You can’t put an end date on spirituality, says Stephen Hebert

With fewer than 20% of the American population ever interacting with chaplains, Ocean State Stories wanted to understand chaplains’ roles and responsibilities. Although the role of hospitals and hospital chaplains are grounded in the medieval Christian church, the modern-day evolution of hospital chaplains began a century ago.

According to national data, more than half of all chaplaincy encounters occur in hospital-based settings, and some 66% of hospitals today employ chaplains. Given that, we chose to interview chaplains in area healthcare facilities, none of which assess any fees or charges to patients or families accessing chaplaincy services.

Chaplaincy work is grounded in spirituality, not religion

Although she is an ordained Baptist minister, the Rev. Dr. Rotunda East, Chief, Chaplain Service, for the Providence Veterans Administration (VA) Medical Center, her chaplaincy allows her to serve everyone, “regardless of their faith tradition,” she said.  In fact, the Defense Department now recognizes more than 200 religions, including humanism, paganism and Wicca, among others.

“As a nondenominational chaplain, I can’t offer a Catholic patient the last rites, for example, but I can contact a priest to conduct those last rites and I can pray with the patient,” said East, “and it’s my responsibility to meet patients’ spiritual needs.”

Rotunda East – Photo by John Loughlin

When Obadiah (Obie) Desent counsels individuals whose religions differ from his own Baptist faith, he prioritizes their beliefs. “If they have a mosque, synagogue or clergy person nearby, I contact [those entities],” said Desent, the hospice spiritual care coordinator for VNA of Care New England, who also sees patients at Kent Hospital. “Some agnostic or atheist individuals are interested in the spiritual realm; others decline my offer to visit.”

“The difference between spirituality and religion comes up often on the Hasbro Children’s Hospital’s behavioral health unit, where I host a spirituality group,” said Michael O’Neill, a multifaith chaplain providing chaplaincy services at Lifespan’s Hasbro Children’s and Rhode Island Hospitals. “Spirituality is what connects us to our authentic self, to those around us, and to what’s beyond or greater than us, whether it’s God or nature or the universe.” 

The VA’s East believes that spirituality, whether rooted in religion or not, helps people find meaning and purpose. She grounds her vision as a chaplain on a quote from Holocaust survivor Victor Frankl: “No cure that fails to engage our spirit can make us well.”

“During COVID, many people felt alone on their spiritual journeys, wondered why this was happening; they felt no place was safe,” said East. “We created an environment in the chapel that was a safe place to cry; be silent; feel loved.”

When death is imminent

Providing comfort and support to terminally ill patients requires Desent first to build rapport with them. “They need to feel safe with me; I prioritize being their friend before they ask me questions,” said Desent, who also serves as senior pastor at Historic Baptist Church in North Kingstown. “Some people worry about forgiveness, guilt, remorse, the afterlife or fear that God is punishing them,” said Desent. “I gently let them express their feelings.”

Patients tell Desent that they want a pain-free passing, preferably in their sleep in their own homes. “I love that we bring the hospital to [a patient’s] bedroom, with nurses and wise doctors who assess each patient directly and identify the care needed to provide that pain-free passing,” said Desent. “That’s so fulfilling for families who sacrifice so much in their caregiving. Families have a sense of pride that they helped their dying relative fulfill the desire to die at home.”

Obadiah Desent – Photo courtesy of Care New England

When dying patients are being treated in the emergency room or pediatric intensive care unit of Hasbro Children’s Hospital, O’Neill is sometimes called in. When such deaths occur, O’Neill’s role is to bear witness to what is happening. “Some people want to talk and vent their feelings and existential pain; others don’t want to talk,” he said.  “I am available to support families, to pray with or for them, and be present with them.” O’Neill also facilitates making connections with the family’s clergy to fulfill specific religious needs.

How did these chaplains find their purpose in life?

 “Having seen chaplains provide spiritual care to my [fellow Air Force members] and me during my years in Iraq, it was a natural next step for me to become a chaplain,” said East, who served 21 years in the U.S. Air Force.  Since the Revolutionary War, military chaplains have served members of the military, their families and military staff. East’s chaplaincy team at the Providence VA includes three fulltime chaplains (including herself) and two intermittent chaplains.

