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As a hospital chaplain, Kris Pikaart is used to explaining medical procedures to patients and families at Rehoboth McKinley Christian Health Services in Gallup, New Mexico. But since mid-March 2020, when COVID-19 tore into the Navaho Nation, she's had to explain the oxygen delivery spectrum far too often.
"If you need only a little breathing help, you'll use nasal cannula…then a mask over your mouth…then a high-flow oxygen machine—which we never used before COVID-19—that delivers 50 liters of oxygen per minute. If that doesn't work, then a BI-PAP machine seals to your face and pressurizes air into your lungs. The high flow nasal cannula and BI-PAP are loud, like going down the freeway at 70 mph with the windows open.
"The last device is a ventilator, where a tube goes through your mouth directly into your lungs to deliver oxygen and take off carbon dioxide. It's relatively quiet, but people on ventilators are usually sedated into a coma because they're so sick and ventilators are so invasive," says Pikaart, who is board-certified by the Association of Professional Chaplains and endorsed by the Christian Reformed Church in North America Chaplaincy and Care Ministry.
Chaplains provide spiritual and pastoral care to people that society often overlooks, such as those who are ill, elderly, or dying; in schools, prisons, or the military; or working but poor. The pandemic, however, has surfaced news and social media images of masked chaplains holding iPads with gloved hands or leaning against doors to pray.
On a recent call with other chaplains, Pikaart noticed that her colleagues felt especially valued for what she called "our spiritual work in the trenches. We've had a sense of feeling seen as lesser clergy, as if 'those who can't preach become chaplains.' But this has become chaplaincy's moment to highlight our work's relevance and pertinence," she says.
As chaplains provide spiritual care in different settings, they're experimenting with changes worth keeping. Congregations can help by praying for those whom chaplains serve and praying for God to renew chaplains.
"When we got our first COVID-19 patients, an administrator told me I could no longer go into patient rooms. I said, 'No one is going to die alone in our hospital,' so I've gone into rooms all along. Of course, I didn't know we'd get hit so hard that people would in fact die alone. That has been incredibly morally distressing for staff and family," says Pikaart, who wears scrubs, a surgical gown, N95 mask, face shield, and double gloves to see patients in person.
"McKinley County's population is 74 percent non-Hispanic Native American, mainly Navajo and Zuni. One of six people in our county have gotten the virus," Pikaart laments. By mid-May 2020, the sparsely-populated Navajo Nation had more coronavirus cases per capita than any U.S. state. A USA Today investigation on racism and COVID-19 reported that the U.S. Congress consistently allots far less than is needed for Indigenous healthcare and infrastructure. Underfunding at the Rehoboth McKinley hospital meant that staff initially had to reuse personal protection equipment (PPE). Pikaart says they even used donated Easter bonnets as head coverings.
By early April 2021, the Navajo Nation had made a remarkable pandemic turnaround. But by then, McKinley County residents had contracted the virus at almost twice the U.S. average, and almost four times as many infected people died compared to the U.S. average.
Richard Bodini is one of three chaplains at Holland Christian Homes (HCH) in Brampton, Ontario, Canada. The complex includes six towers of independent living apartments (where about half of the nearly 850 residents receive assisted living services) and two nursing care manors with 240 residents. "Before the pandemic, we three chaplains divided the work to cover equal amounts in each building. But as COVID-19 spread throughout metro Toronto, provincial health rules and regulations kept changing HCH practices," he says.
At various times Bodini helped feed residents; could receive physically-distanced masked visitors in his office or in hallways; was barred from entering the manors and then the towers; made 100+ phone calls a week to check on people; was allowed to do end-of-life visits wearing full PPE…
"In spring 2020, when a severe outbreak hit Grace Manor residents and staff, we three prayed together to decide who would voluntarily go into Grace Manor. The Lord led us to choose Rev. Henk Bruinsma, who speaks Dutch and could isolate most easily. It was a big sacrifice. Bruinsma lived in a camper in his driveway for six weeks last summer, went in the house only for meals and showers, and could only talk with his wife from a distance. From May to September 2020, he ministered to many Grace Manor residents and staff.
"Pastor Hank Blystra and I took on spiritual care for the rest of the complex. When Faith Manor's four-month outbreak began in November 2020, Bruinsma transitioned to and continues to serve there. He got the virus and recovered from it, which helped him serve with even greater knowledge and compassion," Bodini says.
Many chaplains minister in workplaces among essential workers who seem invisible to others, such as those in shipping and transportation industries.
