ACPE Research

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April 2020 Article of the Month
 
by John Ehman, Editor, ACPE Research Article-of-the-Month
and Manager for Pastoral Care, Penn Presbyterian Medical Center, Philadelphia PA

[This article should be freely available to all ACPE members through the link to the journal in the Resources section of the www.acpe.edu site.]

 

Taylor, J. B. "A moment in the life of a SARS chaplain." Journal of Pastoral Care and Counseling 57, no. 3 (Fall 2003): 355-356.


GENERAL COMMENT: The purpose of the Article-of-the-Month features is not only to highlight new research but to stimulate thought about topics for research. The topic that occupies everyone's thoughts at this time is certainly the COVID-19 pandemic. There has not been time for more than early, tentative research to find its way through the publication process, and the studies have been medically focused on the situation in China. There will surely be a flood of literature, and hopefully some of that contribution will come from -- or be about -- chaplains. At this moment, however, the most thought-provoking piece for us to consider perhaps may be John Blaine Taylor's 2007 reflection of his first SARS patient visit. It may suggest especially what could be accomplished in the way of case studies and chaplains' self-observations, and hints at many themes to be explored through the spectrum of empirical methodologies.

The brevity of Taylor's reflection makes a summary here unnecessary. It suffices to say that the piece has an almost sentence-by-sentence, even phrase-by-phrase, richness and pertinence for the present COVID-19 context. Take, for example [pp. 355-356]:

  • "I could use the telephone [to talk to the patient], but that can be artificial."
  • "With some trepidation I squirt the cold alcohol gel into the palm of my hand...."
  • " Mindful of my Clinical Pastoral Education..., I did a self-assessment of my own energy and feelings before entering the room in order to help me prepare emotionally."
  • "I was not only anxious. I was afraid."
  • "What if I pass it on to my family and friends?"
  • "I think about my mortality. I also lack knowledge of the mystery of this particular disease. I lack a sense of control around this dis-ease."
  • "I liken the fear around SARS to the uncertainty that accompanied the AIDS virus in early years."
  • "...[T]he sustained stress has exhausted people emotionally, physically, and spiritually."
  • [donning Personal Protective Equipment] "...is not unlike vesting for liturgy in the Christian context."
  • "The image of pastoral companion helps me break the dissonance and discord that was interfering with my being grounded."
  • [the patient says:] "I feel so lonely and isolated and cut off...And I'm scared to death...."
  • "This SARS moment turned out to be a holy moment."

For most of us who have been dealing first-hand with COVID-19 cases, Taylor's words resonate deeply, and CPE group discussion of the piece could productively stay just there. However, with an eye toward research, what are the opportunities to capture -- with some empirical acumen -- that which is going on for us and around us currently? Are verbatims with COVID-19 situations being written and preserved as well as compared to the same students' verbatims prior to the pandemic? Is there the possibility of case studies to be developed? Are there studies under way anywhere at the ACPE center that the chaplains might be able to connect to, maybe to expand medical researchers' perspective into spiritual-psychosocial dynamics at play? Might chaplains be archiving data on themselves by journaling about their experiences or by noting even the crudest quantitative information, like how many patients they are seeing, how often COVID-19 comes up in a day, or how many hours they are sleeping? What observations may be made of processes of normalization in working around COVID-19? How has tele-chaplaincy entered the clinical picture? How does wearing Personal Protective Equipment (PPE) affect interaction? How is emotional expression inhibited by PPE, and how might expressions like crying compromise the PPE barrier? What are the needs being expressed by patients? What are the needs of family members who are prohibited from visiting in person? How have practices changed, and are norms changing? We chaplains should have profound insights on many, many aspects of the COVID-19 pandemic, and a little research-minded intentionality could help us to hold unto and build upon observations and wisdom that can pass all too quickly from our memories.

This is admittedly an unusual Article-of-the-Month, and these are extraordinary days.


