Wednesday, November 26, 2014

Over 1,500

We have now enjoyed over 1,500 visitors to this site. I remind our readers that we are a niche site promoting Hospice Chaplaincy. Hospice Chaplaincy is what energizes my soul. The Chaplain staff here at Cornerstone Hospice is one of the best if not the absolute best corps of chaplains. I pour myself into their work with the intent of developing a top 10% quality group. Your comments and questions are always welcome. If you would like a consult, please let me know.

My experience at the National Institute for Jewish Hospice

Flying to Newark, New Jersey, to attend the NIJH Annual Conference is a highlight in my year. This year was especially good as the leadership was trying a new approach by including a breakout session. Mrs. Lamm, now the out-front spokesperson for the organization called me a week prior to the conference and asked if I would be a facilitator for the Chaplains. I accepted not knowing how incredibly blessed I would be to do so. From the beginning of the conference to the end, the conferees were exposed to the nuances of Judaism that were simply unknown to us. The breakout session was illuminating as our group was comprised of Rabbis and non-Jewish Chaplains. The theme was how we all benefited from the type of information we received at this conference. Rabbis and Chaplains have at least one thing in common__we like to talk… and, not always about the subject! And, that is what made the breakout group so fascinating. I was so very impressed by the professionalism and skill of both Rabbis and Chaplains. We agreed that we needed one another. I believe that in those short moments we were together a bond formed based on mutual respect. Beyond that we agreed that knowledge of Judaism enhanced our ability to serve our Jewish patients. Our Rabbi Chaplains sensed they could better serve their non-Jewish patients through similar events where knowledge was shared. The beauty of the discussions was in the expressed desire on everyone’s part to not be religiously offensive to the patients and families that we serve. And, that is where we came together to agree that we need each other. I was so glad I went to this my third conference. Of course, my generous and spiritually open hospice, Cornerstone Hospice & Palliative Care, Inc. received its re-accreditation from the NIJH. In 2015 we intend to further develop our relationships with Rabbis and synagogues. Building bridges of understanding and mutual respect is a wonderful project. I hope you have to the opportunity to engage in this most worthy effort!

"I did it!"

My little grandson, Mason, is just two, but he has learned how to celebrate an accomplishment. It always makes me smile when I hear him say "I did it!" as he throws his arms up in jubilation. Well, that is sort of how I feel as I share with you that I had a great experience this past Saturday. As an exclamation point to my weight loss, I entered and ran in the Pets and Vets 5K. This race was sponsored by my hospice. The weather was less than nice as it was drizzling, windy, and chilly. But, "I did it!" I ran my first 5K ever and came in second place in my age group. To say that I was elated is an understatement. Self-care cannot be something we tacitly acknowledge as necessary. It is something we embrace and practice. I lost the weight through dieting and exercise. I trained for this 5K for several months and "I did it!" Blessings to you all this Holiday and Holy Day Season!

