HelpJamieBecomeAChaplain

The formatting on this platform leaves much to be desired, so I'm adding a copy of the text via .pdf, which you can find here.

Normally University of Michigan Medicine is full of people. With around 1,300 in-patient beds, plus outpatient services and all the accompanying staff, you can imagine it's hard to get a photo or video without any people or signs, however, it's completely possible around midnight.

Hi, friends!

It's been awhile since I last posted, but that's because my schedule has filled out and in the best possible ways. I had several weeks in which I worked at the hospital about twice as much as I usually do, I’ve started dating again, and am building friendships and community. Life has been good to me. 

While I am immensely grateful for the short-term housing that was provided to me the last few months, it is time to move on. My hosts, Sarah, Nathan, & Belén Nahar were beyond generous, but renovations started on their house today, so I’m in the midst of a move to a house in Ypsilanti—a cute suburb of A2 that is still a part of the local bus system. My new location arrangement is through the end of September, at which point I will have access to a regular stipend, student loans, or income, depending on a few things. My new housemate, Alex, is a therapist who works with children and teenagers and he is providing a basement apartment at no cost in exchange for regular work around the house and yard. We get along great and I look forward to shared board game nights and cookouts.

You might have noticed in the last paragraph that I mentioned “stipend, student loans, or income.” That’s because life continues to unfold in unexpected ways. One development is that hospital spiritual care and related-training programs throughout the country, are grappling with funding cuts that came with the “big beautiful bill.” Consequently, Clinical Pastoral Education (CPE) programs across the country are taking fewer students, residents, and many are even closing up all together. In a time when spiritual guidance and companionship in the face of grief is needed more than ever, the options to get board certified and employment are in many ways drying up. This means that Michigan Medicine’s CPE program has more applicants than ever before, and the funds to only take on four residents this fall. While I am still applying for the residency and think I stand a good chance of being accepted, the application process has become more competitive. Additionally, while I was originally open to applying to residency programs across the country, I honestly do not have it in me to make a move to yet another city. I want to make Ann Arbor home for at least a few years, and possibly permanently. In light of this, I am not only in the midst of my CPE mid-term paper and review, plus the application process for this fall’s residency, but am also applying to a Doctor of Ministry program that is mostly online. While I still have the overall goal of becoming an instructor for CPE programs in the future, my goal is shifting away from a specific job title to more about becoming the best chaplain possible and finding ways to help expand CPE programs overall.

Transitioning away from these updates, I’d like to answer the question I’ve received from many of you: What do I actually do as a chaplain?

So what do I actually do on a shift? I am usually on call with the pager system, as we interns work our shifts when no other spiritual care staff are present—evenings, weekends, and overnights. Pages received are our top priority and usually relate to incoming trauma patients in the Emergency Department or patients facing end of life. (When I refer to end of life, this usually means that death will take place in the next few minutes or hours, not days.) After tending to any emergency pages, I look at patient charts. Generally I start with those flagged as "orders". These are patients from the entire facility—which includes the university hospital, the children and women's hospital, the cardiovascular hospital, the emergency department, and etc.—who have been flagged as in need of attention within the next 24 hours. These patients are often end-of-life, trauma, or otherwise in more urgent distress. Somewhere between 10-20 orders are usually waiting when I clock in. After reading over their medical charts to see why they’ve been flagged, I look at any religious affiliation that might be listed (though this is often as not incorrect), if any other chaplain has visited, and any other important information that might impact the care I provide. If I am caught up on orders, then I look at nursing assessments. These are cases in which a nurse thinks it might be a good idea to check on a patient. These aren’t dire situations and we tend to them as able, knowing that we will not be able to visit them all. In the event that we have caught up on orders and assessments, then we visit wards, meet with clerks and nurses, and ask which of their patients might benefit from a listening ear.

Depending on the time of day, patients might be napping, eating, in a procedure, or with family or friends. I make a note to visit these individuals, if possible, later in my shift. When someone is available, I first try to meet with their nurse to get the most up-to-date info on the patient—possibly things they didn’t think to chart. Is the patient afraid, do they have support, etc. Then I gown and mask up if needed and I let myself into the patient’s room. I introduce myself as Jamie from Spiritual Care and ask how they’re doing. While I could introduce myself as a chaplain, this tends to create a distance with patients who have no interest in organized religion.

