Wednesday, December 23, 2015

Looking forward to a great 2016

There are two particular topics I am working on now and hope to bring to you in the first few months of 2016: body language and the clinical use of prayer.  Body language has at least two aspects: that of the person we are speaking to and our own body language.  There is much to learn about this that will make us more perceptive and effective in our work.  Prayer as a clinical intervention must be explored for its clinical effectiveness.  I invite you to study this along with me.

Have a blessed New Year and growth in your work.

I will be back at the blog the first week of January.

Merry Christmas!

To all of you who have taken the time to read this blog, Thank you.  A Merry Christmas to all.  You are a wonderful gift of compassion and service to your patients.

To Our Staff Working on Christmas




First of all, “Thank you.”  Hospice care is a 24/7/365 operation.  Illness does not call a truce for the holidays.  It marches on.  Your commitment to patient care is one of most noble commitments known.  You have my admiration and deep respect.  To my Chaplain Colleagues, you who will be on call during the day will seek to bring comfort and peace to troubled families.  As I was driving to work this morning, I noticed 5 police vehicles at a residence.  What could be happening?  I doubt the people were having a breakfast for this group of officers.  You may be called to a death or another type of spiritual emergency.  I know you will provide what that family needs.  I have great confidence in you.  To all of my Colleagues who are working on Christmas, peace and best blessings. 

Tuesday, December 22, 2015

A Hospice Take on a Familiar Christmas Story


'Twas the night before Christmas and all through the house no one was stirring but the hospice Chaplain in Grandpa’s room. The family was bowed low by the chimney in prayer, in hopes that God’s intervention would soon be there. The grandchildren were nestled all snug in their beds, with visions of life without Grandpop coursing through their troubled heads. And Mamma with her ‘kerchief, and I in my cap, wished we could settle our brains for a nap. When from the bedroom there arose such a clatter, we sprang from our knees to see what was the matter. The Chaplain sat holding Grandpop’s hand as he said, “Yes, Lord, I am coming home.” I knew in a minute he must be leaving and headed to Heaven. We wept, we hugged, we thanked the Chaplain for her care. Death comes to all, hospice is there.  On Nurse, on Physician, on Social worker, on Home Health Aide, on Chaplain, on IDT, “We care. We love. We serve.”


Thank you, Chaplains, for all you do. Your work is so essential. Have a blessed Christmas celebration. To my Jewish Chaplain friends, May the spirit of Chanukah continue bless

CPE? What's the Big Deal?

From time to time, a Chaplain will have a case that is complex. Complexities come in many forms:  family dynamics, patient internal dynamics, religious issues, conflict, and psycho-social complexities.  Preparation for and experience with theses type of issues are required of the Chaplain. These are key reasons why I am adamant that a hospice Chaplain have a minimum of 3 and hopefully 4 units of Clinical Pastoral Education. CPE prepares a Chaplain for the rigors of hospice chaplaincy. For many hospices one unit of CPE will suffice. In my opinion, that does an injustice to the patients and families. What, then, is CPE? CPE is a hands-on experience that incorporates such matters as pastoral formation and pastoral reflection in order that the Chaplain develops a methodology of ministry that will provide spiritual care to persons of all faiths or no faith. The issue of religious countertransference is often an issue that requires hard work for the Chaplain. CPE is a process. For this reason, there are four units of CPE required as a minimum for a Chaplain to seek Board Certification. Each unit is comprised of 400 hours of supervised study and clinical practice under the guidance of the CPE Supervisor. The end result of CPE is an equipped Chaplain who knows him/herself and has the means to identify those issues of his or her that could jeopardize the pastoral encounters with patients and families. Further, the CPE trained Chaplain possesses the ability to read what Anton Boisen, the founder of CPE, called the "living human document." One of the key reasons I endeavored to attain Board Certification, even though hospices do not require Board Certification or even more than 3 units of CPE, was to develop the skills necessary to benefit the patients and families I would serve. My Board Certification was earned through the Association of Professional Chaplains and the College of Pastoral Supervision and Psychotherapy. At this point, I find it valuable to state in a more detailed fashion what pastoral formation and pastoral reflection include. Pastoral Formation enables the Trainee to articulate an understanding of the pastoral role that is congruent with their pastoral values, basic assumptions, and personhood (312.1); demonstrate competent use of self in ministry and administrative function which includes: emotional availability, cultural humility, appropriate self-disclosure, positive use of power and authority, a non-anxious and non-judgmental presence, and clear and responsible boundaries (312.6) Pastoral reflection enable the Trainee to establish collaboration and dialogue with peers, authorities and other professionals (312.7; demonstrate awareness of the Spiritual Care Collaborative Common Standards for Professional Chaplaincy (312.8); demonstrate self-supervision through realistic self-evaluation of pastoral functioning (312.9). Over the course of 1,600 hours of clinical work and classroom supervision, a Chaplain's theory and theology of pastoral care is very well developed. Therefore, based upon the preparation a Board Certified Chaplain has undergone he or she becomes able to work with the complex cases with other members of the care team as a fully participating partner all for the patient's good. In posts to come will be examples of my understanding of pastoral formation and pastoral reflection.