The compelling story of Telemachus in light of today’s chaos

In this particular post, I clearly identify my theological stance as Christian. If this offends you, I am sorry. In times of chaos, we all embrace that which makes sense to us. My faith makes sense to me and is my strength at this time. Also, this post may come across as political. It is not meant to be. It is a clarion call to peace. Peace transcends politics. I am sure each of us holds an opinion about what is happening in our country right now. The core of the problem is spiritual. Please indulge me as I share a story I hope you will find enlightening. In today's America we need not one but many persons like the character in this true story. May God raise up a corps of Telemachus'. It is said that in the year 402 AD, the young monk felt called to leave the monastery and head out into the pagan world to not only learn what the world had to offer, but to spread the message of Christ to all who would listen. One day in prayer, Telemachus felt called by God to leave immediately and head to Rome. If monastery’s were the hub of a local community’s society, Rome was considered the hub of the world. This was the center of society during this time. Not sure what he would find, or why God had called him on his mission he headed from the monastery and began his trek. Upon arriving in Rome, he was immediately caught up in the crowd. The crowd was immense and excited. Soon Telemachus found himself giddy with the contagious excitement of those around him. He wasn’t sure where he was headed but he knew whatever it was, it had to be great, and there was no way he was going to miss out on it. Within a few moments he found himself deep in the seating area of the Roman Coliseum. Asking those around him, he learned that the Romans had just defeated the Goths, and the emperor had commanded a circus to be held for the celebrating crowd. As he took his seat, he couldn’t have missed the emperor sitting in his seat of honor. He most certainly would not have missed the arrival of the gladiators into the coliseum. As the gladiators lined up below the emperors seat, together they stood and yelled out: “We, who are about to die, salute you”. It was the traditional greeting of the gladiators to their emperors, and in that instant he knew exactly what he had stumbled upon. The Bishops and leaders of the church had spoken out about the gladiator games in Rome, yet most believed it legend. In that moment, Telemachus realized it all was true. Soon the gladiators pulled their weapons and the bloody brawl began just a few hundred yards away from him. The grotesque nature of the sport appalled him. Worse yet, was the reactions of those around him. The spectators where in a blood thirsty ecstasy over what they were seeing. Telemachus was sickened and shocked. In that instant he realized that it must stop. From his seat, he yelled out to the warriors: In the Name of Jesus Stop… But no one heard. Without thinking he jumped over the wall and into the battle arena of the fighters. The gladiators surprised by the unexpected guests momentarily stopped their fights and stared at the monk. “IN THE NAME OF JESUS STOP!” he yelled over and over again. After a few moments, the silence turned to chuckles and outright laughter. One of the gladiators, with a sick enjoyment, took a swing at Telemachus with his sword, just barely missing him. With that the others began to draw their swords. Soon they were chasing this man, across the field of battle to the laughter of the crowd. Most who witnessed the spectacle thought he was a clown or there for comic relief. That was until they heard what he was yelling; For the love of Christ, Stop!… He ran, jumped, dodged and ducked, and with each passing moment his words grew clearer and louder; In the name of Jesus, Stop. In the name of Jesus Stop. IN THE NAME OF JESUS STOP! Eventually the gladiators surged and when the dust cleared, there laid Telemachus on the ground with a sword in the center of his chest. There was silence in the crowd. It was said in that moment, that his words still echoed in the coliseum; In the name of Christ Stop. After what seemed like an eternity, one man got up from his seat, and left in silence. Then another… Then another… Until everyone got up from their seat and left in silence and disbelief. I shout to the community destroyers, "In the name of Jesus STOP!" Will you join me?

Wednesday, November 19, 2014

5 Keys to Maintaining Your Reputation When Undergoing Serious Personal Stress

It will happen to every Chaplain. There will come the “evil day” (using the Biblical idea found in the Bible book of Ephesians). It may involve health, finances, family, or something deeply personal. The issue I want to address has to do with how the Chaplain handles these types of situations and maintains his or her reputation. I am not for a moment suggesting or advocating for stoicism or grin and bear it response. I am advocating for a response to serious stress that will prevent the Chaplain from losing the most valuable possession in all that he or she has …reputation. I want to suggest 5 Keys to maintaining one’s reputation: 1. Develop a support system that will be there for such a time as this. I recall a number of years ago when I was a senior pastor. It was obvious to me that I made a terrible mistake in moving my family across the state to this new place of service. The church was in disarray and in no way ready to even think of becoming a witness to the community. There were factions upon factions. I called upon the local denominational leader and spoke to him about my assessment of the situation. He agreed with my assessment and then told me it was much worse. That was not what I wanted nor needed to hear. Time proved he was correct. I then asked him a question that he scoffed at. I asked if there were a safety net of sorts for such a situation so that I could move from that place. I learned something of great value from that experience. The lone ranger style of life and leadership will leave the pastor or Chaplain with no resources at a time of crisis. I began to build a network of like-minded ministers who I could call or meet to unload the pain I was enduring. There is almost a syndrome among ministers to go it alone, to be a lone ranger. Build a network of colleagues who will encourage you and support you. 2. Watch your emotions. It is very easy to express emotions that will border on bitterness, but will definitely express anger or rage. Lay persons will never understand the level of stress you are experiencing as a Chaplain. The work of chaplaincy is something all to itself. If you express the depth of your emotions, which probably are valid, but way too strong at the moment, you will leave your colleagues and managers wondering about what really is happening with you. Of course, you haven’t told them the entire story, so they only hear what they hear and see what they see. Be very careful at this point. It is not wise to unpack your emotions with colleagues. Unpack emotions within your network of close friends, instead. 3. As you counsel those you visit and provide spiritual support, seek to deepen yourself spiritually. Use your well-developed spirituality to find inner peace. Pray, read your Sacred Texts, journal, ponder, meditate, and promise yourself you will keep the emotions between you and God. If need be, seek counsel from your Pastor, Priest, or other Faith-community Leader. Getting it out often helps reduce the stress level for a time. 4. If you choose to speak to someone up the leadership chain, choose your words carefully. Be careful that you do not come across as assigning blame on them for your plight. That will not turn out well for you. It’s not that they are too busy to hear you out, they need to understand what is happening and what it is you would like them to do to help. Again, I caution, choose your words, your tone of voice and attitude carefully. 5. When you come through the crisis (as you will) approach any and all you spoke to and assure them that their listening ear was helpful to you. Exude humility and genuine gratitude. Be gracious in expressing how much the time they took with you meant to you. That will go a long way to solidifying your relationships. Crises happen. It’s a fact of life. Ruining your reputation over the crisis is rarely the first choice of the Chaplain. Do your best to maintain your poise and dignity. Tears are fine and understandable. Emotional outbursts in front of the wrong audience will have lasting negative results. Bless you as you endure.

