Healthcare Chaplains
Ministry Association
(formerly Hospital Chaplains' Ministry of America)
377 E. Chapman Ave
Suite 260
Placentia, CA 92870-5094
Phone: (714) 572-3626
Fax: (714) 572-0585
info@HCMAChaplains.org

Theological Orientation & Role Definition of Hospital Chaplains: A Survey of Healthcare Chaplains Ministry Association (HCMA, formerly Hospital Chaplains’ Ministry of America) Chaplains
Douglas M. Cecil, D.Min., PCC
Associate Professor of Pastoral Ministries
Dallas Theological Seminary

Introduction

The hospital environment is rapidly changing, both technology and the way patients are treated. Treatment plans are influenced by DRGs (diagnosis related groups) and patients are confronted at the admission desk with advance directives.

Medical care and patient's self-determination have skyrocketed to the forefront of national attention with names like Cruzan and Kevorkian. National healthcare programs have become a political volleyball.

Into the midst of this fast changing, competitive environment enters the Chaplain. What is the Chaplain's role and responsibility in the midst of all of this change? Lawrence Holst well describes the tension that a Chaplain faces when he speaks of a Chaplain walking between two worlds, the world of “religion and medicine.”

To move between these two worlds that are so markedly different-yet were at one time united-is to be in tension. The tension can be painful, confusing, exciting, creative. Like many tensions, it is never fully resolved and perhaps never will or should be.¹

The source of the tension that the Chaplain faces can be readily identified. The Chaplain, often being an ordained minister, often has specialized training as a pastor in the context of a local church. The pastor becomes a Chaplain and is then thrust into a foreign, highly specialized field with a distinct vocabulary and unique set of problems.

The chaplain identifies with both worlds, yet does not feel entirely at home in either. Chaplains are an enigma to both worlds: medicine does not consider them ‘medical enough' and questions their relevance; the church often does not consider them ‘pastoral enough' and questions their identity. But the fact is that despite the tensions and enigmas, the hospital chaplain is very much committed to both worlds and is a vital link between them.²

The ‘role' of the Chaplain appears to be the issue that receives the most attention and coverage in the currently available materials. What are the role and responsibilities of the Chaplain in the modern hospital?

Review of the Related Literature

Within those books and articles that deal with the hospital Chaplain, and specifically the role of the hospital Chaplain, several role models have been suggested. A brief survey of the suggested roles is presented here. Note that the discussion of the role of the hospital Chaplain is a fairly recent topic.

Gemmel views the role of the Chaplain in hospital ministry as no different than the function of the minister in the parish ministry. He states that, “the Chaplain is the Church's representative and servant.”³ Gemmel goes on to state that,

“the function of the chaplain within the hospital . . . is to relate the dynamic content of the Gospel to the experiences through with men and women pass while they are hospital patients, that they may know its saving grace in the power of God's Holy Spirit.”⁴

Heije Faber describes the role of the minister (his general term for Chaplain) in the modern hospital from his perspective.⁵ In order to do this, he makes the unusual comparison of a minister in the hospital to a clown in a circus. The minister, he suggests through simile, is like the clown in the circus. Faber states that, “the clown is a necessity in the circus, without whom the circus is no longer a circus but is reduced to a string of numbers.”⁶ Therefore, the clown brings unity and comic relief to an otherwise tense environment.

But Faber goes on to argue that the clown offers more to the circus than mere comic relief. The clown is a reminder of human frailty and weakness. He is able to reach and entertain people because of his humanness. The people may leave the circus impressed by the feats of the performers but they also leave feeling more human because of the clown.

