Naming and Describing Naming and Describing ServicesServices

Chaplains ProvideChaplains Provide

Rev. Dean V. MarekRev. Dean V. MarekMayo Clinic, Rochester, MNMayo Clinic, Rochester, MN

marek.dean@mayo.edumarek.dean@mayo.edu

NACC Columbus NACC Columbus 20062006

Pre-conference Pre-conference Workshop March 11, Workshop March 11,

20062006

•© Copyright by Mayo Clinic© Copyright by Mayo Clinic•ALL RIGHTS RESERVEDALL RIGHTS RESERVED

•20062006

Our Published TaskOur Published Task

Attendees will develop a catalogue of Attendees will develop a catalogue of pastoral/spiritual care services to pastoral/spiritual care services to

describe what chaplains do. They will describe what chaplains do. They will also author clear definitions to explain also author clear definitions to explain the breadth and depth of the services the breadth and depth of the services

we provide. This catalogue may become we provide. This catalogue may become a standard reference for certifying a standard reference for certifying

organizations. This is a working organizations. This is a working workshop!workshop!

““Chaplains are often exhausted Chaplains are often exhausted by the demands of their daily by the demands of their daily work, yet unable to explain work, yet unable to explain

exactly what they do or how they exactly what they do or how they make a difference to patients or make a difference to patients or

to their organizations.”to their organizations.”

Father Gerard Broccolo, Health Father Gerard Broccolo, Health Progress Magazine, March-April 2004.Progress Magazine, March-April 2004.

A QuestionA Question

What are the services that only What are the services that only chaplains can provide?chaplains can provide?

What makes our contribution to What makes our contribution to the healthcare team unique?the healthcare team unique?

The Work – Part IThe Work – Part I

Four published works describing chaplain Four published works describing chaplain services were distributed to 34 services were distributed to 34 participants: participants:

1.1. CARE ManualCARE Manual, Mayo Clinic, 1999, Mayo Clinic, 19992.2. Spiritual Needs and Chaplaincy Services, Spiritual Needs and Chaplaincy Services,

Providence Health System, 2000Providence Health System, 20003.3. Professional Chaplaincy, Professional Chaplaincy, Larry

VandeCreek and Laurel Burton, 20014.4. Measures of Chaplain Performance and Measures of Chaplain Performance and

ProductivityProductivity, Catholic Health Initiatives, , Catholic Health Initiatives, 20022002

CARE PROGRAM (Chaplain Activity

Record – Electronic)USERS MANUAL

Department of Chaplain Services

Mayo Clinic, Rochester, MN

June 10, 1999Revised: April 26, 2001

July 16, 2004November 12, 2004

May 31, 2005 19919999

Service TypesService TypesDirectDirect

AM AdmitAM Admit Home Visit Home Visit AnointingAnointing Hospice Home Care Hospice Home Care Anticipated Death Anticipated Death Office Drop In Office Drop In Bereavement Bereavement Pastoral Contact Pastoral ContactCare Conference Care Conference Pre-surgical Contact Pre-surgical ContactCode 45Code 45 Public Worship Public Worship Crisis CareCrisis Care Research Intervention Research InterventionDeath Death Retreat Care Group Retreat Care Group Ethics Consult Coordination Ethics Consult Coordination Ritual/SacramentRitual/SacramentEthics ConsultEthics Consult Scheduled Spiritual Scheduled Spiritual AssessmentAssessmentEthics ContactEthics Contact Spiritual Care Spiritual CareFamily CareFamily Care Staff Care Staff Care Funeral/WakeFuneral/Wake Staff Care Group Staff Care GroupGroup FacilitationGroup Facilitation Staff Staff Development/TeachingDevelopment/Teaching

Service TypesService TypesIndirectIndirect

AdministrationAdministration Mission Support Mission Support CPE AdministrationCPE Administration Preparation TimePreparation TimeCPE MeetingCPE Meeting Professional Professional OrganizationOrganizationCPE PreceptorshipCPE Preceptorship ResearchResearchCPE SupervisionCPE Supervision RoundsRoundsCPE TeachingCPE Teaching SupervisionSupervisionMeetingMeeting Volunteer Volunteer CoordinationCoordination

20200000

20020011

PROFESSIONAL CHAPLAINCY

Its Role and Importance In Healthcare

EditorsLarry VandeCreek D.Min.

