When the Rev. Tenku Ruff, a Soto Zen Buddhist priest, took over as the pastoral care director at Phelps Hospital Northwell Health in Sleepy Hollow in June, she knew she was entering uncharted territory: She was taking on the hospital-based position in the middle of a pandemic.
As she spoke to doctors and other staff, she heard about Chaplain Cyril Owambo, who early in the pandemic, was asked to counsel a family whose loved one had just died of COVID-19.
“The family really wanted him to come in and offer a prayer. He was so afraid to go in," said Ruff. "The staff helped him put on his PPE (personal protective equipment). He was shaking. And he went in anyway and everyone was really touched by it.”
Ruff later asked Owambo about it.
“He said, as soon as he got in the room, he understood why he had gone in. And he felt like he had done the right thing,” said Ruff. “The family was so relieved to have him in there. And it was so meaningful for them.”
Chaplains, whose role it is to help others under duress, now find themselves under stress. Chaplains like Owambo have witnessed first-hand the ravages of COVID-19 in much the same way as front line workers.
"We got a sense that there was a lot of spiritual distress and anxiety among our members,” said Kyle Christiansen, marketing manager for the Illinois-based Association of Professional Chaplains.
So beginning in March, the association has hosted an average of two Zoom meetings a week to help members cope with the COVID-19 pandemic and to share best practices.
“The goal of these round tables originally was to pass along best practices and ideas for providing spiritual care during a pandemic,” Christiansen said. “How would you do that when you have to wear a mask and PPE? Normally chaplains like to be very personal in presence, and sometimes they weren't even allowed in the rooms with the patients.
The sessions quickly evolved to be more of a professional support community.
“Chaplains could talk to other chaplains in a way that they couldn't talk to their colleagues at the hospital," Christiansen said. "Chaplains have a unique job and as much as they are valued and appreciated by their coworkers, their colleagues don't necessarily understand what it is that they do. "
Role of the chaplain
Hospital chaplains are professionally certified clergy members specially trained to support belief systems across faiths and cultures. They meet patients, conduct a spiritual assessment, determine what resources they have and then help them find their own strength.
“Everybody has different needs. Some people have their own pastor or their home parish, and that helps them," said Ruff, of patients. "And some don't and some just need to talk."
Hospitals typically have a few paid chaplains and also rely on volunteer clergy of all faiths to speak with patients. White Plains Hospital, for example, has seven paid staff chaplains and a roster of about 40 volunteer clergy members of all faiths. Since March, however, the volunteer clergy have not been permitted to visit patients.
Phelps Memorial, which has two paid chaplains on staff, has been permitting one volunteer Catholic priest, Rev. Ron Lemmert to come in to offer sacraments to Catholic patients.
“He wasn't allowed to go into rooms, but he would offer the sacrament to patients from the door as permitted during this time," Ruff said. “I said, 'how did you find the strength to do that'? And he said, 'I couldn't not be there.'”
Being there when family can't
During COVID, chaplains were increasingly called upon to be there when family members could not.
“I've never experienced anything like this before,” said Rabbi Fredda Cohen, director of the department of Pastoral Care and Education at the White Plains Hospital. Because family members were prohibited from the hospital, chaplains like Cohen became the connection between the patient and their family, often facilitating Facetime calls. "And so we were there for many of the goodbyes, which was very sad," she said.
Prior to the pandemic, Cohen spent 80% of her time with patients and their families, with 20% devoted to hospital staff; during the pandemic, the need for counseling of hospital staff increased.
Seeing the pressure the healthcare co-workers were under added stress on chaplains.
“We didn't quite know how this virus spread or how to treat it. There were a number of our healthcare providers who got COVID themselves," said Ruff, who previously served as chaplain at NYU Langone. "They had so much risk. They weren't well protected. And they still showed up. They just did absolutely everything they could for patients and, and for their families, holding up the phones to patient's ear. And it really took a toll.”
Ruff, who has attended many of the chaplain support sessions organized by the Association of Professional Chaplains, said it was helpful to hear what others have been going through.
“Some of the things I was hearing (in her role as chaplain) are very difficult and very sad," she said. "It was good just to be able to talk about it very freely and openly to people who have no judgment or no ideas of how I should be. I need to practice good self-care by creating a support network for myself in order to enable myself to continue to do this work.”
Christiansen agrees. "By opening up the sessions, chaplains were able to get spiritual support from one another by talking about what they're experiencing, how difficult it is to be a chaplain right now and the stress that they're under, and do it in a confidential, secure, safe place, among their colleagues.”
The group has already started talking about how to handle a second wave, if it occurs.
"There's a fear of post-traumatic stress," said Christiansen. "Many chaplains and clinical staff that were on the front lines at the beginning are worried they're going to be triggered when a second surge does come and wonder how they can be there to offer support."
Job has ‘tremendous meaning’
Rabbi Cohen, who was part of a payer circle every morning, said she found “tremendous meaning” in her work.
She witnessed pastoral and clinical staff set personal beliefs aside and come together in prayer and comfort for their patients. At a family’s request, she would accompany priests to a patient rooms for last rites and they would pray together. She once read a Catholic prayer along with a nurse who was Catholic.
The coming together of chaplains and hospital staff to care for patients of all faiths has been rewarding.
“The chaplains worked together with staff members to bring about a spiritual, holy moment for each person,” Cohen said, noting that when she told the family of a Jewish patient who had been in the ICU for a long time that she would pray for him, she was touched when the doctor and nurse who had cared for him for so many weeks joined in.
Cohen said her faith became stronger for having gone through the experience.
“I felt that I had a lot of purpose and in spite of the very sad experiences that we witnessed, we also were there for the miraculous experiences," she said. "And I think every patient being discharged was a miracle in and of itself because we all felt so grateful.”