Spiritual care has almost disappeared at Ross Memorial Hospital

Hours for in-house chaplain down 90 per cent from 2020

Just a few years ago, patients at Ross Memorial Hospital wanting to talk to someone about life’s most profound questions could ask for one of the three chaplains who worked on site for a combined 40 hours per week. Today, there is one chaplain available in the building for four hours on Wednesday mornings.

It’s not a COVID-related change. The pandemic actually prompted an increase in hours in 2020, given that priests, ministers, pastors and imams weren’t allowed to visit members of their faith communities who were in hospital. From 40 hours a week in 2020, the allotment fell to 12 in May 2021, then to four a year later. The chaplain uses that time to visit patients and to lead a short worship service twice a month.

Chaplains provide emotional and spiritual support for people in hospital; the position also exists in other settings outside a house of worship such as the military and prisons. Although they typically come from a religious context, chaplains aren’t necessarily ordained as ministers or priests; many are lay people trained in compassionate, non-judgmental listening, and often have related special skills and training.

When patients are admitted to the Ross, they are asked whether they have a religious affiliation and whether they would like the chaplain to visit them. The hospital also provides a non-denominational sacred space (formerly known as the chapel) where anyone can spend time in quiet reflection. Local clergy are welcome to visit members of their congregations who are in hospital, but with many communities of faith experiencing declining membership and therefore reducing their own staff’s hours, their ordained personnel have less time available to spend at the Ross than in the past.

The hospital — which provided background information but did not make anyone available for an interview — says that in an increasingly secular society, fewer patients seem to be interested in receiving spiritual care, although it does not track the number of requests for such care. Spiritual care doesn’t necessarily have to be religious care, the Ross says, noting that staff on the hospital’s recreation team do their best to keep tabs on people who are there for longer stays, and to provide support for all aspects of a patient’s needs, including passing along requests to the chaplain.

Whether clergy or lay people, rather than being the overbearing religious types they’re often assumed to be, chaplains have an important role to play in health care, says Ron Mahler. Formerly a chaplain at the Ross, he is now a spiritual care provider at the Peterborough hospital and has undergone extensive training in counselling and other aspects of his work.

“People’s spiritual wellbeing is often connected to their mental health and even their physical health,” Mahler says. “We’re spiritual beings.” He and his colleague at the Peterborough Regional Health Centre are also available to staff, who are experiencing never-before-seen levels of stress and burnout as a result of the pandemic, cuts to health care, overwork and a patient population that’s increasingly violent and disrespectful of their expertise.

Barely one-quarter of Canadians take part in a group religious activity such as going to church at least once a month, according to Statistics Canada. (The proportion may well be higher in Kawartha Lakes, where churchgoing is still a central part of life for many, if much less common than in the past.)

Whether patients attend church or not, they still need connection and compassion, says John Boyachek. “Most people in the hospital are looking for some comfort and guidance and help, and someone to talk to about spiritual things, because they’re contemplating their mortality, whether it’s a simple operation or something terminal.”

Boyachek was until recently the lead pastor at Lindsay’s Fairview Baptist Church and secretary of the Lindsay and District Ministerial, an association of local clergy. Twenty years ago, he notes, it wasn’t unusual for members of his congregation to spend a month in hospital recovering after surgery. Now, many patients are in and out in a few days. Those staying for longer periods have more serious health problems than in the past — they may be waiting months for a place in a nursing home or be in palliative care and nearing the end of their lives. Those conditions tend to prompt some deep questions about suffering, legacy, death, memories and eternity, even among those who wouldn’t call themselves religious.

Patients don’t necessarily have a strong local support network or even a loved one who lives in the area; they may be estranged from family or have outlived their most trusted friends. “A number of people are disconnected,” Boyachek says. “There are people who are nervous talking to doctors and nurses. They may be dealing with family issues.” Someone trained in spiritual care can fill the gap, helping people process what they’ve heard from medical staff, especially when faced with a decision about a procedure, medication change or other major health issues, he says.

With nurses, occupational therapists, doctors and other medical professionals so overtaxed, there’s rarely someone who can set aside open-ended time to sit with a lonely or worried patient who’s grappling with a scary diagnosis or difficult treatment choices. That kind of care is exactly what chaplains exist to provide, but, says Mahler, the overwhelming majority of patients will not ask for such help, possibly because they’re leery of religiosity, but more likely because they simply don’t know there’s a confidential listener available to them.

“Most times people will keep going forward with their baggage and their fears,” Mahler says, “but if you go into their room and you go in gently, treating them and validating them as a person, they will open up to you and tell you anything.” He says he’s encountering far more people with mental health concerns than in the past.

The Ross provides a list of local clergy and a range of religious texts to patients who ask for spiritual care outside the chaplain’s Wednesday morning hours. The hospital declined to provide specifics, but basic math dictates that four hours per week for the chaplaincy represents a vanishingly small amount in the $67-million budget line for salaries and wages in 2022, posted in the financial statements on the hospital’s website.

The 90 per cent decrease in hours allotted for spiritual care at the Ross is out of step with surrounding hospitals. The Peterborough Regional Health Care Centre’s two chaplains combine to work 40 hours a week. There’s a chaplain on-site one full day a week at each of Muskoka Algonquin Healthcare’s two much smaller hospitals. Soldiers’ Memorial in Orillia and the Northumberland Hills Hospital in Cobourg rely on volunteer spiritual care teams whose members are available at all hours in person or on call.

While the system in general, and the people at Ross Memorial Hospital in particular, work diligently to diagnose and treat physical ailments, medical structures are not primarily designed to meet the needs of a patient wondering whether anyone cares what happens to them or whether their life mattered. That’s where spiritual care comes in, says Boyachek. “It’s not science, it’s not medicine, it’s not clinical. It’s care.”

Clarification: When this story appeared in print, the Rev. John Boyachek was wrapping up his ministry at Fairview Baptist Church. He became executive pastor at a church in Bramalea just as the October issue came out.