the art of spiritual triage

I was discussing the changing nature of modern hospitals with one of the full-time chaplains the other day.

We observed that acute health care is geared more and more towards getting people through and out the door as quickly as possible. This is not only a matter of bottom-line thinking. It’s also indicative of the fact that we’re getting better at helping people recover and rehabilitate more quickly.


This has major implications for pastoral care. Because people often aren’t in hospital long enough to get a visit from a chaplain.

Some people are, of course. Their stays are plenty long enough. And for them hospital can be a pretty lonely and disempowering experience — unable to set your own timetable or rhythms for meals or visits or procedures, often cared for by a different member of nursing staff each day, and sometimes even shuffled from ward to ward.

This means that pastoral care staff have to learn the art of ‘spiritual triage’. Not only do people’s needs differ wildly. Not only is your capacity limited. But you’ve got to balance the need for ‘rapid intervention’ — e.g., with people who are so far away from home that it’s unlikely their family (or church family) will be able to visit and support them — with the opportunity to reach out to someone in the loneliness and isolation that can accompany extended hospitalisation.

Thrown into the mix is the fact that, in my experience at least, it’s easy to overthink it. Because all the weighing up of costs and benefits can go out the window in a flash. Maybe the patient you’ve decided probably needs most care is out getting physio when you visit. Or maybe someone else in the ward wants to start a conversation…

What do you reckon? Has the notion of ‘spiritual triage’ got legs? How might it apply in your pastoral context?

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