Different approaches to spiritual care

After 15 years as a pastor, I became a hospital chaplain, As is true for many others of the chaplains who have made that transition, I had to learn a different way of working with people.

A pastor often has the luxury and the challenge of working with people in a variety of settings, across long spans of time. As a pastor, across several years I’ve had the privilege of hours of conversation with several family members. I’ve done funerals for people that I’ve known for nearly three decades. I’ve done weddings for the children of people I knew in college. A pastor deals with moments across lifetimes.

In contrast, a chaplain deals with lifetimes in moments. My contact with a family may be for two hours, from the time a loved one arrives in the ER until they are moved to a room. Or from the time the patient’s heart stops until I walk the family out of the hospital. And while these may be some of the most intimate and heart-wrenching moments in a family, I am only there for the moment. I don’t know how the story started. I won’t know how the story goes on.

Chaplains work in shifts. Our goal is to provide patients and families with “continuity of care”. One chaplain meets the person who just had an accident. The next chaplain may work with the family who arrived from out of town. The next chaplain may pray with the significant other before the surgery. All the way through, we are passing on information so that there is someone who can care.

In contrast, pastors are the continuity of care. A pastor can learn the family’s connections and names and struggles. A pastor can listen to the stories as they are passed from one generation to another (and can even become part of those stories.) A pastor remembers the late night conversation about drug use and then the process of reconciliation and then the celebration after the healing.

Chaplains seldom teach and seldom preach. So seldom, in fact, that it feels odd when we are leading an interdenominational chapel service. Pastors have teaching and preaching as a core responsibility.

Pastors defend a particular flock.There is a responsibility to be compassionately clear about a set of teachings. Chaplains care for sheep from many flocks. We may connect a patient with spiritual care from a very different teaching from our own, and then pray with a patient who is from the group we grew up in.

Our roles as chaplains and pastors are very different. And yet, often our callings are similar.

Both chaplains and pastors are, or can be, involved in what Eugene Peterson calls “the cure of souls.”[1] The soul is, for Peterson, “the essence of the human personality.” The cure of souls, he says, is “the Scripture-directed, prayer-shaped care that is devoted to persons singly or in groups, in settings sacred and profane.”

When Peterson is writing about the cure of souls, he is doing it in a book that contrasts pastoral care with “running the church.” The one is about souls, the other is about buildings and programs. And although chaplaincy isn’t about specific communities of faith, there can be a temptation to become focused on tasks and deadlines and efficiencies.

To resist all that, Peterson talks about the care of souls in terms of initiative, language, and problems. At our best, we are assuming that God is already at work and we are joining that work in process. At our best, Peterson says, “The primary language of the cure of souls is conversation and prayer.”[2] At our best, we are not seeing people as problems to be solved, but as mysteries to be listened to, valued, loved.

Done well, our work as chaplains and pastors is different. But done well, people will know they are loved.

  1. Eugene Peterson. The Contemplative Pastor. Grand Rapids: Eerdmans, 1989, 57.
  2. Peterson, Contemplative, 57.


Before You Walk In Copyright © 2021 by Jon Charles Swanson. All Rights Reserved.

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