Wednesday, December 16, 2015

Children and Spiritual Pain at Christmas


Children and Spiritual Pain at Christmas

 

For me this topic hits home.  As I reflect on Christmas when I was a child, the memories are a mixture of pleasant and pain.  When I was 10, my Dad died.  That was the line of demarcation between pleasant and pain, what was and what is, then and now.

 

If any family could have totally messed up grief and mourning it was mine.  I know the adults in the family were well-intentioned, but what a mess it was.  My grief counsel was “brave boys don’t cry” and “you are now the man of the house”.  Being a compliant kid that I was I didn’t cry.  I had no idea how to be the man of the house so I put that one on the back burner.  The fact was that my family had no idea how to handle a sudden death which my father’s death was.  He came home from work with terrible chest pain and died a few days later at the hospital.  There were no warnings of any physical problems, it just happened.  A wise person once said, “The death shapes the grief.”  The shape of our grief was intense at first and then silence.  It just wasn’t discussed.  So, we three kids (my older sisters and me) were left to ourselves.  There’s more to the story, but that is not germane to my point in this article.

 

Should you be suffering the loss of a loved one and you have children, may I gently suggest a few actions to take that might bring a measure of healing to your children’s wounded hearts?

 

  • Kids need words.  I longed for my Mother to talk to me about how she was feeling and what she would say to me in my pain.  That never happened.  Kids need words.
  • Kids benefit from rituals.  Light a candle, say a prayer, donate to a hospital that focuses on the illness that your loved died of, go to church/synagogue.
  • Kids need routine.  What you’re going through is not part of your daily schedule, but as much as is possible, keep a routine.  Your child will benefit from that.  Believe me, there was no routine in our grief journey.
  • Kids do not grieve as adults.  It’s just different for them.  Talking about what happened may come sooner than later, but expect it to come later than sooner. Within a year of my Dad’s death, my Mother had to have gall bladder surgery.  I stayed with my Aunt and Uncle during that time.  I lay awake at night wondering if she would die, too.  Grieving is a tough journey for kids.
  • Kids benefit from hospice grief counsel for children.  If you do not know how to help your child with grief, please contact your local hospice.  They will have someone who specializes with children’s grief. 
  • One last thing, time will NOT heal this wound.  Your child needs tools to work her way through this process. 

 

I do hope your Christmas is merry.  But, it isn’t and it is because of the loss of a loved one, my heart goes out to you.  If I can help, I am happy to hear you and connect you with someone with a focus on children’s grief.  Blessings for comfort and peace.

Friday, December 11, 2015

How a reputation is lost…


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?


Stressed?

Stressed? 
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. 

A research-based article on fostering hope in caregivers


A research-based article on fostering hope in caregivers

Caregivers shoulder physical, financial, emotional, and spiritual issues that for most would be back-breaking.  How many of us in hospice chaplaincy haven’t witnessed the exhaustion of the caregiver of an AD/dementia patient? or of the Parkinson patient? or ALS patient?  That is not to exclude the stress and mental, emotional, and spiritual exhaustion caregivers of COPD, cardiac, or cancer patient’s experience.

