3

       The Minister is a Team Member

      Getting Into the Game

Activating the Role of Minister

      There are at least three dimensions involved in the pastor's enactment of this role with hospitalized parishioners. Each is important and related to the other. The first dimension can be referred to as preparatory in nature, the second is the act of taking initiative, and the third focuses the actual provision of care.

      Preparing to be pastor when parishioners are hospitalized involves two efforts: an educational process for the congregation, and the continuing professional development of the minister. In the life of the congregation, there can be concentrated emphases during which the pastor and other resource persons provide information about the health care field, perhaps lay ministry, and certainly the role of pastoral ministry during the crisis of illness. It has been mentioned several times already how important this type of preparation can be for persons who have never experienced hospitalization. Some of the information shared in chapter two can be useful. Equally important would be utilizing a panel of resource persons from local hospitals to address key issues. Examples of topics which could compose an emphasis week might include:

      1. Patient-physician relationships

      2. Informed consent and decision making

      3. Living wills and natural death acts

      4. Bereavement and survivorship

      5. Coping with illness in the family

      6. Faith and wholeness during illness

      7. Patient and family concerns during illness

      Forming a health care cabinet in the church could provide a central lay focus to bring before the congregation pertinent issues. It would certainly be possible for such a group to address preventive as well as crisis issues.

      A central portion of this preparatory phase is for the congregation to understand what the pastor can offer during illness and hospitalization and how the resources of the congregation may be utilized to provide added support. During illness, the pastoral role is experienced in many ways. Clarifying a hierarchy of needs is often part of an initial assessment visit. Much of this is accomplished through listening to what has led to hospitalization and how the experience has been to date. Providing basic support is essential, just being there and caring while at the same time symbolically representing the love of God. The sharing of scripture, communion (if appropriate), and prayer constitutes a sacramental ministry. On other occasions, counseling which refocuses values, assists decision making, affirms relationship is important. The congregation can benefit from discussion of the pastoral role prior to a crisis. It informs them regarding the functions of ministry and aids in removing any sense of awkwardness about the minister's visits.

      Each congregation must decide how to organize itself for providing care during a member's illness. This deciding and any subsequent revisions of the plan are best accomplished prior to crisis moments. A health care council can provide scenarios to which any action plan can be theoretically applied in an effort to test out how well an organizational scheme might work. Any plan must contain both spiritual and concrete services. Prayer, for example, is a comforting notion to patients, especially when they know an entire congregation is participating. It is also useful to have persons who know that a prepared meal or mown grass will be a welcome sight. Nor will anything more quickly spoil the good intentions of a caring congregation than a patient-family who receive ten phone calls a day inquiring as to current status. One person can be appointed as the communications link. A similar role can be reserved for another person to serve as “gatekeeper” on bedside visitation. The only thing worse than a perpetually ringing phone is an endless string of visitors, all of whom expect the patient to be glad to see them, as if the event had been planned with the visitors in mind!

      A recently hospitalized patient counted the number of persons entering her room each day.¹ The daily average was fifty-six. This included staff as well as personal friends. Nevertheless, think of how you would respond to having even two unscheduled visitors to your home on a day when you felt great.

      Obviously a careful balance is required, lest the patient feel abandoned or forgotten. Some churches divide members into networks to provide support. This model allows for a rotating coordinator who can delegate responsibilities.

      The pastor's preparation is also ongoing. An excellent approach, perhaps the best, is an opportunity to be a part of a Clinical Pastoral Education program.² If C.P.E. is unavailable to you, there are other ways to grow as a helping person during life crises. A senior minister who is willing to be a mentor, such as was mentioned in the introduction, is one alternative. More formal structures might involve contracting with a chaplain, pastoral counselor, social worker, psychiatric nurse, marriage and family therapist, mental health professional, psychologist, or other persons trained in counseling, to periodically review your interpersonal interactions with parishioners. Special workshops are available, usually for a nominal registration fee, as are books written to enhance understanding from the pastor's perspective. The important thing is to view yourself as being in the process of learning, to have a learning plan, and to enlist the support of your congregation in supporting your efforts, with both time and budget. It is easy to demonstrate that every professional caregiver group has requirements for continuing education.

      In addition to preparation, the second aspect of implementing the pastoral role is the act of initiative. In normal parish life, the minister is often needful of opportunities for either anonymity or temporary relief from being “on duty.” The positive side of this constant spotlight is that s/he doesn't have to spend any significant time contesting the role. Entering the hospital, however, is yet another matter. At worst, it is as if all the status and recognition in the parish gets left at the hospital information desk. In the minister's accustomed place stands the physician. Consequently, initiative is called for in a unique way to assume the role as pastor. The responsibility is always there to define who you are, what you are doing, and to be persuasive enough to enlist hospital staff's cooperation. This is not comfortable, although it is a challenge. The inadequate solution is to capitulate to an awkward system in the name of a busy schedule, slip into the patient's room, pray, and then leave. Initiative, however, can lead to a team membership and is to be equated with assertiveness, not aggressive behavior, though it may on occasion feel like the latter. In hospitals where chaplains are employed or where a C.P.E. program exists, some of this ground may have been plowed for you. If not, perhaps the local Ministerial Association can devise a project to improve working relationships between ministers and hospitals.

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