The clown not only performs a vital role, but also changes the climate of the circus through his presence. Similarly, the Chaplain, who is comfortable with himself, is able to soften the institutional aspect of the hospital climate.⁷

Faber explains that his purpose is not to look just at the minister's task, but to look at the minister himself.⁸ His desire to look at the minister himself stems from his conclusion that usually the minister, because of the tensions that exist in the hospital, feels inferior, ceases to be himself and fails to see himself making a contribution. In this situation, the minister loses direction and purpose. Almost in desperation he raises the question, “What is the essence of the pastoral ministry? What is irreplaceable about it? And what, in the light of this, are the possibilities open to us of realizing this essential ministry?”⁹

Faber suggests that the essence of pastoral ministry in the hospital is to join the sufferer in his struggles. He would acknowledge that the minister is a representative of Christ, yet the definition of “a representative of Christ” is in question. To be a representative of Christ is to offer pastoral solidarity with another.

The pastoral ministry is therefore pastoral solidarity with the other, supporting him in the quest to become one who dares to believe in himself, because he has discovered through the minister, experienced (emphasis his) through him, that Christ believes in him. As a result, he begins to look for that light in hope and in turn finds himself wanting and able to be in solidarity with others.

To represent Christ is therefore essentially a way of being (i.e. an interaction of word and deed), in the deepest sense an attitude. When we grasp this, we can see that the presence of the minister changes the ‘climate' of the hospital: instead of being an institution it becomes a home. It becomes much more than a factory, a place in which ‘feats' are performed. This happens in the same way in which the ‘climate' of the circus changes through the presence of the clown, who by his performance puts the ‘feats' of the others in perspective.¹⁰

George W. Barger and his associates surveyed Chaplains in Nebraska in 1984. A questionnaire was mailed to all the members of the OAICA (Omaha Area Institutional Chaplains Association) and the Nebraska State Chaplain's Association. The results of this survey showed that Chaplains see themselves playing three major roles in the hospital: counselor, professional and religious functionary.

Counseling in the survey was defined as meeting the patient's needs, and being available to assist people no matter how large or small the need may be. A religious functionary was defined as one who “lifts up spiritual values within a hospital” and gives “concrete support through prayers, the Sacraments and Bible reading.”¹¹

Perhaps the most interesting finding of the survey was the lack of consensus among Chaplains regarding their role. As the authors remarked, “Perhaps the most important finding of this study is the low level agreement that exists among Chaplains as they describe their role expectations.”¹²

Norman Dawson categorizes the Chaplain's function at the hospital into four major roles.¹³ He views himself (the Chaplain) as priest, teacher, counselor and “clown.” It is interesting that the image of a clown with reference to the hospital Chaplain comes up a second time. In any event, Chaplain Dawson sees his initial role as being a counselor. He says that the initial aim of the Chaplain “should be to discover the nature of that person's need at that moment. Having discerned that the chaplain will be in a position to decide the most appropriate role, that of priest, counselor, teacher or clown.”¹⁴

Lawrence E. Holst has tried to summarize what he has observed about the role of the Chaplain. Holst observes that the impact of Clinical Pastoral Education (CPE) has forced the pastor to move past his own world and to join the sufferer in his world. He observes that,

“. . . the C.P.E. (Clinical Pastoral Education) movement attempted to stimulate pastors to explore their own inner world in order to become more sensitive companions to other's struggles with the vital issues of life. C.P.E. boldly attempted to link the external and internal world of the learner, the cognitive with the emotive, theory with practice, theology with psychology.”¹⁵

Holst goes on to suggest that,

“The task of pastoral care is to join the sufferer, to enter the pain, to engage the absurdity, to descend into hell . . . not to minimize or to mitigate the suffering, but to help the sufferer to put the suffering in perspective.”¹⁶

Raymond G. Carey lists what he views as the roles of the hospital Chaplain.¹⁷ He conducted a survey among permanent staff Chaplains, one-year CPE residents, and CPE students who were taking the CPE training for one unit of credit. The result of the survey found that these Chaplains viewed themselves in five major roles: comforter, liturgist, witness, resource person, and counselor.

In addition to the roles that are listed above, other Chaplain authors have written that the Chaplain can take a role in research,¹⁸ as ombudsman¹⁹, which handles complaints against the institution and is a patient representative, or other roles depending upon the specific setting²⁰ or institution.²¹ These role definitions are based on observation and the expertise of the particular Chaplain author.

