Thursday, May 28, 2015
What does Ephesians 4:11-12 have to do with Hospice Chaplaincy? More than you think. The passage reads (NKJV): “11 And He Himself gave some to be apostles, some prophets, some evangelists, and some pastors and teachers, 12 for the equipping of the saints for the work of ministry, for the edifying of the body of Christ.” Most Chaplains will tell you that it is somewhat rare that a parish minister will visit a hospice patient, particularly if the patient is elderly and is a member of the church. We seem to have gone through a very odd experience in the Church when it comes to ministry to the sick these days. I have heard ministers say, “Why should visit this person on their death bed? They haven’t been to church in years? And, they want to see me now?” Others suggest that Ephesians 4: 11-12 excuses them from making sick visits as that is the work for the laity. Seriously? Let’s look at the passage for a moment. The Pastor/Teacher is, indeed, to equip his people to do the work of ministry. There is no argument there. However, in observing the ministries of those who hold to this view over a period of years, I have found no training courses offered to equip the saints for the work of ministry. It becomes a matter of credibility. If a minister holds to this belief that he is the equipper, then where is the equipping occurring? And, all of us know that the work of ministry is more caught than taught. Yes, every lay-volunteer needs to read about the methods of ministry but more so they need a mentor to show them how to do the work of ministry. This is where the professional clergy enter the picture. Mentoring is fundamental in showing a deacon and any other lay person how to visit a hospice patient…what to do, what to say, what not to say, how to pray, what to pray…things that are fundamental. Here is what I know… I served as a Senior Pastor for 25 years and now, after nearly 10 years in hospice chaplaincy and a like number of years attending churches, preaching in churches, and teaching in churches as a member not a professional clergyperson, I hear what pastors should hear. “He doesn’t care about us old people.” “He has his few he cares about.” “I only hear from him when the church needs money.” “When my wife was in the hospice dying, he never came… and neither did anyone else from the church.” Ouch! These are painful indictments. Is it really beneath the Pastor to make a death visit and impart the mercy and peace of God to a newly widowed spouse? Is it really beneath the Pastor to embrace the sorrowing children who just lost their Mother to cancer? Please, Pastors, do not take cover in Ephesians 4:11-12. Your credibility is compromised and as a result you platform for ministry is severely compromised with that family. You know and I know your congregants talk. They will share what did not happen. You’ll look bad. Why not take a promising volunteer with you and equip that person to show the heart of Christ to the newly bereaved? On the job training is how most of us learned to do ministry. My heart sinks when I hear statements from church members of all denominations say those things about their pastors. A great way to stop that kind of thing is for pastors to mentor their members so they can do the work of the ministry.
Monday, May 18, 2015
I think we just scratched the surface of the issue in our first article on this topic. Let’s get down to the two serious ways a service failure can bring negative attention to your hospice. 1. People talk. When your hospice has a service failure, the people affected by it talk to their friends and particularly to friends with a loved who might benefit from your hospice. I have seen this happen several times. This is one reason why it is imperative that a hospice keeps its word, whatever the issue and is prompt to follow up what it said it would do. 2. Social media is the friend of the complainant. It is astounding how Twitter, Facebook, and the many other social media outlets can spread negative comments like wildfire. The sad part is that if your hospice has done a good job of service recovery, the multitudes who received the Twitter or Facebook message will never know. Your hospice’s reputation is wounded. As there are ripples that seem to spread out forever when you throw a rock in a lake, it takes what seems like an eternity to live down a service failure. Every hospice needs a Service Recovery Team that is skilled in working with disappointed, hurt, or highly upset/angry caregivers to resolve the issues. This effort is often rewarded with understanding and reconciliation. Having been part of that type of Team, I know. In conclusion, how do service failures apply to Chaplains? We can be the reason for the service failure through carelessness in dealing with a patient’s deeply held beliefs, with giving unwise counsel, by failing to visit the patient when promises have been made, by outright disrespect, and a long list of other damaging actions. I urge you to be vigilant at all times. Never assume a relationship. Always look to be a source of comfort, counsel, and companionship. Bless you, Chaplain Colleagues, for the good you do.
Friday, May 15, 2015
It doesn't happen often, but when it does it's not good. Service failures can come from any discipline: physician, nurse, social worker, Chaplain, volunteer specialist, bereavement counselor,CNA,team manager, et al. When a service failure occurs, you can bet the world that there will future losses of referrals as a result. People talk and when there is a hospice service failure they really talk. Let's face it, hospice is a fairly new industry and one that has its detractors. There are myths about hospice care and when a service failure occurs the mythology takes on a sense of reality. Let's look at how the hospice professional can prevent service failures. I recognize that in some cases no matter how perfect the hospice performed there are some persons that will find something wrong. I get that. In this article I am not addressing those folks. The effective working of hospice is especially dependent upon thorough training. Training not just in one's particular area of work, but also, in people skills. It is not too far a statement to suggest that most all hospice professionals are skilled. It is incorrect to state that each professional has mastered people skills. As I review the training opportunities presented in the hospice industry, the focus is mainly on medical or specialty disciplines. Rarely, is the topic of people skills addressed. However, excellent people skills are fundamental when dealing with a patient who has just received the terminal diagnosis or who has just been told that there is nothing more a physician can do. Beyond that, there are challenging family dynamics the hospice professional must navigate. It's one thing to know how to painlessly insert a foley catheter or how to bathe a patient with dementia or how to use the documentation template for spiritual care clinical notes, but it's a totally different matter to know how to build trust and maintain a healthy relationship with the patient and caregivers. I advocate for more practical training dealing with people skills. Here are several EASY principles to keep the patient/caregiver relationships healthy and happy. 1. Follow through. Do what you said you were going to do and follow up to see that it was done. For instance, recently I served a patient in a hospice house who requested a faith leader to provide rituals for him. I made the appropriate referral to the faith leader who stated he would visit later in the day or the next morning. Experience has suggested that with that large window of time, it is best to follow up. I did follow up the next morning by asking the family if the rituals were performed. They affirmed the faith leader came and the patient was extremely happy and blessed. This good experience plus the excellent care provided this patient will make for a very good relationship, and, might I add, a very good Family Satisfaction Survey. 2. Leave your pain at the door. Hospice professionals are people. People have problems as part of the human experience. Therefore, on certain days hospice professionals are less than 100% because of issues they are facing. It takes maturity, discipline, and determination but it is absolutely necessary that the hospice professional leave his/her pain in the car or at the door before encountering a patient. It is fundamentally inappropriate to discuss personal problems with a patient or caregiver. They are facing enough without being a sounding board or counselor to the very ones supposed to be providing care. Stay in the moment. Focus on the task at hand. Give the patient and caregivers all you have in spite of all you are facing. 3. Watch your language. Remember, the people you are serving are on edge. They are going to be more sensitive and aware of what professionals are saying to them. Never, ever, say, "I am here to see the man/woman who is not long for this world", or "I know how you feel", or "You're like every patient who wants to go the unit". There are so many really insensitive or hurtful statements that it is imperative that hospice professionals guard their language. This is enough to get you thinking. Think of ways you can improve your people skills. Talk to your Manager about training you think would be helpful to the IDT. Bless you, Chaplains, you carry a great deal of expectations. Do your best. I have confidence in you.
