Spiritual care practitioner Brenda Steward continues to visit patients at Sunnybrook Health Sciences Centre in Toronto, sometimes arranging family visits via iPad.

Previous installments of this story can be found here: Part 1, Part 2

Much has changed since COVID-19, the disease caused by novel coronavirus SARA-CoV-2, was declared a global pandemic in March—including the suspension of in-person church services and social distancing and isolation measures for all Canadians. But some Anglicans who work in the healthcare field now find themselves on the front lines of this public health emergency. Among them are hospital chaplains and spiritual care providers who work in health facilities, nursing homes and hospital wards.

In order to give a picture of the challenges they face, the Anglican Journal reached out to spiritual health practitioners by email and asked each the following questions:

• What has working as a spiritual care provider been like during the COVID-19 pandemic? How is the virus affecting your place of work?
• What challenges to your work does COVID-19 present? Are you able to visit patients as usual? Do you have to wear protective equipment?
• What prayers do you have for this moment in time? How might people pray/rely on their faith in a time of emergency like this?
• Have your church and diocese been supportive during this time?
• What are some ways parishes/Anglicans can support spiritual care providers and other healthcare workers?

Responses have been edited for length and clarity. This story will be published in several installments.

“I find the empty family waiting rooms are emotionally hard to process.”

Brenda Stewart

Spiritual Care Practitioner, Sunnybrook Health Sciences Centre
Toronto, Ont. (Diocese of Toronto) 

Working as a spiritual care practitioner during the COVID-19 pandemic can be stressful.

It is exhausting.

It is inspiring, in that every day I see the commitment and sheer humanity of our care teams. I’m proud of the supportive role spiritual care plays as part of these teams and in helping support them.

It is, at times, emotionally overwhelming. I find the empty family waiting rooms are emotionally hard to process.

The lack of visitors in the hospital feels strange and sad. I continue to provide spiritual and emotional support for patients in person or by secure iPad, but I’m limited to providing family support by phone. Through the hospital’s iPad program, however, I am able to connect families and patients through iPad visits. We are required to wear a mask and protective shield for all in-person patient interactions and, of course, full protection as required for all infection-controlled rooms, including COVID and persons under investigation for COVID. In terms of professional practice—masks and shields limit our ability to respond with facial expressions and our voices are often muffled behind masks. Physical distancing plays a role too. Taking someone’s hand is discouraged, which can be heartrending. No hand holding. No hugs. No putting your hand on someone’s shoulder.

I often see how people’s understanding of a compassionate God, who invites us to be in relationship, is proving deeply comforting for them in these evolving times.

Some patients and families share how isolation and self-isolation is increasing their feelings of vulnerability and how they are discovering a need to “talk to God.” I often see how people’s understanding of a compassionate God, who invites us to be in relationship, is proving deeply comforting for them in these evolving times. This is a new world of virtual praying and praying through layers—shield over mask. For me, it illustrates how God of every faith is everywhere—and how sacred spaces are nurtured.

[In response to the question: ‘Have your church and diocese been supportive during this time?]

Church—No.

Diocese—It is my hope that the ongoing work of Canon Joanne Davis (chaplain at Sunnybrook hospital) and General Synod Director of Faith, Worship and Ministry Eileen Scully to bridge the gap between the diocesan and spiritual care practitioners will someday make a difference.

Perhaps in this time, a virtual support group for Anglican front-line health workers, including spiritual care, would be helpful.

“This is what each one of us signed up for, to be present, ready and able to support our patients to the fullest extent of our capacity and skill.”

Lucinda Landau

Spiritual Care Practitioner, St. Joseph’s Healthcare
Hamilton, Ont. (Diocese of Niagara)

Fortunately, we have an experienced team of spiritual care practitioners working at St. Joe’s in Hamilton. We’ve been able to maintain coverage of our regular inpatient units, and we rotate the 24-hour on-call crisis care in hospital. Even with the suspension of our educational program, units that were covered by spiritual care residents are now covered by the on-call chaplain. We assigned a specific chaplain to cover the COVID-19 unit, and in case any of us are called after-hours, we’ve received training on how to ‘don and doff’ the Personal Protective Equipment (PPE).