It is in the purview of the Chaplain to foster hope in the caregiver.  How?  “Previous research conducted by Benzein and Berg [Benzein E, Berg A. The level of and relation between hope, hopelessness and fatigue in patients and family members in palliative care. Palliative Med. 2005;19(3):234–240.] noted that family members of patients in palliative care had significantly lower hope than the patients, indicating that the family members' suffering may be greater than the patients. One reason for the lower level of hope noted by Benzein and Berg was that the needs of family members of patients in palliative care were insufficiently met, especially in regard to information and communication from healthcare professionals. Caregivers in the study by Perreault et al [Perreault A, Fothergill-Bourbonnais F, Fiset V. The experience of family members caring for a dying loved one. Int J Palliat Nurs. 2004;10(3):133–143.] also identified the lack of support from healthcare professional as a factor that negatively affected their caregiving experience. Thus, it was postulated that encouragement and support offered by healthcare professionals can provide family caregivers with the strength, confidence, and comfort necessary to participate in the caregiving process, which can ultimately foster hope and lead to a positive experience for both the family caregivers and their loved one.[Benzein and Berg] Similar findings were noted by family caregivers in the current study, indicating that physical support, informational support, and reassurance offered by healthcare professionals and other supportive individuals were necessary to maintain hope during the caregiving experience.” [The Lived Experience of Hope in Family Caregivers Caring for a Terminally Ill Loved One, Sara S. Revier, RN, ACNS-BC, Sonja J. Meiers, PhD, RN, Kaye A. Herth, PhD, RN, FAAN,Journal of Hospice and Palliative Nursing. 2012;14(6):438-446.] (emphasis mine)

Each Chaplain will have to decide how this information informs their approach to spiritual care, but there are several huge targets at which to aim one’s care: informational support, encouragement, and reassurance.  While it seems that these three arenas of support require a good bit of talking, they also require a good bit of listening.  I can recall listening to the exhausted pleas for help of the daughter of one of the dementia patients as she was at the end of her patience and emotional strength after what seemed to be several sleepless nights.  She needed to be heard more than she needed to be talked to.  I did, however, give the nurse a call to explain some of the issues she was having with her mother and have her provide education on those matters.  The daughter just needed to talk it out.  For this woman, prayer inspired new hope even in her most exhausted moments.  It provided a sacred break in her world.

I am convinced that hospice Chaplains have the background in pastoral care to provide for the needs of caregivers.  Thank you for all you do in your work!

The International Readership of this Blog

I am not sure of the state of chaplaincy across the world, but we have a following that is world-wide. To Chaplains in Australia, Russia, The Ukraine, France, and other countries, please feel free to provide input on how your work is going and how this blog might encourage you.

