Last week, Fairview Health Services announced it would be laying off 250 people – among those a number of chaplains.
Jamilla Hassan is one of those chaplains who was laid off. She’s a Somali woman, who since 2020 has worked with patients at M Health Fairview University of Minnesota Medical Center, both East and West Bank campuses, the latter of which is home to a large Somali and Muslim population. She recalled hearing about the need for someone like her when she was first hired at Fairview.
“There (were) a lot of things that I was told that I should solve,” Hassan said. “(Somali patients) feel like they were looked down on. They feel like they were loud and misunderstood.”
Fairview employs 42 chaplains across the entire system, according to a spokesperson for the health system.
As a whole, 13 chaplains across the system have been laid off, 10 of whom work either at the East, West and sometimes both campuses, said Carolyn Browender, a chaplain also affected by the layoffs who works on the West Bank campus.
The decision for system-wide layoffs was made to ensure that Fairview can operate sustainably in a health care environment that is facing tremendous pressures, a company spokesperson said in an email statement.
“An important and necessary part of this work is aligning our workforce to evolving strategic priorities, all while addressing the demands of inflation, including increasing labor costs, and payer reimbursements that don’t keep pace with inflation,” the statement read.
By Browender’s count, after the cuts, there will be three staff chaplains between the East Bank and West Bank. That number does not include the six chaplain residents, who are in year-long training and working between both banks. Their positions were not cut, she said.
Fairview said in an email that the layoffs are widespread among the company and have not disproportionately “gutted” one role or department.
“The impacted positions are diverse and spread throughout the system (10 hospitals, 80 clinics, executive team, etc). No role, department or location was ‘gutted’ as has been reported elsewhere. It really is a position here, a position there, so as not to disproportionately impact one service or location,” a spokesperson for Fairview wrote to MinnPost in an email.
But the chaplains feel differently. They think the reduction of their workforce will have significant effects on the patients. Chaplains see a handful of patients each day, sometimes on their own, and other times when a doctor is in the room.
At times, chaplains find themselves in roles of supporting the hospital staff during traumatic situations, Browender said.
A significant reduction
The cuts will reduce the number of chaplains available to help patients. Dr. Ryan Kelly, an internal medicine and pediatric physician at the University of Minnesota Medical Center, fears that could impact patient outcomes down the line.
Kelly has seen what chaplains can do for a patient’s health.
“Any support you can give someone while they’re in the hospital that helps them feel respected, allows them to focus more on their health care, and helps the hospital stay go better, which actually improves their out-of-hospital experience down the road,” he said.
Kelly said the chaplains can offer services that build trust with patients who have had bad experiences in the past with health care systems.
“If you take someone who has faced stigma by seeking health care and they’re nervous to be in the hospital because of those experiences, if you’re able to offer cultural support, like smudging, which our chaplains do, it drastically improves their overall experience – and patients are very thankful.”
With the layoffs, there will no longer be any permanent Muslim chaplains in the East and West Bank locations, Hassan said.
“(Having) one permanent Muslim person to be there would make me feel good … we can’t all go. People need us. Maybe we’re not as important as the doctors, but we are important for the soul,” Hassan said.
Breaking trust with communities?
By being at Fairview as a chaplain and an informal “cultural broker” – as her colleague Browender called her – Hassan feels she’s created more trust between Somali patients and the hospital.
“Sometimes I barely talk about the religion, nor I talk about their disease. They just tell me what’s happening in Somalia, and that gives them the comfort,” Hassan said. “They trust you. They tell you whatever they want to tell you. There are things they don’t tell their families that they share with you.”
While all the chaplains are trained to do interfaith work, Hassan has focused on working with Somali Muslim patients. During some tense procedures or hard times, she says she has comforted the patients with her presence.
“Talking in my language, it makes them feel wanted; it makes them comfortable. All that to be taken away, it’s a bit hard,” Hassan said. “They took a piece of their comfort.”
Browender said that chaplaincy as a profession has historically been dominated by white Protestants. To her, Hassan and Tamer Abdelaziz – the Muslim lead chaplain – were needed additions to a profession that didn’t have a diverse workforce while serving patients from many backgrounds.
According to Browender, there is still one Somali chaplain with shifts at Fairview, although her position is considered to be a “casual” chaplain.
“(These cuts), it really goes against a lot of their (Fairview’s) professed public values about health equity and inclusion and patient safety. There’s absolutely no doubt in my mind that because of Jamila’s presence, that she has saved lives,” Browender said.
Hassan recalled a young Muslim woman who was on the fence about a medical procedure. Hassan opened up about her own personal experiences, and the patient ended up going through with the procedure, which Browender said saved her life.
In her work, Hassan also helps Somali patients understand certain concepts, like “end of life” or “hospice,” in a way that will resonate with them.
“Most of my Somali population, they don’t (understand) the way it’s explained to them. They don’t understand what comfort care and hospice is. Every time that happens, they will call me and Tamer,” Hassan said. “I tell them, ‘It’s (treatments) not gonna work, now we’re gonna wait from Allah.’ This is what I told my fellow doctors, that end-of-life or comfort care, means nothing is working for the patient. The patient is waiting for Allah.”
Hassan and Browender’s last days are on Dec. 1. Fairview wrote in an email that “employees will receive various types of support, including retraining, job search assistance, resume and interview training, and priority hiring opportunities for one of the 1,600 available positions in our system.”
Kelly wonders how this change in staffing will impact his patients, especially since he builds relationships with patients when asking about spiritual and cultural identities, and then is able to get them those supports.
“But now if I ask that question, if I don’t have a teammate who’s able to actually do that next step supporting, then it’s gonna be more difficult to ask that question,” said Kelly. “And if I’m unable to ask that question, then I’m not supporting the whole person.”
The chaplains felt they needed to say something – despite worrying that they could face losing severance pay or be asked to leave early.
“I do feel like this is something about taking a stand for the value of our profession, but especially, the realities of the public health impact that this is going to have in the Twin Cities if these things stand, is just huge,” Browender said. “And I don’t think they knew what they were doing when they made these decisions.”
Editor’s note: This story was updated to include a statement from Fairview on the reason for the layoffs.
