Thursday, March 26, 2015

Scars, Part 2

As I mentioned in the previous post, some of your patients have been carrying deep wounds with painful scars. I recall a patient I served who would engage in very deep conversation about God and her spiritual life. She would begin to talk about how God has helped her throughout her life and then for no reason I could discern she would change the subject. She did this for several visits. I began to wonder if there was a problem in her life that God didn’t help her with and would gently ask her in my next visit. The conversation was just as before, deep and filled with her appreciation for God helping her. She began to change the subject when I gently interrupted and made the observation that our conversations were very deep and inspirational and that we both felt good after talking, but it seemed that the conversation took a different direction each time. I assured her I would not pry and that if she chose to keep our conversations on this level that would be fine. But, if she would like to discuss something that perhaps God didn’t handle for her that I would listen and not judge or condemn. She paused, began to tremble and her eyes began to tear up. After that, she opened the dark secret of her life that she said she could not and did not share with anyone else in her life. Further, she said that at this stage of her life she needed to get it out in the open. She then shared that for 4 years was abused by several men in her community. The family dynamics did not allow her to share what happened. For 64 years she kept that secret. During those 64 years, that secret prevented her from developing romantic relationships. After she emptied her soul of the pain, with her permission I was able to connect our counselors with her. She died at peace. Supporting patients and giving them hope is a wonderful privilege for the hospice Chaplain. Here is a strategy to follow with your patients: 1. Develop a trusting relationship. This is something that is earned not given. It takes time. Never assume trust. 2. Use productive interventions such as a life review, journaling, pastoral counsel, sacred texts dealing with God as the source of hope for inner healing. 3. Should the patient reveal anything like my patient did, seek approval to bring in the counseling professionals on your Team. Unless you are a licensed mental health counselor, it is best to refer this patient to one on your Team and continue your spiritual care work with this patient. Bless you Chaplain Colleagues. Yours is a challenging and sacred work.

Scars

One of the most glaring scars I have is on my arm. Years ago when I was in college, I was working on campus. The stake body truck had a chain on the back that I could hold onto as we moved from place to place to do our landscaping. I remember it as if it were yesterday. We hit a bump, I was thrust forward, my arm hit the splintered edge of the plywood which made up the walls of the body of the truck, and I was in instant pain. We stopped. My co-workers gathered around me. I told them I thought my arm was broken. I went to the hospital and the ER folks got me x-rayed and the doctor came in and told me I had a splinter about 3 inches long in my arm. He performed surgery right there in the ER room (after giving me several Novocain shots in my arm). It took weeks to heal and when it did, a scar is left there. Whenever I look at my arm, I can recall that day on campus when it happened. Spiritual scars are much the same. As you discussed the spiritual history of your patient, they may have referenced with ease the horrible, blood bath of a church business meeting that so shocked and disappointed them that they decided they would never come back to church. There so many causes of spiritual scars that you can name your own from your experiences as a hospice Chaplain. The sad thing is patients can recall these instantly as if they happened just yesterday. The deep, deep scars some of our patients recall have to do with the violation of their personhood when they were children. The effects of abuse of any form do not get better with time. Time does NOT heal all wounds. Some of your patients have deep wounds like that. How do you get them to talk about their wounds and their past? Simply put, you don’t. Your patients and mine have to trust us implicitly. The pastoral care relationship has to be on solid footing. You must win their trust and prove yourself trustworthy for this to happen. What saddens me is that the length of stay of our hospice patients has decreased over the years to the point that relationship development just cannot happen as it used to. Dame Cicely Saunders, the founder of the modern hospice movement, coined the term “total pain.” Her definition of total pain included: physical pain, social pain, psychological pain, and spiritual pain. It might be that your conversation with a patient would move toward the topic of suffering. You might consider Saunders’ definition and then ask, “Where does it hurt?” And, then, be silent and let the patient either take the invitation to self-reveal or not. In our next post, we will look at the topic of how hope can spring from suffering. Chaplain Colleagues, yours is a sacred profession. Blessings of wisdom I pray for you.

