Tuesday, August 18, 2015

Best Practice for Chaplains Serving in LTC Facilities (excerpt from the Handbook)

Basic Practice in Chaplaincy 1. Make contact with each new patient on your Team. You have a 5-day window to contact each new patient. Document each phone call in Allscripts. 2. Complete the Initial Spiritual Care Assessment. Document this in Allscripts. 3. Documentation of Initial and Routine visits will be completed the day of your visit. If the visit is late in the day, you have 24 hours to complete the documentation. 4. Synchronize in the morning and evening of each work day. 5. The following provides a primer on functioning with best practices in the facilities. Please keep in mind that each facility has its own nuances. Your professional presence will assist you to comply with the nuances of the facility. Checking In 1. Upon your arrival at the facility, check in at the front desk. Explain who you are, who you represent. Have your badge prominently placed on your blouse or shirt. 2. Ask for the room number of the patient(s). 3. Thank the person who assisted you. Entering the Patient’s Room 1. Remember that the patient’s room and bed are their personal space while they are in the facility. a. Knock before entering the room or, even, on the wall near the bed before crossing the line of a curtain that defines that patient’s particular area. b. If the curtain is completely drawn around the bed, speak outside the curtain and be sure you have the patient’s/family’s permission before stepping inside the curtained-off area. c. Announce yourself by name, with Cornerstone Hospice, and role and ask if it is OK to come in. For example, “Hello, my name is Rich; I am your Chaplain with Cornerstone Hospice. May I come in for a moment?” d. Respect for the humanity, privacy, and situation of each patient and the patient’s family are essential to what we do. Positioning Yourself in the Patient’s Room 1. Position yourself in a sensitive manner. a. Examples, depending upon patient and situation:  If the patient is at all physically exposed because of gown, equipment, etc., seek a facility staff member to cover patient. Do NOT do this yourself.  Perhaps the patient is hard of hearing; position yourself and speak clearly to maximize the patient’s ability to hear you and/or read your lips.  Perhaps the patient has a sight deficiency; position yourself accordingly and use your voice and/or touch to ensure the patient knows you are there and that you have identified yourself, as the patient may not otherwise be able to recognize you from a previous visit.  Sit in a chair, if possible, so that you are eye-level with the patient; however, do not immediately sit, because that might signal to the patient that you intend to stay for a while – make sure you have determined with the patient/family that an extended visit at that time is appropriate and welcomed. (Do not sit on the bed.) If the Patient Indicates He/She Does Not Wish a Visit 1. Do not stay if the patient does not desire a visit. We do take “no” for an answer! 2. Leave a Spiritual Care Services brochure with them for further information and later contact. Touch 1. Be cautious with physical touching. a. It is often natural for us to want to touch a patient: To hold hands or place a hand on the head, for example, while praying; b. To lay a hand on an arm or shoulder as an expression of comfort or reassurance. 2. However, touch can be a “touchy subject”. a. The patient may be in physical pain that even a little pressure might exacerbate. b. The patient’s personal history and/or personal temperament may make touch unwelcome or threatening. c. The patient may misunderstand the intent of the touch, especially if their condition in any way decreases their understanding and perception. d. Whenever possible, if you wish to touch a patient, ask the patient’s permission first. What We Do and Don’t Do 1. Remember, we emphasize listening. Our first concern, always, is simply TO BE WITH patients/families. o To listen. o To let them lead any conversation where they want/need it to go. o To be a quiet presence, if that is what is needed and possible. 2. We seldom or never:  Give advice.  Try to convince anyone of anything.  Proselytize (try to win converts to our religious beliefs and communities) – this one is a NEVER. Communicate with the patient’s faith community to provide a pastor, priest, Imam, Rabbi, or other religious leader to assist with your work with the patient. 3. We may pray with patients/families. a. We will pray:  If they request it.  If they agree to our suggestion/offer to pray.  After clarifying if they want us to pray with them, then and there, or for them, in our own time, perhaps back in the sanctuary.  After clarifying what prayer means to them and what style of prayer is appropriate for them. (We do not assume prayer using a particular religious form or language, unless it is clear from the patient/family that is what they want and expect and if we ourselves are comfortable with that kind of prayer.)

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