A Chaplain’s Voice
— guest post by Maija Mikkelsen, MDiv, chaplain for Doernbecher Children’s Hospital and Bridges Pediatric Palliative Care —
I consider my job to be my vocation, my calling by the divine or the universe. As a spiritual-care provider to seriously ill children and their families, I strive to show them love, acceptance, and accompaniment. I am also passionate about providing evidence-based, innovative, just, comprehensive spiritual care to all patients, their families and our staff.
However, since arriving at OHSU 14 months ago, I frankly have become appalled by the dire state of spiritual care at OHSU.
My chaplain colleagues are tired and defeated. They have spoken out, strategized and begged for more support for years. High-level leadership has continuously ignored and dismissed their pleas. As the newest chaplain, I still have some energy left to fight for my fellow chaplains, for OHSU staff and for all our patients and families we care for.
Since I began working at OHSU just over a year ago, I have provided at least 1,800 hours of on-call coverage to the hospital. These shifts are 24-hour extensions of my normal working days where I am tied to my pager, waiting, wondering if I’ll be called in and what sorrow I will be walking into. Essentially, 20% of my life these past months has been beholden to a pager, ready to respond to all manner of tragedy, and I get no compensation in return beyond my base salary. A salary, I will add, that is below the average chaplain’s salary for this region.
Before I joined the chaplain team, there were only four chaplains, meaning that a quarter of their lives — waking, sleeping, holidays — was set aside to be ready to jump into action providing care for any and all people. This care is often at the end of life or at a crisis point. I say this not to be dramatic, but to emphasize the extreme emotional toll of the work that we are on deck to provide.
We five chaplains are responsible for the care of almost 600 patients. Some experts suggest that at a hospital of OHSU’s caliber and acuity, we should have a staffing ratio of one chaplain per every 45 patients. As the pediatric chaplain, I myself am responsible for providing spiritual care for approximately 150 patients.
It is simply untenable.
Because of the lack of adequate staffing, the high on-call demands and the utter refusal of OHSU to provide a budget for spiritual resources and continuing education and the lack of fair on-call compensation, I have witnessed a great deal of distress in myself and my colleagues. We are exhausted and burnt out. I have heard my colleagues reflect on how they do not feel seen or cared for by the institution at all — a sentiment I wholeheartedly agree with. For nearly every facet of OHSU’s mission and values, the investment in spiritual care falls short. We are sorely underequipped and undervalued.
This makes me so incredibly angry. OHSU is failing so many — patients, families and staff — by not giving the chaplain service the resources we need.
Seeing how OHSU disregards the value of spiritual care for patients and families, and disregards my chaplain colleagues and myself, compels me to eye the door. It is my team and the families that I serve that keep me coming back.
It’s the quiet father who I stand with in the Labor and Delivery resuscitation suite for hours, while I’m at the ready to bless his infant child in case she doesn’t make it.
It’s the child whose hand I hold as he dies in the operating room, standing in for his family who cannot be there.
It’s the distraught father surrounded by police officers, who I accompany late one night while he wrestles with the agonizing decision about how to cope with his child’s sudden death.
It’s the husband weeping at his wife’s bedside in the ICU, who I sit with for hours while he cradles their baby, wondering if she’ll survive the night.
It’s also the couple who can’t stop sneaking kisses when I marry them in the hospital room — the time is now, because after years of postponing their wedding, a looming hospice admission makes every moment crucial.
It’s also the nurses and respiratory therapists who are stretched beyond what seems humanly possible, working to keep patients alive and their own selves afloat. It’s the techs and HUCs scrambling to make sure everyone has what they need. It’s the medical residents grappling with all the stressors that come with their training. It’s all the staff here at OHSU.
It’s all these folks. They are why I am fighting for more compensation and more resources from OHSU.
Study after study demonstrates the benefits of adequate spiritual care. They show increases in patient satisfaction, increases in patients from minority backgrounds reporting their needs have been met, increases in patients seeking less aggressive care at the end of life, increases in patients recommending the hospital. The list goes on and on. I truly believe that investing in chaplains, investing in us, is an important way of investing in staff and patient care.
It is clear that chaplains could provide a great deal of multi-faceted benefit to OHSU. We simply are not equipped and not resourced to do so.
My chaplain colleagues and I care deeply about all those that we serve — from the staff we support, to the patients we pray for, to the families we comfort. We deeply value the availability of chaplains at all hours, but we need fair compensation for the time that we are on call and we need more resources.
I know this is not a story that is unique to chaplains. My fellow salaried AFSCME Local 328 members who provide vital 24/7 on-call coverage also do not have fair compensation for the work they do. We all deserve a fair contract: a contract that recognizes all that we pour into our work; a contract that honors — and does not exploit — our calls to care for those most in need; a contract that shows us that OHSU leadership sees us, values us and is invested in us.