Wednesday, March 25, 2015

The Chaplain and Driving

What in the world does driving have to do with chaplaincy? Well, if you're a hospice Chaplain, a lot. It's how you get to your patients. So, what's the big deal? You are aware that your driving style is part of your annual performance evaluation, aren't you? Therefore, it's something you need to pay attention to. Each hospice has its own policy about driving, but suffice it to say that if you get two speeding tickets or moving violations you will be terminated. What a shame it would be for a great Chaplain to lose his job because of bad driving habits. Follow these suggestions and stay on your job: 1. Remember, if you are going to be late for a visit, your iPhone can travel faster than your car. Simply call the next patient or the patient's caregiver and let them you'll be late. None of us likes to be late, but none of us likes to pay a speeding ticket and jeopardize our job, either. 2. As far as insurance is concerned, get the upper limits on your policy. You might need it some day. As for me and my driving adventures, my car has been shot, been hit by a patient's caregiver, and came within a gnat's eyelash of a head-on collision (I can still hear and feel the brakes squealing). Yep, my car was shot. Thankfully, the bullet did not penetrate the passenger door and then penetrate my ribs. It must have been a stray bullet because I was simply driving through a tough part of town. The incident when the caregiver hit my car was one of those challenging Chaplain situations. This gentleman was well-known for his horrific driving. I was visiting his spouse and was engaged in conversation when he stated he was going to the VA clinic and would be back later. He left the living room and headed to the garage. It occurred to me that I was parked in the driveway and he would hit my car if he backed out. Well, as I went out to the garage I observed him giving his big van more power as he was trying to move my car out of the way. He wasn't aware he had destroyed the left fender and all that attached to it. I am not the best at diplomacy, but I had to be in this case. He paid the bill to fix my car and was very apologetic. But, as you all know, I had to report this incident and go for a drug screen. Just another day at hospice. 3. Keep your car in as good a shape as you can. My car has over 250,000 miles. It still gets oil changes every 3,000 miles. It gets washed twice a month, gets new tires as needed, gets tuned up if needed, etc. I do not like car notes, so I will run this car until it needs hospice care itself! 4. Be extremely careful who you transport in your car. It is my personal policy never to transport a patient or caregiver. That is assuming too much risk. Besides, it is our hospice's policy restricting this. My colleagues will tell you that during extended orientation when nurses, aides, social workers, or Chaplains are taken on shadow visits, it is my personal policy not to transport our women IDT members. This has always been my manner. It's not to be sexist, but respectful. Respectful in 2015? Yes. I respect my wife too much and I respect our employee's spouses too much. There is plenty of time to talk at a facility or at the office. You may have another view and that is fine. This has held me in good stead for 3 decades of pastoral care. 5. Lastly, be safe. You are the most important person to your family. Be as safe as you can. Accidents happen to safest of drivers. Just know you are loved at home and at work. Bless you, Chaplain Colleagues. Yours is a sacred work.

Tuesday, March 24, 2015

3 Ways to handle patients who do not answer your phone calls

Let’s face it. The hospice environment is fast moving and dynamic with all the changes and challenges. The Chaplain’s daily schedule would greatly profit by patients and/or caregivers answering their phones and working with the Chaplain to set an appointment either for an Initial Assessment or a Routine Visit. Any seasoned hospice Chaplain will tell you that that is fantasy. So, what can a Chaplain do to see his/her patients when they don’t answer the phone? 1. Talk to the Nurse. She or he usually has a good idea what is happening with the patient and caregiver. Most Nurses ask the patient if they have seen the Chaplain. Most Nurses will share the truth about what they were told by the patient or caregiver. If it seems that the Nurse can broker or negotiate with the patient or caregiver to give you a chance to speak to them over the phone, then use this strategy first. I have used is successfully many times. 2. Make a joint visit with a Nurse or Social Worker. Explain the situation with the Nurse and/or Social Worker. A joint visit is a good way to see the patient if they are open to seeing you but for one reason or another does not answer the phone. The Nurse or Social Worker may indicate that the patient is exhausted by the continual ringing of the phone and have decided to simply not answer the thing. The patient and caregiver know they must see the Nurse and in most cases the Social Worker, so they do recognize their phone numbers and answer. Yours is not familiar and so they don’t answer. This strategy works only if the patient and/or caregiver are open to seeing you. 3. The third and worst strategy is to assign this patient as a Decline and move on. However, let me be clear, this is the absolute last option. It is your responsibility to contact the patient or caregiver and present a non-anxious voice presence on the telephone to secure a visit. If, after 3-5 attempts, there is no response, then assign the patient as a Decline. Again, let me remind you that you may do this ONLY after you have spoken to the Nurse, Social Worker, or Home Health Aide and fully understand the family dynamics and that there might be a very good reason no one answers the phone; and after you have attempted a joint visit with the Nurse or Social Worker. I know this takes precious time, but the patient is a precious soul, a dying precious soul who needs a Chaplain. If you have another strategy that has worked for you, please share it and I’ll post it here.

3 Sure Signs of Burnout

There is no doubt that hospice chaplaincy is one of the most draining professions in healthcare. We hear of nurses that burn out; social workers that burn out; and, now, we will talk about Chaplains that burn out. Here are 3 sure signs you are burning out: 1. You isolate yourself. You don’t connect with your Team, your Team Manager, your fellow Chaplains, and your Spiritual Care Director. You’re on your own and you don’t even realize it. You break off conversations because you say you have patients to see (you do, but not right away…you could have spent time in fellowship). You make up ‘reasons’ to avoid Chaplain meetings. Your excuses sound acceptable, no one questions you. At first, the isolation bothers you, but after a while, it is your new normal. Friend, you’re headed for trouble. 2. Your work begins to suffer. You’ve been an excellent Chaplain, but now your work is slipping. You make one call to a new patient to set an appointment and if there is no answer, you leave a message and ask the patient or caregiver to contact the office should they need you. They never call… and you are ok with it. The passion is gone. The urgency is gone. You call them once, document it, then forget it. In addition, you neglect your patients. I can’t tell you how many unfulfilled promises of a visit I have read through the years by Chaplains who are burned out. Some of these unfulfilled promises (better termed “lies” because that is what they really are) were made up to a year ago or longer. Friend, you’re in trouble now. 3. You are beyond asking for help. Your work pattern seems to be like quicksand. You can’t get out of it. You’re stuck and getting sucked down, helpless to stop the strong tug downward. You now recognize what is happening. Your productivity is extremely low, fellow IDT members are talking, calls are being made to your Managers by caregivers, complaints are filed. Fried, it’s over. Burnout is a terrible thing. Yet, it can be averted. But, you’re the only one who can call for help. Self-awareness that was honed to a sharp edge gets dull. You have to recognize that. Unless there is someone on the IDT that really knows you well, you will become more isolated. If you are burning out and are reading this and have gotten to this point in the article, I urge you to contact your Managers. We get it. We can and will help.

