How to Plan a Pastoral Hospital Visit

Showing kindness to the sick from a distance—paying bills, meal trains—is surely not wrong, but what is interesting about the biblical command to visit the sick is the emphasis Scripture places on embodied presence.

I was hungry and you gave me food, I was thirsty and you gave me drink, I was a stranger and you welcomed me, I was naked and you clothed me, I was sick and you visited me, I was in prison and you came to me. (Matt 25:35–36)

Pastors, in particular, are to visit the sick:

Is anyone among you sick? Let him call for the elders of the church, and let them pray over him, anointing him with oil in the name of the Lord. (Jas 5:14)

Hospital visits and similar in-person ministry are a necessary part of the pastoral task. Pastors and other church leaders might as well take this opportunity to think through how and why to do hospital visitation.

What things are done in a pastoral hospital visit? Are there helpful resources for preparing such visitations?

Presence is the very first thing that is achieved in a pastoral visitation to the sick. A pastor may trip over his words; a care-team member may have forgotten the cards from the Sunday school class; there may or may not be the ability to administer anything in the way of the sacraments (baptism, communion, anointing with oil)—but what a pastor can do is be there.

One of the chief things that illness or surgery or childbirth effects is social disintegration. The person being visited has had limits imposed upon their relationships, upon their ability to move through space, and upon their participation in community. Central to the pastor’s visit to the hospital or the sick-bed is that pastor’s presence.

Application: While observing proper boundaries and medical regulations, pastors should be as present as possible in their hospital visits—representing to the visited the community from which their illness has separated them.

Pastoral care is the second thing that a pastoral hospital visit affords the opportunity to do. The weak and infirm, the shut-in, the postpartum mother, those about to perish, and those coming out of a medical procedure—all need to receive the counsel, care, edification, instruction, and encouragement brought by the pastor. Come ready with Scripture verses and good questions, but avoid turning the visit into catechesis. See if there is anything they want to talk about, and prepare to receive from them the kind of conversation that they are ready to give. This conversation may be more or less than you had prepared for. The Lord draws near to the brokenhearted; you draw near to them also.

Application: You are there for the love and care of the ailing person’s soul. Christ has entrusted you with the precious moments with one of his sheep in their hour of trouble. Trust in the Lord, follow the leading of the Holy Spirit, and do not lean on your own understanding.

As limited as time often is for pastoral hospital visits, one can still bring the Word of the Lord into the space of the visit by preparing well ahead of time. Avoid preparing a Bible study, but do come equipped with key verses which speak to those in need, distress, or illness. The following Scriptures are ready comforts for the minister to offer:

• Christ came into the world to save sinners (1 Tim 1:15).
• God does not delight in the death of a sinner (Ezek 33:11).
• Christ ever intercedes for us (Heb 7:25).
• The Spirit helps us in our weakness when we don’t know what to pray (Rom 8:26–28).
• The Lord seeks the lost, brings back the strayed, binds up the injured, and strengthens the weak (Ezek 34:16).

Application: Let the Word of God do the work that only it can do. Come prepared with short, manageable passages (no more than a few verses), which will give them hope in the goodness of the Lord. The Logos Counseling Guide can assist you in this task.

One of the most powerful tools with which a pastor can come equipped to such a visitation is the Psalter. As Walter Brueggemann explains, the Psalms bring “stylized, disciplined speech … together with the raw, ragged, mostly formless experiences in our lives.”. When we bring the songs of the Psalter into the visitation room, we bring the painful, formless experience of illness and medicine and mental health and surgery and prognosis and prescription and loneliness and exposure and worry into the structure provided by the psalms. Doing so does not mute or “fix” the needs or of the person being visited, rather, as Byung-Chul Han has noted, “the Christian narrative gives pain a language.”

