Clinical Pastoral Education, commonly referred to as “CPE,” is a pastoral care educational process of action and reflection. In our second year of divinity school we entered the CPE journey together at Wake Forest Baptist Health. CPE is offered at medical centers across the nation for academic credit and professional development. Our internship lasted from August to May. We were each assigned various units in which we served as the primary chaplain providing spiritual care to patients, families, friends and staff. Erica served on cardiology and pediatric floors. Hillary served as chaplain on an oncology/hematology floor. Megan offered pastoral care to families in surgical waiting and explored how children experience grief and art as care. CPE was life changing for each of us and we believe, if you let it, it can change your life too.
10. Pastoral care with naked people
You never know what you are going to walk into. Hospitals are vulnerable places full of stories and experiences. As a chaplain you walk into someone’s story and can be welcomed into very sacred spaces that are full of raw, naked emotions of pain and loss, and you get to be a part of that. It is messy. It is hard. The tissue boxes NEVER have enough tissues in them, but it is also really beautiful. Maybe you cannot fix it. Maybe all you can do is sit with them. But in that sitting, God is present. And sometimes you walk in and someone is physically naked… and you walk right back out.
9. Sometimes you just have to throw out the rule book.
CPE begins with a crash course in pastoral care. Within a week or so you learn the system, find the good coffee shop, grab your badge and are left alone on your floor. Thoughts rush through your head: “What do I say? Knock first… enter… sanitize hands. Ask to talk. Sit or stand? Which care gate am I entering? How do I get a food voucher? Where is the chapel anyway? Can I do this, really? Am I allowed on this floor?” And then the morning comes where the rule book you have been clutching to gets left on your desk and for the first time you think you might be able to do this in your own way. Throughout each encounter at the hospital you develop your own style of pastoral care that seeks to compassionately reach across boundaries. But never forget to sanitize. There really are “hand washing police.”
8. “How does that make you feel?”
This question has become a cliche for many of us throughout divinity school, but in CPE you realize that your own emotions are important. Once a week you gather with your fellow interns and beloved supervisors around a small table, in a dimly lit, cold room, to check-in. Conversation bounces around the room as everyone is invited to let down their guard and explore their own stories in relation to those of the medical center patients and staff. Somewhere between checking the on-call calendar, sharing a cookie around the table (thanks Dr. Jensen!) and passing the tissues to the person on your left, you realize that your emotions are not that bad after all. In this context you learn more about yourself than you ever imagined possible and exploring your emotions becomes a fun past time. So, really, how does this make you feel?
7. Food Towers 101
PPI – Personal Professional Integration – is meant to help you work through the questions, the emotions, the baggage and the theology that inevitably gets brought up on the floors. Sometimes it’s awesome, and you come to understand yourself, a patient, and God in a whole new light. Sometimes you realize that what makes you who you are is something you never thought of before. Other times, you’ve been arguing with God about how unfair, painful and completely-100%-wrong this situation is and no one can give you an answer. Sometimes you’ll have to bring those unprocessed, raw emotions and lay them on a table in front of your peers, and it will feel uncomfortable, and invasive, and you’ll hate how vulnerable you feel the first time you cry. But your peers will work with you to sift through the emotions, work through the pain and hold you gently with grace, compassion and insight. You’ll develop a love-hate relationship with PPI, but if you trust that everyone around the table wants to care for you, you’ll come out better for it. Other times, you’ll build a fortress of cafeteria food around you to protect your emotions from getting out.
6. Never Surrender
Weekly or bi-weekly (depending on your luck) you are “invited” to your supervisor’s office… not for cookies and tea but to check-in, review verbatims, talk about reflections and quite often to cry. As CPE started we all made a pact to NEVER SURRENDER to our supervisors’ eyes inviting us to cry as we talked about our week… our challenge was quickly lost. As the internship progressed we grew to cherish these tears and sacred office floor cries. Our new challenge: NEVER SURRENDER to the thought that crying was bad or meant we were weak. As we cried and sat in our own brokenness and feelings of inadequacy, the gentle nudge of a supervisor handing over a tissue, leaning into our frustrations, and crying with us became affirmation that we were enough. Your presence is important. You can do this and should never surrender.
5. Resident Temper Tantrums
“I’m not a real chaplain… real chaplains are good at this… they know what they’re doing… I’m just going to chat with people – nothing special about that.” If there was a quarter for every time chaplain interns doubted themselves, we could build our own temple of commerce. In lieu of quarters, we have our residents who see our talents and gifts and refuse to give up until we acknowledge we did a good job. The residents become these beautiful, stubborn reflections of God who show us exactly who we are, even when we try to ignore it and avoid it. They teach us to claim our gifts, to stop moving and trying to be better, and simply see ourselves as uniquely talented and called by God. Sometimes, it takes a grown man to sit on the floor for twenty minutes in a very public place before we realize how good we are just the way God made us.* Who knew tantrums could be so effective!
