My Journey as a Hospital Chaplain: Balancing Compassion Fatigue and Burnout

Reflections on a Decade of Supporting Individuals Through Life's Most Vulnerable Moments:  How to Prevent Compassion Fatigue and Burnout

If you’ve ever wondered about the inner life of a hospital chaplain or sought inspiration for your own journey of caregiving, I hope to offer heartfelt insights and practical wisdom through my own personal experience. Learn about factors predicting burnout among chaplains and caregivers, profound challenges surrounding compassion fatigue, and moments of deep reflection that highlight the importance of community in job satisfaction as a chaplain and caregiver. 

The Beginning of the Chaplaincy Journey

About 15 years ago I was invited to participate in a chaplain internship at a local hospital. The internship was facilitated by the Spiritual Care Director. During the internship, I would do several rounds a week and visit with patients through the different departments of the hospital. This would include ICU, Critical Care, Labor & Delivery, Telemetry etc. I was responsible for a set list of patients that was given to me for the day. We would then be provided group supervision once a week where we could talk about our different experiences, ask questions, and learn from the clinical supervisor and each other.  

Transition to On-Call Chaplaincy

After I successfully completed the internship I was offered a contract position as an on-call chaplain. I had a pager and was on call from 5 pm to 6 am, two or three times a week. If a critical injury or illness came through the emergency room I would automatically be paged. I would then check in with the charge nurse in the emergency room to see if they needed me to come support the family or patient. 

Nurses and other hospital staff could page me while I was in the hospital with other patients or families that  needed support. Sometimes a Catholic family was requesting a priest for last rites. Then, it was my job to call a list of after-hours priests that would come to the hospital to support that family. When it was myself that needed to come to the hospital it was usually middle of the night and I would be immersed in some of the most horrendous traumas someone can imagine encountering in an emergency room. Other times I was requested to come into either critical care or ICU to support a family where the patient was actively dying and it was beautiful. The person dying would be very old and had lived a long full life and died surrounded by love and I felt honored to be able to witness it. And oftentimes, I would arrive after my pager would go off and they wouldn’t need me to come in.

Unique Aspects of an On-Call Chaplain

Being a hospital chaplain came with several unique and often unexpected challenges that extended beyond typical job descriptions and expectations. From navigating the emotional terrain of connecting with strangers during vulnerable moments, and managing the duality of on-call chaplain as a professional role and the solitude that often accompanied this vocation—the experiences and insights were profound. 

Here are some unique aspects of the job that were demanding yet deeply meaningful:

1.  Confidence in a New Role: As I stepped into the position of on-call chaplain I had a master’s degree in spiritual psychology and had completed a chaplain internship. Yet I still didn’t quite know what to do when showing up to support a family. I didn’t know what to say. I wasn’t sure what to do. I wasn’t confident about my role. There was an evident lack of support that I needed to help navigate my new position. 
2.  Emotional Connection with Strangers: I was sharing intimate space with a family and loved ones that I have never met before and likely would never see again. The ongoing support required within the hospital setting as a on-call chaplain was tiresome and perpetual.
3.  Balancing Dual Roles: I was often with a family and loved ones on the worst day of their lives and then I would leave and go back to my ‘regular life.’ My day job had nothing to do with hospitals,death or dying. Straddling both worlds was difficult and left me feeling perplexed with more unanswered questions.
4.  The Pager Era: I had a pager. This was 2008-2015, almost nobody had pagers anymore. 
5.  Recognition by Hospital Staff: The doctors and other hospital staff treated me with high regard and were grateful for my help. I was there to support the family during a very stressful and often traumatic time. The recognition from the hospital staff validated the importance of my position and provided me with the sense of belonging I was craving within a relatively solitary role. 
6.  Unknown Outcomes: I was left with a lot of unknowns when I went home, most of the time I didn’t get a follow up. I often wouldn’t know if the patient had lived or died. As a on-call chaplain I was emotionally invested in each case, not having closure was difficult to accept.
7.  Lack of Continuous Support: I had very little support. Directors changed over the years and I wasn’t in an environment with colleagues I saw regularly, and there were years where regular support wasn’t available to me. My friends and family didn’t want to hear about what I was witnessing, and I don’t blame them. They didn’t sign up for this job like I did and a lot of people don’t want to be exposed to other people’s tragedies and losses.  