"Sea port ministry was not even on my radar when I went through formation to become a permanent Catholic deacon. Yet 90 percent of global trade moves by ship, and so thousands of seafarers visit Vancouver every year," says Dileep Athaide, a retired college professor and union activist in Vancouver, British Columbia, Canada. He is an Apostleship of the Sea (aka Stella Maris) port chaplain.
"Pre-covid, my ship visits would be about 30 to 60 minutes. Seafarers and officers always welcomed me to the mess [ship dining and socializing area]. English is the working language on most ships, but it helps that I speak some Hindi and understand a bit of Tagalog," Athaide explains.
He offers the spiritual and pastoral care that crew members ask for, whether praying for a family member, counseling, offering a homily, celebrating a mass with bread and wine consecrated by a priest, doing a ship blessing, or counseling crew after a death at sea. Driving the minivan donated by a UK maritime charity, he often gave rides to the malls, churches, or other places for seafarers on shore leave.
But the pandemic has greatly curtailed what Athaide can do. He can still email with people on ships with internet access. He can still deliver little gifts—baked goods, pizza, mobile wifi units--and talk with crew members, but visits are shorter, masked, and usually restricted to the outer deck at the top of the gangway. He now enters ships only for a crisis or exceptional situation. "I have to decipher pastoral needs very quickly," he says.
Christine McAteer is a volunteer National Express Bus chaplain for Workplace Chaplaincy CIGB in Birmingham, England, UK. Besides working part time as a National Estate Churches Network support officer and Birmingham Mothers' Union diocesan secretary, she is in training to become a Church of England ordained priest.
"Chaplaincy visits to bus drivers have stopped and re-started during the pandemic, depending on infection rates. The drivers are delighted to see me back in the garages. I don't drive, so I visit by bicycle, rather than travelling by bus, to avoid cross-contamination—a round trip of about 20 miles. Garage rooms have few seats and limits on numbers of people. We must talk whilst physically distanced and wearing face coverings. I have had conversations through a glass slat with people locked in offices. It has been very strange," McAteer says.
Social media technology makes more difference in some chaplaincy settings than others. "The iPad has been a game changer. Nurses may do this in other hospitals, but in ours, I've been the person with the iPad to connect to families. Most people have phones but there's often terrible connectivity on the reservation. Sometimes I ask people to drive in. They sit in the parking lot with an iPad and maybe a grandchild who can help. I give them a tour of their loved one's room, IV setup, and the nurse they've talked with on the phone. I show the window with a view to the sunrise or sunset, because that makes a big difference to Navajo people," Pikaart says.
As the youngest of three HCH chaplains, Bodini took responsibility for using social media technology to connect with residents, staff, and families. He recalls a woman who had a massive stroke while visiting her daughter and died three days later. The woman's husband lived in Faith Manor, but, because of the pandemic, they couldn't hold a funeral at Heritage Fellowship Christian Reformed Church, a congregation formed specifically for HCH residents.
"We used Facetime to do the funeral home visitation and graveside service, which I conducted. Family across Canada and the Netherlands were able to join through Facetime and share words with the husband. Sadly, he died seven months later from COVID-19," Bodini says. He and his colleagues now use Zoom for family visits and staff devotions and HCH's in-house television channel for Bible study and Sunday worship for residents. Even when in-person pastoral care resumes, they expect to continue using technology to create community with family who live far away or can't visit often.
Dileep Athaide sees better internet connectivity as a mixed blessing. "It does provide news and entertainment and certainly helps seafarers stay connected with their families back home, but it can also isolate crew members from each other," he says.
Christine McAteer says that doing training or chaplain prayer support over Zoom saves travel time and is easier to fit around work commitments. "But remote technology doesn't work for my chaplaincy. Face-to-face visits with safety precautions work best."
Asked what she wishes people knew about those she serves, Pikaart says, "What a precious question. I'm really ambivalent when people talk about healthcare heroes. The dear people fighting for every single breath and hanging in there are the heroes. I've seen people in the hospital for six or seven weeks and they survive and go home. I've never seen or imagined such resilience and strength. Navajo people are not whiney. They are such a patient, inherently gracious people in bearing their suffering. Many have had ten to twelve coronavirus deaths in their extended family, yet, after their mom dies, they just want to thank us for the care we gave.
"The level of community trauma here has been so bad. Most of my colleagues have been sick along the way. I haven't. Sometimes patients can't stand being on oxygen for another week and say, 'I'm done.' They can talk. Maybe they could get better. But they can't or won't do it anymore.
"That happened with a woman from a big Pentecostal church on the reservation. I was able to get her husband and two children in to say good bye. I looked out the window and saw her fellow church members in the parking lot with their hands in the air, praying all day. It was beautiful to see how they wanted to be present in her dying. I went out to talk with them, and a Navajo woman told me that they pray every day for everyone at our hospital and the other hospital in town," Pikaart says.