Tuesday, March 17, 2015

5 Types of Communication Styles

5 Types of Communication Styles If there is one thing a hospice Chaplain attempts to do, it is to communicate. There have been times when I either miscommunicated or just did not communicate at all. Those are frustrating experiences. Can you relate? From time to time I review notes that I gathered in CPE to remind myself of the type of communicator I want to be. Perhaps some of these thoughts will inform your chaplaincy. Type of Communicator Blamer: Shifts focus to another; tends to say “Why do you always…? Compliant: Passive/aggressive behavior is common; Assumes no responsibility in the conversation; tends to say, "Whatever you want..." Distractor: Destroys focus of the conversation; Can ask something like “What time is it?” ½ Process: Assumes the power position by saying: “I want, I think, I feel” Effective Communicator: Maintains context, protects self and others; He/she may say “I want, think, feel”, but will also say: “What do you want, think, or feel?" The Communicator has learned the art of negotiation. Key points of understanding: * “You” messages are always blaming messages. “Why” messages are always blaming messages. * The use of “what” and “how” will allow the other person to explain without having to justify. * “What” and “how” deal with structure. Structure explains rather than justifies. The only time that “why” is justified is when it is used as a means to discover “for what purpose?” The better way to express that type of request is simply to say, “What purpose does that serve?” or “I don’t understand.” * A good rule of thumb: “Why” always focuses on justification. “What” and “how” focus on structure. When a Chaplain is having a serious conversation it is incredibly important that he/she conveys the right message. A conversation of this type has three component parts: opposing opinions, strong emotions, and high stakes. Consider this scenario: A family is undecided if their loved one should be buried or cremated. The loved one supposedly told one of the family that he preferred cremation. Not every member of the family heard that. It was not written down anywhere and not signed by the loved one. Several of the family members are vocally opposed to cremation. The Chaplain is now involved in the decision making process. Would you consider this conversation to be serious? In your Chaplain meeting, discuss how you would handle such a situation. Bless you hospice Chaplain Colleagues. Yours is a sacred work. Do your utmost to serve effectively. Your comments are welcome. Send them to rbehers@cshospice.org

Monday, March 16, 2015

If you are looking for work and can't get hired...

Why Can’t I get hired? Not too long ago I was at a meeting where I saw a gentleman who applied for a position at my company. He was upset with me that he did not get a call for an interview. I told him that our HR screens applicants and their information, i.e. resume. That is before I get involved in the process. He thought I should have intervened and had HR move his resume and application to the top of the pile. It doesn’t work that way. So, what could be the problem? I took a look at his resume. There was the problem. In today’s post I want to provide encouragement and guidance to those of you actively looking for a position as a hospice Chaplain. Let me be as clear as I can at this point. Chaplain jobs in today’s environment are few and far between. So, you have to be sharp and present a resume that will garner the attention of the HR rep. It’s just that simple. I would encourage you to read Healthcarejobsite.com not just for job openings, but for the terrific help they post for resume development. It is very worth your while to put their suggestions to use. If you want your resume to stand out above the others, you can’t the attitude that “I’m good and so is my resume, so that is that.” Friend, that won’t work. This post can’t do the work only you can do. What are some things a hospice is looking for? Experience that speaks of value and significance; bi-lingual ability; teach-ability; humility; servant-mindedness; team player; stick-ability; and all the day to day chaplaincy skills. Oh, and one more thing… you have to be able to type at least 20 words per minute. Today is the day of electronic records. You will have to input your finding from your visits into a program designed to capture those facts. I suppose I assumed you would know that, but so many have not entered the computer age that it is best to just say it. Blessings to you Chaplain Colleagues who are searching for your place of service.

Thursday, March 12, 2015

3 Useful Aphorisms that will keep your thinking right

3 Useful Aphorisms that will keep your thinking right 1. Be careful what you think you know. Anonymous 2. You don’t know what you don’t know. Anonymous 3. To know what you know and what you do not know, that is true knowledge. Confucius These three statements would make for a good discussion with your Chaplaincy Team. How do these statements inform your style of chaplaincy? I would be interested to hear what your Team comes up with. You may contact me at rbehers@cshospice.org.

