Hospital chaplains finding ways to help the ‘nones’ — patients who identify as religiously unaffiliated

Nearly 3 in 10 Americans do not identify with a religion. Hospital chaplains sometimes have to check their beliefs at the door when trying to serve and comfort those folks.

Lying in his bed at a Wheaton rehabilitation center, Eddie Wisniewski grimaced when a chaplain holding a Bible appeared in the doorway.

That day in 2022, Wisniewski had already been in a hospital for days, then spent a week in physical therapy. He was relearning how to walk as he recovered from lymphedema that left him with swollen legs.

He was not in the mood for preaching.

The chaplain, the Rev. Arnold Hoskins, however, made no attempt to sermonize. Instead, Hoskins, the manager of the Spiritual Care Department at Northwestern Medicine Marianjoy Rehabilitation Hospital, where Wisniewski was staying, walked in quietly and asked Eddie about his many visible tattoos.

So began a yearslong relationship in which the chaplain and Wisniewski, a 64-year-old Harley-Davidson devotee and father of three, have never spoken one word about God.

Wisniewski is one of an increasing number of people in America who researchers call “religiously unaffiliated,” or more commonly, the “nones” — those who respond “nothing at all” when asked their religious affiliation. Wisniewski grew up attending Catholic Mass, but now finds comfort and meaning in other things, from spending time with his friends and family to working on his motorcycles.

Decades ago, fewer than 10% of people identified as what researchers call “nones.” Today, that number is closer to nearly 3 in 10 Americans, according to Greg Smith, a researcher at the Pew Research Center.

Wisniewski’s and Hoskins’ connection illustrates the way in which chaplains are updating how they support people as Americans’ search for spiritual meaning is shifting.

And reaching the religiously unaffiliated can come with challenges. Chaplains who are devout may have to check their religious beliefs at a patient’s door.

The nones are a complicated, diverse group in terms of their religious experiences. Many have grown up with religion but no longer attend church; 90% of the nones in the Pew survey said they seldom or never attend religious services.

The Pew report, built on a 2023 survey of 11,000 people, found that among the about 3,000 religious nones, about 29% reject the notion of any higher power or spiritual force. Many feel religion can cause harm, or societal problems such as intolerance. And although some have a negative view of religion, the report found people “on the whole express mixed views rather than outright hostility” toward religion. Nearly all nones say they seldom or never go to religious services.

But that doesn’t mean they have completely excised spirituality from their life; many say they believe in some kind of higher power. And spirituality can be demonstrated or leaned on in other ways, Pew noted, surveying people about everything from nature to crystals to tattoos.

Wisniewski said he sometimes talks to his deceased parents, buried near his Bridgeview home. And on the occasions when he does “talk to the man,” God, he said he will pour himself a Jack and Coke and sit in his garage. He asks questions. He has all kinds of questions he doesn’t know the answers to.

But he doesn’t enter church much anymore, and he doesn’t find a lot of value in being preached to. Wisniewski finds spirituality more through his numerous tattoos, or through the memory of people who died, like his friend whose ghost recently appeared in his house, Wisniewski said, telling him he was “just checking on you, brother.”

Chaplains have long discussed how to best help the religiously unaffiliated, said George Fitchett, a professor in the department of religion, health and human Values at Rush University. As the American public has shifted from attending services at religious institutions to finding spirituality through other means, chaplains, too, have shifted their approach.

A study Fitchett co-authored in 2021 found that 93% of patients and their families said they wanted at least one visit from a chaplain during their hospital stay. Among those reporting no religious affiliation, 83% said they still wanted a visit from a chaplain.

“They’re really trained to be excellent listeners, to help people sort out the losses and the struggles and the joys,” Fitchett said of chaplains.

The distinction between spiritual care and religious support is an important one, chaplains said.

On Sundays, Hoskins preaches at Freedom United Methodist Church in Chicago. The other days, he is manager of Marianjoy’s spiritual care, where the chaplains’ job is not to convert, or preach, or seek to bring patients to any specific type of higher being. It’s to meet patients where they are, and find out how they can support their medical care.