4. Good Vibrations
The pager becomes your best friend and worst enemy, all at once, during your first on-call shift. (Granted- there is often a resident on-call back up person there too) “Which button does what? What if I miss a page? Have I missed a page? What if I don’t know where the building is? Where do I put the pager anyway? How germy is this thing?” These questions fade away as soon as you hear that first vibration. Action time. Anxiety grows as you walk down the hallway (trying to recall that residents’ advice to paint a picture in your mind as you walk) into the unknown. As the primary pastoral care provider in the hospital, while on-call, you never know what you might encounter. But somewhere between the first moment when a family stares at you in expectation and the moment you leave the room after a silent prayer, you realize, again, that you can do this. You are a chaplain. On-call shifts invite you to claim and accept your pastoral identity. But, always remember to pick a good tune for the pager. You will hear it a lot.
3. Hiding in the Playground
On the 12th floor of Brenner Children’s Hospital (a part of Wake Forest Baptist Health – this is all confusing, but don’t worry; they provide maps and a quick tour during orientation) is a slice of heaven on earth: the rooftop playground. The playground overlooks Winston-Salem’s lights and highways – you can even see Wait Chapel in the distance.
“Need U. PG now” became a familiar text for us throughout our CPE experience. Meeting on the playground for a twenty minute self-care break would ground and center us after devastating visits, frustrating questions around why we are women doing this job or dealing with stress from life outside the hospital. Finding little ways to care for yourself throughout your CPE internship is essential. Without taking time to relax, breathe and find the beauty around you, burnout is unavoidable. Developing healthy self-care habits throughout CPE translates into life outside the medical center, empowering you to be the best minister you can be. So take time to play… and some days a gallon of mint chocolate chip ice cream helps too.
2. Why God, Why?
We can’t sugar coat it – way too many awful things happen at the hospital. The stories we encountered in these rooms were painful, horrific, unbearable and often unfair, and the breath is sucked out of your chest. Your heart will break for these beautiful suffering souls, and you’ll find your way to the basement floor angry. Angry with a system that hurts people, angry with violently reactive people, angry with people who make bad choices, and angry with God for not doing anything. Why did you let this child into a family that would abuse him? Why did you plague this child with cancer? Why weren’t you there to protect their mother in the crash? Why….? Your theology will be thrown on its head, even if you think you’ve mastered Tupper’s providence** or have God mostly worked out in your head. You’ll think things you logically know you don’t believe but nevertheless your heart will cry out for a God who doesn’t let any of this happen. You won’t really get an answer from God, but God’s presence will begin to take on tangible, holy and intimate faces and even in the midst of shattered lives and broken dreams, we find ourselves present, aching alongside and doing our best to sit in the mystery.
1. Soul Friends
Throughout the CPE internship you spend MANY hours with your cohort of learners. From time in didactics to sharing verbatims to lunch breaks and worship services you grow close, quickly. Over the course of your CPE internship these relationships become invaluable and blossom into soul friendships. As colleagues and classmates, you have struggled with God, yourself, your supervisors and one another. In the midst of heated debates and thoughtful critique of one another, bonds develop that are not easily separated. These friendships challenge, support, affirm and help you grow as a minister and person.
Throughout our CPE journey we became the best of friends. Our stories overlapped as we challenged one another, cried together and affirmed each other. Theologically we come from three very different places, our callings differ and our passions are unique to who we are. Yet, throughout our year long internship together we developed skills for pastoral care, grew to embrace who we are individually and gained the ability to eat inordinate amounts of ice cream. So, if you have been wavering on the decision to apply for Clinical Pastoral Education, do it – you will not regret it and everyone needs a good excuse to eat ice cream.
* If you want to hear this funny story ask Erica about our friend Rodney.
** “Tupper’s providence” refers to Dr. Frank Tupper’s Providence of God course. Tupper is Professor of Theology.
Erica Walecka, Hillary Irusta and Megan Snider
Third Year MDivs
Erica, Hillary and Megan are all third year students preparing to graduate in May. Erica will serve as a resident chaplain at Wake Forest Baptist Health next year in Winston-Salem, NC. Hillary will serve as a resident chaplain at Moses H. Cone Memorial Hospital next year in Greensboro, NC. Megan will serve as Minister to Children and Families at Galloway Memorial UMC in Jackson, MS after graduation. They plan to stay connected via Skype dates, road trips and self-care phone calls.