Apathy—The Death knell of Spiritual Care Leadership
The sage wisdom of the great philosopher Jimmy Buffet speaks to our topic:
‘Is it ignorance or apathy? Hey, I don't know and I don't care.”
We are on the precipice of what I understand as a crisis in hospice spiritual care leadership. The healthcare world is changing at a rapid pace. Hospice has been changing at a whirlwind pace. I don’t see stability on the horizon, but more change. Much of the change will have to do with money and management. Already there is a new model for re-imbursement for hospice providers. The U-shaped model affects Chaplains in that their presence with the transitioning hospice patient is required on a more frequent basis, particularly the last week of life.
In addition to this is the new wave of evidenced-based chaplaincy. Chaplains are on center stage to prove their worth. That’s right, prove their worth… At Cornerstone Hospice our guiding philosophy positions our Chaplains very well for this new wave. We have as our guiding philosophy Outcome Oriented Chaplaincy which has as its core the following core elements: Accountability, Best Practice, and Collaboration. The Chaplains at Cornerstone were hired because of their skills and background education and experience for the field of hospice chaplaincy. We require 3 units of Clinical Pastoral Education and a Master’s degree in Divinity, Counseling, or a related field.
Our Chaplains are informed and reminded that this is not the pastorate, this is chaplaincy. There are requirements: a daily goal of visiting 4-6 patients; participation in and adding value to the IDT meetings; meeting all standards of iCare, performance issues, and personal/professional growth. To summarize, hospice chaplaincy at Cornerstone is for ministers who live out their calling by serving with excellence the needs of our patients, families, and staff. They recognize they earn hours for PTO, not just take a day off without telling anyone. They receive annual evaluations for their performance. They are open to corrective action. It’s called accountability. The hospice cannot bill Medicare for Chaplain Service. Chaplaincy is an unfunded mandate that the hospice provides as a service to patients and families. It is incumbent that the Chaplain understands this and lives out a work ethic befitting this economic issue. To buck at accountability is the height of arrogance and reflects a lack of understanding of what hospice care is about.
Regarding spiritual care leadership, as the Spiritual Care Program Manager, I do not have the option of coasting since I have “made it” to management. There is a great deal expected and required of me…externally by Cornerstone and internally by my own passion and commitment. The Chaplains I serve need inspiration, instruction, and support. Those three elements move me to be my best and do my best. Like the Chaplains, I realize that spiritual care is on an unfunded mandate. Therefore, my leadership is designed to so develop and maintain the highest standards of spiritual care possible; to develop the pastoral care skills of our Chaplain team; to design a methodology for the Chaplains to document their visits; and, to be a resource for the entire hospice. Providing a webinar for the Association of Professional Chaplains on the topic of Communicating Spirituality to Patients with Alzheimer’s Disease and Other Dementias; conducting a workshop at the annual conference for Healthcare Chaplaincy Network; and, having the dementia care webinar on the front burner for Trinity Health in November of 2016 are evidences of my commitment to the field of hospice chaplaincy.
I urge my colleagues who are Directors and Managers to join me in these days of change to inspire their ranks to highest levels of spiritual care and to design programs of value that will educate the Chaplains. Proving our worth and value is no small task. It requires our absolute best in focus and hard work.