How you shake someone’s hand …

There is a gentleman at my church (yes, I attend church and even teach a class) that shakes hand like a vice.  I’m not sure what his point is in doing that but he does_every week.  How you as a Chaplain shake hands, speak, and express yourself facially and with your body will dictate the success or failure of your visit.

 

Here are a few of the more notorious types of handshakes:

 

•  The Vice Grip—As I mentioned above this is a hand crushing type of handshake.  Ultimately its purpose is to show dominance, strength, and even intimidation.  These qualities are the last things a Chaplain wants to express to his patients and their family members.
•  The Lobster—This handshake has this moniker because the dominant person simply grasps the other person’s fingers, but does not grasp the hand.  Again, this is along the lines of dominance and superiority and not a handshake a Chaplain should employ.
•  The Sweaty Handshake—If you’ve ever experienced this handshake you know that your hand is perfectly dry, but the other person’s hand is sweaty, giving a yucky feeling.  This is not atypical for a hospice patient or family member to be nervous when they greet you. If their hand is sweaty, so be it.  Do not allow your facial expression to look surprised or dismayed or shocked. 
•  The Dead Fish—Chaplain, know thyself.  If your personality style is passive or reserved, do not allow that to come across in the way you shake hands.  A handshake begins the visit, as does your tone of voice and your facial expression.  You just can’t sabotage yourself with a dead fish, limp handshake.
•  The embraced handshake—This is a very acceptable handshake if it matches your facial expression and tone of voice.  A handshake where you embrace the other person’s hand with your hands conveys warmth and caring.  Be sure all about you agrees with warmth and caring.
•  The firm handshake—I saved this one for last simply because there is a difference between it and the vice grip.  Firm, but not crushing.  Firm, but not intimidating.  Firm but brief so as not to linger trying to out shake the other person.  Facial expression and tone of voice convey your level of engagement with the person.  

 

Chaplain Colleagues, the way you begin your visit cannot be undervalued.  Your smile, you kind words of greeting and your handshake will put your patients and their families at ease.  Providing a non-anxious presence will serve as a catalyst to many a positive and healing discussion.

How you say it ...

In the last post, I wrote about body language.  How we present ourselves to our new patients and their families and our ongoing caseload of patients will lay the foundation for effective pastoral care visits.  Coupled with body language is our speech.  

 

Professor Albert Mehrabian has pioneered the understanding of communications since the 1960s. He received his PhD from Clark University and in l964 began an extended career of teaching and research at the University of California, Los Angeles.  Mehrabian's findings were:

• 7% of message pertaining to feelings and attitudes is in the words that are spoken.
• 38% of message pertaining to feelings and attitudes is paralinguistic (the way that the words are said).
• 55% of message pertaining to feelings and attitudes is in facial expression.
  As you know, in hospice chaplaincy how you say your words is just as important as what words you say.  You convey your meaning non-verbally with your body language and amplify that with your voice. 
  It is helpful to have examples so we can actually hear how a voice should sound.  The Guardian has an instructive site that provides examples of what someone should sound like to engage, to calm and to soothe.  These are three of the many tasks a Chaplain performs in pastoral care chaplaincy.  Please go to https://www.theguardian.com/science/blog/2015/apr/16/is-your-voice-trustworthy-engaging-or-soothing-to-strangers to listen to the examples.
   
  I hope you are gaining insight regarding the skills required to convey our meanings to our patients and their families.  This will help us to connect with them quickly and start the spiritual care relationships on a solid foundation. 
   

Facial Expressions and the Chaplain

My goal on the topic of body language has been to get the facts and present those that are most pertinent to the hospice chaplain.  Today, I will present a topic of great interest to successful interaction with patients and their families.  There are few things that irk me more when I am with a patient that is in the throes of an illness that leaves the patient with an odor or some physical deformity and someone comes into the room and  makes a facial expression of horror or some such thing.  The chaplain must not surrender pastoral care decorum to odors or deformities.  Facial expressions speak volumes to the patient and to their families.  There are 6 emotional facial expressions.  Can you list them?  I will assist you by providing a letter or two or three for each one.  In coming articles I will address the components of facial expressions.  For now, we just want to identify the expressions that we use, as well as, those of patients.

 

H- - p - - - - s

S - - - - - -

F - - -

D - - g - - t

S - - - r - - e

A - - - - r

 

A chaplain must be proficient in conveying several vital cues through facial expression:

• Empathy
• Interested listening
• Hopefulness
• Affirmation
• Acceptance
• Concern
• Compassion
• What other facial expressions can you think of? 
   
  In future articles we will examine practical tips on how to express these vital emotions.
   
   

Body Language Skills (Pre-test)

Body Language Skills  (Pre-test)

 

Match the following from the left column to the interpretation of the behavior in the right column.  This is a good start at understanding how your non-verbal language speaks as loud, if not louder, than your spoken language.  “Edward T. Hall (1959), a well-recognized social anthropologist, maintained that in a normal conversation more than 65 percent of social meanings are transmitted through the non-verbal channel.” (Kris Rugsaken in body-speaks, Clearinghouse Academic Advising Resources)  If that remains the case in 2016 then the Chaplain has to pay attention to the matter.  The answers to the pre-test are below the exercise.

