Serving as Chaplains in a Time of COVID-19

Sandy Dodson showed up for her first day of work at Bethesda Hospital on a Monday in early March, a solo chaplain and a new member of the palliative care team. She was looking forward to being part of an interdisciplinary model of health care, but on Tuesday, she heard the news that Bethesda was pivoting to become a hospital serving only patients with COVID-19.

“This was obviously not part of my plan, and as a single mother of a teenager, I had to figure out what I could and could not do responsibly,” says Dodson. She made the tough call to be on site but not to go into patients’ rooms. Daily, she reviews charts, goes on rounds with doctors, respiratory therapists, nurses and nutritionists. She makes phone calls to patients and families, listening, sharing information, and helping people process grief. She also spends a great deal of time with staff. “Staff care is a big part of chaplain’s work,” she says. “Many people don’t realize that. Last week we had four deaths and that was really tough for staff. Sometimes I’m a sounding board, and sometimes I just sit and am sad with them.”

Dodson acknowledges that the lack of personal contact makes chaplaincy very difficult. “What I got the most satisfaction from was being alongside patients,” she says. “COVID has done a number on that. Palliative care exists to help a family and patient to make decisions about comfort care, restorative care, thoughts of quality and quantity of life. I find so much meaning in those kinds of conversations, but it is trickier when you’re not in the room.”

Bethesda has capacity to serve 100 patients with COVID-19, and at one point the hospital was nearly full. Today, it’s closer to 50% of capacity. Bethesda has served more than 400 patients since the end of March and 74% have left the hospital alive, Dodson says. “I remind myself daily that many more patients leave than die, but I have been around death more than I’ve ever been. And for those who die, it has been so hard on their families because they can’t be there at the end. Those families are left with their best hopes instead of being able to see the person in the final stages of life.”

As she helps people deal with the loss of life and dreams, to be present as people grapple with anger and despair, and to live with the ambiguity and unrest of our current times, Dodson says her faith is her ultimate coping mechanism. “In a realm of all of these unknowns, I have a faith that has been tested and is solid. God is with me always, even when God is silent. I don’t have to add faith into the pot of unknowns. I’ve got one thing, and it’s a pretty huge thing.”

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Liz Mahan, a chaplain in the HealthEast system, says this about COVID-19: “It has affected everything, even and especially how we die.” As she has learned how to work as a tele-chaplain, she observes how social distancing has added to pain and suffering. “The pain is acute in not being able to see each other, and it’s my job to listen to that pain. Many ask, ‘Will I die alone?’ It breaks my heart that I can’t physically be with patients. In fact, I haven’t met about half of my current patients in person.”

She has found interesting aspects, however. “Many people, especially caregivers, don’t want video visits but they want to talk by phone. I am having long and deep conversations. I work hard to be very present on the phone, to just stop and be with people, to really listen. I crank up my intuitive skills and compassion and pray. I have learned to pray really good prayers.”

Mahan has also discovered a wonderful thing about human beings in hospice: even in their last stage of life, they care deeply about the rest of the world. Several of her patients were grieved about the murder of George Floyd. “We are passionate and empathetic creatures,” she says. “We are tribal animals. We need connection.”

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Jackie Falk discovered her call to chaplaincy when she was in her late 50s. After earning her theology degree, she said she’d do anything but chaplaincy! Fast forward to May 2018 when a colleague asked her to apply to serve as the chaplain in the St. Louis County Jail. Two years later, she is still serving in this capacity. “It’s really good work, and a really precious gift since I came to the ministry so late,” she says. She also notes that at age 72, she can “pull the grandmother card out in a heartbeat!”

Prior to COVID-19, she spent her days visiting face-to-face with people who were incarcerated, people Falk says are dealing with “lives of uncertainty.” During the pandemic, she can no longer meet in this manner, but she continues to talk by phone to and provide resources for inmates from all faith backgrounds. “I’ve learned to trust the power of prayer in this time,” she says. “I start my days by praying for everybody on the roster.”

As she ministers to people in the jail, she is reminded that Jesus told us do to this work. “In jail, people are often at the end. But I am there to remind them, no matter how extreme the situation, no matter what darkness people see inside themselves, Jesus loves them.”

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As both a hospital chaplain and hospice chaplain in Fargo-Moorhead, Chelle Lyons Hanson has found that her jobs are “all about managing change” — about visitation in the hospital and especially ICU, about how she can serve patients and families, about how to adapt to a lack of personal protective equipment, about how to manage the dramatic increase in hospice care. “How do we do things we’ve never trained for?” she asks. “How do we help people grieve when they can’t be together?”

Lyons Hanson first served as a chaplain in the chemical dependency field, then shifted to higher education. But, she says, “The Spirit nagged me to come back to chaplaincy. I’m particularly drawn to end of life. I feel connected to those situations where someone is dying, when people really want to talk about things that matter to them.”

In this time of COVID, she says more people in her area are choosing hospice, to make sure they can see their loved ones at the end of their lives. She also finds that fewer people are connected to communities of faith, yet their concerns about meaning and purpose must be attended to, especially in the late stages of life. “It has been harder with COVID, but I have found people are really interested in talking by phone. Calling people had previously been harder for me because you don’t have the non-verbal communication to draw on, but conversations by phone in the last few months have really surprised me.”

Lyons Hanson also spends time attending to the spiritual needs of staff in hospitals and hospice. “They are scared about bringing COVID home to families, about losing jobs or getting furloughed. We don’t realize the impact that has on people.” To help, she creates and distributes resiliency messages and provides resources for staff to meet the needs of patients and families when chaplains can’t be physically present.

In recent weeks, with growing calls to address racism on top of the pandemic, Lyons Hanson has observed a level of stress she’s never seen before. “The pandemic put us over the top in terms of stress, but now many of us are feeling a call to have conversations about racism in a context where people are already stressed and putting their lives on the line. It’s very difficult but I believe we, as chaplains, have an important role to play in this conversation.”