Amid layoffs, M Health Fairview chaplains raise concerns about spiritual care

CATHY WURZER: We're getting a clearer idea of who lost their jobs in the most recent round of budget cuts at one of Minnesota's major medical providers. Last Thursday, Fairview Health Services announced it was eliminating 250 positions. That includes 13 chaplains and two spiritual care support staff positions, mostly at the University of Minnesota Medical Center.

The layoffs include the center's only two Muslim chaplains in a region with a growing Muslim population. We're going to talk about this. But first, we'd like you to know that M Health Fairview, which is run by Fairview and the University of Minnesota, is a financial supporter of NPR News.

Joining us right now to talk about the effects of the layoffs among the spiritual care staff is Bill Dexheimer-Pharris, a Lutheran pastor and chaplain at the University of Minnesota Medical Center, and Imam Tamer Abdelaziz, who was the lead Muslim chaplain for M Health Fairview until his position was among those eliminated last week.

Tamer, thank you so much for joining us. We talked with you during the height of the pandemic, I remember, when things were pretty bleak. And I'm sorry to talk to you again at this time. I know it's quite a shock to lose one's job. Was there any inkling among staff this could happen?

TAMER ABDELAZIZ: Cathy, thanks for having us. We didn't-- we were just kind of broadsided. I would say it felt like a collective gut punch, you know, so to speak. We just really had no idea that something like this would happen, especially with our patient demographic. And the care that we're providing, essentially, are something essential to not only the physical healing that one needs, but also the spiritual and emotional needs as well.

CATHY WURZER: Bill, let me ask you a little bit about what you all do. Chaplains that I know talk a lot about presence when describing their work, which is kind of a big catchall phrase. What does that mean, exactly?

BILL DEXHEIMER-PHARRIS: If I could, Cathy-- and thanks for having us on. This is great. I sometimes have a hard time describing what we do, because it's so broad and depends on each patient and family and their experience. But I'd like to share some beautiful words that I actually taped up on my wall a couple of weeks ago.

They're from my colleague, palliative chaplain Kate Bradtmiller. She was featured in Fairview's intranet site, talking about chaplaincy. And I love these words that Kate shared, and I kind of want to make them my own, but here's what Kate said.

"Being a chaplain is a privilege, because I get to honor people's identities and support the ways in which they find meaning. When I meet patients in the hospital, I tell them that my job is to care about what is most important to them, to make sure their voice is heard during their journey with illness or trauma. I love my job, because I get to listen deeply every day and because I work with providers whose dedication and compassion is unparalleled."

And that's how I feel about Kate. And unfortunately, Kate and Tamer and eight other university chaplains who I've worked with for years-- I've worked for over 28 years now as a chaplain there. But I'm needing to say goodbye in another couple of weeks from them.

CATHY WURZER: And you are still working there. Tamer, as I mentioned, you were one of those who lost their job. And let me ask you this. I mean, when you and I talked during the height of the pandemic, it was really clear that you were serving the needs of many different people, right? How is it important, why is it important, to have chaplains from various faith backgrounds that match the populations you serve?

TAMER ABDELAZIZ: Well, it's extremely important, because there's certain needs that not all chaplains will be able to meet. One of the particular instances that I'm called for is end-of-life circumstances as well as some of the beautiful things like the beginning of life. And there was just, the past week or so, some babies that were born that got to come in and whisper the Islamic call to prayer in each one of their ears. And it just felt so good.

And you know, I don't think other chaplains know how to speak Arabic or communicate in Arabic with the patients, but I do, and that really helps with rapport as well. And if I'm looking at just the chaplains that are left over-- and no disrespect or anything to them, because I love all of them, but they're all white. And it speaks to a narrative that has been perpetuating throughout the US and what's going on. It's something called white supremacy and Christian privilege, and I'm aware of it. I know it's in the air that we breathe.

CATHY WURZER: Fairview said that it was facing pressures like higher labor costs and inflation that led to these 250 positions being cut. And we asked Fairview for information on the layoffs in the spiritual care department, and they said that this decision was made in part because of the changing ways in which our patients, their families, and our staff seek spiritual support. Tamer, what do you think that means?