Across the world, leaders seek to balance senior vulnerability to the pandemic with others' desires for more freedom. Bodini says, "If you don't think old people's lives are worth much, then you haven't sat down and talked with a senior. We never stop learning or growing in faith. Before the pandemic, over 250 residents in the Towers were actively volunteering throughout our entire complex. They fed residents, led devotions before meals, and led hymn sings and Bible studies. Even now, some volunteers are connecting through phone calls and hallway visits."
He also asks churches to pray for healthcare workers. "Some people push back against COVID-19 regulations. But when you see how doctors and nurses have to triage people in long-term care and emergency rooms—it's awful."
Dileep Athaide says that, because of the pandemic, ships have been stuck at anchor for weeks and crew changes delayed, forcing seafarers to work months beyond their already-long contracts. "They get paid, but they feel like prisoners. Owners can't risk having seafarers catching the virus on shore and then getting sick when they're in the middle of the ocean. Working so long without a break creates mental and physical health hazards. Suicides have gone up," he explains.
Christine McAteer says that COVID-19 has killed bus drivers and their family and friends. Many have been ill but recovered. She finds bus drivers eager to talk and often tearful. She laments, "I see the trauma in their eyes. People often dismiss bus drivers as grumpy, miserable, and cantankerous. Some are, but many are simply working hard to provide for their families."
From March through June 2020, Kris Pikaart had no weekends off. She slept in her basement for months though still interacted with her husband and their two daughters. Her caseload lightened in the summer but got even worse from late November 2020 through January 2021. By then her husband, who had been without work, found a nonprofit administrator job in California, so now he's home only a week per month.
"My colleagues and I barely keep our heads above water. I need those who have a little time, space, and bandwidth to uphold me in prayer. The brief texts I receive—thinking of you, praying for you—mean so much. We have just received kindness upon kindness from our friends, community, and family. They bring dinner, help with the kids, and so much more. I look back with a lump in my throat, tears in my eyes, and so much gratitude," she says.
Richard Bodini and his colleagues have dealt with so much death. "In mid-December 2020, Faith Manor lost seven people in a week and then seven more in the next 30 hours. I made condolence phone calls to each family, and five of those phone calls were moments before I conducted a wedding at an outside facility," he recalls. He says he finds his hope in his colleagues and daily meditation on the Psalms. "Our manor staff have been incredible. They've learned and applied so much and have grown stronger and tighter as a team."
Deacon Dileep Athaide says, "I can only be a pastor if I am myself pastorally healthy. What feeds my faith and soul is connecting and praying with other Catholics." He prays the daily Divine Office and, in this pandemic time, uses Zoom to lead regular Bible study and prayer sessions with several groups, including a Magnificat Ministry women's fellowship and members of the Vancouver Goan Association, with whom he prays the rosary and provides spiritual direction.
Since Christine McAteer spends so much time online for work and training, she finds renewal away from screens. Instead she prioritizes solitude, exercise, Bible reading, music, and time in nature "to listen to the voice of the Holy Spirit."
The Navajo Nation sprawls across Arizona, New Mexico, and Utah. By mid-May 2020, the Navajo Nation had more coronavirus cases per capita than any U.S. state. On April 5, 2021, The New York Times described the Navajo Nation as "perhaps, the place in the continental U.S. that has best contained the coronavirus pandemic." Navajo President Jonathan Nez said that community acceptance of masks, curfews, checkpoints, lockdowns, and vaccines made the difference.
The New York Times profiled several hospital chaplains. Read this Banner story about Richard Bodini and Holland Christian Homes. This Washington Post story details the plight of merchant sailors stuck at sea because of COVID-19.
Workplace Chaplaincy CIGB in metro Birmingham, England, UK, provides chaplains in many kinds of workplaces. Its church resources include prayer and worship suggestions and recommended essays and books on justice and the theology of work. Consider including seafarers' concerns in congregational worship by using Sea Sunday resources. Read this devotional by United Methodist pastor and chaplain Jan Johnson about pandemic changes and God's faithfulness.
Chaplains can find training, support, and COVID-19 resources through Association of Professional Chaplains and Association for Clinical Pastoral Education, which may soon merge, and this
Facebook group page for Professional Chaplains.
Chaplaincy Innovation Lab, based at Brandeis University, near Boston, Massachusetts, offers coronavirus-related research, webinars, self-care ideas, and much more for chaplains in all kinds of settings.
Feel free to print and distribute this story at your staff, board, education, worship, or outreach committee meeting. These questions will help people start a conversation about chaplaincy and the often overlooked people they serve:
