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Pastoral Care Services

Gail S. Mansell, Director, Chaplain, FAPA, BCCC, BCPC
Wendy Mindte, Chaplain
Supportive Care & Pastoral Care Services
Eric Olson, Chaplain
Supportive Care & Pastoral Care Services
Bruce Purpura, Chaplain
Supportive Care & Pastoral Care Services
Volunteer Chaplains:
Reverend Carl Mosley
Reverend Daniel McKenty
Elder Graison Wainwright
Mary O’Neal, Chaplain
Kelly Owrey, Chaplain
Lora Pangratz, Chaplain
Catholic Communion Ministers:
St. Mary’s Star of the Sea/Holy Savior
St. John Neumann
St. Lukes/St. Andrews

Providing Emotional and Spiritual Support

At Atlantic General Hospital and Health System, a team of 2 fulltime chaplains, a part-time chaplain and 7 compassionate volunteer community clergy from a variety of religious traditions, are available to provide patients and families of all faiths spiritual care, sacramental ministries, emotional support, end of life support, Advance Directive consultations and other support services.

For much of the world, physical health, emotional and spiritual wellbeing are inextricably intertwined. Consequently, many individuals from diverse backgrounds do not respond well to care that does not incorporate the spiritual dimension. Many U.S. health care providers are now gradually recognizing the importance of spirituality in health and healing. More than 50 U.S. medical schools now offer elective courses in spirituality. Our partnership with faith-based organizations in our community and Pastoral Care Services helps us incorporate spirituality into the delivery of care, thereby achieving the World Health Organization vision of health.

An interfaith family chapel for private prayer and meditation, open 24 hours a day, is located on the second floor of the hospital on the North side. Patients, families and associates are welcome to join us in the family chapel as we host brief services of prayer, reflection, and meditation for renewal of our souls and healing.

If you are a patient, a family member or friend of a patient, or an associate, the hospital Chaplain is available to provide emotional and spiritual support. To speak with the Chaplain, arrange a visit, or to request a spiritual caregiver for a particular faith tradition, please call 410-641-9725, weekdays from 8:00 a.m. - 4:00 p.m., or ask your nurse or any member of your Health Care Team to contact us by phone. On evenings, holidays and weekends, please ask your nurse or the Patient Care Supervisor to contact the on-call chaplain. Our patients’ and families’ personal clergyperson or faith community leader is always welcome at the hospital and Pastoral Care can assist as a liaison to facilitate community clergy visits.

Demystifying Spiritual Care

Holistic health care entails caring for the whole person, comprising three interrelated parts: body, mind, and spirit. We experience spirit, just as we experience our minds and bodies, and this is called spirituality. Although there are several dozen definitions of spirituality,1 healthcare practitioners are forming a consensus regarding spirituality’s central aspects: meaning, purpose, and connectedness. The following definition captures this well:

"Spirituality is a dynamic and intrinsic aspect of humanity through which persons seek ultimate meaning, purpose, and transcendence, and experience relationship to self, family, others, community, society, nature, and the significant or sacred. Spirituality is expressed through beliefs, values, traditions, and practices.”

Spirituality Versus Religion: Religion is “an organized system of beliefs, practices, rituals and symbols designed (a) to facilitate closeness to the sacred or transcendent (God, higher power or ultimate truth/reality) and (b) foster an understanding of one’s relationship and responsibility to others in living together in a community.” Spirituality and religion were once so intertwined that trying to separate the two seemed pointless. This is no longer the case. Today, the number of people with no religious affiliation is increasing. In 2017, more than a quarter of U.S. adults (27%) identified themselves as “spiritual” but not “religious,” up from 19% in 2012. In short, all religions are expressions of spirituality, but not all expressions of spirituality may be tied to religious beliefs.

How does spirituality affect our well-being? The World Health Organization defined the four dimensions of well-being as physical, social, mental, and spiritual health. The spiritual dimension “is not material in nature, but belongs to the realm of ideas, beliefs, values, and ethics that have arisen in the minds and conscience of human beings, particularly ennobling ideas.” The spiritual dimension plays a significant role in our health, well-being, and quality of life.

What is spiritual struggle or distress? Illness can cause spiritual struggle or spiritual distress, “a state of suffering related to the impaired ability to experience meaning in life through connections with self, others, the world, or a superior being.”

A health crisis—experienced first-hand or by a loved one—can challenge a person’s entire belief system or view of life. The negative emotions we experience and express during a health crisis are evidence of our spiritual distress:

  • Shock: “I never thought this would happen to me!”
  • Disruption: “Why did God let my child die?”
  • Anger: “That drunk driver should get what he deserves for what he did to my son!”
  • Hopelessness: “I was hoping the clinical trial would work. What’s left?”
  • Resentment: “My mom doesn’t deserve this. She’s the kindest person I know!”
  • Guilt: “My children have been after me to stop smoking. I guess I got what I deserved.”
  • Abandonment: “Where is God now?”

Spiritual struggle also can be caused by a death or loss because these experiences can change our connections with ourselves and others, sometimes permanently.

  • “I could always count on my dad’s advice. Now that’s gone.”
  • “How can I continue jogging now that I’m losing my leg?”
  • “I can’t have normal conversations with my wife anymore because of her dementia.”