3 Ways to work with a bivalent manager

If you are going to succeed as a hospice Chaplain, you are going to have to work effectively with a Team Manager. It is as simple as that. My experience and observation about how a Team Manager accepts a Chaplain is this… In most cases, the TM will give the Chaplain the benefit of the doubt at the beginning of the relationship. That is a window you, the Chaplain, can use to your great advantage as you begin to establish your work with patients and families and the IDT staff. Your energy, positive outlook, winsomeness, and skill will keep you in good stead with your TM. If you are out of compliance with your visits, late to meetings, scattered with your schedule, make excuses, and do a shabby job you will have trouble. Every once in a while you will come across a bivalent manager. What is that? Sounds scary. I assure you, it is. A real life example will serve to explain… I once worked for a TM who ruled the Team with an iron fist. Hers was always the final word on everything. It was literally her way or the highway. When I came to her Team, I observed how she worked and what she expected (demanded) from the various disciplines in the IDT. There was a new initiative in the organization to upgrade from paper charting to electronic charting. I threw myself into gaining insight and understanding about how to use the program presented to us efficiently and effectively. I did grasp the logic behind the program when it came to the spiritual care elements. The IT Team made me a trainer for the Chaplains. This made my TM very happy. I was able to meet all of my obligations to patients and families, attend all meetings on time (it was her time, not Standard or Daylight Savings Time), and maintain a positive attitude. Those who challenged her lost... their jobs. I recall one episode that has remained emblazoned in my mind. As part of each meeting she would bring us up to speed on hospice news and any other announcements. Well, she had an announcement to make and that was that non-Clinical people were never to give medical advice to patients. That made sense to me as I would not consider doing so, but apparently, there were some on the Team that crossed that boundary. The announcement was stated matter-of-factly with no sense of intense emotion. A couple of weeks later, the atom bomb went off. It seems the non-Clinical person(s) did not heed her warning. It was evident that she was upset when she walked into the room. The normal opening to the meeting was put aside. As she was standing at the head of the conference table she leaned forward and slammed her hand on the table and in a growling voice stated that whoever gives medical advice again would be fired on the spot. Wow! What an introduction to a hospice TM! Through my time on that Team I learned from others that that was her manner. She not only acted that way in Team, but in her relationships with others in the office. When other Managers saw her coming they expected a confrontation of some sort. In meetings, she would give scathing comments about those on her Team that were not meeting her expectations. Her world was good or bad, friends or enemies, negative or positive, hero or villain, believers and non-believers, life and death, fantasy and reality, and so on.* (*Harvard Business Review, March 10, 2015; How to Manage Someone Who Can’t Handle Ambiguity, Manfred F.R. Kets de Vries). de Vries, Distinguished Professor of Leadership Development and Organizational Change at INSEAD, works to coach such bivalent leaders. I will leave the coaching up to him, but will give 3 simple ways to work with a bivalent manager: 1. Do your work with excellence. That is all this manager wants. 2. Solve her problems before they become a problem. Managers deal with people problems all day long. They know who will have problems and why. Be efficient. Learn your job and the nuances of it. Do not be scattered or appear to be the weak link. 3. Become her go-to person in some aspect of the Team. If it with the computer program, know it thoroughly. If it is with patient needs, be able to speak with certainty about that patient. Whatever is happening on the Team, be the one she feels comfortable speaking with. Those are simple, but they work. To this day, that manager speaks well of me. To this day, she speaks ill of those who did not meet her expectations and demands. So, Chaplain Colleagues, if you work for a bivalent manager allow the experience to grow you. You will be better for the experience.

Wednesday, March 11, 2015

Spiritual renewal...more than just words

My previous post on the subject of spiritual self-care had more to do with identifying the problem areas than providing solutions. In this article, my intent is to provide a very workable strategy to integrate into your life. To assist with this process, please read the article, Renewed Through Spiritual Self-Care, by Lucille Zimmerman. This article is found at http://www.ministrymatters.com/lead/entry/3886/renewed-through-spiritual-self-care. To whet your appetite for the content of this article here are a few nuggets for your enjoyment: Spirituality signifies the inner attitude of living life in search of the sacred, a search for meaning in life through something more powerful and bigger than ourselves. It is the way we invite God into our daily lives. One philosopher and writer calls it “the wild joy we humans fall into.” Another writer, Elizabeth Harper Neeld, says, “The spiritual life is the core of who we are. It is Life with a capital L. It is that part of us that knows infinity. That loves. That longs for connection. That is unsatisfied without purpose and meaning. That is moved by ritual. That is timeless” (A Sacred Primer, 20) Spiritual experiences show up as a coincidence, conversion, near-death experience, awakening, mystery, energy, emotion, beauty, awe, wonder, and silence. These experiences show up in ways that cannot be put into words, and they don’t have to be earth-shattering. Sometimes the best moments are when we hear the still, small voice of God. Mother Teresa said, “We need to find God, and [God] cannot be found in noise and restlessness. . . . The more we receive in silent prayer, the more we can give in our active life. We need silence to touch souls” (A Gift for God, 68–69). In order to do that, we must carve a time, space, and frame of mind, free of distraction, to nurture our spirituality. Teresa of Avila said, “The life of prayer is just the love of God and liking to be with him." What is particularly appealing with this article is that it does not give a formulaic way to increase one’s spirituality. I found myself nodding in agreement, propping my chin on my hand in thought, and concluding this writing was speaking from experiences that were not all that different than my own. I have discovered that consistency in developing my spiritual life through various disciplines such as, Bible reading, prayer, journaling, personal reflection, corporate worship, private worship, being honest with myself about where I am in life, and maintaining a connection with an accountability partner keeps me pretty spiritually centered. The task of hospice requires a fully present Chaplain. It takes focus and work to maintain that feeling of being centered. Bless you Chaplain Colleagues in your most sacred work.

