Special Care for the Spirit Is Good Medicine, Too
In the midst of the noise and bustle and bright lights of the intensive care unit at Stanford Hospital, about to get a new heart, Cindy Flynn was not afraid. It wasn’t the first time she'd been there. Seventeen years earlier, then just 50 years old, Flynn had arrived at Stanford, pain gripping her chest. A heart attack, doctors told her. And the damage done meant she would need a transplant one day. It was world-turning information.
Now, Flynn's life was about to change again and a familiar face appeared: Father John Hester, a tall, ruddy-faced man with a deep, calming voice full of warmth. "I was surprised," Flynn said, "but I actually knew him from our church. He sat and talked to me for a while. We prayed together and he gave me communion, and it felt like I wasn’t alone."
We're not there to proselytize. We're there to support, to care. It's not something we force on people.
For the staff and volunteers of the Spiritual Care Service at Stanford Hospital, that’s been the exact idea for several decades now—adding something extra to the work done by medicine and medical professionals, reaching out to patients who need their faith’s familiar rituals, like communion, and to those patients whose faith might be shaken in the crucible of illness.
The service now stands as one of the most well-known, respected and innovative programs in the country. Those who trained in its model of clinical pastoral care lead respected programs around the world; young physicians find valuable new perspective when they shadow chaplains; and hundreds of volunteers make it possible for someone to be at a patient’s bedside whenever needed, and for as long as needed.
An extra element Of value
Stanford’s model of care reflects major changes to what once was commonly called pastoral care and served up Christian denominational beliefs and little else. "The Catholics did sacraments and the Protestants read from the Bible and made a prayer," said the Rev. George Fitzgerald, DMin, director of the Spiritual Care Service since 1988. "Now we’re interfaith, and what we do is about support and cooperation. Now we teach the value of active listening, and we never try to convert anyone."
Underlying all those changes has been a broader acceptance of "spirit as a significant part of a person’s life and something that can really contribute to health and healing," Fitzgerald said. "There are all kinds of studies that show that when patients have a supportive religious community, they tend to do better. And there are other studies that show that at hospitals where chaplains visit patients, those patients drift toward earlier discharge and need less pain medications."
Physicians, too, Fitzgerald said, "have really recognized the importance of spirituality in a patient's life. They don’t always have the time to sit down and take an hour with a family, but they are interested in working together with us, to see us as a part of the health care team."
And that includes the many volunteers—more than 200—who have regular visiting hours or are on call. Mike Flynn, Cindy’s husband, has been a Spiritual Care volunteer for five years. He had always gone to Mass on Sundays, and taught a religion class to kids at church; it was not until he retired in 2001 that he had the time to pay attention to that part of him that wanted something more to do—to help, he said. One morning at his church in Palo Alto, the call went out for volunteers for the Spiritual Care team at Stanford. "I just said, 'I'm going to give it a try.' I went to the classes, and it turned out to be exactly, for me, the best thing I could do because of the personal nature of it. It’s like saying, 'What would Christ ask of me? Christ would ask of me to bring his spirit to other people.'"
We train them to be respectful, to be reverent, to be gentle in every way so patients can tell us anything they want, how they want, or they can go silent. We're there for them in that moment.
The volunteers are trained to respect all the responses they might get when they enter a room, Flynn said. "We're not there to proselytize. We're there to support, to care. It’s not something we force on people. For people who can’t get to a service, we can bring it directly to them—the kind of spiritual nourishment people can’t get any other way."
Broad diversity Of views
Flynn makes his rounds to Catholic patients. Other volunteers and chaplains serve specific faiths or respond to needs that are more universal. Stanford has a chaplain, the Rev. Susan Scott, who is focused on patients facing death and their families. Scott has special knowledge of the paperwork and other arrangements to be made, stepping in to help make the process less difficult. Through her work with patients, the hospital created a pamphlet to help patients complete an advanced directive, a document that specifies what actions are to be taken if a patient is unable to make decisions because of illness or incapacity.
I don't know how to explain it, but it does make a difference. It's just having somebody there and talking to you as a person, and not just a patient.
Just as Scott has a special assignment, so do others. Rabbi Lori Klein works with patients at the Cancer Center; Father Hester is the one who responds to calls from the intensive care units. It’s one way to make sure that everyone most in need will have a resource, said Barbara Ralston, the hospital’s Vice President for Guest Services. The success of the program, she said, is visible in the philanthropic support it receives from the community and the substantial resources it offers at the hospital. "This service really means a lot to people,” she said, “and we’re very proud of it."