Reading a psalm (individually or responsively), or, better yet, softly singing or chanting a psalm over the person makes the moment a place of worship and precious communion with the Lord. It brings the sufferings of the patient into the life of Jesus, for, per Rowan Williams,

The Psalms are the words of Jesus, the Word who speaks in all scripture. … He speaks for us, makes his own the protesting of troubled cry of the human being, so that his own proper and perfect prayer to the Father may become ours.

Psalms 4, 37, 46, 91, 103, and 146 are excellent for such moments which proclaim the truth that God is our refuge.

Application: So much of the experience of the sick and needy is that of being muted. Bringing the songs of the Psalter into their experience, though chanted respectfully and quietly, gathers their moments and their pain and their fears into worship. It gives voice to their affliction, and names as meaningful their moments of infirmity.

The pastoral hospital visit is also a time for prayer. This is central to what James instructs the church to do when it visits its members who are ill: have the pastors pray for them (Jas 5:14). Such prayers must be freed from any artificial weight applied by the pastor to “be super meaningful.” I know the temptation, but that is not what these prayers are about. Simple, honest prayers, prewritten or spontaneous, are aimed at nothing other than collecting the prayers of many who are praying (family members, folks from church throughout the week, the prayers of the sick person themself, prayers of friends who live a long ways off) who may or may not be present, in a unified prayer to the Lord.

Given the sensitivity of such visitations, I often find that coming prepared with prewritten prayers (memorized and internalized is better) can be incredibly fruitful. It takes all the pressure off of the situation. There is no magic to be worked here, no brilliance of pastoral charism; just the words prayed by many Christians other than ourselves in similar situations to a God they too put hope upon and whom they also found mighty to save.

Application: Be prepared to pray. Either in the room with the visited, with the family, perhaps even with the staff or professionals who are providing care. The best thing that prayer can be is simple and honest. Most prayer books have prayers for such purposes. Find a good prayer book and keep it handy.

Finally, a pastoral visit to a hospital (or other such situation) presents an opportunity for the administration of the rites and sacraments of the church. Again, usually these visits are shorter in length than other pastoral occasions and so economy of time is important. Planning out three brief 5–15 minute visits is usually more fruitful than planning a single visit in which a pastor feels the unbearable (unbearable for all involved) weight of having to “do everything.” There are, however, minimally two rites which the pastor should be able to administer appropriately and flexibly which the sick, bedridden, postpartum, recovering, ill, or dying person will be benefited by: the anointing with oil (cf. Mark 6:13; Jas 5:14) and baptism (where necessary).

Depending on the tradition in which one ministers (I for instance, am an Anglican pastor), two more rites may be available to offer those being visited: Communion to the sick (in which the elements of Holy Communion are brought from the gathered worship of the church to the site of the visitation), and what is called “last rites.” While both of these are far more common practices in Roman Catholic and Eastern Orthodox communities, there are ways to offer them which conform to more evangelical, Protestant, and/or Reformed churches.

There are ways for a pastor to administer these within whatever tradition he may be a part, and there are manuals and service books available for such services which can all be meaningfully adapted for the circumstances. I keep a “visiting bag” with me throughout the week. Among other things that are in it I always have:

1. A small container of water
2. A phial of oil
3. A Book of Common Prayer

The nature of human ailment usually precludes a pastor’s ability to plan long in advance. Just as an expectant young couple prepares a “go bag” when they near the time of childbirth, so also pastors can prepare things so that they are ready at all times to respond to the needs of their flock.

Application: Be versed in the rites for administering oil, a brief service of Holy Communion, baptism, and last rites. These are not things that a pastor should “not be really certain how to do” when and if they are requested during a hospital visit.

What are the different types of pastoral visits?

It is helpful to think through the ways in which different kinds of pastoral visits might differ.

Firstly, there is the most general and most common kind of pastoral visit. That of a general health-related need. This includes everything from the visitation of outpatients following significant (but not necessarily life-threatening) procedures, the visitation of those under care that keeps them recovering at home or in a hospital, those who are dealing with mental-health events that confine their movement beyond home or medical facilities, and situations of intense hospitalization.

