. This approach may seem unbending and uncooperative, but clergy must remember that it is what the patient has requested.

Because of an increased emphasis on safeguarding patient privacy and confidentiality (in the United States, at least), it is important that clergy be cautious about discussing sick patients with others. A clergy person should get permission directly from patients or their families before print ing any names in church bulletins or before reading patients' names aloud in church, even when the congregation prays for the sick.

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Delmar Smolinski is a hospital chaplain at St. Mary's Medical Center in Saginaw, Michigan.
William Rabior is a hospital chaplain at St. Mary's Medical Center in Saginaw, Michigan.

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