LAST Friday was my final day of eight-and-a-half years’ working as an NHS chaplain. I began what you might call my career at the age of 25, when I was ordained deacon in the diocese of Durham, and, with short breaks for study or illness, I have been doing a variety of jobs as a priest in the 35 years since then.
This last period has been an intense exposure to people at some of the most vulnerable times of their lives. Indeed, a good deal of it has been about accompanying people who are saying goodbye to life, or are watching someone they love die, or supporting people who are coping with the immediate aftermath of a loved one’s death.
The unique aspect of the part played by a chaplain is that they are called to be present for people, in whatever way those people find most helpful, as they process whatever they are living through.
Unlike clergy in other contexts, NHS chaplains, whatever their faith background, take a self-denying ordinance of non-proselytisation. This is because they are employed by health trusts which are, these days, acutely aware of the rights of the patient before all else. There is no privilege for religion — Anglicanism or anything else.
If chaplains were to use their position to promote one or other religion, they would quickly find that their freedom to act as a front-line member of staff would be rescinded. It would be replaced by a diminished system, allowing access only where a patient has specifically requested a chaplain’s visit. Indeed, one of the responsibilities as chaplain is to ensure that patients who do not want to be troubled by religious people have that right respected. They are gatekeepers of the wishes of patients in these matters.
MANY parts of the NHS take seriously the good evidence that attending to people’s spiritual needs aids their health, and supports their recovery. Again, the definition of what counts as spiritual is patient-centred.
Chaplains try to stand alongside people and let them disclose what it feels like to be where they are. Chaplains support patients, as they articulate the questions that their condition raises. What chaplains offer is unconditional loving human regard and attention — what some might call compassionate concern.
In its best form, this is a regard that helps others to open up about what is happening to them, or to the person they are concerned for. It can help to bring into the light of day questions that might seem too hard to name, or long-buried regrets or anxieties. Those explorations are often accompanied by tears — of regret, relief, or sorrow, and sometimes of joy, forgiveness, and acceptance, too.
I believe that what we chaplains bring, although it might never be named, is love and hope. Our humanity is stripped bare by our mortality. Who we were, good or bad, lies in the past. We are now just ourselves, facing our end. Who will love us?
All of us, I guess, hope that when our time comes, there will be people from our past — our relations, children, friends — who will love us through to the end. But what if there is no one? I have sat by the bed of those who apparently have no one in the world to love them as they come to their final moments.
I know that my muddled life is no justification for love: this is not about what people deserve. But I know that I will always need love; and sitting by someone’s death-bed, I know that others do, too. So that is what I try to do, as I look at someone’s face and give my full attention.
I CARRY with me hope. Whatever faith I represent, I suspect that chaplains may be more important for this quality than almost any other. Conversations with many colleagues around the country make clear that, in an uncertain world, when death comes, as so often, unexpectedly and certainly unwantedly, the presence of people who hold out hope is important.
It might not be vocalised at all. It might be expressed more by demeanour than anything else. And yet I know that I believe that all shall be well, and all manner of thing shall be well. I know that I believe it because of the resurrection and the victory of God over death and evil. I do not have to explain it: I just have to embody it for the people whom I am with when I act as a chaplain. I hold it for myself and for them, when the hand I am holding lets go its grip on this life.
ONE of the gifts that chaplaincy has given me is the experience of exercising a ministry out of a place of both equality and vulnerability. It is exercised by a staff member like other staff, whose purpose is to put the well-being of patients at the centre of all that we do (and, by extension, their families and other staff members). Our validation is our staff badge alone.
Our usefulness is to be discerned by what we can offer. We have no clinical utility, and yet we are, for the most part, valued members of the team. The equality that we share is because we focus so strongly on those whom we serve.
So my religion is not so important, somehow. But don’t imagine that my prayers are never wanted, or the sacraments are never dispensed. It is the placing of chaplains on an equal footing with all our clinical colleagues that is so liberating.
We have no evident right to be doing this: NHS chaplains do not have a legal mandate like those in prisons and the armed services. The pressures on NHS budgets are huge, and you might think that soft targets such as chaplains are at risk. My experience, however, is that, out of this vulnerability, chaplains offer something that their colleagues know brings great value to the patients. It may never be quantified, but they see the difference it makes.
IN THE Church of England world of Renewal and Reform, of Establishment and the holding on to privilege, of anxiety about the survival of dioceses and parishes, this NHS world of not making a show of your religion — of simply embodying love and hope — might seem so counter-intuitive as to be ridiculous.
As I move on from chaplaincy, however, I believe that the Church I love, and which I am presently prevented from serving as a priest, has yet to begin to discover what its future might be, if it embraced structurally the values of vulnerability and equality, of embodied love and hope, which seem to be found so often in the work in its parishes, and which lie at the heart of the work of a health-care chaplain.
Canon Jeremy Pemberton was an NHS chaplain, and now works as a singer, celebrant, and consultant.