Laurel Burton Th.D.

DesignZGroupinc NYC

2001

Chapter IIIChapter III

1.1. When religious beliefs and practices are tightly When religious beliefs and practices are tightly interwoven with cultural contexts, chaplains interwoven with cultural contexts, chaplains constitute a powerful reminder of the healing, constitute a powerful reminder of the healing, sustaining, guiding, and reconciling power of sustaining, guiding, and reconciling power of religious faith.religious faith.

2. Professional chaplains reach across faith group 2. Professional chaplains reach across faith group boundaries and do not proselytize. Acting on boundaries and do not proselytize. Acting on behalf of their institutions, they also seek to behalf of their institutions, they also seek to protect patients from being confronted by other, protect patients from being confronted by other, unwelcome, forms of spiritual intrusion.unwelcome, forms of spiritual intrusion.

3. They provide supportive spiritual care though empathic 3. They provide supportive spiritual care though empathic listening, demonstrating an understanding of persons in listening, demonstrating an understanding of persons in distress. Typical activities include: distress. Typical activities include:

• Grief and loss careGrief and loss care• Risk screening – identifying individuals whose Risk screening – identifying individuals whose

religious/spiritual religious/spiritual conflicts may compromise recovery or conflicts may compromise recovery or satisfactory adjustmentsatisfactory adjustment

• Facilitation of spiritual issues related to organ/tissue Facilitation of spiritual issues related to organ/tissue donationdonation

• Crisis intervention/Critical Incident Stress Debriefing Crisis intervention/Critical Incident Stress Debriefing • Spiritual assessmentSpiritual assessment• Communication with caregiversCommunication with caregivers• Facilitation of staff communicationFacilitation of staff communication• Conflict resolution among staff members, patients, and Conflict resolution among staff members, patients, and

family family membersmembers• Referral and linkage to internal and external resourcesReferral and linkage to internal and external resources• Assistance with decision making and communication Assistance with decision making and communication

regarding regarding decedent affairsdecedent affairs

• Staff support relative to personal crises or work stressStaff support relative to personal crises or work stress• Institutional support during organizational change or Institutional support during organizational change or

crisiscrisis

4. Professional chaplains serve as members of patient 4. Professional chaplains serve as members of patient care teams by: care teams by: • Participation in medical rounds and patient care Participation in medical rounds and patient care

conferences, offering perspectives on the spiritual conferences, offering perspectives on the spiritual status of patientsstatus of patients

• Participation in interdisciplinary educationParticipation in interdisciplinary education• Charting spiritual care interventions in medical Charting spiritual care interventions in medical

chartscharts

5. Professional chaplains design and lead religious 5. Professional chaplains design and lead religious ceremonies of worship and ritual such as: ceremonies of worship and ritual such as: • Prayer, meditation, and reading of holy textsPrayer, meditation, and reading of holy texts• Worship and observance of holy daysWorship and observance of holy days• Blessings and sacramentsBlessings and sacraments• Memorial services and funeralsMemorial services and funerals• Rituals at the time of birth or other significant times Rituals at the time of birth or other significant times

of life cycle transitionof life cycle transition• Holiday observances Holiday observances

6. Professional chaplains lead or participate in healthcare ethics programs 6. Professional chaplains lead or participate in healthcare ethics programs by: by: • Assisting patients and families in completing advance directives Assisting patients and families in completing advance directives • Clarifying value issues with patients, family members, staff and Clarifying value issues with patients, family members, staff and

the organizationthe organization• Participating in Ethics Committees and Institutional Review BoardsParticipating in Ethics Committees and Institutional Review Boards• Consulting with staff and patients about ethical concernsConsulting with staff and patients about ethical concerns• Pointing to human value aspects of institutional policies and Pointing to human value aspects of institutional policies and

behaviorsbehaviors• Conducting in-service educationConducting in-service education

