Thursday, July 10, 2014

What sets Hospice Chaplaincy apart?

From the outset, I want to say that I love hospice chaplaincy. Here are two observations I believe set hospice chaplaincy apart from other types of chaplaincy work: 1. Hospice chaplaincy is a calling few can fulfill. Is this a prideful statement? Not at all. It is a statement of truth. I have seen chaplains come and go. The work is simply not for them. Dealing with death, uplifting the sorrowful, and working within the confines of a care team are not necessarily great fits for many minister-types. It is a daily grind to meet all the requirements of Medicare and the local hospice agency all the while providing compassionate and heart-felt care for patients and their families. Working with a patient toward a good death, providing wise counsel to hurting family members, and being the active presence in their world that many times has dissolved into chaos all require a unique calling. Hospice chaplaincy is not the pastorate. Hospice chaplaincy is not a counseling ministry. Hospice chaplaincy is not social work. Hospice chaplaincy is not something that a local parish pastor just takes up. The demands of the patients at end-of-life require spiritual care skills that have been honed to a sharp edge through education and praxis. A one-size-fits-all approach to patients is an embarrassment to the work of the hospice chaplain. One with a calling to hospice chaplaincy will never be satisfied with 4 units of CPE, but will expand his or her horizons of spiritual care through continued study and research, through writing, through speaking engagements, through a contagious attitude which inspires colleagues and others. The hospice chaplaincy does not require Board Certification, but should. Every calling in a ministry setting should serve as a motivation to gain as much knowledge, insight, and skill as possible to do the work with excellence. Frankly, as I review my journey of hospice chaplaincy service, I sensed and even heard others in healthcare settings denigrate and marginalize the hospice chaplaincy because of the low requirements for CPE and Board Certification. I hear the other side of the coin from hospice chaplains who are really good at what they do, state that they would have no problem with obtaining 4 units of CPE and even Board Certification but for one thing. That one thing is financial compensation for the Board Certification. Let’s face it, CPE and Board Certification require much time, effort, money, and in most cases, agony of soul. Yet, in most hospice HR job postings, there is a requirement of only 1 unit of CPE and a few years of ministry experience. That needs to change; however, in the environment that hospice now finds itself, the salary scale will not change any time soon. The reasons for that are another story, but suffice it to say that hospices across the country are going through spasms of financial turmoil unseen in the short history of hospice in America. So, in my way of thinking, I value the calling and as an expression of commitment to that calling, I will continue to educate myself, obtain certifications I believe serve the hospice agency well, and will work tirelessly to educate and motivate my colleagues. 2. Hospice chaplaincy requires excellent people skills. One of the challenges I have had to work through is the cynical, raised-eyebrow-looks due to my faith background being Southern Baptist. To some this conjures up an image of a fire and brimstone preacher with veins sticking out in his neck and forehead and maniacal look on his face, and, also, an attitude of spiritual of condemnation and judgmental-ism. I must say that even in the credentialing process I bumped up against this. That was a very disappointing experience. Whatever background the hospice chaplain is from and whatever challenges he or she may experience one thing is crystal clear; the hospice chaplain must have excellent people skills. The hospice chaplain is not the keeper of the faith, the corrector of the faithful, or the critical eye of the wayward patient or family member (as judged by the chaplain). The hospice chaplain must navigate the maze of belief systems different from his or her own; work through prejudices of family members; actively listen for the question behind the question or the pain behind the rage; creatively attempt to communicate spirituality to patients whose minds have succumbed to the ravages of dementia; function extremely well in the clinical environment; humbly ask for clarification of medical terms, social work terms; seek to position the chaplaincy as a vital contribution to the care team; and, do all this and much more, with grace and skill. The chaplain’s persona can be gregarious, sanguine, introspective, quiet, or any combination of such. Concern for the staff, the patient, the patient’s family, the IDT, the many persons that cross the path of the chaplain and, of course, competence in people skills are key components that will bring the chaplain success in his or her work. Thank you to my Hospice Chaplain colleagues who have paid and are paying the price to provide excellence in spiritual care to the patients they serve. I continue to respect and admire your work.

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