Rev. David Janzen stands with his painting titled, Faith Encompasses the Earth.
Most people who deal with the spiritual and emotional needs of patients at the Northumberland Hills Hospital (NHH) agree there is a need for a chaplain at the hospital. So why isn't there one?
The answer to that is more complicated than it seems.
Rev. David Janzen, chaplain at the Golden Plough in Cobourg, has been fighting the battle for a hospital chaplain. He recognizes that the physical needs are well met at the new facility, but the emotional and spiritual needs are often overlooked. Most staff have little or no training in chaplaincy and no time to assist patients and families with their emotional questions in times of crisis. Local ministers do visit the hospital but are restricted by privacy laws to visiting their parishioners. Many people do not adhere to any particular faith, and do not want religious guidance. A small number of patients are adherents of minority faiths.
The end result is a large number of sick and dying people and their families who do not have qualified assistance as they work through difficult life issues.
The chaplaincy story in Northumberland goes back to the time when Cobourg and Port Hope had their own hospitals.
The Rev. Margaret Tandy was on the Spiritual Care Committee (SCC) as the new Northumberland Hills Hospital was nearing completion in 2003. Members of the Spiritual Care Committee serving the hospital were told a chaplaincy position was in the budget for the new hospital.
In an interview last week she stated that the committee was told in 2003 to "prepare to move forward with the chaplaincy.
Her committee drew up a list of the qualifications required for the post. "It took a couple of years before we realized it wasn't going to happen," commented the Anglican minister from Port Hope. She wondered then how the spiritual care needs of all patients would be met.
Since then the SCC has submitted a request each year for a half-time chaplain.
In the meantime the SCC has done what it can to fill in some of the gaps.
Workshops were held to introduce staff to some of the issues around palliative care and dying. Hospital staff were made aware of interfaith issues. But the committee recognised First Nation needs were not being met.
The committee continues to press forward with proposals it thinks will meet some spiritual and emotional care needs, and it presents the hospital with an annual request for a part-time chaplain.
Rev. Janzen recognises the good intentions of the committee members but feels their successes have clouded the real issue.
The work of a chaplain cannot be adequately filled by Christian ministers or trained lay people. They simply don't have the training and the understanding of the inticacies and subtlety of the work done by a skilled chaplain.
He acknowledges that a minister can serve his or her parishioners and members of the same faith - but that leaves out the care of the vast majority of sick and injured people who have no religious affiliation or non-Christian beliefs.
In the four years he has been in the community he has heard the same noises - there is no money in the budget. In his discussions with the SCC he has heard the frustration. The Rev. Tandy concurs. She says the frustration comes from the delayed hope of getting a chaplain.
Rev. Janzen is on the Cobourg Ministerial Association. It created a task force to move the issue forward at the hospital and raised a number of questions with the SCC.
The Cobourg Ministerial wants to be helpful but it hasn't heard back directly from the SCC or the hospital about the questions asked.
The Cobourg ministers also defined the chaplaincy position and the benefits it would bring to the hospital. The study was passed on to the SCC with the hope the committee would take the information to the hospital.
Rev Janzen took the task force information to the ministerial associations in Brighton, Colborne and Grafton - all are within the NHH cachement area. Every one came back with their support for the hospital chaplaincy. They were dismayed at the hospital's non-action on its perceived earlier committment.
On April 9, 2009, Rev. Janzen took his information directly to the new NHH President and Chief Executive Officer, Robert Biron.
Rev. Janzen laid out the history of the interaction between the ministrial associations and the previous administration. He found Mr. Biron open and receptive, and understanding of the value of a chaplain. There was no argument against having one. It came back to money.
In a phone interview on June 5 Mr. Biron explained that when he arrived last December the hospital was in a $2 million deficit position. Through the efforts of his staff in finding efficiencies, the hospital has found $1.4 million. There is still work to do, he admits. The hospital is not allowed to carry a deficit and staff is still working internally to make "further efficiencies".
(For further information on the hospital's plan to reduce its deficit click on Hospital budget announcement.)
If not enough money is saved that way, the hospital may have to have a discussion about the scope of services it offers and make some choices. Mr. Biron is committed to having a community engagement over programs and a dialogue regardiing how the hospital will look going forward.
It's difficult for him to introduce new services while in a deficit position and potentially considering service cuts.
Rev. Janzen hopes that those who feel there is a need for the services offered by a chaplain will contact the hospital and lend weight to the request.
But Mr. Biron says it's not that simple. The community and the ministerial associations "need to understand it's not just about voices". The hospital needs to hear all perspectives - and that's where it is now.
A telephone survey was conducted by the hospital in April and the results are being studied. Now the hospital needs to structure how it will engage with the community.
The CEO admits the chaplaincy situation needs to be addressed in the coming years; he values the chaplaincy and he looks forward to having the discussion, but there are much larger issues which need to be dealt with now.
The SCC is attempting to find a short-term solution to fill the void. It is developing a model using clergy and trained lay people. The Rev. Tandy says the clergy has some training in chaplaincy skills. Anyone fulfilling the task would understand they were not to proselytize. She agrees with Rev Janzen that it wouldn't be the same as having a hospital chaplain. But they appear to differ beyond that.
Rev. Tandy wants the hospital to see the benefit of having a regular person available, and begin to see the importance of a chaplaincy. Then, perhaps, if the money becomes available, the hospital will move in that direction.
She accepts that the SCC may offer this alternative because nothing is happening the way things stand right now.
Rev Janzen sees it differently.
A system relying on an on-call lay person or minister could be a recipe for disaster says Rev. Janzen. Ministers minister to people of their own faith. Chaplains are trained to help people of all faiths and of no faith. Chaplains help people in their journey and with their wholeness, and with the healing in their lives. It is work that is full of nuances.
For years the hospital administration has turned down a chaplain due to lack of money. (A part-time chaplain would cost $60-70 thousand a year, including benefits) Now that it's in a deficit position, the hospital was able to find $1.4 million in efficiencies within months. Rev. Janzen has difficulty with that.
A chaplain will not ease the workload of area ministers. They would continue to serve their parishioners. The trained chaplain would meet the spiritual and emotional needs of the majority of people in the hospital who have no church affiliation.They have no where to turn with their questions. Some don't even know the questions. The chaplain can help them to find the questions and look to the answers. People facing operations, death, and diagnosis are often lost and don't know where to turn. Emergency, neo-natal and palliative care all have spiritual issues. "A lot of deep questions come out of these situations," says Rev. Janzen. The nurses are the front line of the staff but they don't have blocks of time to deal with the emotional needs and questions.
The suggestion that current staff can handle the issues shows a lack of understanding of spiritual care he says.
Rev. Janzen does understand the difficulty of introducing a new program while the hospital is in deficit. But the issue isn't one of dollars and cents. He wonders if the hospital recognizes the chaplaincy as a need that it wants to address. He is convinced the CEO acknowledges a chaplain is a necessary thing to have.
Rev. Janzen hopes that the hospital will respond if there are enough people who advise it of the need. It's all about treating the whole person. The hospital is unlikely to consider cutting social work or physiotherapy, so why are spiritual and emotional needs not being adequately met?
To get a brief overview of the role of a chaplain click on What is a Chaplain?
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