7. Professional chaplains educate the healthcare team and community 7. Professional chaplains educate the healthcare team and community regarding the relationship of religious and spiritual issues to institutional regarding the relationship of religious and spiritual issues to institutional services in the following ways: Interpreting and analyzing multi-faith services in the following ways: Interpreting and analyzing multi-faith and multi-cultural traditions and multi-cultural traditions

as they impact clinical services as they impact clinical services • Making presentations concerning spirituality and health issues Making presentations concerning spirituality and health issues • Training of community religious representatives regarding theTraining of community religious representatives regarding the

institutional procedures for effective visitation institutional procedures for effective visitation • Training and supervising volunteers from religious communities Training and supervising volunteers from religious communities

who can who can provide spiritual care to the sickprovide spiritual care to the sick• Conducting professional clinical education programs forConducting professional clinical education programs for

seminarians, clergy, and religious leaders seminarians, clergy, and religious leaders • Developing congregational health ministries Developing congregational health ministries • Educating students in the healthcare professions regarding theEducating students in the healthcare professions regarding the

interface of religion and spirituality with medical careinterface of religion and spirituality with medical care

8. Professional chaplains act as mediator and reconciler, functioning in 8. Professional chaplains act as mediator and reconciler, functioning in the following ways for those who need a voice in the healthcare the following ways for those who need a voice in the healthcare system: system: • As advocates or "cultural brokers" between institutions and As advocates or "cultural brokers" between institutions and

patients, patients, family members, and stafffamily members, and staff

• Clarifying and interpreting institutional policies to patients, Clarifying and interpreting institutional policies to patients, community clergy, and religious organizationscommunity clergy, and religious organizations

• Offering patients, family members and staff an emotionally and Offering patients, family members and staff an emotionally and spiritually "safe" professional from whom they can seek counsel or spiritually "safe" professional from whom they can seek counsel or guidance guidance

• Representing community issues and concerns to the organization Representing community issues and concerns to the organization

9. Professional chaplains may serve as contact persons to arrange 9. Professional chaplains may serve as contact persons to arrange assessment for the appropriateness and coordination of assessment for the appropriateness and coordination of complementary therapies. complementary therapies. Patients increasingly demonstrate interest in healing from many Patients increasingly demonstrate interest in healing from many sources not represented within the traditional healthcare disciplines. sources not represented within the traditional healthcare disciplines. Many of these complementary healing traditions are grounded in the Many of these complementary healing traditions are grounded in the world’s religious traditions and chaplains may utilize or make a world’s religious traditions and chaplains may utilize or make a referral for complementary therapies such as:referral for complementary therapies such as:• Guided imagery/relaxation trainingGuided imagery/relaxation training• MeditationMeditation• Music therapyMusic therapy• Healing touch Healing touch

10. Professional chaplains and their certifying organizations 10. Professional chaplains and their certifying organizations encourage and support research activities to assess the encourage and support research activities to assess the effectiveness of providing spiritual care. effectiveness of providing spiritual care.

While many chaplains serve in settings with little interest While many chaplains serve in settings with little interest in conducting research, others are employed by centers in conducting research, others are employed by centers with a research mission. Increasingly, chaplains attend to with a research mission. Increasingly, chaplains attend to research in the following ways:research in the following ways:• Developing spiritual assessment and spiritual risk Developing spiritual assessment and spiritual risk

screening toolsscreening tools• Developing tools for benchmarking productivity and Developing tools for benchmarking productivity and

staffing staffing patterns that seek to increase patient and patterns that seek to increase patient and

family satisfactionfamily satisfaction• Conducting interdisciplinary research with Conducting interdisciplinary research with

investigators in allied investigators in allied fields, publishing results in medical, fields, publishing results in medical,

psychological, and psychological, and chaplaincy journalschaplaincy journals

• Promoting research in spiritual care at national Promoting research in spiritual care at national conventionconvention

20200202

Digging DeeperDigging Deeper

What are the services that only What are the services that only chaplains can provide?chaplains can provide?

What makes our contribution to What makes our contribution to the healthcare team unique?the healthcare team unique?

The Work - Part IThe Work - Part IIn groups of four we:In groups of four we:1.1. examined the various published descriptions examined the various published descriptions

of services that chaplains provideof services that chaplains provide2.2. eliminated eliminated generic services, generic services, i.e., those i.e., those

services that other non-certified, non-services that other non-certified, non-chaplains can providechaplains can provide

3.3. agreed on those services that are unique to agreed on those services that are unique to chaplainschaplains

4.4. wrote each service type on its own post-it wrote each service type on its own post-it note (51 service were noted)note (51 service were noted)

5.5. collated the 51 notes into 16 unique collated the 51 notes into 16 unique categoriescategories

Generic ServicesGeneric Services

As it contained the most As it contained the most comprehensive listing of chaplain comprehensive listing of chaplain

activities, we looked again at activities, we looked again at Professional Chaplaincy Chapter III to Professional Chaplaincy Chapter III to

determine which activities were determine which activities were unique to chaplains, i.e., what services unique to chaplains, i.e., what services

only chaplains could provide -only chaplains could provide -

There are some services that some There are some services that some chaplains provide that other non-chaplains provide that other non-

chaplains could well perform, thus chaplains could well perform, thus releasing the chaplain for those releasing the chaplain for those

services that are sui generis to the services that are sui generis to the profession.profession.

