Systematic observational studies of the chaplain's role and function in the secular health‐care setting are few. With an episode‐based diary recorded on handheld digital tablets, palliative care chaplains at a large urban hospital with a diverse patient population recorded details of patient visits in near‐real time. Cluster analysis revealed groups of activities we called "doing" and "being," and conversation topics of "practical matters" and "ultimate concerns”; chaplains were most satisfied with visits that involved all of these. Chaplains offer patients and families a space to express significant concerns; however, visits with spiritual or religious activities or topics were relatively rare. Broad quality of life concerns are central to the evolving professional role of chaplains in the secular setting of the modern hospital.