Tuesday, December 8, 2015

The 3 Most Important Needs of a Chaplain in Crisis

When a Chaplain needs help… There are times when a Chaplain needs emotional assistance. The reasons vary from their own grief at the loss of a loved one to burnout. It is essential that the Spiritual Care Manager or whatever your title might be is aware of the resources to give the Chaplain the support he or she needs. Here are the three most important needs of a Chaplain who is in crisis: 1. Your undivided attention and support. In the highly complex world of hospice care the manager must express compassion and understanding. Yes, it is a corporate world and not a religious institution we are working with. Patients need to be seen, compliance is always breathing down our backs, and productivity screams for fulfillment. With all of that said, your Chaplain needs your support. If a PRN Chaplain is not available and it appears the Chaplain will be on PTO for a few days, see the patients yourself. It will be a refreshing change of pace. Your Chaplain will never forget your help. 2. Keep it confidential. The only people that need to know that the Chaplain is engaged in EAP (if that is the route the Chaplain has chosen) is the Benefits Specialist and yourself. The outcome of the EAP is none of our business. Protecting the Chaplain’s privacy is. 3. Stay in contact with the Chaplain when he or she returns to work. An email or phone call of support does a world of good. We all remember the adage an ounce of prevention is worth a pound of cure. That is true when it comes to self-care. Chaplains are the worst at following our own advice. Perhaps an in-service like what follows would help: Christy Matta, M.A., writes with clarity about stress reduction and stress management. Her insights on the 5 Signs of Emotional Exhaustion at Work caught my eye. The work of the hospice Chaplain is heavily emotional. A Chaplain that does not practice self-care is a sitting duck for emotional exhaustion. Chaplains MUST engage in self-care or fall prey to a potentially career ending crash. Matta’s article can be found here: http://www.mentalhelp.net/poc/view_doc.php?type=doc&id=48310&cn=117 Her assertions about emotional exhaustion arrest our attention: o Negative Feelings: Frustration and irritation at work are common when you're emotionally exhausted. Your frustration might be focused on parts of the job, coworkers behavior, or job politics and bureaucracy. o Feeling Pressured and Out of Time: When we're emotionally exhausted we don't have the resources to handle the pressures of the job. You might find yourself feeling pressure to succeed, without time to finish your work or do a good job or without time to plan for your day and proactively deal with work demands. o Negative Thoughts: Our thoughts are closely linked to our feelings. When we're feeling bad, we're also often thinking negative thoughts. Thinking "I'm alone," having overly judgmental thoughts towards your co-workers or the organization or thinking harsh thoughts about yourself are all common signs of emotional exhaustion. Thoughts that "I shouldn't have to deal with this" "this is unfair" or "my coworkers/supervisors/management are incompetent" are judgmental thoughts that might be a sign of emotional exhaustion. o Strained Relationships: Feelings of isolation and negative thoughts about coworkers, supervisors and administrators can leave you with strained relationships at work, adding to feeling isolated and unappreciated. o Counterproductive Work Behaviors: When you're emotionally exhausted, you may feel drained or depleted and find that you are more emotional at work. When you're emotionally exhausted, you may lose the ability or desire to resist temptation. As a result, you may end up acting in ways you otherwise wouldn't. Do you find yourself acting in ways that undermine your colleagues or the company for which you work? Examples might include anything from stealing, or fraudulent behavior to purposeful tardiness and avoiding safety measures. Steps to healthy self-care: 1. Recognize you are in the throes of emotional exhaustion. 2. Talk to someone you trust about it. 3. Make any adjustments you can. 4. Take a few days off. 5. Evaluate how you spend your off hours. 6. Do something that gets your mind off of work. 7. Feed your spirit. 8. Talk to someone you trust. (not a repetition, just an emphasis) 9. Get your body moving. 10. Learn to relax. Most Chaplains don’t know how to do this well at all. Blessings, Chaplain friends. My model for ministry is Jesus Christ. He said to his weary disciples in Mark 6:31, “Then, because so many people were coming and going that they did not even have a chance to eat, he said to them, “Come with me by yourselves to a quiet place and get some rest.” When your work is such that you meet yourself coming and going, it is time to rest and to eat. For the glory of God and the inner healing of man …blessings upon you.

Monday, December 7, 2015

Patients’ expectations of Chaplains: What you need to know.

“What do patients expect of Chaplains?” This question was posed to me at a volunteer training event. At first, I thought it was a simple question to answer and because I was the speaker fielding questions, I proposed a few simple answers: kindness, respect, listening skills, no preaching, and expertise in matters religious and spiritual. I felt those were too simple, so I did a little exploration. From the Family Satisfaction Surveys in the Deyta reports, I analyzed the Positive Comments to find out more information. The Negative Comments gave no insight. Keep in mind, the family members received the Family Satisfaction Survey within a month of the death of their loved one. Here is a list of descriptors family caregivers used to describe their experience with hospice. The List—You will notice that I pulled together quite a number of descriptors as they were very similar in meaning. 1. By far, the number of times the following words were used were the most frequent: loving, nurturing, kind, respectful, considerate, warm, understanding, great help, gentle, comforting, sensitive, thoughtful, humane, patient, companionship, soothing, sent by God. Without question these attributes of the hospice team were valued far more than any of our expertise or clinical skill. These people had the expectation that we conveyed to them that were important to us, that they mattered. 2. Coming in second place in numbers of times used were these words: great, marvelous, wonderful, awesome, best, super, terrific, outstanding, incredible, exceptional, excellent. All of us like to hear these words said of us, but think about it...these words are filled with affirmation and energy! We met all of their expectations and in the midst of their grief they were able to find the words to express their positive emotions. 3. A very distant third were words used to describe clinical skills: expertise, professional, knowledgeable, skilled, informative. My sense is that it was assumed that the physicians and nurses, social workers, chaplains, home health aides, volunteer specialists, and bereavement counselors were all well trained and could do their jobs. It wasn’t the skills that mattered most it was how they went about using their skills that did. So, how do these positive words inform your hospice chaplaincy? Will you do something differently than you have been as a result? If so, what? What did you gain from this?