• Grief and loss careGrief and loss care• Risk screening – identifying individuals whose Risk screening – identifying individuals whose

religious/spiritual conflicts may compromise religious/spiritual conflicts may compromise recovery or satisfactory adjustmentrecovery or satisfactory adjustment

• Facilitate spiritual issues related to organ/tissue Facilitate spiritual issues related to organ/tissue donationdonation

• Crisis intervention/Critical Incident Stress Crisis intervention/Critical Incident Stress Debriefing Debriefing

• Spiritual assessment Spiritual assessment (some thought this is only the (some thought this is only the chaplain’s to do)chaplain’s to do)

• Communication with caregiversCommunication with caregivers• Facilitate staff communicationFacilitate staff communication• Conflict resolution among staff members, patients, Conflict resolution among staff members, patients,

and family membersand family members• Referral and linkage to internal and external Referral and linkage to internal and external

resourcesresources• Assist with decision making and communication Assist with decision making and communication

regarding regarding decedent affairsdecedent affairs

• Staff support relative to personal crises or work Staff support relative to personal crises or work stressstress

• Institutional support during organizational change Institutional support during organizational change or crisisor crisis

• Participate in medical rounds and patient care Participate in medical rounds and patient care conferences, offering perspectives on the spiritual conferences, offering perspectives on the spiritual status of patientsstatus of patients

• Participate in interdisciplinary education Participate in interdisciplinary education (if about (if about religious issues)religious issues)

• Chart spiritual care interventions in medical Chart spiritual care interventions in medical chartscharts

• Assist patients and families in completing advance Assist patients and families in completing advance directivesdirectives

• Clarify value issues with patients, family members, Clarify value issues with patients, family members, staff and staff and the organizationthe organization

• Participate in Ethics Committees and Institutional Participate in Ethics Committees and Institutional Review BoardsReview Boards

• Consult with staff and patients about ethical Consult with staff and patients about ethical concernsconcerns

• Point to human value aspects of institutional Point to human value aspects of institutional policies and behaviorspolicies and behaviors

• Conduct in-service ethics educationConduct in-service ethics education

• Act as advocates or "cultural brokers" between Act as advocates or "cultural brokers" between institutions and patients, family members, and institutions and patients, family members, and staffstaff

• Clarify and interpret institutional policies to Clarify and interpret institutional policies to patients, patients, community clergy, and religious organizationscommunity clergy, and religious organizations

• Offer patients, family members and staff an Offer patients, family members and staff an emotionally and spiritually "safe" professional emotionally and spiritually "safe" professional from whom they can seek counsel or guidancefrom whom they can seek counsel or guidance

• Represent community issues and concerns to the Represent community issues and concerns to the organization organization

Chaplains may utilize or make a referral for Chaplains may utilize or make a referral for complementary therapies such as:complementary therapies such as:• Guided imagery/relaxation trainingGuided imagery/relaxation training• MeditationMeditation• Music therapyMusic therapy• Healing touch Healing touch

Chaplains attend to research in the following ways:Chaplains attend to research in the following ways:• Developing spiritual assessment and spiritual risk Developing spiritual assessment and spiritual risk

screening tools screening tools • Developing tools for benchmarking productivity Developing tools for benchmarking productivity

and staffing patterns that seek to increase patient and staffing patterns that seek to increase patient and family satisfactionand family satisfaction

• Conducting interdisciplinary research with Conducting interdisciplinary research with investigators in allied fields, publishing results in investigators in allied fields, publishing results in medical, psychological, and chaplaincy journalsmedical, psychological, and chaplaincy journals

• Promoting research in spiritual care at national Promoting research in spiritual care at national conventionconvention

What’s Left?What’s Left?