It is clear that there have been a number of roles suggested for the hospital Chaplain. From the review of the literature we see the following suggestions: servant, clown, counselor, professional, religious functionary, priest, teacher, mediator, mobilizer, enabler, comforter, liturgist, witness and resource person.

The Need for the Study

Most of the data collected and reported in the related literature was from individuals of predominantly the same theological orientation, individuals sympathetic with the practice of Clinical Pastoral Education (CPE). But, what are the role and responsibilities of other hospital Chaplains who are not primarily from the same theological orientation and training? Are the role and responsibilities of a Chaplain from a different theological orientation and training the same? Do the religious convictions of the respondent influence the responses to the research? Would a different theological orientation alter the results?

A study was proposed that would survey the role of a hospital Chaplain from a different theological orientation. The research data base was limited to Hospital Chaplains' Ministry of America (HCMA, now Healthcare Chaplains Ministry Association) trained Chaplains. This study assumed that HCMA Chaplains, having subscribed to a doctrinal statement, would reflect a different theological orientation and clinical training program.

The Descriptive Survey Method

The descriptive survey method was chosen for this study for two main reasons. First, the descriptive survey method looks at the phenomena of the moment and then describes precisely what the researcher observes. The underlying assumption of such an approach is that the given conditions that are established in the study usually follow a pattern or norm so that the results can be used to establish a course of action for the future. In this case, research of hospital chaplaincy, the question is “How do HCMA hospital Chaplains currently view their role?” The descriptive survey method would answer that question.

Secondly, the descriptive survey method is appropriate in this instance because other studies in the past have employed this method. It is acknowledged and agreed upon that what one researcher found to be valid in one sample population at one particular time cannot be accepted for all time as a constant. However, the studies of the past which employed a similar method will give insight into the data that is recovered in this study. The accumulation of data over a period of time, therefore, may allow conclusions that have a firm base in fact.

The Descriptive Survey Design

The survey was designed from the review of the related literature. It explored two main questions. The first was, “What is your purpose as you visit in the hospital?” Or, stated another way, “What are you trying to accomplish as you visit in the hospital?” The second was, “In what role do you see yourself as you visit in the hospital?”

Under each of these two main questions several possible purposes and roles were listed. The response that was required of the respondent was one of degree, based on a five choice scale that was bracketed from “never” to “always.” The answer scale was designed to affirm the observation that often Chaplains find themselves in situations where they need to adapt their role and purpose to reflect the needs of the patient at that moment. The Chaplain may enter a situation with one role in mind, yet find that he or she should change roles to help meet the need of the patient.

The scale also acknowledges the fact that Chaplains find themselves in all of the roles that were listed at some time or another. Every Chaplain has found himself or herself in the role of counselor for example. Yet that may or may not be that particular Chaplain's primary view of his ministry. The scale was designed to reflect the degree to which the Chaplain values a particular role or purpose and how often they find themselves in that particular role.

The survey also addressed the possibility that role and purpose might often be indistinguishable from each other. Chaplains might see themselves in one role with two purposes, or just the opposite. In most cases, however, it doesn't appear that Chaplains have made a distinction between role and purpose or thought through the options or possibilities. The purpose often expresses the role and the role often represents the purpose. Therefore there should be a high correlation between the purpose and the role. If the responses do not reflect a correlation between the role and the purpose, then the respondent or the instrument could be suspect.

From the review of the related literature eight main categories were identified and isolated. These categories of the way that a Chaplain views his or her purpose and role, were mentioned at least twice and often times three times in the literature. In some instances the categories were identified by responses from another survey that was taken.²² This literature background gives evidence that these eight categories are common roles used to identify Chaplains.

Counselor

The counselor role was mentioned numerous times in relation to hospital ministry.²³ It is seen by some Chaplains as their primary ministry and the ministry that is used initially when approaching a patient.²⁴ A counselor is defined as a person who meets the patient's needs.²⁵ The Chaplain's role as a counselor is to discover the nature of the patient's needs at that moment and then meet those needs, whatever those needs may be. A counselor would therefore be primarily patient directed and interested particularly in the patient's personal needs at the moment.