Stanford Hospital's Spiritual Care Service is designed to provide the broadest possible resources for patients and their families. Its services include:
- supportive visits by chaplains and volunteers to serve faith groups whether Buddhist, Christian, Hindu, Jew, Muslim, Sikh and other options
- religious resources such as Bibles, Buddhist chanting tapes, Muslim prayer rugs, Shabbat candles and other prayer materials
- onsite observances of holidays including Christmas, Chanukah, Eid al-Adha, Diwali and others
- memorial services
- an interfaith chapel open 24/7 that contains sacred writings and prayer books of several faith traditions
- trained volunteers from a variety of faiths
The Spiritual Care Service's clinical pastoral education program is certified by the Association for Clinical Pastoral Education and offers a year-long training or summer internship. It also offers a shadowing program for Stanford School of Medicine students.
Stanford's model for spiritual care service has grown to include important innovations:
- Dedicated volunteers created the first-ever guidebook of its kind to train volunteers for Muslim spiritual care. Pulished in 2007, that guidebook inspired a training manual for all Spiritual Care volunteers.
- The hospital's Jewish Chaplaincy is directed by Bruce Feldstein, a former emergency medicine physician. He is an adjunct professor of family medicine at Stanford and teaches a required class at the School of Medicine titled "Spirituality & Meaning in Medicine" and an elective class titled "The Healer's Art."
- In the No One Dies Alone program, volunteers under the supervision of the Rev. Susan Scott serve as compassionate companions by sitting with patients who are dying and alone.
- The most recent addition to the Spiritual Care Service team is Rabbi Lori Klein, who serves as the chaplain for the Stanford Cancer Center.
In 2010, Spiritual Care Services made 245,000 visits to patients, and its volunteers—from 12 countries, speaking 10 languages—gave 103,000 hours. Hester knows quite well the difference those volunteers have made. In the early years of his nearly four decades at the hospital, he might see 80 people in a day, forgetting to eat or drink. Finally, a nurse sat him down and said, "Right now, I should have you see a doctor. What have you been doing?"
"That's when I said, 'We've got to replicate presence, and we’ve got to bring in more caring volunteers," Hester said. "Now we have Hindu, Buddhist, Jewish, Muslim, a diversity of Christians, Wiccan—everyone. We train them in the ministry of presence—to be totally open to the other human beings, to listen. We train them to be respectful, to be reverent, to be gentle in every way so patients can tell us anything they want, how they want, or they can go silent. We’re there for them in that moment."
Hester and his colleagues try to anticipate when they might be needed at weekly meetings with all the clinicians on a unit. "Sometimes they'll say, 'Would you go and meet with the family? We’re going to be giving him bad news and we’d like you to be there."
Cindy Flynn didn’t have much doubt that she would be OK, but she does believe that she would have felt more pain and would have been more afraid had she not known that so many prayers were being said for her, including Hester’s. Knowing that she was in the thoughts of others, she said, built a feeling that "was very, very peaceful. And that felt good. I felt relaxed enough so I could just concentrate on getting better. It truly does make a difference. I don’t know how to explain it, but it does make a difference. It’s just having somebody there and talking to you as a person, and not just a patient."
Just as Scott has a special assignment, so do others. Rabbi Lori Klein works with patients at the Cancer Center; Father Hester is the one who responds to calls from the intensive care units. It’s one way to make sure that everyone most in need will have a resource, said Barbara Ralston, the hospital’s Vice President for Guest Services. The success of the program, she said, is visible in the philanthropic support it receives from the community and the substantial resources it offers at the hospital. "This service really means a lot to people," she said, "and we’re very proud of it."
About Stanford Hospital & Clinics
Stanford Hospital & Clinics, located in Palo Alto, California with multiple facilities throughout the region, is internationally renowned for leading edge and coordinated care in cancer, neurosciences, cardiovascular medicine, surgery, organ transplant, medicine specialties and primary care. Stanford Hospital & Clinics is part of Stanford Medicine, which includes Lucile Packard Children's Hospital Stanford and the Stanford University School of Medicine. Throughout its history, Stanford has been at the forefront of discovery and innovation, as researchers and clinicians work together to improve health, alleviate suffering, and translate medical breakthroughs into better ways to deliver patient care. Stanford Hospital & Clinics: Healing humanity through science and compassion, one patient at a time. For more information, visit: StanfordHospital.org.