Chaplaincy and Pastoral Ministry

Chaplaincy and Pastoral Ministry

Friday, 14 July 2017

Warning the Sick

by David Pettett

When visiting the sick, the 1662 Church of England Book of Common Prayer Order for the Visitation of the Sick, directs the minister to say, “whatsoever your sickness is, know you certainly that it is God’s visitation.” The instruction continues with two possible causes of the person’s sickness, one being to try the patience of the sick for an example to others and the other that the sickness may have been, “sent unto you to correct and amend in you whatsoever doth offend the eyes of your heavenly Father”.

In 1798 Charles Simeon of Cambridge wrote a sermon outline, subsequently published in his 21 volume Horea Homiletica­ (outline 421). In summary, Simeon’s outline calls upon the people to repent and make a covenant with God because the calamities that have come upon them are indicative of God’s wrath against them. Without repentance, they cannot hope to escape. With repentance, there is nothing to fear.

These examples from the seventeenth and eighteenth centuries show a belief that sickness and other ‘calamities’ may be a warning from God. They serve as a warning that the sick person should examine their lives to see if there is some sin from which they should repent. A biblical justification for this theological understanding of sickness may come from Luke 13:4-5 where Jesus suggests that natural disasters act as warnings to others that they should repent. Neither Jesus’ words, nor the words of the seventeenth and eighteenth century authors, suggest the calamity or sickness has come as a punishment for sin. They serve as a warning and encouragement to a person to examine their own life to see if there is any sin they must repent of.

This approach to pastoral care has a clear understanding that a person will face God as their judge. Sickness and disaster are opportunities, sent by God, to examine one’s life, recognising that in the human condition we are finally answerable to God.

In his book, Pastoral Care Emergencies[1], David Switzwer suggests there are nine needs of the dying. They are: Expressing feelings, overcoming loneliness, finding meaning in the present, believing that life has been meaningful, having consistency between one’s own perception of self and other people’s perception of our self, having control, continuing to feel useful, expressing spiritual needs and, finally, finding the ability to let go.

Building on the work of Howard Clinebell[2], Highfield and Cason declare that there are four spiritual needs shared amongst all humanity. They are the need for: meaning and purpose, to give love, to receive love and the need for hope and creativity.[3]

These twentieth century authors approach pastoral care entirely from the perspective of the patient. They focus on what perceived needs the patient may have and attempt to direct the patient to some point of acceptance or integration of these needs. This approach is entirely person centred. There is no orientation towards God.

From a Christian perspective of pastoral care, these twentieth century approaches are inadequate. If the human condition is that we are sinners in need of God’s forgiveness, before we face Him as our judge, Christian pastoral care must encourage those who are sick to take the opportunity of their sickness to examine their lives and to repent of any sin they might become aware of. The sickness is seen as a gracious visitation of God to prepare us for the final judgement we will all face.

In speaking of spiritual needs, Christian pastoral care must consider the biblical understanding of the human condition. As human beings, we are people created in the image of God but that image has been adversely affected by sin. As such we are answerable to God. We will face judgement. Christian pastoral care therefore encourages the sick to take stock of their lives and to take the opportunity presented by God to repent of sin.



[1] David K Switzer: Pastoral Care Emergencies. Paulist Press. 1989
[2] Howard Clinebell: Basic Types of Pastoral Counselling. Abingdom Press. 1966. Clinebell suggests there are four basic spiritual needs: 1. to find meaning in life. 2. to have a sense of the transcendent. 3. to have healthy relationships with God, others and with nature. 4. to experience inner awareness, creativity and freedom.
[3] M F Highfield and C Cason. “Spiritual Needs of Patients: Are they Recognised?” Cancer Nurs. 1983 Jun;6(3):187-92.

Tuesday, 13 June 2017

Reflections of a retired hospital chaplain

The Rev Lindsay Johnstone, a former hospital chaplain in Sydney, Australia
(Ed: After many years as a chaplain in a major teaching hospital in inner city Sydney, Lindsay has retired to Oxfordshire, U.K.)

The heart of chaplaincy ministry.
There is a sacredness to being welcomed to share the pilgrimage of people who are especially vulnerable. Jesus, who died to change our lives and those of patients, clients and staff to eternal hope, has caused the Holy Spirit to live within us. As we cooperate with him, He loves others through us, sometimes verbally and sometimes through presence alone.

While the chaplain is observing, the Word and the Holy Spirit do it all.[i]
There is a powerful opportunity to witness God working well beyond the obvious input of a chaplain, including patients being converted through their own reading of gospels they had been given. Getting to know staff members over a period of time would lead to pastoral discussions relating to their work, family relationships, and enquiries about belief. A question I was asked was, “Why could Nebuchadnezzar and Ribbentrop go to heaven and a nice guy like me go to hell?” Countless patients could ventilate their health and pastoral needs, with some finding new hope. As a senior chaplain, I could mentor pastoral care students, and liaise with the hospital executive, and facilitate health service- based online training.

