116 3rd St SE
Cedar Rapids, Iowa 52401
The next time you start divulging personal information to a hospital chaplain as a way to share the burdens you or a family member are experiencing, you might want to zip it.
Depending on the hospital, anything you tell them could be included in your – or your family member's – medical record.
Dayna Leichty of Little York, Illinois, learned this the hard way.
In March, while her son was receiving treatment at the University of Iowa Hospitals and Clinics, she was visited by a hospital chaplain.
“We just chatted as a lot of people would with someone from the spiritual department,” said Leichty. “You expect that you can trust them, you expect that they might be there for comfort, for support, for prayer, so we welcomed them in.”
Leichty told the chaplain a variety of things she had thought would be kept confidential.
“I mentioned things about my own health,” explained Leichty. “Things about my own opinions and past, then it turns out that it was all written down in my son's medical history, medical chart and it had nothing to do with his health.”
Soon after, a UIHC medical staff member approached Leichty and regurgitated the information Leichty had shared with the chaplain, including that she was pregnant.
“It just wasn't anybody's business,” Leichty said.
Leichty immediately began trying to get the chaplain's note removed from her son's medical record. It was not an easy process.
Since 1996, UIHC chaplains have documented information exchanged in a conversation between a hospital chaplain and a patient.
“The information gathered during pastoral conversations and the care offered to patients/families frequently is of value to other members of the treatment team”, according to a statement provided by UIHC spokesman Tom Moore concerning general spiritual care services policy.
But Leichty was not informed that what she told the chaplain would be documented in her son's medical record.
UIHC hospital chaplains are not required to “notify patients or families what information they provide will be noted in the medical record,” said Moore.
Leichty thinks this policy is flawed.
“When someone comes in representing the clergy or representing a religion that it's going to be something that you can trust will be confidential, but it turns out conversations are only confidential if it starts out ‘Father, I have a confession,'” said Leichty.
According to Moore, UIHC exempts the Sacrament of Confession because it would be considered a breaking of the seal of the confession.
Spiritual care services are also offered at other Eastern Iowan hospitals including St. Luke's and Mercy in Cedar Rapids and Mercy in Iowa City; however, their policies are not as stringent as those at UIHC.
Mark McDermott, director of pastoral care at Mercy Iowa City, and now at Mercy Cedar Rapids, explained a hospital chaplain is required by the Joint Commission on the Accreditation of Healthcare Organizations to document information learned while visiting a patient.
“If they ever came and saw a chaplain on a unit, they would ask ‘Did you document that visit, that's very important,” explained McDermott. “If it wasn't documented, then it wasn't done.”
However, McDermott said if a patient – or a family member – asked him to keep certain information not relevant to the patient's treatment plan confidential, he would respect that.
“Things that come up like that all of the time,” said McDermott. “I would be discreet.”
St. Luke's hospital chaplains also use discretion in what they document about a patient visit.
Spokeswoman Sarah Corizzo said hospital chaplains are “encouraged to share with the patient what they may include in the patient's medical record, and in doing so, with other members of the treatment team.”
Leichty believes hospital chaplains serve a purpose, but hope that hospitals will re-examine their spiritual care services policy to better inform patients.
“Just a little disclosure to say we view our clergy as one of the medical team so if you need to talk to one of them they're available to you and just so you know as a nurse or a doctor their conversations with them will be part of the medical chart,” said Leichty. “Easy as that.”
By Jami Brinton, KCRG-TV