Spiritual Care and the Role of ChaplainsMario Ceballos, Dmin

The speaker does not have any relevant financial relationships with any commercial interests

Spiritual Care and the Role of Chaplains

Describe the role of the chaplain on the medical team.

Demonstrate how to do a spiritual assessment

Demonstrate how to provide spiritual support to grieving patients and their families

What are Chaplains?

Chaplains are members of the healthcare Team

They are professionally trained to minister to patients of all faith

They are ministers endorsed and supported by their churches

Ministers specialized in Health Care Ministry

Patient/Family/Employee FocusedClinically Academic/Theological

and Educationally trained (AUA) and Integrated with the Medical Team

Provide Support GroupsAvailable 24 hours/7 days a

week/365 days of the year/

What Do Chaplains Do?What Do Chaplains Do?• Promote the integration of Spiritual Care with the Promote the integration of Spiritual Care with the

health care of patients, by providing health care of patients, by providing • Spiritual care to hospitalized patients by visitation Spiritual care to hospitalized patients by visitation

patients, families, employees and staff patients, families, employees and staff • Support groups such as grief recovery counseling Support groups such as grief recovery counseling

and othersand others• Articulate the institutional culture and systems, to Articulate the institutional culture and systems, to

patients their families and staffpatients their families and staff

• Support the hospital administration on the ethical Support the hospital administration on the ethical decision-making, patient care and in the mission of the decision-making, patient care and in the mission of the hospital.hospital.

• Foster a partnership in health care ministry with Foster a partnership in health care ministry with community clergy and area faith group leaders. community clergy and area faith group leaders.

Hospital Chaplains Training Requirements

• Religion-Theological education, at the graduate/professional level, which involves a Graduate work taken at a school accredited by the General Conference Of SDA Education Department (AUA Masters in Chaplaincy) or by a recognized organization in the Country were the school is located such as the Association of Theological Schools as is the case in the United states

Health Care Clinical Pastoral Education Program

The CPE programs must be accredited by a national recognized organization and/or by the Adventist Clinical Pastoral Care Education

Adventist Hospitals in North America, Australia, Puerto Rico and the Philippines provide Clinical Pastoral Education Training.

Not only Adventist Hospitals but many other health care and parish base CPE centers around the world provide training and every year hundreds of ministers and seminarians successfully complete one or more units of CPE.

Standards for Adventist Board Chaplain Certification

(BCC)

• Bachelor’s Degree plus a theological education at the graduate professional level, which involves a minimum of three years or 72 semester hours taken at a school accredited by the Association of Theological Schools

• CPE Clinical observation and practice Shadowing, CPE Clinical observation and practice Shadowing, Rounds, On-call, Chapel Classroom Reflection, Rounds, On-call, Chapel Classroom Reflection, Didactics, Peer group interaction and Supervision. Didactics, Peer group interaction and Supervision. 1200 hours over four units, 1200 hours over four units,

• Ordination/commissioning, and Ecclesiastical Endorsement by the chaplain home division

The Role of the Chaplain on the Medical Team

Patient Spiritual Care

Staff training on spiritual care (AHS Research)

Staff Spiritual Care

Patient assessments

Leadership Spiritual Care

Institutional mission and culture ambassador

Healers and spiritual counselors

The Role of the Chaplain on the Medical Team

Doctors and nurses were preparing Kathleen Hynes for a stem-cell transplant at Long Island's North Shore University Hospital last June when she asked them to page another member of the medical team—hospital chaplain Kimberli Lile.

Ms. Hynes, a 53-year old cancer patient, wanted the chaplain to bless the cells before they were administered intravenously

There is growing evidence that many patients with major illness have better outcomes when hospital care is combined with spiritual care.

The Role of the Chaplain on the Medical Team

Medical schools are adding courses on spirituality and health, and training residents to consider patients' spiritual needs. Some two-thirds of U.S. hospitals provide chaplaincy services; others rely on local clergy and lay volunteers.

Studies indicate as many as 40% of patients with serious illnesses like cancer struggle with spiritual concerns, which can harm emotional and physical well-being.

http://www.wsj.com/articles/SB10001424052970204826704577074462494881428

A study published online in July in the Journal of General Internal Medicine found that among 3,000 patients hospitalized over a three-year period at the University of Chicago Medical Center, 41% wanted a discussion of religious and spiritual concerns, yet only half of that group reported having one.