There is no place for self-glorification nor the glamorisation of other chaplains.
The protocol of confidentiality enhances the heart of one-on-one ministry and helps to hedge out reportable results and public reputation. On one of my long train commutes to the hospital, I looked up a passage in Deuteronomy 30 to seek to be stroked by the Lord with affirmation for serving him! Suddenly my mood changed as I read, “The Lord will circumcise your heart that you may love him.” I went through an unexpected experience of mortification and self-loathing, being confronted with the darkness in my heart and my total unworthiness. Sometime later I was impacted at a deeper level by Galatians 2:20, properly translated – “I have been crucified with Christ… it is no longer I who live… the life I now live in the flesh I live in the faith which comes from the Son of God who loved me and gave himself for me.” It is in dying to self that we can serve.

It is sacred to see and celebrate God working outside our own comfort zones.
I came to cherish working with chaplains of different backgrounds. Respect grew with chaplains of other faiths, but without the need to compromise my own convictions. It was a sacred experience to be a regular presence among medical and administrative staff, and long-term patients; and to be a support for some patients and ex-patients who could not find meaningful support in their local church. The power of Christian love is essential in relating with the unusual.  It is a privilege to relate with people who did not seem to fit a norm in many churches. One long-term Christian patient preferred to be identified as of the opposite gender.

The Lord works powerfully while the chaplain seeks to find and fit in with what God is doing. Midnight call-outs with a one and a half hour drive from my home in the Blue Mountains west of Sydney to the hospital were a favourite part of my work and a special privilege. A son requested a visit for his dying mother. When I explained that I talk and pray aloud, even if it seems the patient cannot hear, he said emphatically, “She won’t hear anything!” I addressed her by name and she opened her eyes. Timing is beyond us, and another callout patient died minutes after my visit. It is important to seek the Holy Spirit’s guidance for what to do and not do in specific situations. I visited a patient, whom the doctors said a few days earlier, would soon die. When I visited her, she was dressed and packed, and was going home. She had been prayed for and anointed with oil[ii] to receive healing two days before by a chaplaincy colleague.

I gave another patient a printout of a special blessing[iii] I used with him. A couple of days later, he told me that he had made several photocopies of it and gave it to some of his friends.

Ministry with mothers who lost their precious babies in the womb or at birth would sometimes be followed by pastoral support for a nurse or a social worker.

When praying quietly on my own in a multi-faith prayer room, if a Muslim entered, I would in my heart pray that God would give this person a saving vision of Jesus. One time, a Muslim lady in the prayer room asked me to explain the Trinity to her, and then the Holy Spirit. She accepted a copy of Luke’s Gospel with an article on “Why Jesus is essential.”[iv] I do not know what she did with it.

Volunteer chaplains have a special contribution to make. They can offer a dimension that complements the role of chaplains who may have spent all or most of their working life in employed pastoral roles. Some volunteers have come out of professional and business careers where they have exercised considerable responsibility. This helps in their understanding of many patients. They also often have distinct expertise that they can add to the functioning of a chaplaincy team.

Every ministry sometimes has to cope with bureaucracy and opposition.

Pro-forma official reports, often done on line, to prove the effectiveness of chaplaincy are of themselves devoid of spiritual value. They seem to be necessary because of the need to satisfy public sector funding bodies of “evidence based” chaplaincy effectiveness. Content-wise they are meaningless and distract the energy of chaplains. The only spiritual benefit I can find with them is that they are another opportunity for a chaplain to die to self![v] The real work is hidden. Such reports can provide no meaningful guide.

In any Christian ministry team, there can sometimes be conflict and even opposition. Paul referred to spiritual opposition as a “thorn in the flesh” in 2 Corinthians 12:7.[vi] When the Lord told Paul, “my grace is sufficient for you”, he was, in effect, saying, “When you face difficulties, be encouraged and strengthened by the intimate reality of my presence in the lavish outpouring of favour upon you that you could not merit if you tried. Bask contentedly in the overflow of my inexpressible love beyond the comprehension of height, breadth and depth. I am with you to strengthen and nurture you.”

The key to effective chaplaincy is an unhurried and perpetual locking-in to intimacy with the Father, the Son and the Holy Spirit. Then he picked us up and set us down in the highest heaven in company with Jesus. (Message version of Ephesians 2:5). The longer the commute to work, the greater the opportunity to bathe the ministry of the day in intimacy with Jesus. A major theme of Paul’s Epistle to the Ephesians is that though still on earth, by faith we can enter into the reality that our inner being is “in the heavenly places”. Though still very much living in the earthly fallen order, where we share not only in Christ’s resurrection, but also in his ascension.





[i] Compare the words of Martin Luther, “the Word did it all” in a sermon at Wittenberg in 1522.
[ii] James 5:14
[iii] My own wording, but based on input from the approach of Roy Godwin
[iv] The Essential Jesus”, an Australian translation of Luke’s Gospel
[v] Mark 8:34
[vi] The word for thorns is used in Numbers 33:55, Joshua 23:13 and Judges 2: 4 to refer to human opponents of God’s people, and is nowhere used in the Bible to refer to illnesses.