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11 Questions to ask to diagnose your spiritual health

In a recent professional meeting, a certain leader’s name came up out of a sense of concern for the direction his leadership was taking him and his group. The direction seemed incongruous with what his group’s faith principles were about. Then, someone who knew this leader quite well mentioned that this deviant direction was in keeping with the fact that this leader lost his faith years ago. That comment lodged in my mind and really demands investigation. “Lost his faith”… years ago. How sad and tragic. Ministry is such a grind that it can completely deplete a pastor’s personal resources and leave him/her spiritually dry as the Gobi Desert. Let me focus on the same experience for a hospice Chaplain. The demands of his/her hospice agency, the challenges of the entire task itself, and life in general can leave the Chaplain spiritually weakened. Are there certain instances within hospice that can cause a Chaplain to lose his/her faith? Pediatric hospice can do it. Trauma hospice can do it. Adolescent hospice can do it. The variety of ‘unfair’ diseases can do it. Each of these and many more can sap the spiritual strength of any Chaplain after many years of hospice service. So, what is there to prevent total spiritual and faith breakdown? Certainly, loss of faith must be seen as somewhat rare. Spiritual weakening is more the norm. Perhaps through a short series of questions we can identify warning signs of spiritual weakening:  1. What was your spiritual life like before coming into hospice?  2. What were your spiritual disciplines beginning from your earliest recollections?  3. What are your spiritual disciplines now?  4. What are you reading for inspiration?  5. Are you attending a faith community on a regular basis?  6. Are there bitter, resentful, or angry feelings associated with your ministry career?  7. How do you release those types of feelings? Better, have you released those feelings?  8. How do you process what you see, hear, and feel when you visit hospice patients?  9. What do you do for fun? Do you exercise? Eat well? Socialize?  10.Are your family relationships healthy and growing?  11.How do you relate to God? Spiritual health and well-being does not come without the investment of time and what you do with that time. Find what works for you…reading, meditating on Sacred Texts, singing, changing the scenery for your spiritual disciplines, pray; be creative in how you approach your spiritual disciplines. Is there someone you call an accountability partner? Try that. You might find it helpful. Whatever you do, do not be a Lone Ranger. Too many pastors who come into hospice work cultivated the Lone Ranger style of living. In hospice Lone Rangers don’t last long. It’s ok to ask to talk to your Manager. He or she has been there, done that and can give you perspective. Bless you, Chaplain Colleagues, in your sacred work. Don’t do it alone and don’t neglect your spiritual life. Strong, healthy spirituality will support you in the great work we call hospice.

Tuesday, March 10, 2015

To new readers...

Welcome to Embraced by the Heart of Hospice! There is a following of this blog from France, Russia, Canada, and quite a number of other countries, as well as, from America. It is a pleasure to educate and inspire Chaplain worldwide. Please feel free to share your thoughts. Just click on "No Comments" (I know, it sounds strange to do that) and leave your thoughts in the pop-up dialogue box. Blessings to you and your sacred work!

3 Traits of an emotionally elite Chaplain

I had the pleasure of listening to William Vanerbloemen teach on the subject of emotionally elite staff candidates. What a tremendous series of insights William brought to the table. These principles are easily transferable from a church setting to chaplaincy. This process is what I am following here. The first trait of an emotionally elite hospice Chaplain is:  He or she can take a N.A.P. That is, the Chaplain provides a Non-Anxious Presence. There are plenty of crises in hospice care. The Chaplain, however, cannot allow him/herself get caught up in any drama that may go along with crises. Whether the crisis concern staffing, or downsizing, or transfers, or change in general, drama is off limits to an effective Chaplain. A non-anxious presence is what places oil on the waters of staff crises. The IDT certainly needs the Chaplain to be calm and assured that all will be well. It would be disastrous if the Chaplain gets caught up in family drama during a visit. Again, the Chaplain’s calm, non-anxious demeanor brings peace to the family in crisis. Taking sides in a family dispute or engaging in argumentative behavior defeats the purpose of the Chaplain. So, learn and keep on learning how to “take a N.A.P.”  The Chaplain uses the pronoun “we” far more than “I”. The Chaplain supports the Team by using “we” rather than “I”. Yes, there are times when grammar requires the Chaplain to use “I”, but overall, the Chaplain is secure enough emotionally to realize that by spreading the praise his/her stature grows among team members. And, in front of a patient or family during a visit, the use of “I” by a Chaplain sets the stage for a very boring visit. Again, hospice is not about us as individuals. It is about the patient and family.  The Chaplain is on the solution side of a problem. This suggests the Chaplain is not a negative thinker and not a negative influence among the IDT members or, for that matter, facility personnel or other associated with hospice. I have been around hospice staff through the years and noticed that when the chips are down they can’t seem to help themselves but to complain and bellyache to any and everyone who would listen. That is a trait of a highly unprofessional employee. Being positive and hopeful in the face of hospice challenges is the road less traveled. An emotionally elite Chaplain will adopt that manner of behavior to the betterment of the organization. Calling upon all emotionally elite hospice Chaplains! Your presence is required and very much needed in this juncture of hospice history. We need you!

