What does a hospital chaplain do for patients seeking health care in Connecticut?

CTInsider – Sunday, December 29, 2024
By Jordan Nathaniel Fenster

Rev. ReBecca Sala described her work as “archaeology of the soul.”

Her first masters’ degree, long before she became a hospital chaplain, was in museum administration of archeological collections. She doesn’t see the two roles as very different.

“I’ve been a searcher my whole life,” she said.

In the same way that an archaeologist gently brushes away the silt and stone of centuries, Sala said she attempts to gently allow emotions and spirituality to emerge from patients and their families receiving care at Stamford Hospital.

“Being able to explore that with patients at the end of life, when they’ve had a horrible diagnosis, to meet them in that space is a privilege,” she said. “That people even allow me to be there with them is humbling.”

Sala is Stamford Hospital’s manager of spiritual health and wellbeing. She is consciously, intentionally soft-spoken, and is thoughtful about her words. She said she’s cultivated “a non-anxious presence.”

“It’s meeting the patient where they are, not where I want them to be, what we as chaplains want them to be. It’s finding out what’s most important to them in that moment,” she said.

Many if not most spiritual leaders create lasting relationships. Rabbis and reverends and imams might spend decades in a parish or mosque or synagogue, and officiate over the birth, coming of age, marriage and death of their parishioners. Not so for hospital-based clergy.

Rev. Adrian Budica, who heads the department of spiritual care and education at Bridgeport Hospital, said he sees people only at moments of transition.

“We’re in an acute care setting, so people are here for a short time, in which case we meet them just at the transitional moment,” he said. “Sometimes people have one of the most difficult challenges of their life. Patients that say, ‘I’ve been healthy my whole life, and lo and behold, I need surgery,’ or ‘I found out I have cancer.’”

Budica said he helps patients and their family members “sit with their emotions,” and then might never see them again. Often, they don’t want or even expect to see a chaplain.

“We actually make an effort to visit every single patient, if nothing else, to introduce ourselves, to say hello and to do a quick screening,” he said. “If they say in the beginning, ‘Oh, chaplain, I want nothing to do with you,’ obviously we respect that; we’re not there to impose. Or if they say, ‘Oh, chaplain, great, let’s say a prayer and you’re done,’ we might say, ‘Well, we could say a prayer, but I want to sit down and see what’s on your mind and how you’re dealing with it.’”

How Sala manages to deal with the tragedies she’s a part of day after day, and not carry those ever-increasing burdens with her throughout her life, takes work

“I have a very deep meditation practice, and I’m able to let it go as I’m driving home,” Sala said. “When I get home, I’m able to try to lift them up into the universe and hold them.”

Some events, however, can’t be shaken off so easily.

“There are some things that are really tragic and sad that do stay with me,” she said.

For Budica, handling all of the tragedy he faces comes down to self-care and gratitude. Self-care might be exercise or therapy or a fun hobby, but maintaining a sense of gratitude, he said, does not come naturally.

“You have to be intentional about it,” he said. “I’m part of the Christian tradition. Even the story of the 10 lepers, one of the 10 came back. That is kind of like the archetypal way of saying it’s more of the exception. Most people say, ‘I was healed. I have so many things right now to do now that I’m better.’ Only one will take time to say, ‘Hey, I was healed. Wait a minute. Oh, thank you.’”

Meeting people ‘where they are’

Sala said if there was a bridge between the physical and the spiritual, it would be palliative care. The goal of palliative medicine is to improve the quality of a patient’s life physically, emotionally and spiritually.

“With palliative care, our goal is to meet people where they are and really honor and respect their health care wishes,” said Marissa Lavin, a nurse practitioner with Bridgeport Hospital’s inpatient and palliative care team. “We want to make sure people are comfortable. We want to make sure people are peaceful. We want to maintain people’s dignity during some of their most vulnerable times.”

Lavin said giving patients the space to talk is important, both for their emotional and physical health.

“I think when people feel well supported in their journey, it makes a difference for them. Sometimes their symptoms improve. They have a better understanding of what’s going on,” she said. “They’re more open to talk about their illness or their health care wishes.”

Budica said that’s “part of the art of chaplaincy, initiating a visit when you didn’t ask for a chaplain.”

“You might even have a preconception, even a bad image,” he said of some patients. “As I start practicing active listening, people start opening up.”

Sala said she often will just chat about whatever gifts family and friends have sent.

“They will say, ‘I’m not religious,’ but if you look at what’s in their room, photos of family, flowers, pictures that someone has made for them, then once you start talking, like, ‘Tell me about this,’ then they start telling you and sharing how important their grandchild is, their child, the person who gave them these flowers, who’s in the photo, and then they really do start talking,” she said. “They don’t realize that, while they may not have a religious tradition, they still have this inherent desire to connect with people, and they have people and things that are important to them in their lives. We kind of try to open that up for them.”

Tangible and intangible

While the nurses and doctors in the same building deal in tangibles — blood and bone and test results — chaplains are focused on intangibles, things that can’t be measured.

But Budica and Sala are also administrators at large hospitals. They have a staff of clergy and measurable goals and reports to write and submit on a monthly basis. Sala said she could, if asked, find the number of times she or a member of her staff have administered last rights, a sacrament in the Catholic faith.

“We try to keep track of everything as much as possible,” she said.

For example, in September, each member of Budica’s staff spent an average of 2,783 minutes engaged with patients, family or hospital employees, a total of 13,915 minutes across his entire team.

Budica said there has been a growing respect in the medical field for what he called “spiritual care” in recent years.

“There are spiritual care interventions, and we have spiritual care outcomes that we work toward,” he said. “Some clinicians will say, if you cannot measure it, you cannot define it, you’re just having an opinion.”

Those outcomes might be “emotions expressed for catharsis,” or “patient felt more at peace.” Ultimately, for 3,000 minutes a month, Budica tries to “walk a little way with patients in their suffering,” easing the load.

“The fact that I’m at the bedside and I hear so many personal stories and experiences really transforms the way I look at my life,” he said. “It does help in terms of saying, like, life is much greater than my bubble.”

Sometimes, being witness to so much pain does challenge his faith, though Budica believes that “deepening of the faith has to come with a challenge.”

“I don’t take it for granted that the faith and the answer that I have today will apply tomorrow, because I never know what life might throw at me,” he said.

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