However, the role of the Chaplain as counselor also bleeds over from counseling spiritual issues into counseling personal issues. Patients for example may need counseling on medical ethics or family problems. Hospital employees may need counseling with their personal and work related problems.

On the questionnaire this purpose is measured through the statement, “to be able to meet the patient's needs at that moment.” The role is simply portrayed as “counselor.”

Comforter

The role of the Chaplain as a “comforter”²⁶ is also described by some as “teacher”²⁷ and “mediator.”²⁸ In this role, the Chaplain helps the patients deal with their fears and anxieties resulting from their illness. The Chaplain lends objectivity about the illness and helps the patients to put their illness into perspective and to reassemble their lives which have been upset by the onset of an illness.

The Chaplain in this role also has a ministry to the patients' families at the time of serious illness or death. Such ministry is one of bringing comfort to the distressed.

The questionnaire reflects this purpose of the Chaplain with the statement, “to help the patient maintain a healthy and realistic perspective and therefore be able to cope with the fears and anxieties that result from illness.” The role is titled “comforter.”

Professional

In this role, the Chaplain is a professional in a professional environment. The Chaplain has a place in the administrative hierarchy of the hospital.²⁹ But, the Chaplain also is available to the physicians and nurses as a professional resource person. ³⁰ Often the Chaplain is seen as an expert in certain areas that overlap between the medical and spiritual worlds such as grief and crisis counseling.

The Chaplain, as a part of a medical care team, is available to conduct lectures and classes in his area of expertise. The Chaplain in this role is also able to communicate to patients the concern and dedication that the entire medical team has for the patient's well-being.³¹ The Chaplain's support and experience as a professional is also welcomed on the bioethics committee, or on the oncology team.

On the questionnaire this purpose of the Chaplain is measured by the statement, “to serve as a resource person and provide answers to the tough questions that are being asked.” The role is simply identified as “a professional resource person.”

Religious Functionary

In the role of the religious functionary, the Chaplain is there to help uphold spiritual values in the hospital.³² The Chaplain keeps the spiritual dimension of healing in the forefront of everyone's mind.³³ In this role the Chaplain also makes spiritual resources available to the patient, often by arranging worship services or by administering the Sacraments.³⁴ The Chaplain, as the religious functionary, provides concrete support of the patient through prayers or Bible reading.

Other terms that are used to describe this role are “priest”³⁵ and “liturgist.”³⁶ The primary focus of this role is on doing something rather than on being something. The Chaplain in this role is primarily focused on providing expected religious services and duties rather than on being a representative of God.

The questionnaire addresses this purpose as “to provide spiritual resources through Bible reading, the Sacraments or a worship service.” The role is simply portrayed as a “religious functionary.”

Ambassador for Christ

As an ambassador for Christ, the Chaplain is a servant, church's representative,³⁷ and witness.³⁸ The Chaplain serves as a witness in times of crisis of God's love and concern. Often this role of a Chaplain is accomplished by mere presence. As a representative of Jesus Christ, the Chaplain is able to show compassion, mercy, care and love. In 2 Corinthians 5:20 we read that “we are ambassadors for Christ.” This surely applies in the hospital as well as in other settings.

As an ambassador for Christ, the Chaplain has an opportunity to share God's love and concern for the individual. This might take place through touching or listening, but it also might take place as the Chaplain shares the gospel message with the patient.

Some might specifically refer to this ministry as the ministry of presence, or as the “incarnational ministry.” However, the Chaplain's ministry as an ambassador for Christ often goes beyond mere presence to also include the presentation of the gospel. Prayerfully leading a patient to a place where he or she expresses trust in Jesus Christ would be appropriate for the Chaplain in the role of ambassador.

On the questionnaire, this role is simply reflected as “an ambassador for Christ.” The purpose is stated, “to share the good news of Jesus Christ with the patient and be with them in times of crisis as a witness of God's love and concern.”

