Josh Houston was a pastor who longed to leave behind administrative duties to focus on soul care. Lorena Villa had six years of hospital experience as a Spanish interpreter, but wanted to offer more meaningful support to patients and their families.

As part of an inaugural class of six in Community Medical Centers’ chaplain residency program, they’re helping each other learn how to minister to patients’ emotional and spiritual needs during a pandemic.

“Being in the hospital during COVID there’s been a heightened sense of loneliness and spiritual longing from the patients,” said Houston. “But I think, what a perfect time to learn and train into this skill set.”

Villa agreed: “It is a big change with COVID. A lot of patients feel isolated; they feel anxious without their families. They really want to talk to somebody and be with somebody who is going to listen.”

More than ever hospitals need chaplains to not only sit with lonely, anxious patients, but also to support frontline clinical staff who are facing unprecedented stress battling a new disease.
 

Accredited training helps Valley hospitals fill chaplain shortage

For Ki Do Ahn, director of Community’s chaplain residency program, the new training program was a decade in the making, so there was never any thought to pausing it because of a pandemic. “It’s been 10 years of prayers and hopes to make it come true,” he said. “In Central California there has been a shortage of professional chaplains.”

Less than 65% of U.S. hospitals employ professional chaplains and only two-thirds of those hospitals have board-certified chaplains, according to the Association for Clinical Pastoral Education. Many smaller hospitals rely on volunteer chaplains, ministers, priests and imams to visit their own parishioners in the hospital.

Community’s one-year residency program is the only training of its kind in Central California and one of about 300 programs in the nation accredited by the Association for Clinical Pastoral Education. The program is part of Community Medical Centers’ commitment to provide culturally-appropriate care and access to a holistic care team.

The residency program is part of the community benefit work the non-profit hospital system does annually as the Valley’s safety net healthcare provider. In fiscal year 2020, Community invested $175 million, about 10% of its operations budget on such training of chaplains, doctors and student nurses, public education, and unreimbursed medical and charity care.

“I think it’s a great service for the Central Valley so chaplains can learn here and serve patients here,” said Ahn. “Before this, people used to have to go to Los Angeles or the Bay Area. I like that we can be a hub for training chaplains for not only Community Regional, but for other hospitals like St. Agnes or Kaiser.”
 

Both Villa and Houston were grateful to find training close to home for their new profession. “I was super excited, because I really wanted to pursue chaplaincy and it’s a lot easier to do at home and where I’m already employed,” said Villa, who had been working for two years at Community Regional as a Spanish interpreter.

When Houston decided to leave his pastor job and look for a different way to minister to people, he worried how he would manage: “Having a family and kids, I needed a full time job and didn’t know how I could do it. I was talking with my wife, and I was looking at UCLA and Stanford and we were thinking we were going to move to wherever the residency was for a year and then relocate again where I could get a job.”

He was thrilled to find a program 20 minutes from his Clovis home. Houston emailed Ahn the night before the last residency spot was filled. “I do feel like this was meant to be,” he said.

Chaplains are crucial to patient care

Chaplains are an integral part of the patient care team. The Joint Commission, which accredits hospitals, requires healthcare providers to accommodate patients’ religious and spiritual needs and requires healthcare organizations to provide support for staff involved in adverse events. Chaplains fill that role – and numerous studies show hospital patients with access to chaplains report less pain and recover faster.

A 2010 study found that 41% of patients wanted to discuss their spiritual concerns with their healthcare team in the hospital, but only half of those patients said they had done so. And patients who were able to discuss religious or spiritual concerns with a chaplain were more likely to rate their hospital care as excellent and report more trust in their doctors.

Other studies have shown that rehabilitation patients who were experiencing spiritual struggles had poorer outcomes and didn’t recover as much physical function. Patients who met with chaplains, in a study involving 14 hospitals, said those visits helped them feel more hopeful and they believed that chaplain visits contributed to a faster recovery.

“Spiritual care is not just standing by, it is really part of the holistic care of the patients,” Ahn explained. “And when there is a lack of spiritual care, patients may be feeling more depressed, feeling more lonely, feeling more sad.”

The distress Villa felt from patients and families when she would interpret for palliative care staff prompted her to want to do more. “I found my call in those end-of-life care family meetings,” she described. “A lot of families were suffering and there was a lot of emotional distress in the decisions that had to be made. I just really felt I could support in a different way, especially when the language is a barrier.”

Villa’s new role allows her to share more of herself: “As an interpreter you’re used as an instrument for communication. Your job is to connect both sides with words. As a chaplain you have the potential to give words of comfort and share your thoughts.”

Chaplain residents learn deep listening to be open to own healing

Houston has found his first weeks of learning about hospitals and healthcare, “felt like putting my mouth on a fire hydrant – it was so much information.” And the work with patients has felt at times overwhelming. But he’s grateful for the spiritual, emotional exhaustion that pushes his limits – and makes him feel he’s exactly where he should be.

He had chaffed at some of the restrictions he felt during his 12 years in church ministry. “So much of church ministry these days involves church management and administration. And while I can do that stuff I consider myself far more gifted in spiritual care and soul care,” Houston explained. “I have a friend who is a chaplain in hospice and she described what she does and it sounded so beautiful and meaningful and significant – and in line with my gifts.”

Besides discovering how hospitals work and understanding infection prevention protocols, Houston said he’s “learning to be an interfaith chaplain, so my faith tradition and my ministry experience can inform that support, but it’s not about putting my faith on top of patients or trying to convert them. And I find so much freedom in that. I simply get to be a companion to listen.”

To do that active listening, Houston and Villa said, the residency training is teaching them to listen first to their own struggles. “I found the chaplaincy training is a lot of inner work so that I can be complete and present for the patient,” explained Villa. “I was thinking I was going to be studying out of a book and there would be textbooks. It’s really hands on and learning from the patient as we go.”

Houston agreed, “In order to offer healing to others in this program, we have to learn to heal ourselves.” He called that kind of learning “difficult but awesome” and so worth the hard work.

“To be in the room and sit with patients and hear their pain and their loneliness,” said Houston. “I don’t know if there are any moments I’ve had that are so beautiful and meaningful and potent. Spiritually and emotionally connecting with people like that taps into the core of who I feel am and the purpose I was built for. I’m really excited to lean into the challenge of it.”