Monday, November 17, 2014

3 Outstanding Clinicians … 3 Outstanding ways of saying the same thing

Carl Rogers, Kathleen Rusnak, and Douglas Smith… only one of those names may be familiar to you. Yet, for the hospice Chaplain, I urge that Rusnak and Smith be much more a household name. What is that these three say that is similar and foundational for pastoral care relationships? Rogers identifies 3 essential attitudes in providing client centered therapeutic relationships: 1.Unconditional positive regard; 2.Empathic understanding; and, 3.Congruence. Rusnak identifies 7 attributes of the pastoral care relationship: 1. Why a Brick Wall?; 2. Loss of Future; 3. Grieving; 4. Life Review and Change; 5. Vulnerable; 6. Authentic; 7. Paranormal/Symbolic. And, Smith adds 1. Eliminating relationships of dominance, and humility training. So, who are these people and what are they trying to bring to the Chaplain and pastoral care? Carl Rogers, the creator of client-centered therapy and counseling, student-centered education, and person-centered approaches to human relations and community building, is arguably the most influential American psychologist of the 20th century. While some may dispute this, pointing to the domination within academic psychology of the behaviorism of B.F. Skinner, if the view is widened beyond the academy to include the entire sphere of influence, the fact is indisputable that Rogers' profoundly humanizing psychology of human potential has been embraced by not only American culture but by much of the developed world. Those spheres include education, organizational consulting, health care, psychotherapy and counseling, community action and social agency, adult development, communications training, parenting education, and pastoral care. (By Maureen O’Hara, Kathleen Rusnak is an ordained Lutheran pastor with a doctorate in Psychology and Religion. She has been the pastor of three Lutheran congregations, a hospice chaplain in two hospices, the director of spiritual care and bereavement at The Connecticut Hospice (the first hospice in the United States), and lived and worked in Israel for over two years as the director and study coordinator of the theological department at a post-Holocaust Christian European kibbutz in the Galilee, which focused on repentance and renewal towards the Jewish people. She is an internationally known speaker and writer on the topic of end-of-life issues. Her Brick Wall2 is an outstandingly clear presentation on the experiences of persons who have just received the notification that they have 6 months to live. Douglas Smith is a professional speaker, trainer, consultant and counselor. He has worked in hospitals, hospices, and social service agencies. He is the author of several books, including The Tao Of Dying, Caregiving: Hospice-Proven Techniques For Healing Body And Soul, Being A Wounded Healer, and The Complete Book Of Counseling The Dying And The Grieving. His manner of speaking is far different than Dr. Rusnak and his approach to writing is different than that of Dr. Rogers. However, his message is very clear as are the messages of Dr. Rusnak and Carl Rogers. Each of these educators is passionate about treating the client as someone who matters and communicating that fact. They urge us as therapists, pastoral counselors, and chaplains to accept people where they are, be gentle with those at end-of-life and explore with them such things as meaning-making, emotional/existential pain, and communicate in a manner that does not set up a relationship of dominance. I ask you as a reader, have you been to Dr. Rusnak’s website or Douglas Smith site? I am sure you have read Rogerian theory. So, I extend an invitation to you to expand you knowledge to include and I am grateful for all three of these educators in pastoral care. May you be blessed as well.