 

1.    Sitting with legs crossed, foot kicking slightly	a.    Open, relaxed
2.    Arms crossed on chest	b.    Readiness, aggression
3.    Sitting, legs apart	c.    Rejection, doubt, lying
4.    Hand to cheek	d.    Apprehension
5.    Locked ankles	e.    Doubt, disbelief
6.    Head resting in hand, eyes downcast	f.     Evaluation, thinking
7.    Touching, slightly rubbing nose	g.    Boredom
8.    Rubbing the eye	h.    Defensiveness

 

There are many more non-verbal behaviors, but the above tend to occur in a pastoral care encounter.  How did you do?  Will you be more self-aware of your non-verbal communication?  Did you notice that two of the above have the same answer?  Why do you suppose I included two non-verbals with the same interpretation?

 

Answers: 1, g; 2, h; 3, a ; 4, f; 5, d ; 6, g; 7, c; 8, e

3 Powerful Thoughts on Forgiveness

As we work with patients and families and seek to facilitate forgiveness when that issue arises, it is always good to have to have reference points that give you as the Chaplain a means to offer guidance.  As a foundational starting point, explore these thoughts.  More posts on forgiveness will follow.


…When we dare to look at the myriad hostile feelings and thoughts in our hearts and minds, we will immediately recognize the many little and big wars in which we take part.  Our enemy can be a parent, a child, a "friendly" neighbor, people with different lifestyles, people who do not think as we think, speak as we speak, or act as we act.  They all can become "them."  Right there is where reconciliation is needed. Reconciliation touches the most hidden parts of our souls.  God gave reconciliation to us…

~Henri Nouwen

The Judeo Christian Scriptures affirm that the chief end of sacred writ is to guide us into love. A road block to that destination is the incessant search for what is wrong with our community, co-workers, friends, family, neighbors and the world. We get lost in this and become part of the problem. How can I claim to love God, if I do not love people? Perhaps we should strive to welcome people and give them a measure of unmerited favor.  This is the evidence of love; this is our guiding principle: the healing presence of GOD.-Guillermo Escalona

“As I walked out the door toward the gate that would lead to my freedom, I knew if I didn't leave my bitterness and hatred behind, I'd still be in prison.” ― Nelson Mandela

How do these statements inform your chaplaincy? 

Awareness: of Self, of the Dynamics that surround us and how it all affects us

In reading the Hospice Foundation of America December 2014 e-newsletter, I was captivated by the article "A Resolution Worth Exploring". I hope you will be, too!


A Resolution Worth Exploring As you ponder resolutions for [the new year], taking better care of yourself professionally should be close to the top of the list. Ronald Epstein, MD, professor at the University of Rochester School of Medicine and Dentistry, practicing palliative care doc, and published researcher on self-care, says such things as getting rest, eating well, getting exercise, taking vacations, and spending time with family are great to do but don't necessarily translate into better care for patients. Instead, Epstein suggests learning skills that promote mindfulness. What does Epstein mean by mindfulness? "I guess you would say mindfulness is an attitude of mind and mindful practice is what you do in everyday work," he says. "If you are practicing mindfully, you are aware of your own reactions, you are aware of the dynamics in the family, you are aware of how this is affecting you, you are able to monitor the way that you react and also to regulate your own reactions to stressful circumstances so that actions are better aligned with your values." This informs hospice chaplaincy in that if we are practicing our discipline mindfully, we will be self-aware, aware of the family dynamics around us, how our work affects us (positively and negatively), and how we respond to the stressful circumstances surrounding the hospice environment. Living and practicing our ministry means we do not deny our emotions or reactions and seek feedback from colleagues when we feel a bit off balance. I urge hospice Chaplains to practice not just good self-care but 'mindful' self-care. Our work is too demanding to do anything less. May 2016 be your best and most rewarding year in your hospice career

Adaptability: The Most Necessary Trait for the 21st Century

Without question, change is the mantra of the 21st century.


 There have been major changes in hospice regulations: decrease in re-imbursement rates, higher demands for documentation from Medicare, regulations galore, and pressure to perform and survive. These types of changes have brought incredible stress to the leadership of hospices across the nation. Some hospices have not been able to survive. In fact, the myths associated with hospice have taken on a life of their own. From physicians to potential patients and their families, poor information is winning the day. In the IDT meetings the stress of regulatory oversight is taxing nurses with more documentation than they have had to deal with in previous days. And, more is expected of Chaplains regarding documentation and performance standards. In the not too distant future hospices will be reimbursed based on their scores on a family satisfaction survey. The scrutiny is unlike at any time in American hospice history. The IMPACT Act will require hospices to be surveyed once every three years to make sure the organization is competent and efficient.


 The Chaplain is the soul and conscience of the IDT. I have noticed that as the Chaplain’s demeanor goes, so goes the Team. That is a very broad statement but I believe it is true. The Chaplain has the power of influence. He or she usually opens an IDT meeting with an inspirational presentation and prayer (in many cases). The Team looks to the Chaplain for stability and strength. Our Chaplains are doing a great job supporting their Teams by actively caring for the Team members and through ancillary actions such as The Blessing of the Hands, Celebrations of Life, Memorial Wreath, and the daily work which highlights their clinical skills. The underlying element that makes the Chaplain so effective with the IDT is the characteristic of adaptability. When change is announced or experienced, adaptability requires a calm demeanor as evidenced by a relaxed facial expression and body language. If there is a need for a decision, the Chaplain will remain poised and use his or her wisdom in making a decision. In conclusion, change is upon us. This is not a new phenomenon. The question boils down to "will you be flexible and adaptable?" Bless you, Chaplain Friends, in your great work.