I usually sit near the patient so I can make eye contact, rather than look down at them. I find that most patients, religious or not, and assuming they’re not tired, like to talk—the hospital can be a lonely place. While I’m listening, I’m paying attention to any clues that point to spiritual or emotional distress. How are they finding or making meaning? Who or what do they look to for support? Do they have pictures of family or cards in their room? Do they have religious books on their table or are they listening to religious music? Clues lie all about if you pay attention. I use these clues as hooks to ask questions, to dig deeper into the person’s narrative. At some point I will assess whether or not they would like or benefit from prayer, other spiritual or religious resources, or ongoing spiritual care. These meetings can be short or long. They can be perfunctory or incredibly emotional. It is not uncommon for a patient to say this spiritual care and listening presence has changed their life. It’s immensely rewarding. 

After visiting with the patient I take a few moments to reflect on how or why I might have connected with a particular patient. Was I triangulated? Did I connect in a certain way because of my own history? What diagnosis should I provide and how should I chart the conversation and needs for the benefit not only of the patient (who can usually see the information in any discharge paperwork), but also for the doctors and nurses who will access this information so that we as a team can provide the best possible care? In the midst of all of this, the most important person I have to care for is myself. A lot of my job is maintaining the composure of being the most calm person in the room—this requires a great deal of self-awareness and self-care. 

Shifts can be long. They can be hard. But they can also be full of joy. And, honestly, I love it all. 

Fundraising Needs

I have managed to support myself financially off the sale of remaining furniture that I am finding I just don’t need, but there’s still only so much of that available! While my financial needs are modest, I do still have a few expenses. 

In order to get through the rest of May, I need to raise $500, which will cover:

$150 pharmacy co-pays.

$50 Uber rides for when the bus is not available. (Mostly for overnight shifts when I get off at 6 a.m.)

$125 cell phone service.

$125 living expenses.

$50 tuition ($400 currently remains due.)

Prayer Requests

• For insight and energy as I apply for CPE residency at University of Michigan Medicine and entrance into a Doctor of Ministry program.

• That Oban & Peaty will transition well into new housing.

• That I grow in my ability to better assess when a patient might be taking advantage of my desire to believe the best in all.

• That financial support will continue to come in so I can complete my chaplain internship, so as to move closer to board certification.

Know that I think of each of you often and thank God for your friendship and generosity.

Be well in all ways,

Jamie

A partial and late reflection from Maundy Thursday.

A new command I give you: Love one another. As I have loved you, so you must love one another. By this everyone will know that you are my disciples, if you love one another.

—John 13.34

Did you ever wonder why today is called Maundy Thursday? Maundy comes from the Latin mandatum, which means commandment. Jesus, nearing the hour of his death gives one final commandment to his disciples. After washing their dusty feet with his own hands, he commands them—he commands us—to love one another. And not just to love one another, but to model our love after his. What does this form of love look like? We don't have to imagine—John paints the picture for us. Jesus's love looks like humility. It looks dirty and uncomfortable. It looks like service to others' most bodily needs. And it makes people ask questions. 

This passage in John speaks to me right now in a new way. When people are sick or dying they are not at their best. They might struggle to stay awake or finish a sentence. Their face might be misshapen. They might smell. They might not even remember who you are. They might have been a terrible husband or father. They might have been mean to those around them. And yet we're called to love these people. We might have to gown up and mask up. We might have to use more hand-sanitizer than we thought we'd ever use in a lifetime just in one day. We might have to sit in silence waiting to see if the family will say anything or nothing. Yet this is where Jesus is.

Friends,

I'm coming to the end of my second week of chaplaincy and all the training that comes with it. I'm tired but present, and that feels healthy.