Thursday, November 13, 2014

The Existential Slap

A hospice patient goes through a lot before they become a hospice patient. They have been ill for some time, they haven’t felt well, and to top all of this off, like a wrecking ball comes the terminal diagnosis from the physician that they have 6 months to live. The reaction of the patient to this devastating news is called “the existential slap.” In the International Journal of Palliative Nursing (November 2004, Vol. 10 Issue 11, p520) Nessa Coyle pens an article that focuses on the psychology of patients when a physician discloses the diagnosis of a life-threatening illness. The usual habit of allowing thoughts of death to remain in the background is now impossible. Death can no longer be denied. This awareness precipitates a crisis for most individuals, who are suddenly faced with addressing and most likely rearranging, their priorities in the time they now anticipate is left. The "existential slap," occurs when the reality and inevitability of one's own personal death sinks in. (Abstract to the article) Following this diagnosis a recommendation to hospice is made. In a flurry of activity the patient and family is met by an Admissions Nurse for a 3 hour meeting to enroll the patient in hospice followed by the Case Manager/Nurse, Social Worker, and Chaplain all within a 5 day Medicare mandated window. Is it any wonder that one of the key personality traits we look for in hospice Chaplains is compassion? The patient is reeling from the diagnosis of 6 months to live and is thrown into an environment they are totally new to and may never have heard of before or at least not understood. The Rev. Dr. Kathleen Rusnak references how her new patients described their reaction to the Existential Slap. The first time I heard a patient say, “When the doctor told me I had less than six months left to live, it felt like “I hit a brick wall,”-- I didn’t hear it. The second time a patient said that to me, I heard it the first time. And then I read this metaphor in a hospice nurse-practitioner’s thesis on suffering. The interviewed patient stated that she felt like she “hit a brick wall” when the doctor told her she had six months left to live. Metaphors are very powerful. They express in symbolic language the depth of raw feeling and emotions that cannot be directly expressed in words. ( For now, as there is so much more to be explored in the Existential Slap, I want to do a deeper dive into what Dr. Rusnak so candidly wrote when she described her response to the patient, “I didn’t hear it.” If there is one regret I have as a Chaplain, it is that like Dr. Rusnak, I didn’t hear or at least didn’t “get” what the patient was actually trying to communicate. Could this be what Heidegger refers to as “the forgetfulness of being?” We, the IDT, the Chaplains as a group are so incredibly busy that we often are thinking ahead to the next patient, the next this, the next that that we are not in the moment, but in the next moments! And, we forget. We forget that before us is a new patient who has just started the hospice journey and is about to have the most daunting experience of a lifetime that will conclude with the end of life on this planet. Which among us has died before and lived to tell about it? I’m not talking about near-death experiences. I’m speaking of the real experience of death. With that clarification, the answer is simple, none of us. Can we grasp the magnitude of what this new hospice patient is attempting to process? It’s pretty hard, isn’t it? In this article, I simply want to urge my fellow Chaplains to do whatever is necessary to be in the moment with your patients. We who are living fall prey to the “forgetfulness of being” while the patient we serve is moving rapidly to the stage of the “mindfulness of being.” Simply put, the mindfulness of being is encapsulated in the long hours of self-reflection where the patient pours over life searching for answers to these questions and more: “Who am I? What was my purpose? Did I have a purpose? Did I waste my life? Did I love? Was I greedy? Did people love me? Will I be remembered? Did I make a difference?” (Rusnak) I am sure you recognized that these questions are core issues to spirituality. And, that is why we are present with them as hospice Chaplains. Blessings to you my Colleagues.

How to keep your hospice Chaplain career position

In yesterday’s article I shared some vital information about how to get a hospice Chaplain career position. Today, I want to share how to keep it and excel in your hospice Chaplain career. First of all, let me state unequivocally, getting a hospice Chaplain career position is not easy. Therefore, when you are offered a position and begin your career, I urge you to cherish it. Here are 5 ABSOLUTES to excelling in your career. 1. Keep a positive ATTITUDE. There will be highs and lows in hospice chaplaincy. You will love the face to face work with patients and families. Most Chaplains enjoy serving people. However, there will be that “2x4 to the head” moment when nothing you do will satisfy a patient or family. Also, there will be changes in the way you document, changes in what is expected in documentation, additional information required, changes, changes, changes. In 2014 this is the norm. Your IDT colleagues may grouse and complain among one another and even to you as they ask your opinion. Do not fall into that trap of negativity. Remain positive. Trust your leadership to navigate the very difficult maze of Medicare demands. Create a brand for yourself as being Mr. or Ms. Positive. That will take you a long way in chaplaincy. 2. Embrace the highest in ethical standards. Your time is your own to create your work day. At Cornerstone Hospice our day begins at 8AM and concludes at 4:30PM. Most field staff begin their day in their home making phone calls setting appointment, it is expected that we all put in a full day’s work. With that said, I urge our Chaplains to make 2 visits in the morning and 2 in the afternoon. If at all possible they are to complete their charting in their computers after each visit, so they can finish their day at 4:30PM and then be with their families. We have a mandate to visit our caseload 1-2 times in every 30 day cycle. The verbiage in the computer may state, “per month”, but it is 30 days. Beyond staying in compliance, it is expected that Chaplains will maintain confidences within the IDT. Once you break a confidence, everyone will know. Your reputation is blown and you have gained a very negative brand. So, work hard, stay in compliance, advocate for your patients, and keep your word and all confidences. 3. Make yourself available for projects. Chaplains are busy with patients and families. That is a given. However, from time to time there will be special projects that need a Chaplain. Be the first to volunteer. Your willingness will be appreciated, particularly when you make vital contributions to the work team. 4. Increase your skills and knowledge base. As I wrote that sentence, I heard voices of complaint and dissatisfaction, because there is usually no added compensation for degrees and certifications. However, the nature of our work demands highly skilled pastoral care clinicians. Becoming Board Certified from a nationally recognized organization will help excel in your work. Taking Continuing Education courses will assist your skill development. Here is my attitude … The better prepared I am to do my work, the better care I will provide a patient at their most vulnerable moments in the course of their hospice journey. In addition, my skill level will greatly benefit family members. Please do not succumb to the temptation to be satisfied with where you are. Growth is an imperative in our field of service. I am sure I could write much more on this vital topic, but I’ll leave it at what I wrote. When you have your annual performance evaluation, your personal brand or reputation will precede you. Your excellent work will be noted. You just may receive a merit increase in pay as a result.