What our patients face …

I read a sign that went something like this: “Remember, dealing with death is an everyday thing for us, but for our patients it is their first time.” Do we know what the patient has been through? What is a ‘day-in-the-life-of’ our patient? What have been this patient’s experiences in the healthcare system? What do we really know about this patient? How do the previous questions inform your chaplaincy? I ask because in too many conversations with chaplains I get a queasy feeling that a one size fits all approach to spiritual is being used. That simply won’t cut if for excellence in spiritual care. Please listen carefully to the results of a compelling study conducted by Julia Overturf Johnson, BSN, MA, Daniel P. Sulmasy, OFM, MD, PhD, and Marie T. Nolan, PhD, RN titled, “Patients’ Experiences of Being a Burden on Family in Terminal Illness”, found in The Journal of Hospice and Palliative Nursing. September 2007; 9(5): 264–269. “An under-recognized aspect of care burden at the end of life is how dying persons experience and manage the fear of being a burden on their families. This burden can have emotional, physical, social, and financial aspects. Patients with terminal illnesses face grief and fear not only for their own future but also for their families’ future. These concerns over how their illness will affect their loved ones may influence how they seek care, what decisions they make about their care, and even how they experience dying. The purpose of this study was to further explore the concept of fear of being a burden on family from the perspective of the person in the terminal stage of illness.” My experiences as a field Chaplain attest to the validity of this finding. I recall a nursing home patient with a short while to live shared with me that she would be glad when her life ended so that she would no longer be a burden to her daughter. We explored those feelings a bit. My sense was her statement was not couched in terms of self-pity or depressed mood, but out of a sense of reality. Her daughter’s life was negatively impacted by her illness and the sooner her life could end the better. She was ready to die she said. In another case, the emotions of a husband erupted when he learned that his wife could no longer care for him at home and the option his wife had was to place him in a facility. His worst fears were realized. He was so great a burden that he was “put away.” How do these two episodes in real life inform a Chaplain’s spiritual caregiving? To the patient? To the caregiver? Herein lies another attribute that sets the hospice chaplaincy apart. The hospice chaplain develops a trusting relationship with the patient and family so these fears can find a place in conversation. And, in finding that place they are not diminished, marginalized, or ignored (perhaps a better word would be ‘missed’) by the attentively listening Chaplain. The Chaplain hears the pain, the wounded-ness, the grief the patient is expressing and applies soothing spiritual counsel to the wound. It takes skilled listening, mature understanding, and wise words to assist these persons through their journey of feeling like a burden.

An Emotionally Intelligent Chaplain

Emotional Intelligence is a newer term that has absolutely grabbed hold of the human resources world and business world. And, it makes sense as EI or EQ whichever you prefer has a good bit to do with how an employee perceives him/herself as well as others. It is built upon the concept of self-awareness. You, as a Chaplain, ought to be very familiar with the concept of self-awareness since having up to 1,200 or 1,600 hours of supervised clinical training through Clinical Pastoral Education. A lot of CPE is based on self-awareness. Self-discipline and discernment are also key elements of EI. A fun EI test to discover your level of emotional intelligence is found at this site: http://www.queendom.com/tests/access_page/index.htm?idRegTest=3037. I completed it and found that while I had a high level of EI, there was much I could do to grow. This ‘test’ would make a good discussion starter in Chaplain meetings. There are three benefits a Chaplain will gain from improving EI: 1. Emotional Intelligence helps us to “read a room”. How many times have you been in a patient’s hospital, facility, or other room with family and friends in it and the dynamics were both subtle and obvious. What were you learning about those persons surrounding the patient? What did you think was happening with the dynamics? Did this information assist you in relating in a more effective manner with the family? The hospice Chaplain must be keen in this skill. 2. Emotional Intelligence helps the Chaplain to be aware of his or her own emotions and not let them ruin a visit. There will be those times when it would be very easy for the Chaplain to get caught up in an emotional situation and lose effectiveness. As I interviewed a candidate for a position, I noticed that in discussing the loss of his father, he broke down and wept. It was clear his mourning was not complete. This really could get in the way of his work with family members who were in the process of losing their father to death. A Chaplain must be aware of his emotions or risk losing his ability to serve. Now, I am not saying that a Chaplain cannot weep with those who weep. I am saying that transference and projection are not acceptable for the Chaplain. 3. Emotional Intelligence helps the Chaplain understand the emotions of the patient and family/caregiver(s). People need to feel understood. People, at times, exhibit strange emotions. People at end-of-life are allowed to exhibit challenging emotions. If the Chaplain cannot understand the patient or the family caregiver, then an opportunity to assist these folks is lost and their inner peace is at risk. The hospice Chaplain has a lot riding on her connection with the patient or family member. When the Chaplain connects and conveys understanding and shows it with appropriate body language, the patient feels able to unburden a potentially deeply burdened soul. As you can tell, we have barely scratched the surface of this topic. I encourage you to do your own study and exploration of this topic. It is broader and deeper than I imagined. And, Chaplain Friend, bless you as you live out your ministry.

