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Medical professionals learn language of spirituality
September, 2002
Karen Schmidt was working as a home care nurse when one of her patients told her his illness was a punishment from God for a life of alcohol abuse and suicide attempts.
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“He left me stunned. I didn’t know how to address his spiritual need. I didn’t know what words to use, and I was so afraid of making it worse,” said Schmidt.
That was why, four years ago, Schmidt became one of the first health care professionals in the country to take part in an innovative Clinical Pastoral Education program at Massachusetts General Hospital.
Traditionally, Clinical Pastoral Education, or CPE, is part of the education of seminary students, who learn how to counsel people in times of crisis. But Mass. General is the first hospital in the nation to provide the same type of training to physicians, nurses, therapists and social workers.
“The program taught me the language I was looking for,” said Schmidt, who is also a member of First Church in Wenham and is now a parish nurse. “I learned that I’m not there to fix this man’s problem. I’m there to journey with him in the mystery of these questions.”
Mary Martha Thiel founded an innovative pastoral education program for medical professionals at Massachusetts General Hospital. As Schmidt recounted this experience on a recent afternoon at Mass. General, Hospital Chaplaincy Director Mary Martha Thiel just leaned back and smiled. That’s because it was Thiel – a United Church of Christ minister – who was chiefly responsible for bringing the program to Mass. General five years ago.
“When I came to Mass. General, there was a rabbi here 30 hours a week and me. At the time, the hospital had 900 beds.I was able to increase the staff, but I knew it would never be enough to cover everything,” she said.“Meanwhile, we had this wonderful CPE program where we’d get these bring young things from seminary and send them out to the various units in the hospital. But they’d only be here for a few months.”
That’s when Thiel came up with the idea of CPE training for those people who would be dealing with patients for the long-haul: the doctors and nurses.
That was five years ago, and since then, more than 40 practitioners have gone through the program. It has been so well received that plans are underway to replicate it at the Yale New Haven Medical Center beginning in January.The program also attracted the attention of the Kenneth B. Schwartz Center, a non-profit organization dedicated to strengthening the relationships between patients and caregivers. The Center each year offers fellowships enabling nurses, doctors, social workers and other clinicians to go through the CPE program at no cost to themselves.
“It’s a wonderful, wonderful program” said Marjorie Stanzler, Administrative Director of the Schwartz Center. “It gives people a whole new comfort level in talking about what gives the patient’s life the most meaning. Sometimes that’s the patient’s religion, but not always. Studies have shown that patients don’t get their spiritual needs met from their caregivers, and caregivers say they don’t have the comfort level needed to deal with those needs. But the clinicians we’ve sponsored have talked about how it has revolutionized how they can talk to their patients.
Mary Kraft would agree. As an anesthesiologist it is part of her job to meet with pre-operative patients.
“I would say 99.9 percent of patients who are about to face surgery are anxious, and some come in dripping in religious symbols,” she said. “In the past, when I saw that, I could say something like ‘your religion seems to mean a lot to you’ and they could open up and talk.”
Kraft knew these conversations were helpful to people, but didn’t know how to broach the same topics with people who didn’t come into the hospital wearing crosses or medalions. Going through the CPE program changed that.
“Now I’m very comfortable with the vocabulary of spirituality,” she said. “I can say ‘this is a stressful time in your life how do you manage’ and that gives them an opening to talk. If they say faith or spirituality play a part, we’ll talk about that; if it doesn’t, sometimes we’ll talk about why it doesn’t or what does help them relax. ”
Kraft said she was fearful, at first, that patients would find her questions intrusive. But she has found instead that they appreciate her taking them time to talk to them.
Thiel says it is easier for the patients when they can have these types of conversations with a doctor or nurse who is already part of their health care team, rather than with a hospital chaplain who is brought in cold.
In fact, she said, when she first conceived of the program, others in chaplaincy circles expressed fear that it would eliminate chaplains altogether.
On the contrary, Thiel said, those clinicians who have gone through the CPE program make better use of the hospital chaplains, because their training helps them better determine when there is a patient who needs counseling or support beyond what they can provide.“Typically, it takes years for a chaplain to be able to function on a team,” Thiel said. “This program absolutely brings everyone together.”
