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Questions arise about the scope/boundaries of chaplains’ relationships with patients/families. Interviews were conducted with 23 chaplains, who face questions/challenges regarding how to end visits and interactions—individual conversations and ongoing relationships with patients/families. Chaplains confront uncertainties and rely on verbal- and non-verbal cues to gauge how long to stay with each patient/family, sometimes unsure. These data, the first to explore chaplains’ challenges in ending visits/relationships with patients/families, have critical implications for practice, education, and research.

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Introduction Hospital chaplains aid patients confronting challenges related to palliative and end-of-life care, but relatively little is known about how chaplains view and respond to such needs among Muslim patients, and how well. Methods Telephone qualitative interviews of ~ 1 h each were conducted with 23 chaplains and analyzed. Results Both Muslim and non-Muslim chaplains raised issues concerning Islam among chaplains, doctors and patients, particularly challenges and misunderstandings between non-Muslim providers and Muslim patients, especially at the end-of-life, often due to a lack of knowledge of Islam, and misunderstanding and differences in perspectives. Due to broader societal Islamophobia, Muslim patients may fear or face discrimination, and thus not disclose their religion in the hospital. Confusion can arise among Muslim patients and families about what their faith permits regarding end-of-life care and pain management, and how to interpret and apply their religious beliefs in hospitals. Muslims hail from different countries, but providers may not fully grasp how these patients’ cultural practices may also vary. Chaplains can help address these challenges, playing key roles in mediating tensions and working to counteract Muslim patients’ fears, and express support. Yet many Muslim immigrants don’t know what “chaplaincy” is and/or prefer a chaplain of their own faith. Muslim chaplains can play vital roles, having expertise that can heighten trust, and educating non-Muslim colleagues, providing in-depth understanding of Islam (e.g., highlighting how Islam is related to Judaism and Christianity) and correcting misconceptions among colleagues. Hospitals without a Muslim chaplain can draw on local community imams. Conclusions These data highlight how mutual sets of misunderstandings, especially concerning patients’ and families’ decisions about end-of-life care and pain management, can emerge among Muslim patients and non-Muslim staff that chaplains can help mediate. Non-Muslim chaplains and providers should seek to learn more about Islam. Muslim patients and families may also benefit from enhanced education and awareness of chaplains’ availability and scope, and of pain management and end-of-life options. These data thus have several critical implications for future practice, education, and research.

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