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Reflections of a Hospice Chaplain

Reverend Stuart Coates recently retired as Chaplain of Strathcarron Hospice. One of the 'founding fathers' of the SPPC, he has been an active and valued member of SPPC groups and the wider palliative care community throughout his career. Though retired from the Hospice, he continues his role as Chair of the Forth Valley Spiritual Care Committee and his interest in the Cross Party Group in the Scottish Parliament on Palliative Care.

Within this blog, Rev Coates shares some reflections on his 27 years as a Hospice Chaplain in Scotland...

It is hard to imagine that it’s 27 years since I was appointed as first full-time Hospice Chaplain in Scotland!

The normal arrangement for health care chaplains at the time was that they were employed by the Church of Scotland, but Strathcarron Hospice broke new ground by employing me directly. This may seem a small matter, but it turned out to be a pioneering step now implemented throughout healthcare chaplaincy across Scotland, and maybe mirrors the transition of focus from religious care to spiritual care by which chaplaincy has become increasingly characterised.

I have always felt the task of offering spiritual care to be demanding and rewarding in equal measure. My initial mindset was that I might occupy the post for a few years before returning to parish ministry. However, my experience of multi-professional collaboration in palliative care prompted me to feel that this area of work carries a privilege which it would be hard to imagine in other settings.

My learning curve has focused on finding creative space to learn from patients and colleagues how the former’s goals can best be realized. I have been reminded of the qualities of partnership between caring professions which has always had a unique influence on the best kind of holistic care.

I call to mind a Sunday afternoon in December 1991 when a very small number of us gathered in Perth to inaugurate the Scottish Partnership in order to promote these qualities, both professionally and in the shaping of policy for palliative care.

Alongside a growing confidence in the promotion and delivery of spiritual care, the unique place remains for chaplains, in collaboration with religious, community and life stance groups, to ensure that the religious needs of patients, their families and caregivers are addressed.

I have always been fascinated by the manner in which these needs – sometimes along with a patient’s belief or life stance – can be subject to change in the face of crisis or life-threatening illness. The best deployment of spiritual care involves being attuned, sensitive and responsive to this potential for change, and to the opportunities for exploration which a spiritual crisis can bring about.

I guess that the indefinable nature of spiritual care could lead to suspicion - eg: 'what do chaplains actually do?' with consequential questions such as: 'when a chaplain is made privy through pastoral conversation to uniquely personal confidences, what place is there (if any) for these to be shared?'

In reflecting on the latter question I am prompted to consider the meaning of words which we use in this sphere of health care - 'palliative' and its etymological cousin 'chaplain', both derived from the same Latin word pallium = shelter, whereby those undergoing crisis can feel confident of a safe haven for their inmost thoughts and feelings.

Close to the core of the chaplaincy task is a creative inner dialogue balanced between two tasks outlined above: on the one hand of collaborating in a multi-disciplinary team, and on the other of being a repository for people’s stories.

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