The following services were The following services were considered especially suited considered especially suited to chaplains because of an to chaplains because of an

implicit or explicit reference implicit or explicit reference to religion and/or spirituality to religion and/or spirituality and because of the specific and because of the specific competencies necessary to competencies necessary to

carry them out.carry them out.

Chapter IIIChapter III

2. Professional chaplains reach across faith 2. Professional chaplains reach across faith group boundaries and do not proselytize. group boundaries and do not proselytize. Acting on behalf of their institutions, they Acting on behalf of their institutions, they also seek to protect patients from being also seek to protect patients from being confronted by other, unwelcome, forms confronted by other, unwelcome, forms of spiritual intrusion.of spiritual intrusion.

5. Professional chaplains design and lead 5. Professional chaplains design and lead religious ceremonies of worship and ritual religious ceremonies of worship and ritual such as: such as: • Prayer, meditation, and reading of holy Prayer, meditation, and reading of holy

textstexts• Worship and observance of holy daysWorship and observance of holy days• Blessings and sacramentsBlessings and sacraments• Memorial services and funeralsMemorial services and funerals• Rituals at the time of birth or other Rituals at the time of birth or other

significant times of life cycle transitionsignificant times of life cycle transition• Holiday observancesHoliday observances

7.7. Professional chaplains educate the healthcare Professional chaplains educate the healthcare team and community : team and community : • Interpreting and analyzing multi-faith and Interpreting and analyzing multi-faith and

multi-cultural traditions as they impact multi-cultural traditions as they impact clinical services clinical services

• Making presentations re: spirituality and Making presentations re: spirituality and health issues health issues

• Training of community religious Training of community religious representatives regarding the institutional representatives regarding the institutional procedures for effective visitation procedures for effective visitation

• Training and supervising volunteers Training and supervising volunteers • Conducting professional clinical education Conducting professional clinical education

programs for seminarians, clergy, and programs for seminarians, clergy, and religious leaders religious leaders

• Developing congregational health ministries Developing congregational health ministries • Educating students in the healthcare Educating students in the healthcare

professions regarding the interface of professions regarding the interface of religion and spirituality with medical carereligion and spirituality with medical care

The Work - Part IIThe Work - Part II

After lunch dyads were formed and After lunch dyads were formed and participants were instructed to:participants were instructed to:

• chose one of the 16 categories and chose one of the 16 categories and write a clear concise description of write a clear concise description of the service the service

• name the skills/competencies name the skills/competencies necessary to accomplish the servicenecessary to accomplish the service

• separate the separate the service providedservice provided from the from the skills neededskills needed to provide the service to provide the service

The 16 Service The 16 Service TypesTypes

(In Alphabetical Order)(In Alphabetical Order)

The number of “hits” associated The number of “hits” associated with each category represents the with each category represents the number of times the service was number of times the service was

mentioned in the Part Imentioned in the Part I

1. Advocacy – 1 Hit1. Advocacy – 1 Hit

• Chaplains are a voice for the voiceless, Chaplains are a voice for the voiceless, vulnerable, and persons at riskvulnerable, and persons at risk

• Editorial comment:Editorial comment:– Advocacy may be viewed as a skillAdvocacy may be viewed as a skill to to

facilitate appropriate services for facilitate appropriate services for patient care patient care

2. Charting Spiritual 2. Charting Spiritual Care – 1 HitCare – 1 Hit

• Record a clear and concise summary of the Record a clear and concise summary of the patient’s spiritual concerns, how they have patient’s spiritual concerns, how they have been addressed, and the plan of carebeen addressed, and the plan of care

• Communicate necessary information to the Communicate necessary information to the interdisciplinary teaminterdisciplinary team

• Comment:Comment:– Charting is an institutional imperativeCharting is an institutional imperative– Bullet 2 would view it as communication Bullet 2 would view it as communication

for the sake of collaboration, and thus for the sake of collaboration, and thus indirect service for patient careindirect service for patient care

3. Continuing Education 3. Continuing Education – 3 Hits– 3 Hits

• Professional development and Professional development and maintenance of credentials for ministrymaintenance of credentials for ministry

• Comment:Comment:– The writers wanted to see that the The writers wanted to see that the

experience gained in ministry would experience gained in ministry would also be shared with othersalso be shared with others

– This, then, would be categorized This, then, would be categorized under under EducationEducation