Patients who had a spiritual discussion reported being more satisfied with their overall care, whether or not they said they had desired it.

The Role of the Chaplain on the Medical Team

The Role of the Chaplain on the Medical Team

Patients may hesitate to ask for a chaplain's services out of concern that chaplains will proselytize—even though in many cases they don't use explicit theological language and "are there to be companionable and offer support," says Wendy Cadge, associate professor at Brandeis University.

Doctors, she adds, may feel uncomfortable asking patients about spiritual needs, or that it is inappropriate to do so.

The Role of the Chaplain on the Medical Team

That's where tools such as spiritual history-taking can help, says Christina Puchalski, director of the George Washington Institute for Spirituality and Health, in Washington D.C., who developed a screening questionnaire.

Ann Berger, chief of pain and palliative care at the National Institutes of Health's Clinical Center in Bethesda, Md., says it is "an easy way to ask these questions of patients and teach spiritual assessment to health-care providers." Chaplains visit referrals from such questionnaires and often make rounds to chat informally with patients.

Chaplain as Religious Expert?

‘The spirit of the Lord God is upon me, because the Lord has anointed me: he has sent me to bring good news to the oppressed, to bind up the broken hearted, to proclaim liberty to the captives, and release to the prisoners; to proclaim the year of the Lord’s favor.’ Isaiah 61:1-2 NRSV

This is the call to all Christians and particularly those ordained or authorized for ministry by the Church. Traditionally chaplains have been viewed as ‘religious experts’ – the ones with the knowledge of the Bible, the ability to perform specific religious functions, the hotline in prayer, the ones to call in the face of ethical issues, a confidential ear in all circumstances.

As religious ‘experts’ chaplains are expected to have a more intimate awareness of the Bible – of God’s ‘saving’ plan for humanity, of God’s love, healing and promises, of answers for the important existential questions (i.e. Cobb 1998, 115 ‘whether life is meaningful, purposeful and worthwhile and whether it has been a gift or a burden.’) The religious expert’s role is to help people find meaning. One of the recent developments in Christian theology has been the importance of narrative (Lyall 2001, 50). This means as those with knowledge of God’s story, chaplains are able to be alongside people in a journey where stories come together; the career, the one being cared for and God’s story.

Religious authority

Many patients still find something distinct and important about sharing their deepest thoughts with an authorised minister of religion – whatever their church background it is the sense of hope they carry (Capps 1995, 8). Take, for example, an elderly, very disturbed terminally ill woman. The medical staff unable to help calm her called for chaplaincy input. She needed the reassurance of being able to confess her ‘sins’ and receive God’s forgiveness and love before being able to die at peace with herself, other people and God.

Prayer

There is also an assumption that chaplains have a ‘hot line’ to God. In this increasingly non-religious environment it is intriguing just how many people want and expect prayer; perhaps it is a ‘lucky charm’ an ‘insurance policy’ – maybe deep down it meets a need, a desire to make sense of life – to feed the ‘spirit’ or to bring about wholeness. In a recent chaplaincy audit at Adden brooke’s (2004, 13) 90% of people expected chaplains to pray! 

Scottish Journal of Healthcare Chaplaincy Vol. 9. No. 1. 2006

SPIRITUAL ASSESSMENT TOOL – FICA

F: Faith or Beliefs

I: Importance and Influence

C: Community

A: Address

Demonstrate how to do a spiritual assessment

F: What is your faith or belief? Do you consider yourself spiritual or religious?What things do you believe in that give meaning to your

life?

I: Is it important in your life? What influence does it have on how you take care of

yourself? How have your beliefs influenced in your behavior during

this illness?? What role do your beliefs play in regaining your health?

C: Are you part of a spiritual or religious community? Is this of support to you and how? Is there a person or group of people you really love or who

are really important to you?

A: How would you like me, your healthcare provider to address these issues in your healthcare?

1. Joint Commission Resources: 2003 Comprehensive Accreditation Manual for Hospitals: The official Handbook. Oakbrook Terrace, IL: JCAHO, 2003. Dec 2003 Vol. 29 #12 Page 662 (notes slide 4;16)

2. Christina Puchalski; Spiritual Assessment in Clinical Practice; Psychiatric Annals; March 2006; 36,3 ; Psychology Module pg. 153

3. Puchalski Christina; A Time for Listening and Caring; Oxford University Press 2006, Page 10