Working with seniors was almost a natural career path for the VNA of Care New England’s Desent, who, even as a teenager, enjoyed hearing his grandparents’ stories. “I found it fulfilling to visit assisted living and nursing homes with my church to sing and minister to the residents,” he said.  

For O’Neill, becoming a chaplain was “a happy accident.” While he was pursuing a graduate divinity degree, he was working with incarcerated individuals. “I learned the value of listening and holding people’s stories… to discover what’s meaningful for them,” he said, “and that led me to clinical pastoral education.”

O’Neill appreciates Hasbro Children’s Hospital’s strong community of people that comes together to support kids and their families in difficult situations.

 “The interdisciplinary care creates a safety net for pediatric patients and their families,” said O’Neill, Hasbro’s primary chaplain; when needed, four additional Rhode Island Hospital chaplains are available to provide chaplaincy services at Hasbro. “These kids are going through a great deal and I appreciate being part of the communal sense of mission and purpose in caring for them.” 

Michael O’Neill – Photo courtesy of Kathy O’Neill

Chaplains play important roles even when death isn’t imminent

More often, O’Neill engages with children in intensive care, on the behavioral health unit (BHU) or receiving treatments for cancer or other disorders.

“I find joy and fulfillment working in Hasbro Children’s Hospital; it’s a community that comes together for the vulnerable,” said O’Neill. “I enjoy checking in with kids…and encountering them where they’re at. Some of our conversations are silly; others are deeply meaningful.”

“Some of our Vietnam vets are still trying to ‘get home,’ even nearly 50 years later, and may be struggling with suicidal thoughts, abusing alcohol or drugs, or engaging in other maladaptive behaviors,” said East, whose active-duty experience allows her to readily connect with other veterans’ experiences. “We meet them without judgment in those dark, self-destructive places. We grieve their losses [with them] and explain that those morally injurious experiences are only part of them, not their entire identity.”

East and her team hold weekly moral injury (invisible wound) groups for veterans. “We can’t give a pill for those [experiences that are] sometimes hard to verbalize or describe, such as taking lives, witnessing the taking of lives or institutional betrayals,” she said. “Being in those dark spaces with other veterans to share soul-wrenching events is a heavy experience,” said East, who gets through them by spending time in nature and connecting with her own spirituality.

Vietnam War veteran finds ‘a new foundation’

For Tiverton resident Stephen Hebert, the Providence VA’s ongoing spirituality group has been transformative.  His experiences serving in Vietnam in ’71-’72 and the difficult transition to returning to civilian life left him questioning his faith and drifting further away from his Catholic upbringing. In his younger days, he had served as an altar boy and a member of Catholic Youth Organization (CYO). Declining to provide details about his Vietnam experiences, Hebert recalled that he continued to question how God could allow war to happen. 

Only 20 when he returned from his tour of duty in Vietnam, he was told to move on with his life, and just have faith. That didn’t resonate with Hebert, who said, “Faith is believing in something without evidence; but I needed some substantial proof.”

Stephen Hebert, VA spirituality group member, holds Simply A Woman of Faith by Pat Hastings, a spirituality coach whom Hebert knew – Photo by Nancy Kirsch

Several years ago, Hebert was invited by a VA social worker to join a weekly spirituality group, which VA chaplains lead. “It gave me a new foundation – not to leave Catholicism behind, but to find a purpose in life and to challenge myself for something bigger than I am,” said Hebert. “Before joining the group, I felt empty inside. I was going to work and trying to raise a family, but I was not taking spiritual time for myself. 

“Spirituality is different for everyone, yet we come together under a spiritual umbrella,” said Hebert.  “The VA chaplains’ focus on spirituality keeps us all on an equal footing, and we discuss our challenges in life, medical issues and how spirituality can help us with these challenges.” 

These weekly meetings, said Hebert, have inspired him periodically to pick up Scriptures, read the Bible or return to his parish church. Through the spirituality group meetings and the chaplains’ wisdom, he’s learned to value life, to slow down and to live in the present. “Forget about the past, which we can learn from, and forget about the future; enjoy the moment,” he said. “I’m a more generous person; I can accept compassion and love now; in the past, I thought that there was a motive behind someone caring for me.” 