Chaplain George H. Grant, PhD, Executive Director, Spiritual Health, Emory Healthcare, offers the following special comments. He and the staff at Emory were among those at the forefront of a chaplaincy response to the Ebola outbreak in the fall of 2014.

John Blaine Taylor's experience from 2003 during the SARS crisis rings true for thousands of our spiritual health professional colleagues across the planet who are currently responding to patient's, families and staff during this global pandemic. His personal account calls for a space and perhaps even a repository of experiences associated with COVID-19. Accounts of our work, in its many forms, helps us to stay engaged, inspired and adaptive as our roles in healthcare and other community contexts evolve. As for us here locally at Emory in Atlanta, we are enlisted as "essential clinicians" for a broad spectrum of support directly in the clinical environment and through other accessible media connections. This was true for us during the Ebola crisis when choosing care over fear became the song that we lived by. The courageous work of our masked spiritual health clinicians and that of our healthcare colleagues, where deep concern can still be felt through our eyes, causes a trust that health treatment is multi-faceted and a very human relationship. The machines can make possible a life to continue, human connection and respect for values makes life worth living -- even for a few last moments or for years to come. The holy ground where we listen, walk and talk is highly personal and community health driven. What is being made real are the moments of "standing in" when families cannot be present and for care response in the never-ending day where we and our healthcare colleagues are exposed to constant trauma and moral distress. What I am learning about myself in this moment is that leading with reverence is the best of what I can be for my colleagues and fellow care-seekers. I assume that my thoughts are not unique. I am simply joining echoes from our past to the chorus of now and in the future.  --GHG


 

Related Items of Interest:

I.  Transforming Chaplaincy (www.transformchaplaincy.org) has announced in its April 2020 Newsletter:

Transforming Chaplaincy is organizing several research projects to describe the important spiritual care chaplains are providing to patients, families and staff during the pandemic and after. Watch future issues of the newsletter for further details. Your suggestions for research about spiritual care during the pandemic are also welcome.
Also, the Editor-in-Chief of the Journal of Religion and Health, Curtis W. Hart, has published in the April 2020 issue a call: "...[I]f you have or write any articles or narratives about living through this virus, or even about the virus itself, please let us know so that we can consider a submission from you" [--see p. 624 of Hart, C. W., "Spiritual lessons from the coronavirus pandemic," Journal of Religion and Health 59, no. 2 (April 2020): 623-624].

 

II.  Resources for chaplains are being developed rapidly in the current COVID-19 pandemic by the Chaplaincy Innovation Lab, ACPE, the Association for Professional Chaplains, and the National Association of Catholic Chaplains. Also, Naomi Paget, BCC, Fellow with the National Center for Crisis Management, published in March 2020, a 74-page document, "Ministry during pandemic: from awareness to implementation," available free of charge from Judson Press. The paper is in many ways broadly written, but at certain points clearly comes from a Christian perspective.

 

III.  The COVID-19 pandemic has raised to a new level the subject of telechaplaincy. This was the subject of a March 21, 2020 webinar from the Chaplaincy Innovation Lab. Also, chaplains may be interested in a March 14, 2020 handout from Penn Medicine, which poses basic questions to be considered about the dynamics of providing pastoral care over the phone. [Update:] The latter handout was subsequently developed into "Telechaplaincy: Preserving the Character of Chaplaincy Care in Telephone Interaction."]

 

IV.  This month's feature points toward the richness of case studies. The subject of case studies for chaplains was explored with our May 2018 Article-of-the-Month and again just last month, when a Related Item of Interest noted a new book by Jeanne Wirpsa and Karen Pugliese, Chaplains as Partners in Medical Decision Making: Case Studies in Healthcare Chaplaincy, now available from Amazon.

 

 
If you have suggestions about the form and/or content of the site, e-mail Chaplain John Ehman, Article-of-the-Month Editor, at john.ehman@uphs.upenn.edu
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