Author talks about her journey as chaplain intern and what inevitably lead to her writing her book

Laura, who worked as a hospital chaplain, talks about how she felt helpless to aid patients who had given up hope for themselves. In this blog, Laura talks about her journey as a chaplain intern, and what inevitably lead to her writing her book Exploring Hope in Spiritual Care: A Practical Theological Guide for Chaplains.


Laura E. Shay

“I’m so sorry, your CT scan showed multiple new tumors. Your cancer is back. There’s nothing more we can do at this point. Unfortunately, we’ve run out of treatment options.”

My cancer is back! There’s nothing more you can do! I don’t believe it, there’s got to be something else we can try?”

“I’m afraid not. We’ve tried everything.”

“What am I supposed to do now?”

“I’d like to introduce you to our palliative care team. I think they can help you.”

“You’ve given up on me.”

“No, it’s just that there are no other treatment options. The palliative care doctor can help control your pain. We want you to be as comfortable as possible.”

“By helping me die? I’m not ready to die.”

“I’m so sorry.”

This is a conversation most medical professionals dread. To most people, hearing the words “there is nothing more we can do for you” equates to losing hope. If hope for a cure is no longer an option, what hope is left? When I started my first hospital chaplain internship, this question jarred me to the core. Prior to this, I had been a nurse for thirty years, mostly working in a research environment. To me, hope was finding the next treatment, finding a cure. I was now being asked to see patients who were out of options. Many of them were catapulted into despair because they no longer had hope for a cure.

“Hi Mr. Jones, I’m chaplain Laura, the chaplain intern who is on-call at the hospital tonight. You wanted to see a chaplain?”

“They told me I’m dying. My liver stopped working. I don’t want to die, please help me.”

I pulled up a chair and sat close to the bedside leaning in to face him. As our eyes met my mind began to race and panic set it. What do I say?  He’s dying? He looks pretty young, I wonder what happened to his liver? A drug overdose, alcohol, hepatitis . . .”

“I’m so sorry, can you tell me what happened?”

“It’s all my fault. They warned me for years about my drug use. Help me, I don’t want to die.”

“I’m so sorry.”

I was stuck.  Surely there must be something they can do. This hospital is known for their transplant program.

“Are you on a transplant list?”

“Yes, they said I’m on the list.”

Thank goodness, he still has some hope.

“Wonderful, let’s pray that you get that transplant.”

After the prayer, he smiled and thanked me. I left his room shaken and unsettled. My interaction felt hollow. Something was missing. Everything I said felt like a cop-out. But how else could I help him? Being on the transplant list provided him with hope, so what was wrong with focusing on that? A chaplain is supposed to be a beacon of hope but I felt more like the grim reaper. I knew a transplant was unlikely. You have to be drug and alcohol free for a period of time before you can qualify. He was extremely jaundice and weak. Even though time was not on his side, a transplant seemed to be his only hope.  

Chaplain training includes many hours of group work that can be quite intense. I chose to share this particular encounter with the other chaplain interns.  During our discussion I discovered a comfort level that I clearly lacked. The other chaplains seemed to have very strong religious beliefs. They talked about helping their patients remain hopeful by reminding them that God loves them and will take care of them even after this life.  This sounded like a good response for some patients, but what about the growing population of doubters and non-religious? What does hope look like for someone who no longer believes in God and is told there is nothing more medicine can do? I chose not to ask this question to the group. Instead, I just listened to their unwavering trust in what they believed.  I felt completely inadequate. As my discomfort grew, so did my consideration to choose a new career path.

All this changed when I decided to explore the concept of hope for my seminary thesis. My quest to understand hope became a two-year labor of love.  As I dug deeper and deeper into the literature, I discovered I was not alone. Many books and articles have been written on hope. The more I read, the more I realized that all the wonderful descriptions on hope could be categorized into four dimensions. These four dimensions of hope not only changed me as a chaplain, but changed the way I live my life. Exploring Hope in Spiritual Care: A Practical Theological Guide for Chaplains, is a culmination of my discovery.  

No one should ever face the end of their life feeling hopeless. However, our “Hope-That” something or someone is going to fix things eventually runs out. If other dimensions of hope have not been cultivated, a person is at risk for falling into despair. At some point we are all going to face the end of our lives. It is important to understand all the dimensions of hope and cultivate them throughout or lives. It is my hope that this book will help the reader deepen their understanding and discover ways to help cultivate hope for themselves and others.

Laura Shay was a nurse for thirty years and is now a board certified chaplain. She currently works in end of life care as a hospice chaplain.

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