Hoskins’ team visits every patient at Marianjoy rehab, hoping to relieve their stress, anxiety or pain through other forms of care, such as listening to music, asking about how they are doing, and simply being the one rehab employee who enters their room and does not discuss lab work or medical details.

Like many chaplains, Hoskins differentiates subtly between patients he is helping at Marianjoy and those he shepherds while pastoring at a church. At Marianjoy, for starters, he is paid by the institution, not by a parish. To him, this means his role is emphatically nonreligious, solely to support the patients at the hospital.

The Rev. Patricia Handley, a chaplain at Northwestern Medicine Lake Forest Hospital, says her calling there is to give hope to patients, to provide what she calls “a gift of presence.”

“I’m asked as a chaplain to be nonintrusive,” Handley said. “In my heart, I’m an evangelist. I want everyone to know Jesus. I want everyone to know the Holy Spirit. But that can’t be my approach to patients.”

Often, she said, one of the first things patients do is explain that they haven’t been to church in a while. She assures them God has no clipboard of attendance, and more importantly, that’s not why she’s visiting.

“I am so aware that it’s a sacred privilege that we’re given when we, as a stranger, walk into a person’s room,” Handley said of the hospital setting. “They’ve never seen us before, and they open their arms and their lives and their most intimate feelings to a stranger.”

She trusts, she said, in the “little piece I play” to comfort and help. For example, if patients don’t want to talk about God, she talks instead about the concept of simple gratitude for what we have. With one couple, she encouraged them to express gratitude for each other at bedtime.

Approaches vary from patient to patient. For Hoskins it has been everything from playing music people enjoy to actually joining in prayer with two women — one about to undergo major surgery — who said the spirit would become present when three people formed a circle.

He connected with Wisniewski by discussing the rehab patient’s love for motorcycles.

When he met Wisniewski, Hoskins remembers, people at Marianjoy seemed a bit intimidated by Wisniewski because of his tattoos and gruff manner.

Hoskins walked in, and he immediately noticed the tattoos running the length of Wisniewski’s arms, homages to his parents and his uncle. As he described that moment, Hoskins slid down the sleeves of his navy suit and pointed to where Wisniewski had tattoos.

Wisniewski is inked from shoulder to elbow with the images and initials of people who are no longer here, a tombstone with wings for his dad, a Celtic cross with “Mom” across it for his mother, and a broken heart on his chest for his uncle.

“That tells me a lot,” Hoskins said. “He has spiritual values about life, about love, about other people’s legacy, and he’s living that legacy through his tattoos.”

Wisniewski grew up attending St. Nicholas of Tolentine Catholic Church in West Lawn, but he now attends church only for funerals.

If Hoskins had opened by offering a Bible verse, that likely would have been their only interaction. And indeed, some patients do not want even the kindest chaplain to stay. Sometimes chaplains see a patient only once, either because the person’s hospital stay is short or because the person declines future visits. But in the case of Wisniewski, Hoskins — whom Wisniewski calls The Rev — kept visiting and the two kept talking.

Wisniewski used to drive a huge trailer of equipment for race cars, exacerbating back issues, and he has been on disability and retired for about 15 years, said his wife, Marlene. Over the past few years, when health setbacks happened, Wisniewski called The Rev.

Sometimes Marlene, who goes by Mar, calls the chaplain. Sometimes, when she notices her husband is down, she urges him to call The Rev.

“He gets emotional when he talks about The Rev,” she said. “Knowing that he’s there for Ed, that’s comforting to me.”

The couple, married 36 years, has three grown children. Sometimes Hoskins calls Wisniewski, like when he said he was popping by to say hello and he was on Wisniewski’s street but couldn’t find the house. Sometimes, as a gift, he brought motorcycle magazines.

“He’s not there preaching. It’s something different that he does, you know?” Wisniewski said. “He never told me where his church is. … He just wanted to know about me. And how I was going to be whole again.”

