Journal of Nursing

Dispensing Emergency Spiritual Care


One department at Ronald Reagan Medical Center stands out for its unique emergency supplies: Muslim prayer rugs, recordings of Buddhist monks chanting, Christian Bibles and Jewish prayer shawls.

For patients struck by a serious illness or a deadly diagnosis, those supplies are just one way the Spiritual Care Department helps patients cope with a crisis. The chaplains offer company, spiritual guidance and religious materials to patients of every stripe, from the deeply observant to atheists in need of support, said the Rev. Sandra Yarlott, director of the Spiritual Care Department at the hospital.

"It's the most sacred work you could ever do," Yarlott said.

With a staff of ordained religious leaders, Yarlott's department takes on the daunting task of meeting the diverse spiritual needs of patients, their families and even the doctors and nurses on staff.

The requests range from the obvious - patients most often ask chaplains to join them in prayer - to the obscure, such as one patient's request for a Vietnamese-speaking Buddhist monk. Chaplains are often called to the tough duty of performing emergency baptisms for ailing newborns being rushed into surgery.

Several of the department's 12 chaplains gathered in December to host a hospital's celebration of the winter's many spiritual holidays, ranging from Christmas, Hanukkah and Kwanzaa to the less familiar Buddhist Bodhi Day, Muslim Eid and the pagan/wiccan Yule celebration - although Yarlott acknowledged they don't see a lot of self-identified "pagans."

Like the multicultural celebration, the Spiritual Care Department caters to a diverse crowd. For tricky requests - such as for the Vietnamese-speaking Buddhist monk - they call for backup: Their volunteer Spiritual Advisory Board draws on a diverse pool of religious leaders across Los Angeles, providing chaplains who are Christian, Jewish, Muslim, Buddhist or Unitarian Universalist, to name a few.

"Questions that are secondary when we are healthy become very pressing when we are sick or dying," she said. "People ask, 'What happens when I die?' whether they are spiritual or not." So chaplains often join patients in prayer, but they also provide nondenominational guidance and company.

"You get the privilege of being with people at the most profound moments," said staff chaplain Rabbi Pearl Barlev.

For religious patients, the chaplains also try to provide religious items that will offer comfort. "We encourage them to use their faith to support their healing," Yarlott said. Among other things, Buddhist patients can receive a small electronic box with recordings of monks chanting; Muslims can obtain prayer rugs; Jews can request a "Shabbat box" with items like a prayer shawl and candles.

The chaplains learn to listen to the patient's real concerns, said Episcopalian Chaplain George Okusi. Because several aspects of a patient's life may be thrown into turmoil by a diagnosis, sometimes addressing just one problem can lift a huge weight, he said.

"They may say that they are sick of cancer, but if you listen, you understand that cancer isn't the toughest issue for them," Okusi said. He recalled a cancer patient who was stressed about leaving a dog alone at home, but was too overwhelmed to think clearly about how to help the pup. "We try to bring them back to a level of thinking, 'If you left your dog unattended, call someone to take care of him.' It doesn't solve their cancer, but then later, you see they are calmer and able to smile because a problem is solved."

The chaplains also work with hospital staff, Okusi said. "We talk with the staff, and encourage them, and sometimes we tell them, 'You need to take care of yourselves, too!'"

Doctors and nurses sometimes come to the chaplains when they lose a patient, Yarlott said. "They get very close to their patients," she said. "We're there for them with grief support."

Medical students training to be doctors also visit the Spiritual Care Department through a joint program with the Geffen School of Medicine. "It's the only program like it in the U.S.," Yarlott said. "In most schools, they're lucky if they get a single lecture on spirituality." the students shadow a chaplain for a half-day to see the importance of religion in healing in many cases and to learn to help patients determine what kind of spiritual support they need.

The department offers one of the top training programs for chaplains in the country, and one of the most diverse, Yarlott said. Classes are open to volunteers, but the competition to work in the hospital in one of the department's five residency positions and six internships pulls in about 10 applications for every open slot. Many of the interns seek the job as a requirement for becoming ordained, Yarlott noted. Participants in the accredited training program learn how to offer grief support, to sensitively approach someone of a different faith and support patients.

"The focus comes back to who you are, and how to keep your own wounds, assumptions and attitudes from getting in the way of patients' healing," Yarlott said. "They have to be trained not to over-guide, under-guide or intrude on patients. It's really an art."


Copyright 2009- American Society of Registered Nurses (ASRN.ORG)-All Rights Reserved


Articles in this issue:

Leave a Comment

Please keep in mind that all comments are moderated. Please do not use a spam keyword or a domain as your name, or else it will be deleted. Let's have a personal and meaningful conversation instead. Thanks for your comments!

Image Captcha  



Editor-in Chief:
Kirsten Nicole

Editorial Staff:
Kirsten Nicole
Stan Kenyon
Robyn Bowman
Kimberly McNabb
Lisa Gordon
Stephanie Robinson

Kirsten Nicole
Stan Kenyon
Liz Di Bernardo
Cris Lobato
Elisa Howard
Susan Cramer