Wanted: Hospice Chaplain

Wanted: Hospice Chaplain Recently, we have interviewed for a number of full time 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 ‘elevator’ speech detailing who you are. It should take 3 minutes.  Convey an aptitude for hospice chaplaincy and a calling to it.  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 rbehers@cshospice.org.

Friday, December 4, 2015

Grief

I recently had the pleasure of hearing David Kessler speak on the topic of grief. David Kessler is one of the world’s foremost experts on healing and loss. His experience with thousands of people on the edge of life and death has taught him the secrets to living a happy and fulfilled life. He is the author of five bestselling books, including the newly released You Can Heal Your Heart: Finding Peace After Breakup, Divorce or Death with Louise Hay. He co-authored two bestsellers with the legendary Elisabeth K├╝bler-Ross: On Grief and Grieving and Life Lessons. Please be sure to visit Grief.com. That site has a great number of resources hospice Chaplains can use. With that said, there are some general guidelines we as hospice Chaplain need to follow and even encourage our IDT members to follow as well. On David’s site he has two lists: The Best Things to Say to Someone in Grief, and The Worst Things to Say to Someone in Grief. The Best Things to Say to Someone in Grief 1. I am so sorry for your loss. 2. I wish I had the right words, just know I care. 3. I don’t know how you feel, but I am here to help in any way I can. 4. You and your loved one will be in my thoughts and prayers. 5. My favorite memory of your loved one is… 6. I am always just a phone call away 7. Give a hug instead of saying something 8. We all need help at times like this, I am here for you 9. I am usually up early or late, if you need anything 10. Saying nothing, just be with the person The Worst Things to Say to Someone in Grief 1. At least she lived a long life, many people die young 2. He is in a better place 3. She brought this on herself 4. There is a reason for everything 5. Aren’t you over him yet, he has been dead for awhile now 6. You can have another child still 7. She was such a good person God wanted her to be with him 8. I know how you feel 9. She did what she came here to do and it was her time to go 10. Be strong Let’s do our best to connect our pure and good intentions with pastoral care skill in providing care to those grieving and experiencing anticipatory grief. Bless you, Chaplains, for your compassionate work.

Thursday, December 3, 2015

Open Letter to CPE Supervisors and Diplomates

It is rare that I have ever written an article like this, but it’s time. What is on my mind has everything to do with the hire-ability and sustainability of your students and trainees. One of the key concepts of Clinical Pastoral Education is self-awareness. Dr. D. James Stapleford was my CPE Supervisor and he did a thorough job on this topic. He introduced the concept in Unit 1, emphasized it more in Unit 2, made a spectacle of it in Unit 3, and completed the process in Unit 4. What I am saying is simple; self-awareness is the coin of Hospice Chaplaincy. If a Chaplain is not applying his education in self-awareness, I can assure you his time working as a Hospice Chaplain will be short. There are several venues a Hospice Chaplain will work in: homes, long-term care facilities, hospice houses, and hospital units. Each has its own unique politic. The self-aware CPE trained Chaplain should be able to read a room, sense what his or her surroundings are saying, recognize the question behind the question, skillfully apply spiritual comfort, and work with the staff at each location. It may not be something you like to hear, but I have observed among a growing number of new Hospice Chaplains that there is a glaring absence of self-awareness. Therefore, I urge you to re-double your efforts to provide extended education on this key element of CPE. That you may know a little about how we operate at Cornerstone Hospice & Palliative Care, Inc.….We require an MDiv or similar Master’s degree, 5 years of experience in a congregational setting or hospice/hospital setting, and 3 Units of CPE. Our expectations of our Chaplains are high. We are happy to hire a new-to-hospice Chaplain and equip them to do great work. While I am aware that each CPE student/trainee comes to the table with their own box of rocks, the impact of their past and liabilities of their personalities must be addressed effectively in CPE. If this offends you, I apologize. If this moves you to address this topic more thoroughly then I am delighted. What is at stake is effective spiritual support for dying patients and their families.