A Reminder

This particular image of a clown describes a role of the Chaplain in a unique fashion. The role of the Chaplain is compared to the role of a clown in a circus. In the role of a clown, the Chaplain brings unity and comic relief to an otherwise tense environment.³⁹ But more importantly, the clown is one who is a reminder of our human frailty and weakness. The Chaplain, in the role of a clown, is one who is able to carry and express our inadequacies.⁴⁰ The Chaplain helps the patient to feel more at home in the hospital environment and to come to grips with their humanness.

On the questionnaire, the role of the Chaplain in this category is expressed simply by the statement, “A Reminder.” The purpose that is expressed on the questionnaire is represented as, “to remind the patient of our human weakness and frailty so that the patient is able to feel more comfortable with his condition in the hospital environment.”

Encourager

The role of the Chaplain in this particular ministry is that of an encourager. The Chaplain encourages the patient to marshal his or her energy and will to get better.⁴¹

The Chaplain helps the patients to maintain their will to live. The Chaplain in this role is there to help the patients see the things that are worth living for and the consequences of giving up too soon.

On the questionnaire, the purpose is reflected by “to encourage the patient to marshal his/her energy and will to get better.” The role of the Chaplain is described as “an encourager.”

Partner

In the role of the partner, the Chaplain is to “join the sufferer, to enter the pain, to engage the absurdity, to descend into hell...not to minimize or to mitigate the suffering, but to help the sufferer to put the suffering in perspective.”⁴²

As is the case with all of these roles, a Chaplain in general tries to assume this role to some extent, trying to be a compassionate partner with the patient and to go through the illness with them as a friend and a witness for Christ. However, as with all of these roles, the Chaplain cannot fulfill all of the requirements that the role demands. The Chaplain cannot fully enter into the sufferer's world; but the Chaplain can point the sufferer to the One who is able to fully enter into his world.

This ministry of identification with the patient, of becoming a compassionate partner is described as “trying to join the sufferer and to enter into the sufferer's world.” The role is simply described as “a partner.”

The Procedures Used to Administer the Instrument

The instrument was administered at one session of the Hospital Chaplains' Ministry of America (HCMA, now Healthcare Chaplains Ministry Association) national convention in Anaheim, California on Monday afternoon, May 21, 1990 . The administrator was allowed five minutes to introduce and distribute the instrument to the respondents.

The participants were given until the end of the day, which was about an hour, to complete the questionnaire. After the introduction and distribution of the questionnaire, the organization's secretary conducted a short business meeting regarding the mailing policy of the organization. Most of the responses were filled out during this presentation.

Following the business meeting, the afternoon session was dismissed. The completed questionnaires were collected at the exit. A few completed questionnaires were turned in the next day.

The statistical package for the Apple Macintosh, “JMP,”⁴³ was chosen to handle the data due to its graphic capability. The age of the respondents was entered as an interval number, as were the years of hospital ministry and number of beds in the hospital.

The Results of the Data

The results summarized a profile of the respondents, and the respondents' view of role and responsibility in the hospital. There were 96 respondents to the questionnaire. The average age of the respondent was 60. The individual had been in hospital chaplaincy for 7 years and served a hospital of 250 beds.

The respondents were asked to place their theological orientation on a continuum between “liberal” and “fundamentalist”. The religious convictions of the respondents were: 42% stated that they were “evangelical”, 38% stated that they were “conservative” and 20% saw themselves as “fundamentalists”. There were no respondents to the other two categories, “neo-evangelicals” or “liberal”.

Based upon the data, the respondents primarily view their role and responsibility as being an “ambassador” for Jesus Christ. The other roles in their order of response were: “comforter,” “counselor,” “encourager,” “partner,” “professional resource person,” “religious functionary” and “reminder.”

From the essay section of the questionnaire, the respondents viewed their purpose and role as an “ambassador.” However, the respondents viewed their role in being an accepted and needed member of the hospital staff significantly higher in the essay section than the corresponding question in the body of the questionnaire.

