The first person a patient’s family will meet in the Trauma Division at Penn Presbyterian Medical Center (PPMC) is not a nurse or a doctor, but a chaplain.
Before the family arrives, Josh Edgar, the principal chaplain for Trauma at the hospital, will have worked to find out which family members may be arriving to see the patient to prepare for his role as the Trauma Team Family Liaison. He will have coordinated with hospital security and be prepared with a plan to have the family briefed by a physician.
For patients who are admitted, Edgar will offer ongoing care in a chaplaincy role throughout a person’s stay at PPMC, helping them to process their traumatic injury through retelling the events that brought them to the hospital, reflecting on their experience, and discussing what gives them strength, and facilitating their own spiritual coping.
PPMC’s provision of Pastoral Care is interfaith, with no goals for interactions with patients, only to create a space to process their traumatic injury.
“Simply stated, as a chaplain, I engage in patient-led pastoral care, which can be described as the art of accompanying and supporting people in health crises as they make meaning and cope with their existential reality,” Edgar explained. “Our main goal is to help others feel cared for – from patients, to their families, to providers and staff.”
“In pastoral care, the aim is to provide a ‘non-anxious presence’ to everyone involved,” he added. “For example, in the trauma bay when I sense providers might not be able to save a patient, I move closer to the bedside in the view of the doctors and nurses so that they can feel supported during an especially difficult moment.”
Growing up, Edgar wanted to be a pediatrician, but he re-evaluated his career path after medical school seemed impractical. The son of a chaplain himself, he began an internship in Clinical Pastoral Education.
“I was very unsure about this career move,” Edgar admitted. “But I clearly remember riding my bike home from my first patient visit and being overcome with emotion as I realized how perfect this role actually was for me.”
After that internship, Edgar began a chaplaincy residency at the Hospital of the University of Pennsylvania (HUP), and then stayed on as per-diem at HUP, Penn Presbyterian Medical Center (PPMC) and the Children’s Hospital of Philadelphia (CHOP).
During the COVID-19 pandemic, Edgar accepted a full-time role as the Trauma Chaplain at PPMC. Given the stress the pandemic put on patients, staff, and families, there was a high demand for chaplain support.
“While the pandemic was extremely difficult for everyone, it highlighted the huge impact that staff has on the lives of patients,” Edgar said. “Patients are always eager to express to me their gratitude for providers, and always share how seemingly small acts of love from doctors, nurses, and other staff make a lasting impact and go a long way.”
During his time at PPMC, Edgar has seen an uptick in the number of adolescents he works with in the Trauma Division, noting that his early interest in a pediatric population and his work at CHOP plays into his work now.
“Everyone is in a vulnerable state when they come through our doors, but the teens who come in are particularly desperate to have someone by their side, especially when their family might not have the capacity to come to the hospital daily,” Edgar said. “I am that person for them sometimes, and there is a distinct sense of earning their trust as they warm up to me.”
When young patients suffer from a traumatic injury, Edgar helps them, as their injury can often help them realize that life can be brief and their choices have serious implications.
“When reflecting on the incident that brought him to the hospital, one young man said to me, ‘I know it’s short, but my whole life flashed before my eyes,’” Edgar recalled.
As a chaplain, Edgar’s role is sometimes confused with that of congregational clergy that patients may have known, and patients can worry that he may press them pray or have certain religious expectations of them.
“A common misconception is that I am here only to pray or offer guidance from one specific religion,” he said. “Sometimes I do pray with patients, but sometimes I don’t. Praying or meditating can help patients cope with trauma, but prayer is not the only thing I do with patients. It’s all about what a patient needs – they lead me, never the other way around.”