Chaplaincy at the time of COVID-19: an interview with Dr Iain Macritchie
(See here for an interview with Iain about his role prior to deployment, as Programme Director for Chaplaincy and Spiritual Care with NHS SCotland.)
Iain Macritchie’s role in the time of COVID 19 at NHS Louisa Jordan
When I heard that our friend Dr Iain Macritchie had been deployed as Head of Spiritual Care and Wellbeing at NHS Louisa Jordan, the field hospital established, at breathtaking speed, in the Scottish Exhibition Centre in Glasgow I texted him ‘Perhaps this is what the whole of your life has been preparing you for.’
Last year I published an article here about Iain’s ‘normal’ job as NHS Education for Scotland’s Programme Director for Chaplaincy and Spiritual Care, so I was keen to ask him about the challenges facing him in his temporary role.
‘Perhaps my initial response was over-dramatic?’ I asked on our Zoom call on 24th April He smiled. ‘Not really. I have felt hugely in the right place at the right time which for me is as good a definition of vocation as I can come up with.’ It was, he said ‘very affirming’ to be able to bring his expertise into play. It’s also a challenge. ‘OK, I’ve got the ball here. I’ve got to run with it. There isn’t really anybody else to do this job at this time. It’s me, and I can do it, and that is both my privilege and my responsibility.’
Setting up the Chaplaincy service at NHS Louisa Jordan
After his appointment, Iain spent a hectic two weeks developing a ‘model of care.’ He planned how best to deliver 24/7 access to the supportive, empathic listening which NHS chaplains offer so well to patients, their families and carers, and NHS staff. He identified how many colleagues were required at the new facility (3 full-time equivalents, the hours shared between 8 chaplains) and recruited staff – all of them people who, though under retirement age, had ‘retired’ from the chaplaincy service and moved on to other areas of work – for instance, church ministry. Chaplains come from all faith traditions, and are employed ‘to deliver person-centred spiritual care,’ accompanying people on their inner journeys.
These two weeks taught Iain that he has ‘an inner strength and resilience that kind of surprised me. I learned that I can do a prodigious amount of work in a very short period of time that even I am amazed about. Like, ‘Wow!’ I look back at the last few weeks and say “Did I do all that?” And, “Yes I did.”’ He found it ‘inspiring’ to see the new hospital come together over those weeks.
NHS Louisa Jordan went operational on Monday 20th April, and is now a fully-functioning field hospital ready to receive patients. None have so far been admitted, and for that Iain is ‘ hugely grateful.’ It shows, he says, that social distancing measures are really working and that the pressure at hospital Board levels hasn’t been as intense as expected.’
Louisa Jordan was a Glasgow-born Scottish nurse who volunteered for service during the First World War, and died of typhus during an epidemic at a field hospital in Serbia in March 1915. She had volunteered to nurse a colleague, Dr Elizabeth Ross from Tain who also died of the disease. Jordan and Ross were showing the same commitment to care for desperately ill patients despite the risk to themselves that we are seeing around the world today.
How has the delivery of Chaplaincy changed as a result of COVID-19?
I asked Iain how the delivery of chaplaincy care across Scotland had been changed due to COVID-19. Iain told me that the chaplains are still able to see the patients they need to see, either by observing social distancing, or by wearing Personal Protective Equipment. (Iain’s staff at Louisa Jordan have all had training in ‘doffing and donning’ PPE and to facilitate this, Iain had to shave off his distinctive beard.) But like all health and social care staff, chaplains have had to discover new ways of working – offering support where possible through video connection or phone has become the preferred mode of delivery to patients, their families and staff.
Do Iain’s clients feel adequately supported through these remoter means of contact?
What was people’s reaction to this change in the way care in delivered? Iain told me that ‘Service user groups say they absolutely “get” the need for this change, and are happy with this.’ He has had feedback from people who are simply grateful that the service is ‘still there’ and grateful for the 24/7 cover. ‘People are definitely using the service, and leaning on the service, and that’s a very positive sign, and the chaplains feel that there being of use.’