Wednesday, November 12, 2014

How to get hired as a hospice Chaplain ...

How to get hired as a hospice Chaplain ... Recently, we have interviewed for a couple of PRN Chaplains. This experience reinforces what I am about to write. There are ways that you will get an interview and ways to interview that will at least get you a second look and even make you a finalist and, further, get you hired. 1. When you respond to a posting for a Chaplain position, be sure to complete the application in as detailed a manner as possible. 2. When you send in a resume, the following are absolute MUSTS:  Choose a format. Word for Windows has several.  Be detailed. Dates and where you worked previously are necessary.  Why you left the position is helpful. We understand if you were to say, “It was not a good fit.”  I prefer a list of at least 3 references.  Since this is hospice chaplaincy, a cover letter that explains your calling to chaplaincy, your experience in chaplaincy, the reason you want to work at a hospice, if you are moving from another venue of chaplaincy to hospice tell us why. If you cannot clearly state a sense of calling, that may be a red flag. 3. Should you be selected for a face to face interview, please follow these guidelines:  Have an ‘elevate’ speech detailing who you are. It should take 3 minutes.  When answering questions take a moment to reflect on what you are about to say, then say it. The way you respond to a difficult question will give us some insight into how you will respond to a difficult situation in a hospice pastoral care scenario.  Give real life anecdotes to illustrate your points.  Do NOT ever use racial, ethnic, or gender slurs. That will immediately disqualify you even though the interview may proceed.  Smile … appear relaxed. Again, this will let us know how you will respond in a pastoral care scenario. 4. After the interview, send a “Thank you” email. That will let us know that you have manners and are professional in your business dealings. After all, no one owes you an interview. 5. If you are invited for a second interview, we are looking for even more of a professional manner of response. We are looking for further clarity on issues. It could be that there are one or two matters that are unsettled in our minds and we are looking to you for more information. 6. And, finally, throughout the process we are looking for someone polished, gracious, professional, and skillful. And, if you follow the above, you have a great chance of getting a chaplaincy career position. If you have any questions about resume writing, cover letter writing, or guidance in how to interview, please contact me at

Monday, November 10, 2014

Self-care: My own quest

It is rare that I will write something about myself, but I thought today would be a good day to do it. As you know, I am a huge believer in self-care. I try to keep it simple and understandable, but also, real. I've read and I'm sure you have read many articles about self-care that give complex and complicated directives about taking care of yourself. I prefer something a bit more simple: eat right, excercise, pray, worship with others at your faith community, get the rest you need, enjoy your relationships, take nothing and no one for granted, express appreciation, be positive, serve others. These are just a few priorities that keep my life centered. With that said, I want to share with you my ever present goal ... to run and finish my first, ever 5K. Cornerstone Hospice is hosting a Vets and Pets 5K Run/Walk on November 22. If you are interested in this event please visit:​m/100962 The fact is I've never run a 5K. I have been working up toward this and think I can get it done. What are you attempting that you've never done? Let's share our hopes and ambitions for self-care. It will make us better Chaplains!

Friday, November 7, 2014

Invitation to our International Guests

Since we are hosting quite a high number of international guests to Embraced By The Heart of Hospice, please email me or leave a comment to inform me on topics of particular interest to you and your work. This blog was created to enhance the work of chaplaincy across the world. It seems to be attracting a great audience. Thank you for visiting. Let's develop a great relationship!

