Tuesday, May 24, 2016

Disturbing Observations

I had the privilege of presenting a workshop at the Healthcare Chaplaincy Network “Caring for the Human Spirit” Conference in San Diego a month ago.  It’s taken that and another presentation of the material to help me process my observations.


While there is no reason to press a Panic Button, these observations certainly should awaken hospice and hospital spiritual care leaders that “Houston, we have a problem”!


  1.  There is an awareness of fewer chaplain positions across the spectrum of healthcare.  There are pockets of hiring, but those are the exception.
  2.  There is uncertainty as to what a Chaplain should be charting by way of a Clinical Note or Narrative or whatever your computer program calls it.  Also, let me categorically state that any hospice that does not use electronic charting is behind the times and out of compliance with Medicare regulations.
  3.  When I present the Algorithms for Spiritual Care, the Users’ Guide, and Template for Documentation and ask the audience if their organization has something similar to assist the Chaplaincy Department in putting together a highly professional Clinical Note the answer is “No”.  That is disturbing.  It shows:
    1. A lack of education and training… Chaplains thrive on education and training.  To not provide your organization with a philosophy of chaplaincy is to minimize and marginalize the efficacy of chaplaincy. To not provide the Chaplains with a Senior Chaplain or Manager is to guarantee that the Chaplain staff will not be exposed to great educational opportunities which will improve their productivity and their patient/family encounters.
    2. A lack of trust in the capabilities of Chaplains.  If organizations are not permitting Chaplains to provide a Clinical Note for fear of HIPPA violations or some other perceived potential legal issues, see the above. 
    3. A lack of requirements for Chaplains.  Now, I realize there are Chaplains who are doing a stand up job and do not have the benefit of Clinical Pastoral Education, let alone Board Certification, but I do believe that due to the critical nature of the hospice and hospital environment patients and families are better served by Chaplains who have had at least 3 Units of CPE.  Of course, Board Certification should be the standard, but in lieu of that at least 3 Units means a Chaplain has been exposed to 1200 hours of clinical education.
  4. I am absolutely convinced that every hospice organization would benefit from exposure to my presentation on Quality Improvement.  The Algorithm, Users’ Guide and Documentation Template will keep the Chaplain on target with documentation and help the Chaplain to paint the picture of the patient’s experience. 
  5. A Chaplain who becomes adept at the Algorithms, Users’ Guide, Documentation Template will take his seat at the table of a medically focused hospice and participate effectively.  This adds to the value of chaplaincy and raises the bar for every Chaplain.  The highly skilled Chaplain will be sought after to provide in-services for the Inter-disciplinary Team and other groups in the hospice.

In conclusion, as a result of a hospice or hospital leader reading this article, I would like to see an in-service scheduled to learn of the Algorithms, Users’ Guide, and Documentation Template.  Self-serving?  Hardly.  My passion is for Chaplains confidently serving the needs of patients, families, and their colleagues on the IDT.  I gave away the materials at the HCCN conference as I did to those in attendance at the CPSP Chapter meeting.  I suggest that once this is fully in place across the continuum of healthcare groups we will see a greater awareness of chaplaincy and higher value placed on chaplaincy.

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