Hoskins reminds him of some of the loved ones he has lost. Like Wisniewski’s parents, the chaplain has an aura of accepting everyone. When his family would put the brisket and pulled pork on the barbecue, anyone was welcome. His family members never blinked at the “motley crew” of people in his life, he said.

“You see all these big old burly guys, they’re scary human beings,” he said. “They sit there and BS with you, and The Rev did the same thing.”

Everyone, Hoskins said, has things that are important to them and that they find comfort in during hard times. For Wisniewski, that is his family, his friends and his Harleys.

Hoskins sees his role as discovering what may help individual patients and how to incorporate that into supporting their medical care. As a chaplain, he gives himself 30 seconds to make a connection with a patient after walking into a room. Otherwise, he might lose the opportunity to make a spiritual assessment, and to help.

“I have to read the room really quickly,” he said.

In December, after being in the hospital again, Wisniewski was discharged. But a week later, he was using his walker in the bathroom, fell and cut his toe, which became infected. Back at the hospital, he had to learn to walk all over again.

The doctors were talking about something neurological; he was frustrated even to hear about it. He wanted to invite everyone over, grill the 10 pounds of Duke’s beef they had ready to go for Christmas, then have a quiet New Year’s Eve. He texted The Rev, updating him about how his Christmas shifted from his plan for festive brisket to weeks in a three-story rehab in La Grange.

Hoskins responded and promised to visit.

On a snowy day in January, Wisniewski sat in a wheelchair in a shared rehab center room with a shelf of ginger ale, snacks and a pair of shoes he could not use resting on the floor.

That day he had taken some steps with a walker, small paces to the door of his room and back. An employee of the rehab center followed with a wheelchair in case he fell.

It wasn’t the January he wanted, but at this point, he said, he was happy to wake up.

“How can I get down? I get depressed, ain’t nothing gonna change,” he said.

A NASCAR race he wanted to watch was scheduled for mid-February. His goal was to be home by then, hosting a party with pulled pork.

But by the time that week rolled around, he still needed to stay in rehab. He’d had a setback, a painful case of shingles the week before.

On a Sunday afternoon in mid-February at the La Grange rehab center, his door opened. This time, The Rev wasn’t holding a Bible. Instead, he had a box. He’d been holding on to it for weeks, Wisniewski’s Christmas gift. It was a miniature Harley-Davidson motorcycle.

Hoskins tried to open it for him, and Wisniewski rushed to stop him, telling him it wasn’t to be opened. Treasures are kept in their box, like the dozens of other ones he kept in his curio cabinet at home.

Talking to the chaplain had softened something. What it was, Wisniewski could not exactly say. It was not that Hoskins said anything specific on his visits that calmed his soul. It was just him being there.

Hoskins had not led Wisniewski to his conversations with God, or that he believed the connection with something spiritual fixed things. It was just that he felt lighter, sometimes.

More than a year ago, a friend had put his Santa Claus hat on top of a stuffed boar’s head in Wisniewski’s garage, saying he would grab it at next year’s Toys for Tots motorcycle ride, when dozens of Wisniewski’s friends meet in the morning and participate all day. That friend died in June.

Another friend died of cancer, a football-size tumor. Every time he was in the hospital in the last few years, Wisniewski came home to find out yet another friend had died. Dark humor helps, sometimes. So does the way he is able to find a bit more peace through his conversations with The Rev, taking note of the things he is grateful for instead of focusing on what is missing.

These days, the friends continue to update each other about their lives, texting back and forth.

After Hoskins hugged Wisniewski goodbye on the Sunday he visited him in February, a rehab employee told him she was surprised the chaplain was visiting. He didn’t seem like a religious guy, she said. Wisniewski explained the man was a years-old friend.

“I really think I would miss a part of living if I didn’t meet him,” Wisniewski said.

This story was supported by a grant from the Chaplaincy Innovation Lab at Brandeis University in partnership with Templeton Religion Trust. Alison Bowen is a freelancer.