Thursday, November 6, 2014

Getting Through the Holidays

As we are headed for the holidays, many families and caregivers will the pain of the loss of their loved one. There will be one less chair at the table. Emotions will be frayed. The holidays have the potential for emotional setbacks. Sue Wintz, Editor of PlainViews, gives practical thoughts on Getting Through the Holidays… Getting Through the Holidays: What About Spiritual Distress? By Sue Wintz Any holiday can be a difficult one for a variety of populations, and this season of the year with so many holidays happening close to each other can be especially so. • For those who are grieving, This Emotional Life on has an article written by those who are bereaved; the MISS Foundation has a page devoted to "Transforming the Holidays and Holidaze" with articles and suggestions. • Cancercare provides information for family caregivers of those living with cancer on how to cope and adjust one’s expectations during holidays and special occasions. • The Alzheimer’s Association provides downloadable holiday tips for caregivers while ElderCare Link has "10 Tips for Coping with Caregiver Blues During the Holidays." • Discovery Health’s mental health section focuses on "How to Get Through The Holidays Stress-Free With Your Family." • Social Work Today has a 2011 archived article, "Divorce and the Holidays – Putting Children First," while PRWeb has "5 Tips for Surviving the Holidays When Going Through a Divorce." • Keeping You Well provides advice for diabetics, and WebMD offers tips on those who are seeking weight loss. Of course there are many more sites, and many more populations that would likely benefit from a quick, practical checklist of ways to manage the emotions that arise during the holiday season. But while they all hint at ways to find new ways to prepare for and endure the holiday season, I found little that specifically addressed the spiritual issues that arise. For example: • How does one who is grieving find a sense of meaning when joyful holiday songs are being played everywhere they go? • How does someone whose holiday ritual is attending religious services cope when they are hospitalized and unable to participate? • When diagnosed with a life-threatening or terminal illness, what are ways that person and their loved ones confront and discuss the fact that it might be their last holiday season? • What ways can caregivers of dementia patients who are wrestling with the memories of how their loved ones used to be before their illness seek hope in the present reality? As chaplains and health care providers, what are the ways that we manage these situations that often reveal deep spiritual distress? Do we simply hand out “Making It Through The Holidays” lists that others have prepared, or do we create ones that directly address the spiritual needs that occur? As the holidays approach, this is a project that can be valuable to chaplaincy practice and how departments prepare for a clear and specific way of providing care to those who are in their setting. What list would you create?