Friday, March 6, 2015

Furthering the Cause of Chaplaincy in America

I received the following email message from Sue Wintz and wholeheartedly support the effort she is leading. It is important that all Chaplains from all areas of service unite and sign this petition. Why Should I Sign: Moving Chaplaincy Forward If you have not already seen it, HealthCare Chaplaincy Network has created a petition to be circulated to all the members of Congress this spring. The objective of the petition is to "raise positive awareness that professional health care chaplains cost-effectively improve patient and family experience and satisfaction with their health care" and "promote patient and family choice of care for all Americans of all beliefs, cultures, and religions." You can read the entire sign-on statement at http://www.healthcarechaplaincy.org/sign-on-statement?utm_source=Special+Article+by+Sue+Wintz%3A++Why+Should+I+Sign%3A++Moving+Chaplaincy+Forward&utm_campaign=PV+Wintz+Special+Article+2-25-15&utm_medium=email and add your name to the petition; all that is asked for is your name and state. The question, of course, is why should you do this? I need to add a disclaimer here. I work with HealthCare Chaplaincy Network and support this petition wholeheartedly. I know and contribute to the commitment that HCCN has to professional chaplaincy and care for the human spirit. I am also someone who has extensive national experience and expertise within the profession as one who served in national leadership. I have worked (and continue to work) with national organizations to network and advocate for professional chaplaincy as well as provide education and consultation to various projects as a subject expert. While both of these roles are important and intersect with each other, it is from the latter that I am writing. We know as chaplains and other professionals that honoring and integrating spirituality into person-centered care is essential. It is clear to us through our professional experience and growing research findings that identifying, integrating, and accommodating persons' beliefs and values into their health care makes a difference in their experience, their treatment decisions, and their ability to cope. Chaplains' expertise makes a positive difference to patients, families, staff, and organizations. We also know that chaplain contributions have not always been recognized or supported. That can be true on the local level, when the organizations where we are employed do not provide funding for the level of chaplain coverage needed, salaries that are not in line with our professional expertise, or look to chaplaincy departments as the first place for layoffs when there is a need to reduce spending. I have heard and continue to hear conversation about that for many years. However, we all need to recognize that this is a much bigger issue, which is why this petition is so important. Everyone who is a chaplain, values the work of a chaplain, and/or supports the inclusion of spirituality as an element of personalized care needs to sign it. My experience is that in order to raise the awareness of the importance of chaplaincy and to integrate spirituality and professional chaplains into health care it is important to develop relationships and engage in conversation so that clients - patients, families, and staff - receive the best care possible. Change can be slow, but it can be accomplished. When you read the sign-on statement, you will see that the focus is advocating for a conversation at the national level. Its purpose is to do exactly what I know works from my own professional experience, and that is to build relationships. Have a conversation. Educate. At this time, there is no legislative agenda as part of the petition. Yes, there are things all of us who are chaplains would like to see: chaplains to be included in the taxonomy coding, funding of chaplaincy services by insurance providers, recognition, and funding by the Centers for Medicare and Medicaid Services (CMS). Now is not the time. Conversation and education is the first step. HealthCare Chaplaincy Network has shown a deep commitment to furthering the work of professional chaplaincy and care for the human spirit with the writing of this petition and their goal to educate the members of Congress in order to begin a national dialogue. Professional health care chaplaincy and its value to Americans is not a topic on the radar screen of most members of Congress or their staff. For the most part, they are not even aware that professional health care chaplains exist and are a cost effective resource to improve the delivery of health care. That is why it is important that this petition be signed, not by a few, but by everyone who believes in the importance of professional chaplaincy and spirituality as an essential component of health care. Reading the sign-on statement and adding your signature to the petition will not take much of your time; you can do it in just a few minutes. However, by signing it you will make a huge difference in its success. The more signatures on the petition, the better chance there will be for that important conversation to be held to educate members of Congress and their staff about the importance of professional chaplaincy. I ask you to do these few simple steps: 1. Go to the website, read the information, and add your name to the petition. 2. Give the link your co-workers, chaplains, and non-chaplains alike; in fact sit down and show it to them. Tell them why it is important. Ask them to add their signature. 3. Do the same with your family and friends. 4. Share the link on the social media networks you are part of: Facebook, LinkedIn, Twitter, etc. and include why you think it is important. 5. Contact your professional association and ask them to promote the petition with their membership. Ask that they sign the petition themselves. Tell them you want them to formally endorse it, as it will give them positive visibility on Capitol Hill when the conversations are held. As a national leader in chaplaincy I am deeply disappointed that, at this writing, none of the professional associations has done so. One last word as a past-and-current leader within professional chaplaincy and while it sounds blunt, it needs to be said. This is not about "turf." It is not about one chaplaincy membership association over another. Despite any differences that exist, they do not matter right now. Instead, this is the time for all chaplains to speak with one voice. I hope that you will be part of this opportunity to promote professional chaplaincy and care of the human spirit. Take the time now to go read and sign on to the petition. Sue Wintz is Director, Professional and Community Education, at HealthCare Chaplaincy Network and Managing Editor of PlainViews. She has over 30 years of experience as a chaplain, consultant, educator, and administrator and has spent nearly 20 of those years working at the national level in networking and advocating for professional chaplaincy. She is board certified by the Association of Professional Chaplains and is a past president of that organization. She can be reached at swintz@healthcarechaplaincy.org

