Lent Blog #7: Is this confidential? The Sacred Bonds of The Pastorate & Pastoral Care

One of the things I appreciated most about one of my fellow CPE interns this past summer was his devotion to his calling to the ministry. In everything he did, he directed it back to the calling he received from God to the ministry. At the time, I didn’t quite understand how he could do it, as every action seemed exhausting to me personally in the throws of CPE. But from the outside, he made a life lived completely in service to God and the Church look effortless. And one of the practices he adopted early on was maintaining strict confidentiality in regards to his patient visits – very rarely did he discuss with us apart from in clinical presentations what was going on during patient interactions. 

For those who know me best, I am an oral processor, which means that I need to talk the serious matters of my life out in order to figure out what has truly happened, and if I need to make a next move or not. Call me an extrovert, call me outgoing, call me bubbly, call me loud and outspoken (or bossy? Or am I confident and the boss). But I need to process my experiences with others. That’s simply how I input my experiences, and it is especially critical in intense situations, like CPE. My group ate lunch together nearly every day, and this time was spent talking about our sickest of patients (leaving out names, room numbers, and family details of course for the sake of HIPPA laws and to respect the pastoral privacy of the patients), and the most most intense situations, difficult issues, personal grievances, group difficulties, and hashing out tensions. This time was our pastoral confessional, and was extremely valuable for me in particular. 

But it is now, months later, that I have begun to think about what this public sharing of patient interactions means, especially having been a patient myself on more than one occasion (actually, now far too many to count, and frankly, so many times that I have lost count). As a patient myself, I always spoke freely with the chaplain. I never once questioned that what I was sharing wouldn’t be public knowledge – that it wouldn’t be tweeted using my real name, shared on Facebook, or talked about publicly in the cafeteria for all to hear. I never asked the chaplain whether I could choose between the confidential chat or the casual “share with your friends” option before we began discussing my medical condition, my spiritual and emotional concerns and my hopes for the future. It was just assumed that everything I said would be kept in confidence. If I knew that the chaplains who visited me were spreading what I said to others on the internet or around the hospital without my permission as a patient, I might be hesitant to ask for one, or feel violated, or even less trusting of pastoral authority in the future. 

Only with the passing of time, some maturity, the gaining of some pastoral authority, working in a church, and most importantly, discernment and prayer, have I come to see how the spiritual practice of my fellow CPE intern was not burdensome as it at times seemed from the outside, but rather a spiritual discipline worth working on, and a blessing for those whose secrets he was keeping. What is more, as someone who has been hospitalized, I would feel honored to have him come and shoulder my secrets for me, as I know my secrets would be safe with him. 

But what does this mean for the future of hospital chaplains and pastors in an era of social media, where information is oft times too available and it is tempting to share of thy self? There is absolutely nothing wrong to share a prayer request with others via Facebook, Twitter, blogs, etc. because heck, we’ve all done it (myself included). By spreading a prayer request around, more of the Body of Christ can raise that person in prayer, and the more voices going to God on behalf of a single concern, the better. But permission from that person must be gained first – there are privacy laws in place to protect the patient, and if the patient finds out that information has been shared, a lawsuit can be filed. Plus, pastoral trust can be broken, and that’s far worse than a lawsuit. 

I’m grateful for the influence of this summer, as it has taught me a lesson. As a future hospital chaplain, I will encounter many patients and families who will inform the way I will see God acting in the world. Everyone has a story, and some will want their stories told. But it is up to them to permit me to be the teller of those stories – I cannot assume that I am the only one who can do so for them. God is the ultimate storyteller, author and designer of our lives, and humans as the pastors called by God have the ability to hold in confidence the stories told to us by those who are most vulnerable. 

Sacred Counselor,

The bonds of this work run deep,

Guard those who call themselves tenders and shepherds of pastoral care.

Bind their tongues, seal their lips.

Help them to keep the secrets and stories of those who visit with them,

And those whom they visit,

In the good times and the bad, the burdens they carry are both joyful and of great sorrow, and only you know truly the whole story.

Be the ultimate and most sacred of pastoral caregiver, 

Both in this life and in the life to come.



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