Serious illness may prompt us to think of our own mortality:

  • “I had hoped to travel more before this hit me. Now, it may be too late.”
  • “I don’t know how much time I have left, but I have to make it to my daughter’s wedding.”
  • “I need to make amends with my sister. It’s been too long, and I may not have much time left.”
  • “What happens when I die? Will I go to heaven?”

Simply being in a hospital may complicate your ability to deal with an illness, regardless of the impact of the illness itself. Hospital patients are

  • isolated from family and loved ones
  • depersonalized in the hospital environment
  • disconnected from their worshiping community
  • not able to employ their traditional coping methods, such as using religious literature and artifacts, journaling, walking through nature, enjoying quiet time or privacy, or eating their favorite foods.

Patients and their families aren’t likely to use the terms spiritual struggle and spiritual distress, but that doesn’t mean they aren’t experiencing it. The spiritual distress they feel may not be expressed in language traditionally associated with religion or faith; however, spiritual struggle or distress is always revealed as a change or loss of meaning and, sometimes, trying to reconstruct what is purposeful

How does spiritual care benefit hospitals and patients? A 2016 study found that 61% of patients wanted to discuss their religious/ spiritual concerns with their healthcare team while hospitalized—but only half of those reported having done so.

This need is met when patients are able to share religious and spiritual concerns with a professional member of the healthcare team who has specific competencies in spiritual assessment and can help them develop a spiritual plan of care.

Patients who discussed religious/spiritual concerns with a member of their healthcare team—such as a chaplain—were more likely to rate their care at the highest level on four measures of patient satisfaction (i.e., doctor’s care, confidence/trust in doctors, collaboration/teamwork between doctors and nurses, and the overall rating of care), regardless of whether they had expressed a desire to discuss these issues.

This can benefit the bottom line, in addition to improving the hospital’s reputation and marketability. The Hospital Value-Based Purchasing Program, an initiative of the Centers for Medicare & Medicaid Services (CMS), rewards hospitals that enhance patients’ experiences of care during hospital stays. By leading to higher patient satisfaction scores, quality chaplain services could result in higher hospital reimbursement from CMS.

Who should provide spiritual care? Board-certified chaplains and certified spiritual care practitioners have the skills and knowledge required to provide excellent spiritual care and engage care recipients in identifying and addressing their own spiritual needs, questions, and concerns. They are part of the interdisciplinary care team and are able to determine and document a spiritual care plan that can be integrated into the patient’s comprehensive care plan.

Shouldn’t community religious leaders supply spiritual care? Although faith-group leaders are a welcome and crucial link in spiritual care, they cannot fill the role of professional chaplains and spiritual care practitioners in hospitals. Prepared by and focused on their religious bodies, faith-group leaders might visit their own congregants in the hospital but they lack the expertise of healthcare chaplains. Faith-group leaders are not part of the healthcare team and have no experience creating spiritual care plans. Certified chaplains must uphold a professional code of ethics common to all certifying organizations, but community faith-group leaders may not be bound by a professional code of ethics that mandates respect for diversity and prohibits proselytizing.

Can the existing healthcare team supply spiritual care without a spiritual care practitioner? The interdisciplinary team cannot be held to the same high level of expectations as a certified spiritual care practitioner in completing a thorough spiritual assessment or addressing spiritual needs. Nurses, physicians, and other members of the healthcare team may address a person’s spiritual needs, but spiritual care is outside their traditional scope of practice. Although they can bring a general understanding of spiritual needs, spiritual care practitioners are specially trained to provide the expert care recipients need and expect.

Spiritual care practitioners rely on these important members of the interdisciplinary care team every day to screen for spiritual needs and 8 distress among patients. It takes a team of professionals working together to provide patient-centered care, and chaplains are a necessary part of that team.

How does religion affect spiritual care needs? In the past, hospitalized patients were expected to be visited by their local church’s priest, pastor, or other spiritual leader—someone familiar with the patient and their family—not a member of the healthcare system. However, demographics show us that this is no longer a reality. From 2007 to 2014, the number of Christians in the United States declined 7.8% while the number of people who identify with non-Christian faiths increased 1.2%. Over the same period, the number of Americans with no religious affiliation rose from 16.1% to almost 22.8%.

No matter what their faith, many people who are affiliated with a religion are not active in their worshiping community and do not have a long-standing relationship with a rabbi, imam, clergy member, or other religious leader. In the absence of a professional chaplain, these patients are unlikely to be visited by anyone to discuss spiritual matters.

Patients who do not have a religious affiliation may seem like unlikely candidates for spiritual care, but patients without religious affiliations are still likely to hold religious beliefs. A 2012 study of 46 million adults who reported no religious affiliation found that 68% believed in God, 58% felt a connection with nature, 37% described themselves as “spiritual” but not “religious,” and 21% prayed daily.

These individualized expressions of religion and spirituality require and deserve personalized spiritual care, something board-certified chaplains are uniquely able to provide. These chaplains design individual spiritual plans of care to meet the needs of each patient. Professional chaplains are educated to care for and help individuals from different faith traditions or no tradition at all. This nonthreatening approach welcomes care recipients to express their beliefs in a welcoming and safe environment.

Among 46 million adults with no religious affiliations:

  • 68% believe in God
  • 58% feel a connection with nature
  • 37% describe themselves as “spiritual” but not “religious”
  • 29% pray daily