This week was another one of firsts. I worked my first shift, was the on-call chaplain for emergencies, and saw patients on my own for the first time. While last week's shadowing of full-time chaplains came with a few eye opening situations, this week's work was surprisingly calm and peaceful (though I do not expect that to be the norm!).

I had my first day of class on Thursday, and it also went well. Right now we're still just setting expectations and continuing to read through the syllabus and handbooks and such. I'll focus on my first full day of homework on Monday, which will include scheduling my weekly one-on-one sessions with the CPE director. I'm sure you'll hear more about the educational aspect as time moves on. I know I need to discern my goals and objectives soon, so I'll share those once they're clearly articulated.

Something I've noticed this week is that often, when others learn that I'm a chaplain, their eyes light up. Their posture changes. They begin to tell stories. This is with folks outside of the hospital—just normal people leading normal lives who once encountered someone whose job was to listen and offer support without judgement. These are people who might not want to walk through the doors of a church, synagogue, or mosque. These are people who might not have had family present. These are folks with children who were sick. While my professional work within the church used to be more academic in nature, I am grateful that my path is now pastoral. I don't preach sermons, but I will offer communion. I will baptize. I will bless. And I will listen to a lot of stories. This makes my heart glad.

I do have a busy weekend and week ahead of me, so I might not have time for another update until mid-late next week. Even when you don't hear from me for a few days, though, know that you're thought of and prayed for. Living in a small town with few friends the last few years was incredibly isolating, given I couldn't drive anywhere. But you all—everyone who has sent a note or made a donation—have reminded me how big my circle of support really is. My heart needed that and it helps when I wonder how I got here and how I'll be able to afford the rest of this internship. You all have reminded me that I have community and that I am not alone. 

Finances

As you know, this chaplaincy internship is unpaid, even though I make my own rounds, chart notes for patients that are shared with medical staff, sit with the dying, and take the worst shifts (as is true for interns round the world). I have no complaints—I want to be here and this is the nature of Clinical Pastoral Education programs everywhere.

Some in my group are full-time pastors and their denomination or congregation help with tuition and provide a steady income while they complete this internship. I, however, am not one of those people. I rely entirely on the support of people like you. Because I was only aware of my acceptance in the program a month before it started, there was no time to save and donations come in just in time for tuition and bills to be paid. I've set it up so that $100 is due every Monday until tuition is paid in full, though I also have the regular bills that need to be paid to get through each week, including some groceries, phone, transportation, and small self-care items.

Given all that, this is my budget and what I need through the end of this month:

$225 March 23rd

$220 March 25th

$220 on March 30th

$665 in total

Prayer Requests

• Pray that people who can give financially and feel led to do so come forward.

• Pray that I pace myself well and protect my energy especially at the end of my shifts and when I go home. I can tell when the computer work or chaos outside of work starts to wear me down and irritate the remaining inflammation in my brain. I'm able to manage this with ice packs and breaks, but I am feeling the long-term consequences of my brain injury more now than I have the last few years. 

• With the need to have more quiet space than most, I do wish for an apartment of my own. That's not possible right now, but I'm aware that I need to think about this as I move forward in the fall, when I (hopefully!) start a full-time residency with a modest stipend. The cost of living here is outrageous, so let's start praying now that something will surface! 

• Tonight I'm especially grateful for a fenced-in backyard that my dogs can enjoy. Peaty escaped once, so I do have to keep him on leash, but Oban can run freely and all three of us have enjoyed the warmer weather the last few days.

• I'm excited to start making friends. I've already been invited out for coffee and another time for a girls' night. I couldn't accept either, as I'm still juggling just getting everything else done, but I'm excited for a time in the not-so-distant-future when I can start to build my own social circles outside of the house and hospital. Pray that I will have the energy to seek out and that I will find friends with whom I can laugh, and grow, and love.

I hope that wherever this update finds you that you know you are part of something bigger than yourself. As part of something bigger, may you be reminded that you are also connected: to your family, to your neighbors, to those being disappeared, to those being bombed, and also to those doing the bombing. Love this earth as if our feet truly walk on it. Love each other as if we each actually matter. Love as if Christ lived and died for it. 

Goodnight,

Jamie