4. Ethics Facilitation – 2 4. Ethics Facilitation – 2 HitsHits

• Promote competent ethical reflection Promote competent ethical reflection and decision makingand decision making

• Comment:Comment:– May be viewed as a skill in service May be viewed as a skill in service

of the patientof the patient– May also be categorized as May also be categorized as

Spiritual InterventionSpiritual Intervention

5. Education – 12 Hits5. Education – 12 Hits

• Interpretation of the interface between Interpretation of the interface between spirituality and health for the institution and spirituality and health for the institution and communitycommunity

• Comment:Comment:– Recipients include patients, families, staff, Recipients include patients, families, staff,

residents, students, parish nurses, residents, students, parish nurses, congregational health ministries, congregational health ministries, volunteers, etc.volunteers, etc.

– Venues include employee orientation, CPE, Venues include employee orientation, CPE, continuing education, churches, Pastoral continuing education, churches, Pastoral Care Week, etc.Care Week, etc.

6. End of Life Care – 1 6. End of Life Care – 1 HitHit

• Pastoral care at the time of loss, grave or Pastoral care at the time of loss, grave or terminal diagnosis, withdrawal of life terminal diagnosis, withdrawal of life support, fetal demise, and sudden deathsupport, fetal demise, and sudden death

• Comment:Comment:– This may be categorized as This may be categorized as Spiritual Spiritual

InterventionIntervention– However, EOL Care it may stand on its However, EOL Care it may stand on its

own as a major ministry in Hospice and own as a major ministry in Hospice and because of the nature of the population we because of the nature of the population we serveserve

7. Interpret Religious 7. Interpret Religious Diversity and Spiritual Diversity and Spiritual

Practices – 1 HitPractices – 1 Hit

• Interpret the spiritual/religious Interpret the spiritual/religious teachings and practices of a diverse teachings and practices of a diverse patient population as they impact an patient population as they impact an individual needindividual need

• Comment:Comment:– This is a skill that may be part of a This is a skill that may be part of a

Spiritual InterventionSpiritual Intervention– It is It is EducationEducation in that it informs staff in that it informs staff

of unfamiliar religious practicesof unfamiliar religious practices

8. Ministry of Presence – 8. Ministry of Presence – 1 Hit1 Hit

• Assist those served to access their Assist those served to access their spirituality as part of the healing processspirituality as part of the healing process

• Comment:Comment:– The ministry of presence may The ministry of presence may

encompass a variety of skills that are encompass a variety of skills that are invoked by the chaplain to release the invoked by the chaplain to release the spiritual power of the patient and spiritual power of the patient and facilitate the healing processfacilitate the healing process

– It is a skill set in the chaplain’s tool kitIt is a skill set in the chaplain’s tool kit

9. Networking – 1 Hit9. Networking – 1 Hit

• Connect community faith resources to Connect community faith resources to particular patient spiritual needsparticular patient spiritual needs

• Comment:Comment:– Networking is a process that results Networking is a process that results

in collaboration for patient carein collaboration for patient care– As such it is an indirect service that As such it is an indirect service that

facilitates a facilitates a Spiritual InterventionSpiritual Intervention

10. Pastoral Presence – 1 10. Pastoral Presence – 1 HitHit

• Ministry to a patient from an initial meeting with Ministry to a patient from an initial meeting with a spiritual assessment through appropriate a spiritual assessment through appropriate spiritual interventions , follow-up ministry, and spiritual interventions , follow-up ministry, and dismissaldismissal

• Comment:Comment:– Pastoral presence, similar to the ministry of Pastoral presence, similar to the ministry of

presence, encompasses a variety of spiritual presence, encompasses a variety of spiritual interventions that are facilitated by the interventions that are facilitated by the chaplain to release the spiritual power of the chaplain to release the spiritual power of the patientpatient

– It is an attitude more than a specific serviceIt is an attitude more than a specific service

11. Prayer and 11. Prayer and Meditation – 4 HitsMeditation – 4 Hits

• Attention to the patient’s condition reflecting Attention to the patient’s condition reflecting the concerns of the patient providing comfort the concerns of the patient providing comfort and reassuranceand reassurance