Thursday, March 5, 2015

3 Key Foundational Elements Required in a Hospice Chaplain

As I was gathering my thoughts for this article I came across a piece about the Empire State Building. Here are some very interesting facts about this building. The Empire State Building was built during 1930-31 in a record one year and 45 days. It rises 1,453 feet, with 103 floors of steel, limestone, granite, and brick weighing over 365,000 tons. There are a total of 1,860 steps from the street floor to the 103nd floor. The building does not sway. It gives, but only to the extent of 1.48 inches in a 110 mile per hour wind. So, what holds up this massive building? There is a fifty five foot deep foundation of steel and concrete embedded in solid ground. It is said that without this foundation the building would not possess its strength. The parallel to the foundation we build for our own lives is obvious. There are 3 foundational elements that a hospice Chaplain must possess to give strength for a career. For those who know me, they will tell you that I believe there is that “Aha!” moment in a Chaplain’s life when he or she either thinks or says, “I was born to do this.” Without that inner conviction, a Chaplain will drift. That is a good introduction to the foundation that must be present in a hospice Chaplain’s life. The foundational elements which provide career-strength and stamina are focused on the emotional, moral, and theological. Emotionally the Chaplain must be self-aware. I recall interviewing a prospective Chaplain and when discussing a family member who had died, she dissolved into tears. There is no question that all of us have lost at least one close family member. However, to succeed in hospice chaplaincy a Chaplain must be clear of unresolved grief. What is a great field for ministry will turn into a nightmare if there is unresolved grief. During a Chaplain’s career, he or she may lose a loved one to death. That will require the Chaplain to seek grief counsel preferably from EAP (Employee Assistance Program). This work is too emotional to have unresolved grief issues or loss issues causing distractions. Morally the Chaplain must be as clean as a freshly washed sheet. The Human Resources Department of a hospice will do a background check, but that doesn’t always reveal what might be lurking behind the scenes in a Chaplain’s life. When there is a breach of moral deportment, the entire hospice will suffer. The news media, in this day and time, flashes news in an instant over the internet and other social media. It is required of a Chaplain that he or she is absolutely squeaking clean. The Chaplain will be in a patient’s home, at times by him or herself. The patient’s family will never have reason to worry or be concerned with the Chaplain visiting the patient without other family members present. Sexual abuse of a patient or caregiver must never occur. Telling off color jokes to staff members is an indication that all is not well in the private life of a Chaplain. Again, it is expected that the Chaplain is a paragon of moral virtue. Theologically the Chaplain must be secure in his or her faith. The issues of suffering, fairness of having such a terrible disease, grief, and the like all have a connection the Chaplain’s theology. It is required of the Chaplain that he or she has a theology of pastoral care, a theology of suffering, a theology of bereavement support, a theology of compassion and mercy, a theology of grace, a theology of death at the bare minimum. To have less makes the Chaplain hamstrung to do the job that is difficult on its best days. The age of the Empire State Building is somewhere around 84 years. Its foundation has held strong through the years and many a storm. Its foundation is firm to say the least. What about your foundation? Is it just as firm? Blessings to my Chaplain Colleagues in this most sacred of spiritual enterprises.

Wednesday, March 4, 2015

One of the quickest ways to lose respect among your colleagues…

There are a few things a hospice chaplain must hold near and dear to his heart: respect, pastoral care skills, and relational skills. Respect given and received will keep the chaplain in good stead with the IDT. Lose it and you find yourself in a hole you dug for yourself. The one sure way to lose respect of your co-workers is to be the source of rumors. Rumor-mongering in the workplace is never good. It creates a toxic environment. For the Chaplain of all people to be the source of rumors is totally incongruous to what a Chaplain is to stand for. As I researched the concept of rumor mongering in the workplace, I came upon Bull’sEyeCareers.com. This site’s mission statement caught my eye: “Career advice for those who seek to enhance their lives through meaningful work, professional development and education.” And, then, came the article titled, “A Bad Workplace Habit to Nip in the Bud this Year.” Here is a small portion of the article you will find instructive: “when the rumors get personal and fellow employees begin to discuss other employees or bosses negatively, it is really time to step away. There are toxic people in organizations who would love nothing more than to drag you into their own web as a partner in crime. You know these people. They are always happy to say what they heard or saw and they are not afraid to drop names about who else knows and what someone else said. They are always happy to be the one who lets you in on the “secret” everyone else knows but you. Make no mistake about it, your name will be the first on his/her lips as they share the story with the next willing listener. They may even embellish what you said or didn’t say. “Here are my five "Be's" for the new year as it relates to workplace rumor mongering: 1. Be careful...about your sources and what you repeat. 2. Be elusive...and avoid being alone with people who always want to snare others into their, "Did you hear about..." trap. 3. Be selective...about what you believe. 4. Be honest...and let people know that you would really prefer to just not talk about other people. 5. Be adept...at changing the conversation.” I urge my Chaplain Colleagues to guard your reputation as your most valuable possession. We are reminded in Proverbs 22:1: “A good reputation and respect are worth much more than silver and gold.” (Darby) What 3 things can you do to enhance your reputation? What 1 behavior will you not do to prevent your reputation from being soiled?