When the data was analyzed against the profile of the respondents, it was observed that the profile of the respondent who chose the response of “ambassador” was most likely to be the individual over the age of 60 and has been serving as a Chaplain under 5 years, who possesses a doctorate and holds “fundamentalist” religious convictions. Yet the differences in the data which indicate this particular response preference was not large.

The Results Compared to the Literature

When compared to other data that has been collected from other sources, the respondent's responses to this study was close, but differed in a few significant areas. The role of the “liturgist” or “religious functionary” ranked significantly higher in Holst's study that was reflected in the literature than in the data that was collected for this study.

The models of ministry that were suggested from the literature were many. The roles suggested were: servant, clown, counselor, professional, religious functionary, priest, teacher, mediator, mobilizer, enabler, comforter, liturgist, witness and resource person. Holst, in his latest research,⁴⁴ listed the role of a Chaplain as comforter, witness, liturgist and resource person (tie) and counselor.

Holst defines his roles as follows. The comforter helps the patient “cope with fears and anxieties resulting from illness.”⁴⁵ The witness is one who prays with the individual and spends time with families as a testimony of God's love and concern. The liturgist administers the Sacraments and the resource person conducts lectures and classes. The counselor counsels with patients and employees on personal and work related problems.

The results of this current study bring new information to the discussion. It is granted that the categories that were used by Holst, and the categories that were used in this research project were different; however a comparison can be established. Holst's research listed the comforter as the respondents' number one choice, while this study listed the ambassador as the top choice among the respondents. The top choices from both research projects are given here in order:

One main difference between the two findings is in the placing of the liturgist and resource person. In this study, the resource person and religious functionary ranked #6 and #7 out of 8 possible choices. In Holst's findings, the liturgist and resource person ranked significantly higher. It might also be observed how “counselor” appeared in Holst's results compared to its placement in the current questionnaire.⁴⁶

The other difference that might be highlighted is that in the current questionnaire, the “ambassador” generated significant support. In Holst's findings, the mean values were highest for the comforter, while just the opposite was true for this study.

However, the possibility also exists that different theological traditions, while defining terms differently actually intend to communicate the same concept. For example, it may be that for Holst the combination of the witness and liturgist role is, in fact, the ambassador that is reflected in this study.

The question that was being considered in this analysis was, “Did religious convictions influence the responses in any way?” The answer seems to be that there was some correlation between the religious convictions and theological orientation of HCMA and the responses generated by this study. The more the respondents viewed their religious conviction as “conservative” or “fundamentalist”, the higher the mean of “ambassador.”

When the respondent's convictions are compared with the respondents who chose the “ambassador” as their primary purpose, the more conservative the religious orientation of the respondent the higher the response on the “ambassador” scale. When contemplating the “ambassador” role, the “fundamentalist” conviction had a 4.63 mean while the “conservative” conviction generated a 4.54 mean, and the “evangelical” had a 4.44 mean. This same pattern occurred throughout all of the roles. The respondents who viewed their religious convictions as “fundamentalist” consistently has a higher mean on all the roles than the other two categories.

The only difference was that when considering the role of “ambassador” the response mean was highest among the fundamentalist, conservative and evangelical in that order. On every other role that was considered the response mean ranking was fundamentalist, evangelical and then conservative.

Conclusion

The results of the questionnaire might indicate that the theological orientation of the respondent influences the perception of the Chaplain's role in the hospital. There appears to be a slight difference between the related literature and the way Chaplains of this particular segment and theological orientation perceive their purpose and role.

While those Chaplains in HCMA who consider themselves as more conservative view both their primary purpose and primary role in the hospital as being an “ambassador” for Christ, being “a significant part of the medical team” was also an extremely important role for the Chaplain even though it ranked low in purpose. So while the respondents acknowledge their role as an ambassador, they also appear to embrace and desire to acknowledge their role as a health care team member.

