Rev. Lorraine Leist Shares Her Experience on the Power of Palliative Care Chaplaincy

Editor’s note: The Rev. Lorraine Leist, M.Div., is a palliative care chaplain at Swedish Medical Center in Seattle, Wash., and an ordained minister in the United Church of Christ, with a board certification in chaplaincy by the Association of Professional Chaplains (APC). For the past two years, Leist served as a faculty member for the CSU Shiley Institute for Palliative Care’s Essentials of Palliative Care Chaplaincy course. She is now pursing her Doctor of Divinity degree.  

Institute – Q: Why Should Chaplains Learn About Palliative Care?

Leist – A:  First, as part of the healthcare team, chaplains need to be able to understand the principles and practice of palliative care, and recognize the need for it as they interact with patients in various settings. For chaplains, learning about palliative care also means learning about chaplaincy in a team setting.

Second, by learning about palliative care, chaplains can broaden their awareness and deepen their knowledge of the spiritual, religious, and existential needs of people and their loved ones who are facing the symptoms and stress of serious illness.

This means learning to listen for how people make meaning of their suffering, what they hope will be their legacy, and what concerns they might have about treatment or impending decisions. It also means helping patients talk openly about any fears regarding their own mortality, and helping them explore any religious, spiritual, or other existential struggles.

Institute – Q: What Is Meaning-Making?

Leist – A:  Meaning-making is the process of encouraging people to explore what is meaningful in their own lives. It is different for every person. For someone who loves gardening, a “holy morning” does not necessarily mean attending a church service; it could be enjoying a cup of coffee, while appreciating the beauty of the morning sun shining on her flowers.

Meaning-making may also involve memorable objects such as photos that remind a patient of how he enjoyed life. For an outdoors-oriented person, this could mean photos of nature trails the patient hiked, mountains he climbed, or sunsets he savored. These memories become especially important for patients with dementia because a photo taken long ago can trigger a momentary happy recollection, improving that person’s quality of life as he engages with his family.

Institute – Q: What Is One Challenge in Being a Palliative Care Chaplain?

Leist – A:  It can be a challenge for some patients who might believe a stereotype that a chaplain represents death. For patients with serious illness, reframing the chaplain’s role as a supportive partner in one’s journey through the spiritual and emotional ups-and-downs of illness can be comforting and can help calm fears.

Institute – Q: What Skills Do Chaplains Need to Work in Palliative Care?

Leist – A:  Teamwork, advocacy, and leadership. Working as a member of an interdisciplinary palliative care team, chaplains must learn to work with doctors, advance practice nurses, and social workers in a consultative service. This dynamic team environment requires flexibility, strong communication and interpersonal skills, and good timing.

When working together in this setting, it is also important to get a feel for when to push and when to pull and when to be still with your teammates. The interdisciplinary approach of palliative care invites chaplains to speak up and become stronger advocates for patients, and to take on leadership roles like leading an ethics workshop with other staff.

Students in the Essentials of Palliative Care Chaplaincy program learn by the end of the course how this team-oriented approach differs from other types of chaplaincy, and they see ways to advocate and take the lead in their own environments. By working through the curriculum, exploring the case studies, and interacting with other chaplains in their cohort, the light bulb switches on and they become inspired to do more!

Institute – Q: What Did You Enjoy Most About Teaching This Chaplaincy Course?

Leist – A:  I loved interacting with the chaplains who are students in the course! In the (eight-week) curriculum, every student is required to do a case study based on something they have experienced in their work, and then the instructor gives them personal feedback. That part of the course is so gratifying! I enjoyed cheering them on, saying, for example, “You’re doing this well, but maybe this could be a little different.” The chaplains I taught in this course actually helped me grow in my profession as well.

About the Institute

The CSU Shiley Institute for Palliative Care offers online and customized education to nurses, social workers, chaplains, physicians, physician assistants, and other healthcare professionals, with the goal of expanding access to and awareness of palliative care. Housed within America’s largest university system, we are extremely proud to be the country’s leading educational and workforce development initiative dedicated to improving palliative and end-of-life care.

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