small-town-picLike most small towns, our main hospital is miles away in a large city. One morning, I found myself up long before daylight driving through the dark on the winding country roads to visit and pray with a member of my congregation who was facing surgery.

At least, that is what his wife told me the day before. When I entered his room, he was in bed asleep, and his wife was asleep on the pull-out bed next to him. It was dark, they were snoring, and no one was being prepped for surgery. The nurse informed me that the man was not having surgery, just a minor procedure.

Now, I know there are no minor procedures, especially to the patient, but based on how this man’s wife had described his impending “surgery,” I had arrived that morning expecting to see him for a final time. As it turned out, he lived on to have many more procedures and tests—and each time, his wife wanted her pastor there with her. It didn’t matter how routine or mundane the procedure, she was convinced that this time, he was going to die!

Most of my ministry has been in or near cities. Now, however, my ministry has been bookended by two assignments in small-town churches. The first church I pastored was in a small town very similar to where I find myself now. However, the ministry and life experience I’ve picked up during the intervening 25 years has helped me approach my current assignment with much more confidence than my first.

There are many aspects of pastoral care that are the same in all situations: big city, small town, and everything in between. People go to the hospital and need to be visited. Members live in a nursing home. People die. Families struggle and need a pastor’s advice. Parents fret over their children. These are situations that are common to all of us. Perhaps, then, the biggest difference is the expectations of a pastor in a small town.

In a small town, you have less anonymity than you do in large communities. People know me because I pastor the local Nazarene church. People feel comfortable approaching me and talking to me. And, yes, pastors here get much more respect than many in larger cities and towns. In some ways, those factors make pastoral care easier to do. All the same, it doesn’t keep you from making mistakes or messing up. If anything, when you make a mistake, everyone knows and remembers!

Pastoral care is one of the most important tasks of ministry. Along with preaching, pastoral care is one way your congregation actually sees you at work. Unlike preaching, however, pastoral care involves direct interaction with those you serve. When you do pastoral care—whether visiting the sick in the hospital, comforting a grieving spouse, spending time at the nursing home with an older member of your church, or sitting in an emergency room with a worried family—you are experiencing important personal time. This face-to-face time goes a long way in building relationships with those in your congregation.


I received a phone call in the middle of the night recently letting me know that the patriarch of a large family in my church had been taken to the emergency room. I am confident I could have prayed for the man and checked on him the next day, and the family would have been fine with that. Yet, I felt I should go to the emergency room. I sat with the adult children of the man—all of whom happen to be on my church board—and I’m glad I did.

The three siblings and I already have a good relationship. We work together closely in various ministries of the church. However, that night as we sat and talked and prayed and shared stories, a deeper relationship was forged between a group of people who were already friends and partners in ministry. As they shared stories about their dad and life in the family, I learned about aspects of their lives I would never have learned otherwise. As I shared stories of my family, they also got to know my family better. We shared stories about our kids and our spouses. We learned how we met. We revealed embarrassing moments. In those few hours, a bond developed that would normally take years to achieve.

I’ve discovered that in times of crisis, my relationship with the people I serve grows deeper than it could in any other way. There is something about sharing community and story in such situations that builds a bond, a kinship, and a trust. I learn about people, what they like and don’t like, their dreams and passions, their hopes and fears. In those times, people are more honest with me about church and my preaching and my work as a pastor. In those settings, we can laugh and joke without hurting feelings. They find a place of safety where they can share their thoughts and feelings with their pastor and their friend. I have learned things that kept me from making mistakes in other settings. Those have all been valuable and well-spent times. I have a long way to go and a lot to learn, but such experiences have taught me a lot about pastoral care in the small-town church.


It’s important to learn the culture of your church and your town. Every church is different in little ways. Understanding these differences can go a long way toward helping you know how to minister to your congregation. What do they expect from a pastor? When do they want you there? This may vary from person to person but it helps to begin by understanding the culture of the area and your congregation.

Over the years, I’ve also learned to ask for help. As I have navigated the landscape of hospital visitation, home visitation, and other types of pastoral care, I have often asked trusted members of the congregation for their opinions. Based on their knowledge of the person or family, I am often able to get a good idea if the family would want the pastor present in certain situations. Sometimes, the answer is no. In other cases, the family definitely expects or needs their pastor to be with them.

Either way, good pastoral care demands a contact as soon as possible. Even when distance or schedule keeps me from getting to the hospital right away, I always make sure to make contact by phone, with a personal visit as soon as possible.

I have also discovered the value of building a working relationship with the hospital chaplains. I have an agreement now with the chaplain at the primary hospital my people use. If, for whatever reason, I can’t be there in a timely manner, the chaplain will visit the patient on my behalf, let the patient know I asked the chaplain to make the visit, pray with the patient, and offer to help in any way possible. Thanks to the generosity of the hospital chaplains, it’s like having an extra staff person.


Hospital visits aren’t the only part of pastoral care. I take the opportunity whenever I can to visit places where members of my congregation work—as long as I can be sure I am not disturbing them and it’s permissible. I can sit for a few minutes at the local feed store and get a good visit in with one of my board members. Several teens work at the local grocery store, so I try to make sure I get in their check-out line to have an opportunity to chat and joke for a few minutes. Regular visits to the nearby thrift store gives me the chance to visit with two other members, and a farm store nearby is a good place to visit another church family. While not too many people want you to visit their homes anymore, these kinds of visits are low-key and non-threatening.

Mostly what I have learned to do is to listen. Most people just want to be heard. I don’t have to say a lot, but I always learn a lot. I listen for clues to their family relationships. I listen to discover where they stand spiritually. I listen to better understand what they think of the church and me. What I learn helps me know how to pray and interact with the members in future encounters. What I hear tells me what they expect and prevents me from making mistakes with them.

Good pastoral care takes time. One hospital visit can eat up most of one day. If someone is facing a serious issue, it means multiple trips to the hospital, and, before you know it, another week has gone by. That is time that could be spent on lots of other things that need to get done. Yet, it’s time that is spent doing something that most of those other things will never accomplish.

Pastoral care builds relationship. It builds trust. And, it builds faith in the pastor. When I stand in the pulpit as their pastor, I do so with a deeper bond between us, thanks to the blessing of being their pastor not only at church, but also beyond the church walls.

Tom Felder is the senior pastor of Tishomingo (OK) Church of the Nazarene

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