The Functions and Services
of the Department of
Pastoral Care
University of
Pennsylvania
Health System
1/27/10
Case #1
A physician calls a chaplain for Ms. Clark, a 68-year-old
woman with a recurrence of cancer who has just said, “I
don’t understand why this is happening to me; I don’t think I
can take it anymore.”
The chaplain visits and listens carefully to the patient as she
tells of her struggle with cancer, the recent loss of her
mother, her feelings of being overwhelmed, and her life of
faith. Honoring her story, the chaplain follows the patient’s
lead in thinking about how her life of faith speaks to the
meaning of the present crisis.
As Ms. Clark identifies ways that her beliefs and spiritual
resources help her to cope, she begins to discern her course
ahead with some hope and peace.
Overview
The Department of Pastoral Care provides spiritual and
religious support in a non-sectarian, inter-faith model for
patients, family and staff. Chaplains do not proselytize.
 Staff chaplains
 Full and part-time Clinical Pastoral Education students
 Fellows
 Residents
 Interns
 Externs
 Adjunct Chaplains
 Volunteer Pastoral Visitors
continued →
Overview
(continued)
 At the Hospital of the University of Pennsylvania, a
chaplain is available 24/7 for requests and referrals.
Chaplains are assigned to each in-patient unit as
members of the multi-disciplinary team
 At Penn Presbyterian Medical Center, Pennsylvania
Hospital, Penn Medicine at Rittenhouse, and
Wissahickon Hospice, chaplains are on staff.
 Chaplains document their visits in the patients’ medical
records at each of these facilities.
Spiritual, Psychosocial, and
Cultural Values and Needs
The Joint Commission on Accreditation of Health Care
Organizations has stated:
Patients have a fundamental right to considerate
care that safeguards their personal dignity and
respects their cultural, psychosocial, and spiritual
values.
These values often influence patients’ perception of
care and illness. Understanding and respecting
these values guide the provider in meeting the
patients’ care needs and preferences.
The Diversity of
Spiritual Values and
Religious Expression
 People may express their spiritual search for meaning
and purpose through an integrated system of religious
beliefs and practices.
 In the Philadelphia area, there over 3500 different
religious congregations representing over 100 different
faith traditions. Chaplains are prepared to serve people
regardless of their affiliation.
Association of Religion Data Archives, 2000
 People may also express their spiritual search for
meaning and purpose non-religiously.
Two Definitions
of Spirituality
1. While many people use the words spirituality and religion
interchangeably, they are in fact very different. Spirituality
can be defined as a complex and multidimensional part of
the human experience—our inner belief system. It helps
individuals to search for the meaning and purpose of life,
and it helps them experience hope, love, inner peace,
comfort, and support.
from "Evaluating Your Spiritual Assessment Process,"
Joint Commission: The Source [Publication of the Joint
Commission on Accreditation of Healthcare
Organizations] 3, no. 2 (February 2005): 6-7.
2. Spirituality is the aspect of humanity that refers to the
way individuals seek and express meaning and purpose
and the way they experience their connectedness to the
moment, to self, to others, to nature, and to the significant
or sacred.
Puchalski, C., et al., “Improving the Quality of
Spiritual Care as a Dimension of Palliative
Care: The Report of the Census Conference,”
Journal of Palliative Medicine 12, no. 10
(October 2009): 885-904
Spiritual, Psychosocial, and
Cultural Values and Needs
 93% of Americans believe in God or a “higher power.”
 89% report affiliation with a religious organization
 90% of hospitalized patients rely on religion to cope.
Harold Koenig, MD, 2001 The Handbook
of Religion and Health; Faith and Mental
Health; and Spirituality in Patient Care
Case #2
Mr. Wilson, a 32-year-old man with Cystic Fibrosis, suffers an
episode of acute breathing difficulty. He fears that he may die
and asks to receive the Sacrament of the Sick from a Roman
Catholic priest.
A chaplain, who is Baptist, responds and makes contact with
a priest from the local Catholic church. The chaplain sits with
the patient until the priest arrives.
She holds the patient’s hand, provides a non-anxious and
caring presence, offers prayers appropriate for this interfaith
situation, and helps the patient express his thoughts and
feelings with his limited ability to talk. The patient’s panic
subsides, and he begins breathing somewhat better.
Four-fold Mission
The mission of the Department of Pastoral Care is to
contribute a religious/spiritual dimension to the patient
care, research, and education missions of UPHS through:
1) Pastoral care for patients, families, and staff.
2) Pastoral Education and other value-based education
offered to clergy, qualified lay persons, and interested
hospital personnel and volunteers.
3) Spirituality Research programs undertaken in an
interdisciplinary context.
4) Partnerships developed with the surrounding interfaith
community to strengthen the wholeness and wellbeing of our community.
Department Mission Element #1
Pastoral Care for Patients,
Families, and Staff
UPHS chaplains provide over 30,000 pastoral care
contacts per year.
Chaplains offer:
 supportive pastoral conversation
 consultation on treatment decisions, ethical dilemmas,
and matters of religious/cultural diversity.
 religious resources
prayer
sacred texts
connections to those who would provide sacraments
Department Mission Element #2
Pastoral Education and Other
Value-Based Education
 Accredited Clinical Pastoral Education programs provide
experiential learning for clergy, seminary students and
qualified lay persons.
