A Day in The Life of a Hospital Chaplain

​I serve as a "Clinical Chaplain" in the context of inpatient psychiatric and substance abuse treatment units. Practically speaking, this means I spend most of my days with individuals of all ages (from very young children to very old adults) who face the daily realities of mental illness. It's a pretty challenge and unique job and, honestly, I love it. On an almost weekly basis, when I introduce myself to others and the conversation eventually tuns to what I "do for a living", my response typically elicits perplexed stares or exclamations of "Oh, God! That sounds hard!" So I thought I would offer a glimpse into what I actually do every day. Here's a day in the life of a psychiatric chaplain: 

5:30 am - Wake, exercise, walk the dog, pray, read, and get ready for the day. I typically read the texts for morning prayer from the Book of Common Prayer and a poem or short story before I leave the house. 

6:15 am - Depart for the office. I sometimes take the bus from Raleigh and other times I drive to the hospital. Either way, my commute usually takes about an hour and I like to get to work before most of my colleagues so I can get a jump on some of the administrative aspects of the day. If I take the bus, I'll spend some time reading or listening to a podcast. Sometimes I'll meditate using the "Calm" or "Buddhify" apps.

7:30 am - Arrive at the office and process emails, pages, etc. This is my way of "easing into" the day and I like that it's typically calm and quiet. 

8:00 am - Morning spiritual care team "huddle" to see how the overnight on-call shift went and discuss any pertinent info about the coming day. 

8:30 am - Finish processing emails and plan spirituality groups (more on that later).

9:30 am - By this time (ideally) I am usually out the door and headed onto the patient care units. Depending on the day, I will attend treatment team meetings, lead spirituality groups, or attend to one-to-one patient visitation. I try to visit a minimum of five patients each day and leave space for patient requests, meetings, groups, etc. This is the point in the day when things start to get really interesting. As I mentioned above, I serve inpatient psychiatric units, which sounds complicated - and honestly, it is. What it means in practice is that all of my patients are hospitalized for concerns related to mental illness and substance abuse. Each day I encounter people with schizophrenia, bipolar disorder, depression, addiction, and a number of other diverse concerns. What is the same for nearly all of them is that each of them feels some connection to "spirituality". I come from a Christian background but not all of my patients do. Though my theology is pretty orthodox (I affirm the historic ecumenical creeds, for instance, and attend a rather traditional Baptist church), my work is not evangelistic in nature. My job is to offer spiritual care and emotional support to patients and this often means simply connecting them to resources for practicing their own, pre-existent spiritual practices. For Muslim patients, I will provide a Qur'an and a prayer rug. For Mormon patients, I provide a copy of the the Book of Mormon. For Catholic patients, I ensure their name is on the Catholic patient census so that they can be visited by a priest or recieve communion from a lay eucharistic minister. For all patients as well I provide opportunities for them to explore and grapple with the realities of mental illness and how their faith or spiritual practice intersects with that and informs their day-to-day life. During this time, I may also lead spirituality groups which provide a community setting for discussing the realities of mental illness, substance abuse, and the ways that spirituality can aid in the recovery and coping process. This is not a "devotional" group although we do often have deep conversations about faith and related topics such as prayer, worship, etc. This is really an open forum for exploring spirituality and, I find, it helps patients to understand the differences between their own beliefs and practices and those of others. 

12:00 pm - By noon, I have typically visited two to three patients and led a spirituality group with between five and fifteen patients. This time also includes writing chart notes documenting each of these visits and consulting with the "care team" regarding details relevant to patients' treatment or advocating for patients' religious practices in the treatment context. At around noon, I try to take a walk around the hospital and get outdoors for about thirty minutes. I use this time get some much-needed sun and clear my head. My patients often carry with them stories of complex trauma and, honestly, hearing and attending to these experiences can be a little draining - no matter how much I might enjoy the work, it's still exhausting. Around 12:30 I'll have lunch with some colleagues or with the child treatment unit (typically on Tuesdays). 

1:00 pm - This time is usually reserved for meetings, planning, catching up on charting, and consultation with colleagues. 

2:00 pm - I'm only 3/4 time at this point which, despite the lower pay scale, has its benefits. Namely, I'm out of the office most days by 2:00pm. My bus departs at 2:30 so I usually read, reflect, or journal about my day to clear my head and be ready to be present when I get home. At 2:30 I catch the bus and am usually home by 3:30 to pick up the kids, head home, and start dinner.

That's what "a day in the life" of this psychiatric chaplain looks like. The work is often difficult and involves offering spiritual care, counsel, and emotional support to patients facing the challenges of mental illness, substance abuse, and trauma. It's hard but also very rewarding and, honestly, I don't think there is anywhere else I'd rather serve. 

Blessings, 

A.T.