Secondly, there is the occasion of the birth of a child which usually occurs in a hospital setting but can also occur at home or in birth centers. While it is not the result of bodily or mental ailment, childbirth carries within itself many of the same features of sickness to which pastoral care is applied: the proximity to mortality, the need for recovery, the application of medicine, the exhaustion and expansion of physical needs, and the unquestionable disintegration of what had been “normal life.” The presence of a pastor, with the family’s permission, in response to the birth of a child, with prayers, presence, and words of comfort, do much to proclaim to the gospel to a family whose world has undergone a fundamental transformation.

The last kind of pastoral visitation is the kind wherein the proximity of death and the gravity of illness place peculiar constraints on all those involved. We cannot treat these situations as the same as those listed above. Certain conversations must now be had that have not occurred before, and difficult decisions must now be made. The pastor occupies a strange position in these moments. The pastor is usually not a medical professional, nor the one who is dying, nor—usually—a family member. Many of the decisions are not the pastor’s to make. Yet, the pastor is often looked to with a kind unspoken authority of one whose job it is, even in some attenuated way, to be present in the place of death. Many pastors, rightly or wrongly, also feel a sense of being in the way and not knowing what to do. Extreme care, therefore, and respect for the family and the caregivers, must be exercised here while finding the appropriate place to perform the pastoral role. Usually, I limit myself in these cases to saying three things at the right time unless asked to do more:

1. Has this person been baptized? Do they want to be baptized?
2. Should I administer last rites (according to one’s tradition)?
3. I’ll be over here praying, please let me know if there’s anything else I can do.

What are some common challenges pastors may encounter during hospital visits—and how can they overcome them?

Pastors, especially newly ordained or inexperienced pastors, often encounter a heightened sense of “not knowing what to do” during a pastoral hospital visit. Hopefully the above sections have helped to diminish that feeling. In addition, it is not unwise to do some research and preparation beyond what I’ve discussed so far: Look into the hospitals, care facilities, birth centers, clinics, mental health wards, etc., in the area in which you minister. Do some research. Where is the visitor parking? Do they have special rules or policies in place for pastoral visits? Do they have chaplain staff that you can reach out to with questions? Will you ever need to get special access to military hospitals, and, if so, how do you go about that process?

Another challenge that pastors can experience, regardless of years in ministry, is the difficult relational tension within and among family and friends of the person being visited. Family feuds, arguments, heightened emotions, stress, unclear advanced directives, legal and financial problems—all create circumstances that are ripe for discord. Here there is little a pastor can come “prepared” to handle apart from a charitable disposition and a willingness to sustain a prayerful peaceability in the face of what can be a really difficult situation for a whole web of relationships.

Rarely are hospital visits something a pastor can carefully plan out weeks in advance. Emergencies are just that. Pastors, especially pastors who minister without a team, can easily feel overwhelmed by the unscheduled needs which the care of a parishioner in such situations can present. Healthy communication, brevity of visitation time, and clear protocols for what to do when you arrive at the hospital (or other facility) will be critical for ensuring the long-term viability of the pastoral care you offer. Additionally, it is always wise to be honest with your church about your limitations while being respectful to the privacy of the visited party. A Wednesday email that reads, “Hey, everyone, I’ve needed to respond to a couple of medical emergencies in our church this week, so we will be cancelling Bible study on Saturday,” usually is a wiser move than a half-prepped study led by a weary pastor whose sermon is also not prepared and who won’t be honest about his exhaustion.

What are some practical tips for pastors to ensure a smooth and meaningful hospital visit experience?

To conclude, I’d like to offer five very practical tips for pastors looking to do hospital visitation.