Discussion

The theological orientation of a Chaplain, or at least the theological orientation of the Chaplains that are represented in this study, appears to influence the way they view their role in the hospital. Or, in other words, the religious conviction of the respondent did seem to influence the Chaplains' response.

The data of this study also clearly affirms, in at least one segment of hospital chaplaincy which is defined by theological orientation, the role and the responsibility of the “ambassador.” Yet all would probably acknowledge that this role is not the only responsibility that the Chaplain must be prepared to perform.

The ways that a particular role is expressed in ministry can be many. There might be one role but many ways that role might be expressed. The role may remain constant, however the associated responsibilities of the Chaplain could be expressed through the other terms that were used in the questionnaire such as, “to meet needs,” “to encourage” or “to comfort.”

Therefore, the Chaplain might have the role as an “ambassador” for Jesus Christ, who, in the expression of that role, performs many functions. As an “ambassador,” the Chaplain may function as a “counselor” in a particular situation. The Chaplain in this role is still primarily an “ambassador” who is performing the “counselor” function.

The current debate and associated literature appears to have overlooked two important components: a Chaplain's theological orientation and a clear distinction between the role and responsibility of a Chaplain. First, a Chaplain's theological orientation is vitally important in the way that ministry will be carried out. The theological orientation of a Chaplain will help define their role and purpose in the hospital.

Second, a Chaplain's role is not exclusive from other responsibilities that might be performed. While a Chaplain might view their role in a particular way, that role will not remain exclusive. Other responsibilities will be carried out. However, whatever that specific role happens to be in a Chaplain's mind will influence their conduct. A Chaplain who views their role in the hospital as a clown will conduct ministry differently than one who views their role as an ambassador.

Future training and equipping of pastors and Chaplains should keep these two components in mind. A program that might try to curb an individual's theological expression might do more to hinder an individual in the ministry than help. Also, while current equipping appears to teach a variety of Chaplain responsibilities, emphasis should be given to the Chaplain's theological orientation which, in turn, is going to help define that Chaplain's associated role.

The Chaplain does appear to be between two worlds. However, the answer does not appear to impose a given set of responsibilities upon a Chaplain apart from their theological orientation. Such a training strategy might do more to encourage the confusion than help to solve it.

References

¹Lawrence E. Holst, Hospital Ministry: The Role of the Chaplain Today (New York: Crossroad Publishing, 1985), 12.

²Ibid., 26.

³Alexander Gemmell, The Hospital Chaplain (Edinburgh: The Saint Andrew Press, 1970), 8.

⁴Ibid., 11.

⁵Heije Faber, Pastoral Care in the Modern Hospital (Philadelphia: Westminster Press, 1971)

⁶Ibid., 81.

⁷Ibid., 87-88.

⁸Ibid., 88.

⁹Ibid., 89.

¹⁰Ibid., 90-91.

¹¹George W. Barger and others, “The Institutional Chaplain: Constructing a Role Definition” The Journal of Pastoral Care 38:3 (1984): 183.

¹²Ibid., 179.

¹³Norman W. Dawson, “Reflections of a Hospital Chaplain” Modern Churchman 27:4 (1985): 10-15.

¹⁴Ibid., 12.

¹⁵Lawrence E. Holst, Hospital Ministry: The Role of the Chaplain Today (New York: Crossroad Publishing, 1985), 16.

¹⁶Ibid., 25.

¹⁷Raymond G. Carey, "Change in Perceived Need, Value and Role of Hospital Chaplains" in Hospital Ministry: The Role of the Chaplain Today, Lawrence E. Holst, ed. (New York: Crossroad Publishing, 1985), 28-41.

¹⁸Edmond Phillips, “The Research Ministry: A New Concept for a Hospital Chaplaincy” Journal of Religion and Health 9:3 (1970): 218-32.

¹⁹Leila M. Foster, “The Chaplain: Patient's Advocate and Institution's Ombudsman” The Journal of Pastoral Care 29:2 (1975): 106-10.