• Comment:Comment:– Prayer is often viewed as something done by Prayer is often viewed as something done by

the chaplain for the patient, “I’ll pray for you,” the chaplain for the patient, “I’ll pray for you,” rather than a sacred/spiritual dialogue that rather than a sacred/spiritual dialogue that facilitates the patient’s journey to his/her soul facilitates the patient’s journey to his/her soul wherein lies the primary source of spiritual wherein lies the primary source of spiritual powerpower

– Prayer is a tool in the chaplain’s kit that may Prayer is a tool in the chaplain’s kit that may or may not be a part of every or may not be a part of every Spiritual Spiritual InterventionIntervention

12. Religious and Moral12. Religious and MoralGuidance - 1 HitGuidance - 1 Hit

• Caring for the soul of the institution, the Caring for the soul of the institution, the chaplain provides religious and moral chaplain provides religious and moral guidance to the system, administration, guidance to the system, administration, employees, and medical staffemployees, and medical staff

• Comment:Comment:– The chaplain is a facilitator of spiritual The chaplain is a facilitator of spiritual

care. This category may better be care. This category may better be included under included under Spiritual InterventionSpiritual Intervention

13. Rituals – 13 Hits13. Rituals – 13 Hits

• Celebration of symbolic acts of the Celebration of symbolic acts of the community of faith, which provide community of faith, which provide meaning to the experience of illness, meaning to the experience of illness, suffering, and losssuffering, and loss

• Comment:Comment:– The number of hits would indicate that The number of hits would indicate that

ritual practices are a large part of the ritual practices are a large part of the services chaplains provideservices chaplains provide

– See next slide for an enumeration of See next slide for an enumeration of services mentionedservices mentioned

13. Rituals – 13 Hits13. Rituals – 13 Hits• Anointing with oilAnointing with oil• BlessingsBlessings• Creating situation specific rituals Creating situation specific rituals

(2x)(2x)• Leading reflectionsLeading reflections• Memorial services (x2)Memorial services (x2)• Religious servicesReligious services• Rituals at birth and other Rituals at birth and other

significant timessignificant times• Sacraments Sacraments • Worship services (x3)Worship services (x3)

14. Spiritual/Religious 14. Spiritual/Religious Assessment - 6 HitsAssessment - 6 Hits

• Discern and understand patients’ spiritual Discern and understand patients’ spiritual needs and concerns in light of their current needs and concerns in light of their current health issueshealth issues

• Comment:Comment:– A chaplain’s spiritual assessment is often A chaplain’s spiritual assessment is often

done informally in hospital, given the short done informally in hospital, given the short length of stay, and informs all spiritual length of stay, and informs all spiritual interventions at the point of deliveryinterventions at the point of delivery

– All participants believe that the All participants believe that the professional chaplain is most qualified to professional chaplain is most qualified to make an accurate spiritual assessmentmake an accurate spiritual assessment

15. Spiritual Intervention 15. Spiritual Intervention – 6 Hits– 6 Hits

• Response of the community of faith to the Response of the community of faith to the assessed spiritual needs and concerns of the assessed spiritual needs and concerns of the patient to find meaning in the experience of patient to find meaning in the experience of illness and facilitate the process of spiritual illness and facilitate the process of spiritual healinghealing

• Comment:Comment:– It is evident that several of the services It is evident that several of the services

already mentioned would better fit in this already mentioned would better fit in this categorycategory

– A more suitable term than intervention might A more suitable term than intervention might be chosen to highlight the sacred nature of be chosen to highlight the sacred nature of our care (cura animarum – care of souls)our care (cura animarum – care of souls)

15. Spiritual 15. Spiritual Interventions (Care)Interventions (Care)

• Crisis Care• Life Review• Sacred Stories• Support• Sp. Counsel/Direction• Advocacy• End of Life Care• Ethics Consult• Interpret Rel Diversity

and Practice

• NetworkingNetworking• Prayer/MeditationPrayer/Meditation• Religious/Moral Religious/Moral

GuidanceGuidance• Spiritual AssessmentSpiritual Assessment• Theological ReflectionTheological Reflection• RitualsRituals

Not mentionedNot mentioned::• Bereavement CareBereavement Care• Family CareFamily Care• Staff CareStaff Care

16. Theological Reflection - 16. Theological Reflection - Sensitivity to Diversity – 2 Sensitivity to Diversity – 2

HitsHits

• Facilitates a patient’s ability in bringing Facilitates a patient’s ability in bringing faith to his or her current experience faith to his or her current experience

• Comment:Comment:– This, too, may be a This, too, may be a Spiritual Spiritual

InterventionIntervention, as the chaplain , as the chaplain facilitates the “spiritual work” of the facilitates the “spiritual work” of the patient.patient.

