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Introduction

As Director of Pastoral Care at a major health care referral center, I continue to spend a great deal of time “keeping up” with what is happening in my own hospital. After fourteen years I keep having this fantasy that people will start coming to me to learn what is going on. It never happens. Somehow it goes with my role that I am the one who must initiate and maintain the working relationships.

For parish ministers, the difficulties of hospital visitation and ministry to the physically ill are certainly compounded by the fact that they are “outsiders” to the hospital staff. Unless a minister took clinical pastoral education courses in seminary, it is not likely that s/he had formal training in how to do hospital visitation. Consequently I am impressed that while ministers value pastoral care during the crisis of illness, many find hospital visiting frustrating.

And that is understandable. Physicians, nurses and other staff may appear somewhat unconcerned, if not abrupt with information and/or directions. Even when the pastor has traveled some distance, as is often the case at our hospital, the patient may be in x-ray, having a test run, or be inaccessible for any number of reasons. Even parking is sometimes difficult. All of this is frustrating for the clergyperson, if not intimidating, and adds additional stress to an already busy schedule.

The Hospital Handbook is an effort to provide the divinity student, the beginning pastor, and perhaps the experienced minister seeking a resource for lay visitors with practical guides to hospital ministry. Included are sections which discuss hospital organization, how to gain access to the system, and knowing what behaviors lead to cooperation with staff.

James T. Wagner, Ph.D.

In my first position as a parish minister, it suddenly dawned on me that I did not know where to begin in hospital visitation. I had attended a thoroughly respectable divinity school. I had taken the suggested courses. I knew the finer points of pastoral counseling, medical ethics, and the existential realities of suffering, but I did not know how to find a patient's room. I did not know aneurism from angina.

Fortunately, I began my ministery as an Associate Pastor, and the Senior Pastor was very understanding in showing me around the hospital, introducing me to key personnel, and giving me a good outline of the do's and don't's of hospital visiting. The key to that first learning experience was finding the right information at the right time. I had to learn, and Russ Ayre, the Senior Pastor, gave me clear, practical information.

That was fifteen years ago. The teachable moments have continued. There was the first encounter with a sick child, the dying patient, the need to consult with a physician, the time it was necessary to help a patient get a second medical opinion. There was the move to the community with the university teaching hospital, and the continued need to understand new medical terms. Sometimes the information was easy to get in order to deal with these hospital situations. Sometimes it was not. I wanted a Hospital Handbook to provide practical information for those critical times in pastoral care.

Jim Wagner is the insider at the hospital, the director of pastoral care who is an expert on keeping people like me informed on what is going on in the hospital and how to relate to these developments. I am the outsider, the parish minister who is an expert on reminding the insiders that we need simple, practical assistance in keeping up with our role in patient care.

Lawrence D. Reimer

INTRODUCTION TO THE REVISED EDITION:

We are grateful for the opportunity to do a revised edition. In the four years since the Handbook was published, we have maintained a careful file of suggestions from users and reviewers, as well as new material which we believed would strengthen the book. The growing number of readers deserves the best we can offer and Morehouse-Barlow agreed.

One dimension of the revision is to update some of the rapid changes occurring in the health care field. Most of these are reflected in Chapter One, sometimes accomplished by changing a verb from future to present or past tense. The issue identified at the end of this chapter, making health care available to all persons, remains a central focus of debate in America.

New material is to be found in several places. Chapter Four has been expanded with additional prayers, scripture references, and an order for the administration of the sacramemt of Holy Communion in a hospital setting. Chapter Five is considerably lengthened by sections which focus on the adolescent as well as the AIDS patient. Admissions of adolescents to specialized centers for the treatment of substance abuse and psychiatric problems are increasing. Ministry to adolescents in these special facilities as well as general hospitals involves unique issues addressed here. As hospital admissions for AIDS patients increases, ministry to these patients and families is clearly an important new pastoral concern. We invite readers to contribute their perspectives on the usefulness of this material. Charles Williams, M.D., has expanded the Glossary and polished all of the definitions.

A new chapter focuses the subject of Medical Ethics. The reader will find a helpful introduction to most of the situations relevant to hospital ministry. Familiarity should enhance the pastor's usefulness. As is true with the other chapters, readings in the form of an annotated bibliography are found at the end.

The Handbook is an effort to add new construction to the bridge connecting the pastor and the hospital. We hope the result will be an easier path for the minister in delivering pastoral care to parishioners. If the book proves useful and fulfills its limited goals, the authors will feel gratified. We made the decision long ago that the effort was worth it, because we believe strongly in the value of spiritual care during illness and its place in the delivery of wholistic health care.

We also hope this book encourages further cooperation between chaplains and pastors. Either of our names could appear first in authorship as the contributions of each have been similar. A small section of this book addresses the appropriate need and probable benefit of more frequent collaboration, particularly in critical life events such as illness.

No single book is adequate, however, to prepare a minister for the specific concerns which might be experienced. This book is directed to those situations most commonly encountered. Even then, it provides a general guide. For more specific information the reader is directed to the annotated bibliography at the end of each chapter as well as the glossary at the end of the book.