As important as self care is for Chaplains and other caregivers, it’s probably one of the most neglected parts of our job. And self care is part of our job, because if we don’t care for ourselves we will be unable to do our job.
chaplaincy
Jesus loves you, but you’re still going to die
Every so often in hospice you get asked a baffling question, one that you don’t have a ready answer for. Sometimes it’s because the answer is simply beyond fathoming or beyond a simple explanation: “why is this happening to me?” or “why does God allow so much evil in the world?” Other times I’m baffled because the answer seems so obvious that I’m trying to understand why it’s asked at all. Such was the question I had posed to me a while back:
“Why does God have to take my mom? She never did anything wrong!”
We need to rethink grief
Artist Motol Yamamoto, who created labyrinths of salt to help express his own grief at the loss of his sister due to brain cancer. Click on the image for more information.
In my hospice, as well as in many others, when someone dies we consider the family members involved and rate their grief as low, medium or high. The thought being that if someone is on the low end, they will generally be fine. On the medium and high end though, we need to be more involved as this person may not cope well.
And I’m starting to think this is really missing the point.
There has been research recently in regards to complicated grief – grief that becomes debilitating to the point of becoming a chronic, life-limiting condition. This is the kind of grief that we in hospice are trying to identify, monitor and assist with. It differs from normal grief in that it is much more of a clinical condition, however it has many of the same characteristics as normal grief. The main determinants between the two, putting it simply, are duration of symptoms and the severity of them. Normal grief can involve impulsive crying, sleeplessness, rapid weight loss or gain, and even auditory or visual hallucinations. But they tend to subside over time and generally do not interfere with daily functioning. Complicated grief resembles PTSD, in that it can have these same symptoms but amplified and intrusive to the point where they cannot function normally. Continue reading
Chaplain certification and other nightmares
Before I completed my last unit of CPE several years ago I was encouraged to go for my certification through the APC. It’s the “gold standard”, the “union card”, the key to get you in the door of any Chaplain job in the country.
Only I didn’t go for it.
I have plenty of excuses now looking back. I already had a job that didn’t require certification and they didn’t really care if I was. I was the Director of Spiritual Services already and none of the chaplains I supervised had their certification either, so I didn’t feel that pressure. As Director, I was also really really busy and didn’t feel like investing any more time then toward putting all the papers together and so on. I also felt really secure in my position and didn’t feel like certification would really help me where I was. Plus, I also got the feeling that although my job had supported me through part of my CPE, they were done with giving me time and financial support to pursue certification.
Then I got let go. Continue reading
Handling authority and conflict: another CPE verbatim
In the beginning…
First I want to thank those of you who read my posts. I have two blogs that I write on, and while this is the one which I update the least (until recently) it is definitely the more popular one. That said I am going to look in to ways to make posts easier to find and rework the design a bit in the process.
That said, I wanted to post another CPE verbatim as an example. This is one that I wrote in my 3rd unit at the Pittsburgh VA which I took at level II. I chose this particular one because I think some might find it helpful to see how to write toward the competencies (I used footnotes) and also because of the context. Most chaplain interactions are seen within the chaplain-patient context, but this one happened within a supervisor-supervisee context. So I also wanted to include this an example of how you can use the CPE environment to look at many different areas. It also included several people, so it was pretty complicated. Feel free to comment.
I don’t deal well with conflict and my main question going in was “did I handle myself appropriately?” If you’re interested in familial roles, handling personal and professional authority, trust and handling conflict you’ll find this interesting. Oh – and I later on ended up firing this person (ok, if you ask her she resigned before I could fire her but that was only because she hadn’t made it back in to the office that day). Intrigued? Read on-
Do seminaries teach practical ministry?
In seminary much of the coursework, depending on where you go, is geared toward making you an effective preacher, evangelist or scholar. You can’t get out without studying original languages (except at Yale Divinity School, which was why I went there!), systematic theology, preaching, church history and so on. But are schools that train ministers effectively training them for practical areas of ministry, such as pastoral care and counseling?
I use the term “practical” here as a way to distinguish between the more typical idea of ministry from the pulpit from the ministry that happens outside of it, such as chaplaincy and counseling.
Is there a gulf between ministry and counseling? Are they seen as not incompatible but effectively separate fields?
I’m interested to find out people’s experiences in terms of their training in and for the more practical parts of ministry that they had in seminary. At YDS for example, CPE was an option but not necessarily a requirement. There were a smattering of courses offered in the areas of pastoral care and counseling, but again these weren’t a requirement and the classes were rather small.