Tuesday, March 3, 2015

The Purim Project

Since Cornerstone Hospice & Palliative Care, Inc. is an accredited hospice with The National Institute for Jewish Hospice, we receive a Jewish Holiday Information Sheet which informs us of each of the holidays and holy days our Jewish patients celebrate. This month, the holiday is Purim. Quoting the Information Sheet, we discover “Purim, a frolicking holiday, also known as the Feast of Lots, commemorates the salvation of the Jewish people from an attempted genocide in the times of the Persian Empire.” Further, there is a lesson remember by the Jews “that G-d, even behind-the-scenes and without miracles, will always save the Jewish people.” The NIJH informs us that there are several ways Jews celebrate this holiday. One focal point is the Mishloach Manot, a food package. This package may be elaborate or simple. We chose to provide a simple but handmade Mishloach Manot. We involved our Volunteers, Spiritual Care Volunteers, and Chaplains to assist in the delivery of these ‘butterflies of joy.’ As you can see, the concept is simple… A baggie is filled with grapes and goldfish crackers and the butterfly shape is made with a clothes pin with eyes and antennae. Our goal is to let our Jewish patients know we are paying attention and are aware of the holidays that give their lives so much meaning.

Monday, March 2, 2015

A panoply of encouragement to do your best.

What is it that keeps you motivated? What keeps your engine running at an optimum rpm? What keeps you going even when all around you is not going well at all? In this post I will open my life to you and let you see what keeps me motivated, positive, and hopeful. First, I want you to know that I cultivate spirituality deep in my heart and soul. The Bible provides inspiration. Prayer provides a place of confession, forgiveness, direction, assurance, confidence, and peace. Together Bible reading and prayer form a solid foundation for my inner life. Proverbs 22:29 (NIV) reads, “Do you see a man skilled in his work? He will stand before kings; he will not stand before obscure men.” There are so many skilled hospice Chaplains that I have learned from and who continue to do their work with excellence. They invested time and information in my life. The least I can do is put that information to use and go several steps farther and gain insight of my own. Giving my best effort, doing a good job, exhibiting confidence and demonstrating my own strengths and abilities are all facets of the beautiful diamond I call, “Excellence in Spiritual Care”. An unknown thinker wrote, “One of the greatest sources of energy is pride in what you are doing.” Every hospice Chaplain should be a student of the profession. Getting into a rut of doing the same thing with each patient is a dangerous place to be. After all, a rut is defined as a grave with both ends kicked out. Make time to read about hospice chaplaincy. Buy yourself a subscription to professional journal such as Plainviews. You will be informed and challenged by what you read. You will grow. And, it must be remembered that soon you and your staff colleagues must do the work of top 10% hospice Chaplains or your hospice might not receive its full re-imbursement. While it is not all on the Chaplains to excel, certainly, the Chaplains should lead the way to excellence. Let me tell you what your manager is looking for when your annual review comes do. The manager is looking at the big picture of your chaplaincy. The big picture is comprised of many small actions. Together they make up the whole. Such things as attitude, commitment to the hospice philosophy, productivity, documentation excellence, and healthy relationships with staff are some of the matters a manager looks to in completing a yearly evaluation. I am not looking for our Chaplains to be perfect. I am looking for them to be consistently excellent. Our bar is high at Cornerstone. So far, our Chaplains are reaching it a good bit of the time. They are aware of two things: first that I must be a top 10% manager and, second, they must be top 10% Chaplains. While these are daunting goals, they are not out of reach. In fact, as Robert Frost put it, “Two roads diverged in a wood and I - I took the one less traveled by, and that has made all the difference.” I may be wrong, but don’t think so, when I say that I believe that many more people are looking to travel an easier road. Therefore, I choose the road less traveled. Yes, it will be harder and more challenging, but the rewards are far greater. Yesterday, my pastor said to me, “I don’t know how you do it. You work with people with so little hope.” At first glance, that statement has a ring of truth to it. But, when you think of it, our patients have every reason to hope… to hope for reconciliation with a loved one and, perhaps, to God; to tie up the loose ends of their lives in the time that remains; to find forgiveness; to extend forgiveness; to realize that life was, indeed, worth living; to celebrate a life well lived; to bless those who need to know that they were and are loved and appreciated; to affirm the depth of love for a spouse; to review life with a spouse and/or children (adult or younger). Hope lives in hospice. So, Blessed Chaplain Colleagues, I urge you to give your all in service to your patients and their loved ones. Be motivated, be positive, be strong, and be faithful.