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The Hospital Chaplain's Handbook

Reviewed by Tim Coleman.

Mark Cobb is a well-respected figure in Hospital Chaplaincy.  He straddles the dual role of Clinical Director and Senior Chaplain at the Sheffield Teaching Hospitals,  which makes him a unique commentator on both bedside and boardroom manner.  He is a sought after speaker in Chaplaincy and champion in bringing a profession that started for most of us in an ancient Cathedral into the high-tech of Intensive Care or the ever changing Management Structures of our Hospital Trusts.

Having myself moved from parish ministry into Hospital Chaplaincy four years ago, how I would have valued a book like this then.  It is clearly written and written in context.  This is the context of an NHS that constantly finds itself in a state of flux.  His overview enlightens for when it was written (2005).  Changes to the NHS are so frequent that the ink doesn’t dry before the structures change and the context within which Chaplains seek to serve the NHS, shifts ground. Thus, the opening chapter on the historical and contemporary setting of the NHS is already out of date.

Mark eloquently defines Religious and Pastoral care and contrasts these with the Spiritual care arguably all patients have a need for in our Hospitals.  A table outlining these definitions with that for spiritual care would have been very helpful, as someone new to Hospital Chaplaincy will need to be clear about this.  His alertness to the sensitivity needed by the practitioner evidences his long experience and highlights the problem that bedevils our profession, namely that we work in the ethereal Divine space between Chaplain and patient or carer. Who can define what goes on? Who can prove that the Eternal transforms the Temporal?  We of faith know that, but how do we evidence this for those who have sold their soul to mammon in the NHS?  He outlines a need for research in our profession, in which he is a leading light, but as a graduate scientist and mathematician. I have yet to see a model for Chaplaincy research, which could evidence what we do in such a way that the statistical confidence limits would be sufficiently robust.  As Richard Holloway once said “faith is faith and never certainty.”

Mark’s writing style is easy to read, making this book readily accessible to church ministers wishing to know more about their colleagues in the NHS.  Equally it would be suitable for Theological Students on pastoral placement.  Every Whole Time Chaplain should have this on their bookshelves.  The quality of the book was such that at times I was crying out for more, especially about stillbirth and baby loss.  He very helpfully tabulates the confusing defining terms, which separate the different forms of baby loss; e.g. ‘neonatal’ and ‘perinatal’ death.  He cites an example of ‘SIDS’ (sudden infant death syndrome or, cot death) and how a chaplain might meet such in A&E.  I hope he finds time one day to inform us more about ectopic pregnancy loss, miscarriage and maternal death: perhaps not what a hospital chaplain meets every day, but will, sooner or later.  I yearned for more about Mental Health Chaplaincy - he does however hit the nail on the head when he says that Chaplains may be the only professional who can establish an empathic therapeutic relationship with someone who has been otherwise labelled, for example, as suffering from religious delusions.

Conversely, his section on bereavement is full and detailed, again bringing the Chaplain into the specialist context of Palliative Care in which we find our care to patients given over to relatives when death draws near and never is it easy to walk away from people in distress like this.  One way or another Hospital Chaplains provide a vital link into support beyond the hospital, which helps complete the story.

His section on Religious and Cultural diversity outlines the pitfalls of ‘being all things to all people,’ which is exactly what the average Chaplain needs to learn as the person on site.  Each of us needs to find ways to adapt our perspective chameleon-like to that of another world-view. We are the ones there first and might be the only religious priest or minister available as and when a holy person is needed.

The book includes all that makes up the tool-kit of a modern healthcare Chaplain, from hand washing through Data Collection and recording in patient notes.  Mark makes it clear that Chaplains are a unique source of confidential staff support in a context where the cost of compassion, if not addressed by the likes of Chaplains, will cost the organisation dearly in staff burn-out or long-term sick leave.

A comprehensive bibliography will introduce the reader to a rich resource base; clearer than any other I have seen.  Perhaps most thumbed of all is an appendix of Liturgies for the most common experiences a Chaplain will encounter - Emergency Baptism, Anointing and Laying on of Hands and prayers of Commendation at Death.  These are just superb, using contemporary and poetic turn-of-phrase and again made me ask for more.  I would have gladly swapped a prayer for a memorial window for a prayer for someone just about to go into theatre for his or her organs to be harvested for donation.

This is the Modern Handbook of Hospital Chaplaincy we need for the 21st Century. It is highly recommended reading for the working Chaplain and if it encourages us to respond imaginatively and compassionately to the many different contexts in which we find ourselves, then it will have served its purpose well.