Mysterious, cacophonous, transcendent rock and roll...

That’s what Black Rebel Motorcycle Club brought to North Carolina last Friday night. And it was the epitome of what a good rock show should be. The band walked out on stage, greeted the crowd, and played for two straight hours of the most groove-heavy, loud, and perfectly executed live music with almost no pauses or needless chatter between songs. BRMC didn’t need to anything special to connect with the audience and create a musical community other than the visceral, raw sharing of their craft with others. It was truly amazing.

Here are some photos from Friday night’s show at Cat’s Cradle in Carrboro, NC.

BRMC @ Cat's Cradle in Carrboro, NC.BRMC @ Cat's Cradle in Carrboro, NC.BRMC @ Cat's Cradle in Carrboro, NC.BRMC @ Cat's Cradle in Carrboro, NC.BRMC @ Cat's Cradle in Carrboro, NC.

As you can see, the lighting was very simple and there were no crazy pyrotechnics or stage antics. It was raw, raucous - an immersive experience from three talented and experienced practitioners of the art of rock and roll. If you ever get the chance to see them again, I highly encourage it!

One Day at a Time

I spend a lot of time every day with people (often including myself) who are so consumed with regret over something they've done in the past that they cannot function in any meaningful way in daily life. I encounter equal numbers of people who, for one reason or another, cannot focus on anything but fear and dread of what might happen in the future. Granted, many of those I encounter are in this predicament because of chronic mental illness. Nevertheless, in my experience, dwelling excessively on the past or worrying overmuch about the future tends to be the cause of much of the remorse, anxiety, and angst I encounter in others.

Into this nearly daily encounter speaks the voice of Richard Walker in his book, Twenty-Four Hours A Day. Aside from "Bill" of Alcoholics Anonymous, Richard Walker is one of the most influential voices in the substance abuse recovery movement and this book has been as influential as any in the genre. In it, he argues the seemingly unusual (especially in our culture) but completely sane idea that one day is enough for anyone. He writes,

"Anyone can fight the battles of just one day. It is only when you and I add the battles of those two awful eternities, yesterday and tomorrow, that we break down. It is not the experience of today that drives us mad. It is the remorse or bitterness for something that happened yesterday or the dread of what tomorrow may bring. Let us therefore do our best to live but one day at a time." - Richard Walker, Twenty-Four Hours A Day

I have been echoing some form of this sentiment on a nearly daily basis to the patients and families I encounter in my work as a chaplain working with patients experiencing mental health and substance abuse concerns. We cannot control or change the past and the future is  completely unknown and, to some extent, arbitrary. We only truly have this moment, this place. This idea got me thinking about worries we all carry around with us and just how ultimately futile an exercise worry can be.

It seems to me that this idea crops up in many places throughout history. For instance, there's this zen saying:

“If the problem has a solution, worrying is pointless, in the end the problem will be solved. If the problem has no solution, there is no reason to worry, because it can’t be solved.”

Or, consider these words from the Tao Te Ching:

“Be careful what you water your dreams with. Water them with worry and fear and you will produce weeds that choke the life from your dream. Water them with optimism and solutions and you will cultivate success. Always be on the lookout for ways to turn a problem into an  opportunity for success. Always be on the lookout for ways to nurture your dream.”

And, of course, Jesus had a lot to say about worrying:

“Therefore I tell you, do not worry about your life, what you will eat or drink; or about your body, what you will wear. Is not life more than food, and the body more than clothes? Look at the birds of the air; they do not sow or reap or store away in barns, and yet your heavenly Father feeds them. Are you not much more valuable than they? Can any one of you by worrying add a single hour to your life?

And why do you worry about clothes? See how the flowers of the field grow. They do not labor or spin. Yet I tell you that not even Solomon in all his splendor was dressed like one of these. If that is how God clothes the grass of the field, which is here today and tomorrow is thrown into the fire, will he not much more clothe you—you of little faith? So do not worry, saying, ‘What shall we eat?’ or ‘What shall we drink?’ or ‘What shall we wear?’ For the pagans run after all these things, and your heavenly Father knows that you need them. But seek first his kingdom and his righteousness, and all these things will be given to you as well. Therefore do not worry about tomorrow, for tomorrow will worry about itself. Each day has enough trouble of its own.

"Each day has enough trouble of its own."

Indeed it does. And, what if, the key to a happy, calm, and meaningful future is to be found in simply tending to the moments we have, one day at a time. If I'm honest, I have to admit that I tend so often to realities beyond my control because I focus on what happened that I regret or worry about what *might* happen. I pray that we can learn to attend to that which is in front of us in this moment and to let that be enough for others we encoutner. I think if we can do that, we might wake up to the beauty all around us and the world might be a little more peaceful.