Summary by HitsSummary by Hits

1.1. 13 Rituals13 Rituals

2.2. 12 Education12 Education

3.3. 6 Spiritual Assessment6 Spiritual Assessment

4.4. 6 Spiritual 6 Spiritual InterventionIntervention

5.5. 4 Prayer/Meditation4 Prayer/Meditation

6.6. 3 Continuing Ed3 Continuing Ed

7.7. 2 Ethics Reflection2 Ethics Reflection

8.8. 2 Theological 2 Theological ReflectionReflection

1 Each:1 Each:

• AdvocacyAdvocacy• ChartingCharting• End of Life CareEnd of Life Care• Interpreting Interpreting

Religious DiversityReligious Diversity• Ministry of Ministry of

PresencePresence• NetworkingNetworking• Pastoral PresencePastoral Presence• Religious GuidanceReligious Guidance

The Chaplain’s Tool KitThe Chaplain’s Tool Kit

What are the tools/skills that we What are the tools/skills that we bring with us when providing bring with us when providing pastoral/spiritual care?pastoral/spiritual care?

Tools/SkillsTools/Skills• Non-anxious PresenceNon-anxious Presence• Non-judgmental AcceptanceNon-judgmental Acceptance• Respect for Diversity Respect for Diversity • Solidarity with the Solidarity with the

VulnerableVulnerable• Ability to ListenAbility to Listen• CompassionCompassion• EmpathyEmpathy• Self-awarenessSelf-awareness• Developed IntuitionDeveloped Intuition• Professional BoundariesProfessional Boundaries• Relational/Comm SkillsRelational/Comm Skills• Comfort with SilenceComfort with Silence

• Gift of TimeGift of Time• Theological EducationTheological Education• Ability to Reflect Ability to Reflect

TheologicallyTheologically• Spiritual KnowledgeSpiritual Knowledge• Religious KnowledgeReligious Knowledge• Shared Spiritual PowerShared Spiritual Power• Denominational EndorsementDenominational Endorsement• Pastoral AuthorityPastoral Authority• Prayer, Rituals, and Prayer, Rituals, and

SacramentsSacraments• DiscernmentDiscernment• Self EsteemSelf Esteem• Ability to Assess SpirituallyAbility to Assess Spiritually

The Work - Part IIThe Work - Part II

• We also examined the NACC competencies We also examined the NACC competencies for certification to name any that are for certification to name any that are genericgeneric

• The group agreed that the competencies The group agreed that the competencies must remain intact as the necessary must remain intact as the necessary heartheart and foundation for all chaplain servicesand foundation for all chaplain services

• PersonalPersonal• TheologicalTheological• ProfessionalProfessional

• No one category could stand alone as more No one category could stand alone as more important than the othersimportant than the others

COMPETENCICOMPETENCIESES

Advocacy

Charting

Continuing Education

Ethics Facilitation

Education

End of Life Care

Interpret Religious Diversity

Ministry of Presence

Networking

Pastoral Presence

Prayer Meditation

Religious Guidance

Rituals

Spiritual Assessment

Spiritual Intervention

Theological Reflection

The Next StepThe Next Step

• The pre-conference workshop The pre-conference workshop participants will be asked by email to participants will be asked by email to review again the 16 categories and review again the 16 categories and offer suggestions to further delineate offer suggestions to further delineate (add or subtract) the services unique (add or subtract) the services unique to chaplainsto chaplains

The Afternoon SessionThe Afternoon Session• Participants were asked to name for Participants were asked to name for

themselves those services that were themselves those services that were unique to a chaplain by reason of unique to a chaplain by reason of profession and competenciesprofession and competencies

• Results were shared at each tableResults were shared at each table• Each table agreed upon one list of Each table agreed upon one list of

services as unique to chaplainsservices as unique to chaplains• The results will be collated and The results will be collated and

compared with the work of the pre-compared with the work of the pre-conference workshop and posted on conference workshop and posted on www.nacc.orgwww.nacc.org at a later date at a later date

The The BeginningBeginning