 Encouraging other veterans to participate in a VA spirituality group, he said, “I think about how spiritually meaningful it must be for people to serve veterans; the chaplains here are exceptional; they listen and they care. I can’t thank the chaplains and the VA enough; I’m on a path I feel so comfortable on now.”

Providing chaplaincy care to family members

Chaplains often help in ways family members don’t know they need until after the fact. 

“I will hold a patient’s hand while their relative showers, find the music that the patient loves and do anything I can to make a positive change in a dying patient’s life,” said Desent, one of the three VNA chaplains. “When patients have passed, I’m with the family, waiting for the funeral home, or escorting the deceased patient out of the home to shield the grieving family from the image of seeing their loved one taken by stretcher into a [hearse].”

Bereavement care and support, including phone calls, literature, and grief support groups, is offered to VNA patients’ families, for 13 months after the death.

Support for medical providers and other staff

Given the close relationships that develop between staff members and their patients, Desent recognizes the grief that staff experience at a patient’s death. “Every clinician has such a tender heart. They are with patients twice a week for up to 12 months, so they grieve, along with the family.”

Desent himself is not immune from grieving some patients’ deaths.

 “I have to compartmentalize [that loss],” he said. “I’m close to many patients; we celebrate birthdays together, pray for their grandchildren or other beloved relatives, and we share burdens.”

Faith helps Desent process his own grief. “I take time to be alone and do my prayers and devotions,” he said, “and the VNA of Care New England also has a bereavement coordinator and social workers [who can support staff].”

“I’m happy to be the container for a [colleague’s stress and pain] and hold that space for them so they can focus on patients and the work they’ve been called to do,” said O’Neill. “It’s very common for healthcare workers to cry and unburden themselves of the pain they feel. Working in healthcare is stressful, so chaplains’ role in providing space for healthcare workers to talk and decompress is important.” 

Being a spiritual care provider has transformed O’Neill’s belief system and spirituality. “The patients we serve give us gifts by sharing their experiences and stories with us; those are sacred,” he said. “I’ve grown and changed as a person because of what I have encountered.” 

Twice a week, East and her fellow chaplains hold brief devotions where staff gather for mutual support. Veterans’ deaths – whether by suicide or from medical conditions – affect staff members, so the chaplains hold processing groups, where staff, and sometimes family members, gather in the chapel.

“They give people time and space to process those losses, and to continue their work, always striving to give the best of themselves,” said East.  

What should people know about chaplains that they don’t?

Many people don’t understand, said East, that chaplains have certifications, trainings, specializations and required continuing education.

National research indicates that hospital patients and their family members believe chaplains are religiously ordained clergy who are there solely to provide prayers. But “that contrasts with how chaplains perceive ourselves,” said O’Neill. “We are spiritual caregivers who meet people where they’re at and explore where they find purpose; we help with existential crises. Religion is only one way that spirituality can be expressed.”

“We serve all patients regardless of their belief system,” said O’Neill. “We’re not here to evangelize.”  Some people are surprised to learn that not all chaplains are religious, he said.  “There are humanistic and secular chaplains who don’t necessarily believe in traditional organized religion who provide excellent spiritual care,” he said.  

“We’re here to help, not judge,” said Desent. “People often expect some checklist, but I’m simply here to listen, provide spiritual and emotional support, answer questions and be a calming presence during a very hectic time.”  

At the VNA, an entire team supports chaplains’ work, said Desent, from the director to home health aides and teams of other professionals. “They look after the wellbeing of our patients and our staff,’ he said, “and provide family members with respite from their caregiving responsibilities.”

The Providence VA participates in a monthly support group of chaplains from other hospitals and HopeHealth, a Rhode Island hospice. East also organizes an annual daylong event for area clergy to visit the Providence VA to learn about veterans’ suicide risks and mental health issues and the VA’s resources.

People working in hospice care lean in to terminally ill individuals, while other [individuals] often withdraw, said Desent. “It’s in my heart to help these individuals and their families.”

 [NK1]I know this is a dangling participle, but it’s a direct quote… !