Tuesday, November 4, 2014

5 Barriers to Effective Communication

A key element to productive, healthy interpersonal relationships is communication. Communication encompasses both listening and speaking. Someone wisely said, “God gave us two ears and one mouth.” Learning to listen is one of the greatest challenges we will face in our work as Clinical Chaplains. Learning what to say is a close second. This chapter is designed to be interactive, as well as, informative. Let’s tackle listening first. Through my days in CPE I was taught much about listening… active listening and interactive listening. Distinguishing between them was not particularly difficult. What was difficult was clearing my mind so I could hear what was being said. What are some barriers to listening? Michael Webb presents “Eight Barriers to Effective Listening”. We will look at five of these barriers: 1. Knowing the Answer--"Knowing the answer" means that you think you already know what the speaker wants to say, before she actually finishes saying it. You might then impatiently cut her off or try to complete the sentence for her. Can you imagine the reaction of a spouse suffering with anticipatory grief who has longed to unpack painful feelings only to be cut off? Pastoral care will suffer greatly. 2. Trying to be Helpful--Although trying to be helpful may seem beneficial, it interferes with listening because the listener is thinking about how to solve what he perceives to be the speaker's problem. Consequently, he misses what the speaker is actually saying. One of the primary purposes of active listening is to discern the “question behind the question” or the “pain behind the statement”. A Chaplain cannot discern anything if he/she is trying to come up with a solution to a perceived problem. 3. Treating discussion as competition—Have you been in a conversation (apart from your work) and spoke about a time of illness or surgery? You were trying to make a point, but the other person interrupted and shared their story. It appeared they were playing a game of ‘one-upmanship’. You said one thing and they were going to see your story and up the ante by telling you theirs. The point you were trying to make got totally lost. You were left wondering why you even brought it up. We are not in competition with our patients. Hospice Chaplaincy is about the patient and family, not about us. We go in to the patient with a blank slate and let them fill it in. 4. Trying to influence or impress--Because good listening depends on listening to understand, any ulterior motive will diminish the effectiveness of the listener. Examples of ulterior motives are trying to impress or to influence the speaker. A Chaplain who has an agenda other than simply to understand what the patient is thinking and feeling will not be able to pay complete attention while listening. Since one of the goals a Chaplain has in a pastoral encounter is to be ‘present’ with the patient, letting the mind wander trying to come up with a cogent come-back destroys the essence of listening. 5. Reacting to ‘red flag’ words—One of the key differences between a Chaplain and a parish Pastor should be/needs to be found at this point. We, as Chaplains, are not the keepers of the faith. We are not called to correct, but to support. When a Wiccan speaks of “Sunnyland”, we don’t react. When a Buddhist says, “We do not believe that this world is created and ruled by a God," we don’t’ react. When a Muslim expounds the Five Pillars, we don’t react. When a Catholic or Presbyterian or Methodist or Baptist or Episcopalian patient shares their view of the after-life and it differs with your beliefs, the Chaplain does not react. The Clinical Chaplain recognizes that the journey of the patient is his or her own journey. The patient’s belief system is just that… the patient’s belief system. Our agenda is simple… to serve the patient. The Clinical Chaplain does not suffer from religious counter-transference which fills the pastoral encounter with the Chaplain’s own anxiety. How does a Chaplain keep from stumbling over the barriers to effective communication? In short, the Clinical Chaplain is self-aware. If the Chaplain struggles with ego issues, he/she might fall prey to “trying to influence or impress”. If the Chaplain struggles with insecurity, he/she might fall prey to “reacting to red flag words”. If the Chaplain struggles with a competitive personality, he/she might fall prey to “treating discussion as competition.” Getting oneself out of the way so that listening becomes a reality is every Clinical Chaplain’s challenge. I was taught an analogy in CPE called “The Window.” This lesson provided a simple means to evaluate myself and where I was emotionally. I used this simple tool prior to the work day and, in some cases, prior to spiritual care visits. I hope you find it useful, too. The Window The Window is an analogy designed to provide insight into our feelings/emotional state. Let’s examine the parts of a window. There are window panes, one of which can be raised and lowered. Have you noticed that the windows in your house often attract smudges? The same thing happens with our emotions. We take on smudges when we have an argument with our spouse, when finances cause stress, when our children have problems, when someone criticizes us, when someone is rude to us, when another driver cuts us off or flips us off. Each day our Window gets smudged. As we can’t see clearly through a glass window, a smudged personal Window prevents us from “seeing” what a patient is saying. Look at your personal Window. What smudges are on it? Clean them off. How? You have options. Use them. Not to have a clean Window means you carry into every pastoral encounter a distracted presence. You can’t “see” what the patient is saying. You’re distracted. Your insight is blurred by the “stuff” of your own life. An effective Clinical Chaplain self-assesses so that his/her visits are devoid of “stuff”. In addition to the smudges, is your Window up or down? Just as an ‘up’ window at home allows a free flow of air, an ‘up’ Window allows a free flow of ideas and communication. As a ‘down’ window at home limits air flow, a ‘down’ Window limits communication. What will cause a ‘down’ Window? Such things as intolerance of others’ belief systems, hidden anger toward other religious systems, bitterness at life or God or someone else, and any other dysfunction that remains unhealed. So, check your Window before you attempt a pastoral encounter. The beneficiary of your self-assessment will be the patient, as well as, yourself. I emphasize, communication is the key that unlocks the door to deep and meaningful pastoral encounters. Becoming a skilled communicator takes work and a growing understanding of the field of communication.

