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‘Saturated with grief’: Hospital chaplains had a trying 2020

Senior chaplain Nancy Many prays with Rafael Lopez in a COVID-19 unit at Providence Holy Cross Medical Center in the Mission Hills section of Los Angeles.
Senior chaplain Nancy Many prays with Rafael Lopez in a COVID-19 unit at Providence Holy Cross Medical Center in the Mission Hills section of Los Angeles. (Copyright 2020 The Associated Press. All rights reserved.)

TAMPA, Fla. – In the decade she has worked as a chaplain at Tampa General Hospital, Rev. Jenny Sumner Carswell can’t remember a year more challenging than 2020.

Same for Mease Dunedin Hospital chaplain Phyllis Shaughnessy, who is struck by how much things have changed, often hour-to-hour, since March.

She knows her loved ones worry about the safety of being in a hospital, but when she steps into her calling, dressed in full protective gear, there’s no place she’d rather be.

In a year when hospitals have seen overwhelming loss, hospital chaplains — the interfaith caretakers of spiritual well being — have found themselves in the center of an emotional whirlpool.

They have always provided support, comfort and spiritual guidance to patients and families in a myriad of situations: end-of-life support, advanced directive planning, trauma and critical cases, fetal losses and surgeries. But this year has been fraught with new challenges.

Early on, when visitors were not allowed — and even now when some are unable to travel or afraid to enter a hospital — chaplains have stood in as family at the bedsides of the ill, attempting to help them find comfort and connection.

Shaughnessy said a mentor once told her that interfaith chaplains are not in retail, but maintenance. Rather than pushing their own beliefs, she said, they help others connect with theirs.

“For some it’s finding a plant so they can touch the earth because they can’t go outside,” she said. “For others it’s finding a sprig of a Christmas tree so they can smell the cypress-y smell. For another it’s a Bible. For another it’s a prayer rug. It just depends on what their faith tradition is. But for many it’s simply believing there’s something greater than themselves and helping them find words that speak to that.”

Shaughnessy said she’s had to learn on her feet this year. It’s meant meeting families under a tree or through windows, or using iPads and cellphones and translators to connect with families around the world to come up with a plan of care.

For Carswell it’s meant being present with someone in their final moments when family couldn’t be there, praying with them, marking a cross on their forehead with holy water. It was singing to someone as they died. It was her colleague placing a big sign in the window of a COVID patient’s room so family could stand on Bayshore Boulevard and know exactly where to direct their prayers.

“A lot of what this year has brought is finding creative ways to bring what’s not physically present in the room into the room,” Carswell said. “Even though the physical connection wasn’t there, the emotional, spiritual connection was there for their loved ones.”

Shaughnessy had heard the reports coming out of China in January. She figured the virus would come here at some point, but had no idea to what extent.

Only in the midst of it did she realize how quickly things changed.

“The reality that’s always been a part of medicine is that we can’t fix everything,” she said. “But with the virus our arsenal is very, very scarce. What we thought we knew got blown out of the water very quickly, and then it was ‘What do we do?’”

But it’s been the small moments that have helped her stay grounded: the times outside a patient’s room where health care workers would listen to each other, wanting to hug but unable to.

“When supplies were low, when numbers were high, when we didn’t even know what risks we were actually taking because we had a lot less information about the virus, the support that the team gave each other,” she said. “I’m talking about housekeeping and environmental service and maintenance to our doctors. The whole gamut. Our kitchen staff and food service who deliver the trays and don’t know what kind of room they’re walking into. Everybody was in the same boat together.”

And there have been moments when even the chaplains had to step away and cry.

“There are days I have to sit down with myself and say ‘OK, Phyllis. Who are you following? Where are you going? Why are you here?’” Shaughnessy said. “And answer the basic questions for myself to be able to go forward with others.”

By late April, Carswell, who serves as Coordinator of Clinical Pastoral Education at Tampa General, sensed the team of chaplains were hitting their limit.

“We were saturated with grief and unknown fear, not just for ourselves but of holding those stories,” she said. “Just like we were figuring out the disease and how it transmits and how to stop spread, we were actively looking at what we needed to do to maintain.”

Carswell wanted to make sure chaplains were intentional about addressing their own emotions.

“It’s telling the stories,” she said. “It’s taking the time to go to the chapel to have quiet space and re-center ourselves.”

She led the chaplains in an exercise. She asked them to take a full breath in, as full as they possibly could. Once they held it, she asked them to take another sip of air.

It’s a breathing regulation technique, but it’s also a reminder: “When we think we’re at capacity, we actually have the ability to hold even more,” Carswell said.

Working as a chaplain over the holidays is always challenging, Carswell said.

The anniversaries of lost loved ones, complex surgeries, diagnoses.

“They’re not just bringing their stories of being a patient here,” she said. “They’re bringing all of their grief from their community and their family systems into our walls, and that’s not something that we can just brush by. That is something that requires us … to excavate the stories of our patients.”

The medical staff, too, have their own lives and losses.

“The intersection of that is heavy,” Carswell said. “In some way, this holiday looks similar but it’s also different. It’s the cumulative grief of this entire year.”

Outside the hospital walls, Carswell said she knows there’s so much that causes anger and angst and division right now. Her work, she said, has not made her fear death, but instead value life. And she hopes others can look through that lens of gratitude.

“We have held the hardest days of people’s entire lives and sat with them in that grief,” she said. “There will be joy and hope after this.”