TAMER ABDELAZIZ: So basically, I think what they're trying to do is sort of outsource this to community volunteers, reaching out to, for example, my faith community, the imams and religious leaders. But that's going to overutilize them. They already have their jobs, and they're working in the community as imams and as spiritual leaders.

So I would like to also highlight the uniqueness of our specialized care as chaplains. Like, we go through a clinical pastoral education process, of which we're certified. In the fall-- or, excuse me, in the spring, I'll be taking on a certificate. I'll be receiving a certificate for a Master's of Divinity with a focus on Islamic Chaplaincy, and we're learning about a lot of self-care, self-development, grief and counseling for patients, family systems-- a lot of things that not always our spiritual leaders are equipped and have at hand.

CATHY WURZER: Pastor Bill, would you like to make some comment on this?

BILL DEXHEIMER-PHARRIS: I would. And first of all, I agree completely with what Tamer said about the fact that all three chaplains, including myself, who remain are white. That's just unconscionable. I do want to point out that my wonderful colleagues-- our Muslim chaplains Tamer and Jamila-- are also, as we all are, interfaith chaplains.

When they do their on-call, they might visit and pray with Christians, with Jews, with Hindus, with anybody-- people of no faith. We're all trained the same way as professional chaplains to, for the most part, be able to serve people of whatever faith background or no faith. But then, when we have special needs, such that need folks like Imam Tamer, we're so blessed to have them. And there's no way that just working with volunteer chaplains, we would be able to even come close to the kind of support for patients and families.

CATHY WURZER: You mentioned volunteer chaplains. Because the question is, who will be left to do the work? Now, I wonder if RNs would also be called into a room to help provide comfort care to a patient who, say, is dying. They already do that, of course, but might this also, Tamer, be another job they'd have to do?

TAMER ABDELAZIZ: I think they're trying to overutilize nursing staff and other medical staff that might be present, with the inclusion of employee-- the employee assistance program for staff support. But you know, I just did a presentation for our ICU on the East Bank. And one of the questions that they had after my presentation on biomedical ethics with regard to end-of-life and critical illness or any emergencies overnight-- they were like, Tamer, is there a Muslim chaplain on call overnight, or can we have access to Muslim chaplain 24/7?

I was like, I'm working on it. We're trying to get there. We're getting more people in the training. And unfortunately, that bubble was burst when we received our-- our layoffs.

CATHY WURZER: Pastor Bill, what do you think is going to be lost, moving forward?

BILL DEXHEIMER-PHARRIS: Well, speaking also about our very overworked nurses and nurse leaders, the level of support for their work. I spoke with a nurse manager just the other day, who said to me, Chaplain, you are so tremendously valued. Your team is so valued by our patients, families, and staff to support our nurses in times of very difficult work conditions.

She's seen chaplains come in during an emergency in the middle of the night and put very anxious patients and families and staff, too, at ease within minutes. That's what folks like Tamer do when they come in, in the middle of the night.

CATHY WURZER: And Tamer, I know this is just fresh news for you. Do you have any idea of what you want to do moving forward?

TAMER ABDELAZIZ: I honestly had a few requests and a few inquiries about my availability. And you know, honestly, some of those requests come from becoming an imam again in the mosque setting, some requests in other fields. And honestly, I might be looking forward to some good self-care time and time to process all this, and just lay low for a little while.

CATHY WURZER: And Pastor Bill, you're still there. What about your future?

BILL DEXHEIMER-PHARRIS: Well, as I said, I've been there 28 years. I'm close to retirement. And I was not certainly expecting to finish out my long career at Fairview, having been part of an amazing department for all these years, to see it really being destroyed at the end of my time here. And so it's very sad.

CATHY WURZER: I appreciate the time. And best of luck to both of you. Thank you.

BILL DEXHEIMER-PHARRIS: You're welcome.

CATHY WURZER: We've been talking to Imam Tamer Abdelaziz, whose position with Fairview is among those being cut, Pastor Bill Dexheimer-Pharris, who is still with the University of Minnesota Medical Center.