Conflict ... Part Two

What are the issues behind conflict? •A conflict is more than just a disagreement. It is a situation in which one or both parties perceive a threat (whether or not the threat is real). •Conflicts continue to fester when ignored. Because conflicts involve perceived threats to our well-being and survival, they stay with us until we face and resolve them. •We respond to conflicts based on our perceptions of the situation, not necessarily to an objective review of the facts. Our perceptions are influenced by our life experiences, culture, values, and beliefs. •Conflicts trigger strong emotions. If you aren’t comfortable with your emotions or able to manage them in times of stress, you won’t be able to resolve conflict successfully. •Conflicts are an opportunity for growth. When you’re able to resolve conflict in a relationship, it builds trust. You can feel secure knowing your relationship can survive challenges and disagreements. I have observed that most people do not like the pain of conflict. But, who is responsible for attempting to resolve the conflict? Pride often gets in the way of conflict resolution. The picture that comes to mind is of two people with arms crossed separated from each other by more than just several feet. They are separated emotionally. They glance at one another hoping the other would offer an olive branch. However, neither does and the conflict deepens until at some point what initiated the conflict is no longer even remembered. This cannot happen in a work environment. If a Chaplain is in conflict with a co-worker, there are expectations the co-worker has of him or her. There is the expectation that because the Chaplain is a minister that a minister will be the first to attempt resolution. Right or wrong, that is the perception. People have great expectations of ministers, don’t they? Unfair? Perhaps, but that is the general feeling among non-ministers. There are values that ministers share: Love for people; Desire to serve people; Passion for our work; We love to please others; We do not like conflict. While hardly an exhaustive list, these are part of a core set of ministerial values. I state this with the intention of presenting an approach to conflict resolution: The Win-Win Approach. The Win-Win Approach to Conflict Resolution Is the person with whom you are having conflict your opponent or your partner in the cause of hospice? The win-win approach says, “I want to win and I want you to win.” This statement is not easy to come to when in a high stakes conflict. However, if there is to be a win-win, then several things must be present in your demeanor: •Self-awareness/Emotional Intelligence—What emotional baggage am I influenced by in this conflict? Is there unresolved conflict that is influencing my emotions? Is there other ‘stuff’ influencing me at this moment? •Needs—What are my needs in this conflict? Must I win at all cost? Do I own any of this conflict or am I a victim of the other person’s need for power and control over me? Your answer to that question will determine if you really want a win-win or win-lose outcome. •Big picture—What is the bigger picture? Am I and my need to win this conflict bigger than the bigger picture? The answer to that will determine if conflict resolution is even possible. What are the needs of the person with whom I am in conflict? Have I considered his or her needs? It’s a good thing to do if you desire a win-win outcome. •Target of attack—In approaching conflict, the target is key. Recently, I came upon a prosecuting attorney who told me that before each trial, she had to develop a hatred for the accused in order to be convincing to the jury. I found that odd as this person described herself as a deeply devoted Christian. However, when there is a conflict, those involved seem to take a similar posture. Hopefully, they don’t hate each other, but certainly there is enough personal attack to go around. The win-win approach has as its target the problem, not the person. “Solve the problem at hand, salvage the relationship if at all possible” is the motive behind the win-win approach. There are other approaches to conflict resolution, but the win-win approach seems to fit the focus of this study. Humility, ownership of responsibility, and integrity on the part of the Chaplain will go a long way to resolving conflict. Does this suggest a “happily ever after” outcome? Absolutely not! There are situations when a conflict has deteriorated a relationship to the point that a working relationship is no longer possible and one of two options exist: re-assignment or resignation. Re-assignment brings relief, albeit, temporary relief because there will be new people and new conflicts. The key benefit of re-assignment is that is gives time for healing and rekindling of passion to succeed in the work of chaplaincy, and it also brings the sense of reality in that there is an awareness that no one can go from one re-assignment to another to another. That type of thing leads to the belief that conflict resides with the person re-assigned. Resignation ends the relationship permanently with no hope of resolution. This is a last resort measure. Resignation fosters the following: victim mentality, self-righteousness, avoidance of responsibility, future problems with relationships, let alone unemployment. No, resignation is not the best solution. If you are in a conflict, seek resolution. The work of the hospice Chaplain is too important to have the anchor of unresolved conflict pulling it down. Conflict drains you of necessary emotional energy. If you can’t resolve it, seek assistance from your manager or HR representative. Whatever you do, do not build a cadre of supporters who will choose up sides. That is unprofessional and simply wrong. Carry yourself as the minister you are and keep your reputation unsullied.

Monday, November 3, 2014

Conflict and How to Deal With It ... Part One

It is inevitable that you will experience conflict with someone close to you. Conflict happens at home with your spouse, your children, in-laws, or other family members. At work you might lock horns with a manager, colleague, and, perhaps, a patient or family member. The purpose of these posts is to explore conflict and suggest means to resolve it. Part One is about the basics of conflicts. I am sure you will identify with much of what is written. Conflict arises from differences, both large and small. It occurs whenever people disagree over their values, motivations, perceptions, ideas, or desires. Sometimes these differences appear trivial, but when a conflict triggers strong feelings, a deep personal need is often at the core of the problem. These needs can be a need to feel safe and secure, a need to feel respected and valued, or a need for greater closeness and intimacy. The culture of 2014 is filled with tension and fear. People today fear failure, losing their job, and societal issues (such as, healthcare or lack thereof; the economy; terrorism). Your colleagues come to work every day carrying emotional baggage from any number of sources. Perhaps it was an argument with a spouse or teenaged child, or awareness that their personal finances are not doing well, or a concern that their car might not make it through the day and repairs are unaffordable, or from some other stressor. They are emotionally vulnerable. It would not take much to push them over the edge. You’ve noticed they are distant or at least not like themselves. Their words are few, their sentences short. They don’t make eye contact much if at all. When they talk about the company it is negative. Nothing is good. It is all bad. Their perception is that no one cares about them. And, then, it happens. The wrong thing is said or something is said with a tone that conveys a harsh message. Their defenses shred. And, they react. A conflict is birthed. Part Two will focus on the issues involved in conflict and an approach that hopefully will result in a win-win resolution.