Experiencing Compassion Fatigue and Burnout

The unique aspects of the job as an on-call chaplain ’ didn't feel like a problem for a long time—until it did. At the time I didn’t understand or know it, but I was burnt out and had compassion fatigue. 

I wasn’t able to put into words what I needed. I went from feeling grateful and proud of the role I was playing, and the responsibility of caring for those during critical and vulnerable times. At one time it felt like a magical once-in-a-lifetime experience that was an honor to be a part of. And then it didn’t.

I began to dread the pager going off. I silently prayed they wouldn’t need me and I started taking short cuts and making excuses that I’m not proud of. I felt inadequate and insecure. I liked saying what my job was more than I actually liked doing it. I don’t take it lightly that I was being trusted with supporting people in what might have been their greatest time of need and I was phoning it in. I was doing the bare minimum and I’m not sure anyone noticed. 

Reflections on Compassion Fatigue and Burnout

When I look back now several years later, I can see how I hit a wall and where it all went wrong. I had no ongoing training or support. I had nobody to debrief with. I had no one to share with, that I could connect with. I had someone I could maybe ask a logistics question, or something very specific, but I wasn’t in a work culture that prioritized well-being and preventing burnout. I was missing necessary support for a position that was emotionally and energetically demanding.  

The original Spiritual Care Director that I did my internship under was great at her position for a number of reasons. She was relatable, warm and down to earth. She was creative and innovative and had many attributes of a great leader. However, about 18 months after I started she was fired for unsavory conduct. After that, it was corporate and clinical. In the new environment I didn’t feel like I could vent, cry or share openly. I needed a community to share with and learn from.

How to Prevent Compassion Fatigue and Burnout: The Need for Community

Years later, my need for community and connection hasn’t changed. Even though I have a decade more of life and work experience in the healing arts, I still need support. I still need mentors and I need to mentor others. 

This helps keep the fire inside going. 

Community helps to inspire, enrich, and see things from a different perspective. I need to be able to tell people when I’m feeling burnt, or triggered, or inadequate. I also need to share the beauty I experience, the wins and the losses.

Walking down the dark halls of the hospital in the middle of the night, sometimes I would feel alone, sometimes I felt grateful, sometimes I felt deep empathy and connection to others. I could sense and tap into that invisible string that connects us deeply to people that we never met before. To meet people where they are at and not try to fix them or change them or share platitudes to try to get them to see it differently.  And I needed to share with people who could help refill my cup. 

Even as the witnesser, I needed to be witnessed. 

Finding Balance as a Chaplain and Caregiver

Around this time I was laid off by the hospital. The hospital decided to use full-time staff instead of contractors—this turned out to be a blessing in disguise. Even though I completed an additional 18-months worth of private Continuing Pastoral Education (CPE), I decided not to pursue chaplaincy further. 

I did miss the grief groups that I was facilitating at the hospital, there was something so hopeful about them. I found the people who attended inspiring and courageous—and I just loved it. The groups were 8-weeks long. Some people came for the 8-weeks and moved on, many came over and over again. Some would even keep coming because they knew they were providing hope and inspiration for the new people coming in. 

We became a community. 

Looking back, I realize how that community fed me. Even though my role was the facilitator, the camaraderie and connections I formed fed my spirit. 

I didn’t have that in my other role as an on-call chaplain. I may not have pursued continued chaplaincy even if I had a community of support and peers, and had built meaningful ongoing  connections with the people I worked with. However, I do think it would have improved my attitude and helped reduce my vulnerability to burnout. 

The Continuous Journey of Support

My time as an on-call chaplain afforded me the opportunity to understand how critical community and support is as a caregiver. In a profession where the risk of burnout is high, the grief groups provided me with a strong sense of connection that helped me find the emotional sustenance and sense of belonging I was needing.

The support of others in maintaining balance as a chaplain and in the caregiving profession cannot be overstated. Grief is a difficult journey that is not meant to be traveled alone—whether you are the one providing support or the one receiving it.

Looking for More?

If you are navigating the complexities of grief and loss, whether directly or indirectly, and seeking support, consider reaching out to your local community resources. Support groups, religious and community centers often offer programs designed to help individuals cope with compassion fatigue and burnout. Connecting others who understand your experiences can provide the emotional sustenance and sense of community that is crucial to each person’s wellbeing. You don't have to walk this path alone.