So what were your experiences? Please comment below and keep the conversation going…
The good stuff
I realize as I write this that it’s tempting to dwell on the difficulties of this position. Yes there are many, but the positives are just as numerous. Here’s just a few I’ve experienced:
A stroke patient who, while she is only able to say “yeah” most of the time, forces out “I’m glad to see you” when I visit.
My dementia patent who holds my hand like I’m her boyfriend every time I visit.
Every veteran who has shared a story about their service. I’ve known a man who survived days at sea after being torpedoed, another who was supposed to have lifted the flag at Iwo Jima if he hadn’t hurt his ankle, and another who was the only one in his platoon who survived the landing at Normandy because he was stateside getting married.
Baptising a patient just a few weeks before he passed, then passing the framed photo on to his widow.
Seeing folks’ faces light up when we present them with a birthday cake.
Having a patient tell me that they want me to do their funeral.
To reassure someone that, after 80 years, they’ve done a good job.
To appreciate the silence and quietness of God’s presence in a room as someone sleeps.
To give someone the final blessing they will ever have in this life.
I’ve met one of Frank Lloyd Wright’s secretaries, an engineer who helped design the World Trade Center, and a man who ran the drill that dug the Holland Tunnel.
I’ve heard stories and met people that will be with me all my life. And that is good.
Standing in the hallway
once again I haven’t written in a while. once again due to feeling incredibly busy.
We had a speaker at our hospice a few days ago who talked about how social workers and chaplains tend to be seen as mildly irrelevant in hospice care. Many chaplains, for example, routinely carry caseloads of over 100 as well as on call duties. I know one chaplain who has over 100 patients and a church. That to me is insane.
Given the fact that I have about 80 patients, and only about 60 of those I see regularly, I should feel like I’m on a luxury cruise. However that’s hardly the case. Admissions happen on an almost daily basis, and these require quick attention even though the impulse is to put them off until absolutely necessary. A quick phone call to the family or patient can usually tell you how much of a problem there may be, so that can help to prioritize things.
Hospice Chaplain Interview: Reblog
I picked this up of the Web and wanted to repost it; the original is here.
A reverend’s rounds: Hospice chaplain ministers to the terminally ill
October 30, 2013 6:30AM ET
Demand for hospice chaplains grows as more Americans seek deathbed spiritual counseling
- NEW YORK — Sunlight permeates the Upper East Side apartment of hospice patient Kam Hi Tse, 78, as he arranges himself in a half lotus position on the sofa and places his hands, facing upward, on his thighs in what’s known as open-palm mudra. The former chef explains in Cantonese to the Rev. Mary Chang, an ordained Lutheran minister sitting next to him, that this pose makes him open to receive blessings from the Buddha. Chang, 70, nods and opens her palms upward, too.
A hospice chaplain for MJHS, the largest hospice and palliative-care program in the Greater New York City area, Chang makes daily visits to the terminally ill and dying, offering conversation and prayer to patients and grieving loved ones. She typically sees at least four patients a day, in hospitals, nursing homes, hospice centers and private homes. Unlike clergy of the past who usually only served people of their own faith, hospice chaplains take a multifaith and sometimes even secular approach. Chang meditates with Buddhists and sings hymns with the Russian Orthodox. She prays with atheists and speaks with people uncertain of their faith.
“I am here to listen, to be present, not to convert or judge,” says Chang, a sprightly Chinese-American woman who on Sundays leads a congregation at the Lutheran Church of the Incarnation in Cedarhurst, NY. Favoring brightly colored clothes when she visits patients, she usually eschews the formal collar and title of her Protestant calling.
Hospice Chaplain fact #1: We work too hard
Earlier this year I attended a conference for the Association of Professional Chaplains in Chicago. During the day there was a breakout session for hospice chaplains to get together and network. One thing we all found out was that most of us are stretched incredibly thin. It was relatively common for a single chaplain to have 75 or even over 100 patients on their caseload. Personally I can attest that we all tend to work too hard, myself included. For a while I had a caseload of about 100 patients which were spread out over four counties. There was no talk of hiring another chaplain, but after a while the management did hire one part-time which soon became full time. I ran into another chaplain locally who said that he had over 150 patients that he saw, and he also had his own church to manage! Continue reading
The Chaplain's Report 