1. Communicate effectively

Clear communication is critical for hospital visitations. Consider the following situations:

• Are you bringing communion? Do they know this? Or—worse yet—are they expecting you to bring communion, but you are not?
• Do they have family with them? Should you communicate with them? Are their family members elsewhere? How can you keep them in the loop?
• Do you know the hospital’s guidelines for visiting hours? Are you respecting them?
• Did you bring oil? Have you asked the hospital staff if the patient can receive applications to the skin?
• Do you have the right address?
• Are you visiting a mother who just gave birth? What do you do if you arrive and the baby is out of the room for post-natal check-ups? Can you wait? Can you come back?

As much as you can communicate with all the parties involved—ahead of time, during the visit, and afterward—the more fruitful your visit will be.

2. Come with a plan that is both formal and adaptable

Hospital visitations are not usually the place in which a pastor should ask, “What can I do?” They are often times where what is most comforting for all parties involved is to be able to hear what the pastor has come prepared to do. They can say “yes” or “no” to that plan, but it is not the job of either the visited person, the family and friends of the visited, or the caregivers. Often the more dire or tense the situation the more helpful a plan is. I do not need my presence creating a situation in which doctors and patients, or the infirm and their children, or ailing mothers and sorrowful children need to curate my care of them. This plan can be adapted, expanded, or shortened as necessary; but coming with a plan places the awkwardness of the visit where it belongs: on the pastor. I usually arrive and share with whoever has the voice in the room, “Here’s what I was planning on doing”; and then I ask for their permission and their thoughts.

3. Follow up

Follow-up is a critical part of a healthy pastoral visitation to the sick. Often the primary recipient of the visitation is not going to be able to manage all of the communication, so it is good to identify who to do that follow-up communication with. It is also best to plan out follow-up care before the conclusion of the visit. “Unless I hear from you all saying not to come, then, I’ll be here Thursday at 12:00 p.m.” does a lot more to ensure meaningful pastoral care than does, “Well, let me know when you’d like me to come again.”

Additionally, there are usually things that a pastor can engage the local church in doing to provide support for those who have been visited, things which go beyond the central but certainly no solitary gift of the pastor’s presence. This would include arranging meals, running errands, tending to yards, caring for pets, etc. All are a part of follow-up; they include the greater community in the care of the sick, the dying, or postpartum.

4. Respect confidentiality (and know where those boundaries are)

This one is simple. Know who is supposed to know what. Pastors are not entitled to know everything that a doctor does; and just as the pastor needs to respect those boundaries, there are things that a pastor is going to be privy to that are not appropriate to share indiscriminately. Know what you are supposed to know and know how much of that you need to keep confidential.

5. It’s not about you

It is, finally, important to remember that a pastoral hospital visit is not about you, the pastor. It is not your job to be amazing, to “fix” anything, or to weigh-in like some sleuth on a daytime drama offering unlooked-for medical advice. It is not your strength in this moment that is going to bless the person you are visiting. It is the Lord’s strength perfected in your weakness which offers hope and life (2 Cor 12:9). Avoid the temptation to believe that you must make the situation “meaningful” in some abstract way. You are there to do the work of a shepherd, and the gifts of our vocation are simple things: presence, touch (as possible and permitted), words of Scripture, prayers, sung psalms, dribbles of oil, the offer of the sacraments, the willingness to hear, “No, thank you.”

We are there to “bear one another’s burdens, and so fulfill the Law of Christ” (Gal 6:2). Christ came not merely to pay the debt of sin from a distance, but to dwell among his people, to care for us, to heal us, to touch us and to be touched by us—and, ultimately, to take up residence within us as his living Temple (1 Cor 3:16). So also, as the body of Jesus, we are called to be present with those who suffer and are sick.

Related articles

• Why Pastoral Empathy Is Not Enough (and Why That’s Good)
• 6 Heartfelt Prayers for Mental Health (Based on Scripture)
• 3 Truths about Mental Health and the BIble
• The Christian Understanding of Death and Dying According to Scripture

Resources you may find helpful for your pastor hospital visit