²⁰An example would be in ministry to families. See Maurice Graham, “The Role of the Chaplain with Religious Families Who are Resistant to Treatment” The Journal of Pastoral Care 40:3 (1986): 273-75.

²¹William R. Morrow and A Thomas J. Matthews, “Role-Definitions of Mental-Hospital Chaplains” Journal for the Scientific Study of Religion 5:3 (1966): 421-34.

²²George W. Barger and others, “The Institutional Chaplain: Constructing a Role Definition” The Journal of Pastoral Care 38:3 (1984): 176-186. This survey identified three roles which are articulated below.

²³This role was mentioned by George W. Barger and others, “The Institutional Chaplain: Constructing a Role Definition” The Journal of Pastoral Care 38:3 (1984), Norman W. Dawson, “Reflection of a Hospital Chaplain” Modern Churchman 27:4 (1985), and Raymond G. Carey, “Change in Perceived Need, Value and Role of Hospital Chaplains”, in Hospital Ministry: The Role of the Chaplain Today, ed. Lawrence E. Holst (New York: Crossroad Publishing, 1985).

²⁴Dawson, “Reflection of a Hospital Chaplain”, 12. He sees himself in this role primarily.

²⁵George W. Barger and others, “The Institutional Chaplain: Constructing a Role Definition” The Journal of Pastoral Care 38:3 (1984): 182.

²⁶Carey, “Change in Perceived Need, Value and Role of Hospital Chaplains”, 41. He uses this name in his article.

²⁷Dawson, “Reflection of a Hospital Chaplain”, 13.

²⁸Gerald H. Pryor, “Hospital Chaplain Handbook: A Practical Guide” (D.Min. dissertation, Western Conservative Baptist Seminary, 1985), 5.

²⁹Barger, “The Institutional Chaplain: Constructing a Role Definition”, 183. He not only refers to this role as a professional but also defines this role primarily by the position.

³⁰Carey, “Change in Perceived Need, Value and Role of Hospital Chaplains”, 41.

³¹Pryor, “Hospital Chaplain Handbook: A Practical Guide”, 5. He mentions this a task of the chaplain in this particular role.

³²Barger, “The Institutional Chaplain: Constructing a Role Definition”, 183.

³³Dawson, “Reflection of a Hospital Chaplain”, 11.

³⁴Carey, “Change in Perceived Need, Value and Role of Hospital Chaplains”, 40. He refers to this role as a liturgist.

³⁵Dawson, “Reflection of a Hospital Chaplain”, 11.

³⁶Carey, “Change in Perceived Need, Value and Role of Hospital Chaplains”, 40.

³⁷Alexander Gemmell, The Hospital Chaplain (Edinburgh: The Saint Andrew Press, 1970) 8.

³⁸Carey, “Change in Perceived Need, Value and Role of Hospital Chaplains”, 41.

³⁹Heije Faber, Pastoral Care in the Modern Hospital (Philadelphia: Westminster Press, 1971), 81-83. The author goes to great length in this book to defend this image of the chaplain as a clown.

⁴⁰Dawson, “Reflection of a Hospital Chaplain,” 14-15.

⁴¹Pryor, “Hospital Chaplain Handbook: A Practical Guide”, 5.

⁴²Holst, Hospital Ministry: The Role of the Chaplain Today, 25.

⁴³JMP: Software for Statistical Visualization on the Apple Macintosh (Cary, NC: SAS Institute, 1989)

⁴⁴Lawrence E. Holst, Hospital Ministry: The Role of the Chaplain Today (New York: Crossroad Publishing, 1985)

⁴⁵Ibid., 40

⁴⁶Ibid., 41. In Holst's findings, the mean values assigned by the chaplain response group was: the comforter (2.90), witness (2.70), liturgist and resource person (2.47) and counselor (2.14). It was also interesting to note that in Holst's findings, when the mean value was combined with the other groups of patients, nurses and physicians, the ranking changed. Comforter was listed first and had a mean value of 2.78, followed by liturgist (2.59), witness (2.50), resource person (2.28) and counselor (1.96).

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