A Deeper Dive into the Interventions, Facilitating Communication
Sometimes it is difficult for patients to discuss their situation. They don’t want to be seen a complainers, or they are so overwhelmed they can’t put words to their inner suffering. Of course, there are other barriers to communication, but these two are thought starters for you.
“Facilitate open expression of feelings” and “Use open-ended questions to elicit feelings” are interventions to assist with communication. Never should communication be something that is forced. Facilitating and using open-ended questions should be a smooth process for the experienced clinical Chaplain and not something is stilted and awkward. The Chaplain needs a clear focus on why he/she is using either of these interventions. When I review Spiritual Plans of Care, I don’t expect to see either of these interventions in the Initial Spiritual Assessment. It seems to me that the Chaplain will need a few visits before these are added to Plan of Care. By the third visit it should become clear to the Chaplain that the patient might have spiritual or existential issues that need to be discussed. Certainly, not on the first visit. The Chaplain has just met the patient and has no idea the inner pain the patient is experiencing. What follows are several gentle open-ended questions/statements that could be used in your work:
- "Tell me how things are going for you."
- "Can you tell me about your understanding of about your illness?"
- "What is the most difficult part of this illness for you?"
- "As you think about what lies ahead, what concerns you the most?"
- "As you look ahead, what do you hope for?"
- "Tell me more about that."
- "Sounds like you're really worried about..."
- "What do you mean by '__' ('futile,' 'vegetable,' 'hopeless,' 'giving up,' 'everything')?"The above places the patient as the driver of the conversation. The Chaplain then engages in inter-active listening. As we know, just getting ‘stuff’ out brings a measure of inner healing in itself and a bond of trust will develop which is essential for quality spiritual care.Your feedback on this vital issue of Chaplain/Patient communication is welcome.