Tuesday, May 12, 2015
Mastering the Mundane Hospice Chaplaincy is one of the greatest adventures a Chaplain will ever take. However, with that said, it is not always lively, challenging, or adventurous. It’s work. With every field of endeavor there is the mundane. The mundane are the things that need to be done because they need to be done. What I want to talk to you about today is Mastering the Mundane. I have observed in the religious world of which we are a part, there seems to be a new method to achieve personal success, or a new App for your smartphone that will help you keep track of any number of spiritual matters, or a new commentary that is better than the rest, or a new comprehensive system that takes our to-do lists to a new level. It’s the shiny new things that get us distracted from the main task. In listening to successful Chaplains, business persons, and athletes, I have come to the conclusion that it is not the new and shiny that brings success, it is mastery of the mundane. Here are some mundane matters that if executed at the highest level will dramatically change not only your outlook, but your success in life: • Are you focusing at work? • Is your devotional life connecting you in a deeper way to God? • Do you waste time on the internet? • Do you work on what’s most important? • Are you growing in your chaplaincy? • Are you tracking your time to ensure you are balancing your life? • Are you responding to your emails efficiently? • Do you need to fall more in love with hospice chaplaincy? • Are you managing your physical self well? • Do you pause to pray throughout the day? • What are your routines? How would you evaluate your morning routine? Your evening routine? Certainly, you don’t need to tackle that list all at once, but a bite at a time. Mastering the fundamentals of life is the goal. We will have so much more to offer our patients as we become healthier in each aspect of life.
Monday, May 11, 2015
The influence a Chaplain can have to make the IDT a stronger functioning team really is significant. There is one caveat to that fact, though. The Chaplain needs to know key facts about group dynamics. Bruce Tuckman is a recognized expert in this field. He came up with a simple process of team formation in his groundbreaking article in 1965 entitled, Developmental Sequence in Small Groups. He suggests this sequence follows the pattern of forming, storming, norming, and performing. In the Forming Stage, team members tend to be more polite and positive as they really don’t know much about the team and want to impress with their good attitude. The Chaplain, in the inspirational message and prayer, can bring the new members into the fold with a welcoming manner that will help them find their way. It isn’t easy breaking into a new team and any encouragement is appreciated. The Storming Stage is a bit different. After about 3-6 months the ‘newbies’ aren’t so new anymore and can push against the established patterns of the team or they can call into question the policies of the hospice or make known their observations of how they did it when they were at such and such a hospice. Those are just a few examples of which there are many. It creates tension within the group and sometimes open conflict. Hospice is a pressure packed environment and not all can survive the pressure and will ultimately leave for other industries. That’s a reality. However, the storming stage makes life very uncomfortable. This is where many teams crash and burn. The Chaplain has a pivotal role in this stage. The Chaplain must maintain his/her head when everyone else’s is flying off or exploding. The Chaplain’s leadership skills in this phase must be sharp. Buying into the negativity is not an option. Putting oil on the troubled waters is the best option. This is where the Chaplain and Team Manager work together to get the team to the next stage. Norming is characterized by reconciliation of expectations, relationships, and each team member’s role. The Chaplain can facilitate this process through very positive and inspirational stories. Coming out of the storming stage can leave some pretty battered and discouraged. A positive outlook and positive message from the Chaplain will bring healing and a new day to the team. What the senior leadership is looking for is the Performing Stage. In today’s hospice environment, performance is key. We are being graded by our patient’s families. The learning curve is nearly straight up or the reimbursements are straight down. Highly functioning teams are what each hospice needs. Performance at a peak level is required. The Chaplain plays a vital role through modeling peak performance, not only in his/her own discipline, but in intelligent and insightful participation in the IDT. The other disciplines are observant of the Chaplain’s words and ways. The Chaplain must make it count. I wish I could say that when the Performing Stage is achieved all will go well. Not so. There will always be turnover on a team. So, the team repeats the stages to some degree or another. Since people make up the team and since people have problems, there may come the day when there are people problems. And, there you go. Hopefully, the Chaplain will remain steady and be a bellwether through it all. Bless you Chaplain Colleagues. Yours is a sacred and demanding work.