On the units, I’ve noticed an underlying tension amongst staff, fear really, about the virus. Colleagues readily acknowledge how exhausting it is to be at work. Everything we do now has an added measure of risk. Did I touch my face, did I take off the gown properly, have I been exposed or have I exposed someone else? Currently, all staff are screened for symptoms each morning as we enter the building; answer “Yes” to any of the screening questions and you’ll be sent for secondary screening, which may involve being swabbed for the virus. Masks have to be worn everywhere in the hospital. The usually busy hallways are completely empty, and we never have to wait for an elevator anymore.

Our spirit of professionalism hasn’t changed, though. This is what each one of us signed up for, to be present, ready and able to support our patients to the fullest extent of our capacity and skill. We’ve always had a ‘family’ feeling amongst hospital staff at St. Joe’s, and that’s keeping us going during the pandemic.

Make no mistake, this is hard—harder than anyone can imagine. But we’re in it together. Our hospital executive team has done a terrific job of communicating with us and leading the way. Their experience and foresight have really prepared us to face this pandemic. The general feeling is one of confidence that we’ll do the best we can because we’ve organized, moved units, opened up new areas for patients and we’re adapting moment-to-moment as changes arise. At the end of the day, we love what we do and are grateful for the opportunity to serve.

This pandemic is very real for me. I’ve already been swabbed twice for the virus and had to be quarantined with symptoms which tested negative. I work primarily with inpatients who have chronic kidney disease, kidney transplantation, hemodialysis outpatients, obstetrics and the NICU. My work on my units has not changed except that I have to wear a surgical mask and additional protective gear as each patient requires. I continue to visit inpatients on my most critical units daily, and follow up any referrals from my other units.

Because of the nature of chronic kidney disease, I have some very long-term relationships with my patients; I know them, I know their families and their life circumstances. I journey with them as their symptom load increases and they experience repeated hospital admissions. Spiritual distress is common as patients face worsening quality of life and even death. We have a dedicated palliative suite for family members to be present with the dying however long it may take—be it hours or days. However, that has changed with the pandemic. Visitors are not allowed to see inpatients. Every time someone from the community comes to hospital, it means staff are at increased risk.

I’ve learned that death, at the best of times, can be mean and messy; losing a loved one during the pandemic can make the process even harsher.

Thus, it’s become increasingly challenging during the pandemic to support non-COVID-19 patients who are dying because family members aren’t with them. We do our best to accommodate the dying, but it can mean that only two family members are present as death becomes imminent. Sometimes they arrive only minutes before the patient passes away. I’ve learned that death, at the best of times, can be mean and messy; losing a loved one during the pandemic can make the process even harsher.

As a full-time spiritual care practitioner, if I don’t pray daily and take reflective breaks during the day, I’m dead in the water, so to speak! I tend to see myself as ‘working for the Holy Spirit’ and endeavour to remain open to inner promptings of the Spirit throughout the day.

With the pandemic, our department has collected a lot of new prayer resources. We share a reflection every day at morning report and newer prayers are circulated afterwards. The Canadian Association for Spiritual Care has specific prayers on its website that we regularly look to. I’ve found it helpful to be part of a private Facebook group sponsored by the Chaplaincy Innovation Lab, with more than 1,600 members internationally. My favourite “pandemic prayer” is from the diocese of Niagara, and I created posters with the prayer and circulated them on my units.

I’ve really enjoyed the “virtual” worship with Bishop Susan Bell—it gives me time to sleep in and feel more rested for the week ahead. I’ve also been following the C of E’s online series of “Pilgrim” apps as well as tuning into virtual worship with the BBC and this has expanded my spiritual awareness of different ways to be in Christ with others outside the parish walls.

I think the greatest need for those of us on the frontline is to be given time to process what we’re experiencing firsthand. Even if the lockdown restrictions are slowly lifted in the community, pandemic limitations in hospital may not change much for the foreseeable future.

Community response in general has been very helpful—the acknowledgement, the gifts of coffee, pizza, garden plants, etc., are very gratifying. Knowing you understand and care about what we’re doing means a lot! Above all, stay in touch, call and pray for us—we need it!