But Iain is conscious of the weapons in his armoury which he can’t at present deploy:
I cannot hold a hand, I cannot put a hand on a shoulder, I cannot come close to somebody, or even give a hug if that was appropriate. That’s not happening at all, and you feel the kind of miss of that. But we are compensating in other ways. We have to be more intentional and more focused in our listening to the nuances and the timbre of somebody’s voice on the phone or the video connection, picking up on these signs.
And Iain mentioned another, practical way in which chaplains can help bereaved families during COVOD-19. ‘There are new arrangements around the registration of deaths and the organizing of funerals. The registration process is now entirely on-line and we, having been coached in it ourselves, can help people through that process.’
The Chaplain’s need of ‘relentless self-care’
How do Iain and his colleagues manage to cope with the burden of seeing so much suffering and death? ‘Yes, these are extraordinary times, and we feel that,’ he said. ‘We need to be ultra guarded around boundaries, and aware of what we’re carrying – I’ve never been aware of that more – and just to look after ourselves.’
He told me about the ‘pastoral supervision’ through which chaplains are supported to ensure that they aren’t pouring themselves into their work of compassion so intently that there is nothing left for themselves. In normal circumstances, chaplains engage with their supervisor on a monthly basis; recently Iain and his colleagues have sought more frequent supervision, ‘just to have ourselves that kind of sounding-board and that support which we are seeking to give to others as well.’
Iain described how beneficial he, personally, finds morning and evening prayer:
I’ve always found it a hugely important just to say the daily office in the morning and the evening to kind of bookend my day. To enter into work with it, and then to leave work behind at the end of the day, and to use the daily office to do that very intentionally.
One of Iain’s long-standing favourite quotations is the comment of a former colleague of his at Highland Hospice who used to say ‘Those of us who are involved in the care of others must ourselves practice relentless self-care.’ Iain smiled gently as he repeated this, adding ‘Relentless self-care is the message that we’re putting out just now.’
Lessons about self, human nature, the NHS and God
I asked Iain what he was learning in the middle of the crisis about himself, human nature, and God. With regard to lessons about himself, he mentioned the personal strength and resilience described earlier. ‘And,’ he continued ‘I’m learning about dependency on other people. In no way could it ever have been “just me.” It’s been about team working of a quality I’ve never seen in my life before. I am so profoundly grateful for colleagues of such quality, and for that sense of them being around, and all pulling together.’
And about human nature? ‘I’m definitely seeing the best,’ Iain said. ‘I think this is bringing out the best in my colleagues. There’s a real “we can do because we must do” attitude: I really admire that. And a courage, yes, as a value and as a virtue, I see a lot of this, a lot of brave people.’ Among his own recruits, and others who have ‘stepped forward’ to assist at NHS Louisa Jordan, there is ‘a willingness to help and to be of help, and to put themselves in places which will require courage.’
And the NHS? Iain thought for a moment, then grinned. ‘I love it. It’s really an extraordinary organisation and I think we’re seeing the best of it in these circumstances.’ He reflected that ‘Institutions can behave appallingly and can also behave really, really well’ and told me ‘I’m seeing this organisation behave really well, and delivering extraordinarily.’
And what has he learned, or been reminded, about God? ‘I’m just so aware of God’s provision in all of this,’ Iain said. Over the time he was working full-on to get the Chaplaincy service up and running, he sensed a divine engagement in enabling him to make contact with people. ‘The number of conversations I’ve had…’ he told me with a touch of awe in his voice. ‘I’ve picked up the phone, and I’ve thought “I really need this person to be in.”’ So often, the person at the other end would pick up and say ‘Oh, Iain, I was just thinking about you, and I was going to give you a call and …’ ‘I have a real a real sense of the provision of God in all of this,’ Iain concluded.
Iain sums up his present situation:
Someone was asking me recently how I’ve been and I had to say that the underlying feeling I’ve been travelling with for a long time now is just profound gratitude, gratitude for colleagues, and for God in all of this, for provision, for daily grace, daily strength, personal health, family, friends just real gratitude for so many good things.