 UPHS CPE offers a variety of programs in units of 400hours each. Over 25 students are involved each year
earning a total of more than 12,000 educational hours.
 Training for Volunteer Pastoral Visitors, for local
denominational groups, and for Penn Med students reaches
a wide range of our hospital and community colleagues
annually.
Department Mission Element #3
Spirituality
Research
 Medical research indicates the importance of spirituality
to patients’ experience of illness and treatment, to the
processes of coping, decision-making, and healing, and to
physical and mental health outcomes.
 Published research by the UPHS Pastoral Care
department has been widely quoted in medical literature.
 The Annual Spirituality Research Symposium has
attracted multi-disciplinary audiences and creative cosponsors since 1995.
continued →
Department Mission Element #3
Spirituality
Research
(continued)
 Chaplains draw on this growing body of research
literature, in addition to religious scholarship, to guide
their pastoral care practice.
 Clinical Pastoral Education students have monthly
seminars to acquaint them with this research, and the
monthly Penn Spirituality, Religion and Health Interest
Group addresses these topics with inter-disciplinary,
multi-institution, community-wide participation.
Department Mission Element #4
Community
Partnership
 Extensive participation in our accredited ACPE
programs, our Volunteer Pastoral Visitor program, and in
denominational training programs has built a strong alliance
between HUP and the local religious community.
 Clinical Pastoral Education programming through the
mentoring program at Sayre High School, and a dedicated
Trauma Chaplain touch the lives of our youth at risk for
violent injury.
continued →
Department Mission Element #4
Community
Partnership
(continued)
 Seminars for clergy and congregations on a variety of
topics engaged in this community network have a major
impact on the health of our neighborhoods.
 Several denominational groups have established teams
and protocols to provide care to their members when
hospitalized at HUP.
Pastoral Care with the
Penn Trauma Service
 Chaplains are designated as the primary liaison
between the Penn Trauma Team, the trauma patients and
their families.
 Chaplains respond to all trauma alerts, 24/7,
establishing contact with families on behalf of the team
and supporting patients and their families and the staff
through immediate crisis intervention.
 Our Trauma Chaplain then follows all trauma patients
throughout their admission.
Case #3
Mr. Dow, a 21-year-old man, is brought to the emergency
department unconscious after being shot. The chaplain on
call, a rabbi, arrives to find a large and diverse family:
some are Pentecostal, some Muslim, but all are very
anxious and upset.
The chaplain hears their questions and concerns, which
are primarily for information about their loved one. He
works as a liaison between the family and the clinical
team. As he develops a relationship with the family, one
person says, “Let’s all pray.”
Aware of religious tensions among family members, the
rabbi leads a moment of silent prayers. When a physician
arrives, the chaplain introduces her, encouraging a sense
of trust.
Referrals to
Pastoral Care
 Chaplains make regular rounds on all in-patient units
and participate in discharge and other patient care rounds.
 When hospitalized, patients are invited to identify
spiritual needs of meaning and purpose, identify their
religious affiliation, request assistance in meeting religious
needs (including dietary) or request a chaplain visit.
continued →
Referrals to
Pastoral Care
(continued)
Staff are encouraged to consider referrals to
Pastoral Care for spiritual support for:
 Patients and families struggling to cope with the impact of
illness and treatment.
 Patients and families seeking support in facing difficult
diagnoses and prognoses
 Patients seeking support in making difficult treatment
and related personal decisions
 Patients, families and staff weighing difficult ethical and
moral dilemmas
continued →
Referrals to
Pastoral Care
(continued)
 Patient or family requests for resources from their
particular tradition (e.g. Christian sacraments, Sabbath
candles, or inspirational literature.)
 Patients and families indicating spiritual concerns and
showing signs of spiritual distress such as interruption of
religious activities, use of explicitly religious language
amid suffering, raising questions of life meaning,
struggling with loss and grief, and apparent distress of
unknown origin.
Spiritual Distress
 Through serious illness, our core spiritual values and
beliefs may feel threatened. This may be referred to as
spiritual distress
 People need not identify themselves as religious to
experience spiritual distress or benefit from time speaking
with a chaplain.
 And since spiritual distress creates pain that may not
respond to medication, it is important to recognize that, for
both religious people and those who are non-religious, it
occurs as a symptom to be addressed.
Case #4
A nurse calls Pastoral Care with a referral for Ms. Lake, a
51-year old woman who has said that she is not religious
but willing to talk with a chaplain. The patient is distraught
after hearing that she must have her leg amputated.
The chaplain visits and explains that religion need not be
part of their conversation. They speak of the human
experience of what it may be like to lose part of one’s body
affecting self-image and social activity, and the patient puts
this in the perspective of her past losses and her worries
about the future.
She says, “I needed to talk this out with someone who
wasn’t going to judge or tell me how to feel or simply assure
me that everything will be just fine. I think I can now make it
through the night.”
Contacting
Pastoral Care
For patient referrals and general information contact the
Pastoral Care Department offices:
HUP: (215) 662-2591
Pennsylvania Hospital: (215) 829-5993
Presbyterian Medical Center: (215) 662-9490
See also UPHS Internet and Intranet home pages (under
the “Departments” submenu).
Extensive information about Pastoral Care Services,
Programs, and Events as well as articles and resources
regarding spirituality and diversity, and links to related
sites are available at the Department website at
www.uphs.upenn.edu/pastoral