Fairview layoffs include significant cut to chaplain program

Layoffs announced this month at Fairview Health Services are hitting hard among chaplains at the health system, including a deep cut at the University of Minnesota Medical Center in Minneapolis.

Workers interviewed by the Star Tribune said 10 of 13 staff chaplains at the U hospital are losing their jobs.

Another three staff chaplains are being laid off at other Fairview facilities in the Twin Cities region, said Carolyn Browender, a chaplain who is losing her job after three years with Fairview hospitals.

The layoffs amount to a roughly 50% reduction in the number of staff chaplains across the health system's metro locations, workers say.

At the U hospital, the layoffs include two Muslim chaplains who play a crucial role in the hospital's service to Somali-American patients who live in the nearby Cedar-Riverside neighborhood, Browender said.

"We're grieving and very disappointed ourselves, but also just extremely shocked and very concerned about what this means for patient care," said Browender, who works at University of Minnesota Medical Center.

Fairview said reducing onsite chaplain services was a "difficult decision."

Spiritual counseling for patients is also provided by "casual" chaplains who work on an as-needed basis, the health system said. After factoring these chaplains, there are still "dozens" working with patients, Fairview said, including chaplains representing a variety of religious and cultural backgrounds, including the Muslim faith.

The health system didn't specify how many people work as casual chaplains. Browender said she's seen a roster for the U Medical Center and six other facilities that suggests about 14 people have this designation, where workers don't get benefits.

Dr. Patrick Herson, a palliative care physician at University of Minnesota Physicians, said he worries about the impact for patients because fewer chaplains likely means patients will wait longer for visits.

Chaplains who work on an as-needed basis do important work, Herson said. But he said it can be harder for them to develop the deep relationships with staff and patients that staff chaplains typically maintain.

Fairview said the way patients, families and staff seek spiritual support is changing — a factor driving the chaplaincy program cuts.

"Every day, our care teams help patients and families arrange for visits and support by trusted spiritual leaders, based on their personal religious preference and unique cultural needs," the health system said in a statement.

"We will continue partnering with our region's diverse community of faith leaders and cultural healers to support our whole-person approach to health care now and in the future."

Fairview is one of the state's largest health systems. It owns University of Minnesota Medical Center and jointly markets services with the U under the brand M Health Fairview.

Last week, Fairview announced it was eliminating 250 jobs amid continued economic stress for hospital and clinic operators. Besides the staff chaplains, two of their support workers are being laid off.

The university hospital is a large medical center that treats patients with serious and complex health problems. As a result, treatment often involves attending to end-of-life care needs for patients and their families. Herson said he's concerned about the potential for burnout among the chaplains who remain.

"Many patients and families face big, deep questions of meaning when confronting a serious diagnosis or poor prognosis," he said in an email. "If people have been through a lot of treatments and interventions and they aren't getting better, they may wonder if they've been forsaken; or if their faith wasn't strong enough; or if they've sinned and are being punished.

"Because our chaplains have specialized training beyond that of most pastors or ministers, they are skilled in having compassionate conversations with patients of all religious faiths, including those who don't identify as having any 'religion.'"

Casual chaplains are often limited in the number of hours they can work at the hospital, Browender said. Chaplains at the U this week filed a petition asking that Fairview recognize their request to join an existing union at the hospital, she said.

"Fairview still has the opportunity to do the right thing and revisit their poorly considered decision to gut our department," she said in an email. "... Even if layoffs move forward, those of us departing will be glad that our colleagues who remain will benefit from union protections."

One of the three remaining staff chaplains at the U hospital is scheduled to retire next year, said Mary Shaffer, a chaplain who's being laid off after nine years at the U Medical Center.

Shaffer, who works with oncology patients, said public statements from Fairview lead her to believe the health system might try shifting work to faith leaders from the community who visit patients in the hospital. If so, the strategy might not work well, she said, since many of those faith leaders are struggling with the demands of leading their own congregations whether at a mosque, synagogue or church.

Katherine Engel, an interfaith and Buddhist minister who is losing her job after three years at Fairview, said patients and their families have spiritual needs, but they aren't always connected to a faith community.

"There's a large number of people that do not have a particular tradition," Engel said. "'Spiritual, not religious, is the fastest-growing self-designation for people. ... Chaplaincy is an avenue for supporting and helping people figure it out for themselves — it's not a preaching situation at all."

The COVID-19 pandemic showed the value of chaplains in care teams, in part because of the support they provide to health care workers when recruitment and retention is challenging, said Doug Stewart, treasurer of the Illinois-based Association of Professional Chaplains. Stewart said he was surprised by Fairview's announcement because he's lately been hearing more about health systems hiring chaplains — and more chaplains seeking board certification.

Fairview said its employee assistance program remains a resource for workers to connect with support, including for their spiritual well-being. The health system did not comment on the union petition by the chaplains, but said of the broader issue for patients: "We know the important role that culture and spirituality play in overall health and healing."