Interdisciplinary Spiritual Care: So Important, it Takes a Team

1. Interdisciplinary Spiritual Care: So Important, it Takes a Team Mark Thomas, MDiv, BCC CHE 3-Part Series on Documentation and Assessment Part 3

2. Acknowledgements Who’s “in the room” Reflection Format: 3 stops for questions/comments

3. Quick Review • Donovan helped us frame the need for and content of • Assessments • Plans of Care • Reminded us that we must be relevant • To the team • To patients’ care and healing • Encouraged us • To be effective • To use understandable documentation language

4. Donovan’s “Equillibrium” The role of the clinically-trained chaplain is to assess the degree to which the patient's emotional and spiritual equilibrium has been disturbed by the healthcare event and to determine what interventions would be appropriate to help the patient restore their equilibrium and when such interventions should be employed. (Donovan / Dowdy)

5. Quick Review • Jane introduced the concept of the “Chaplain as Educator” • Chaplains can help our clinical partners understand how to identify a “disturbed equilibrium”, and how we can coordinate our care to best address the whole person. • Chaplains can ensure consistent care for the whole person, in partnership with other disciplines, through the use of tools like a bio-pycho-social-spiritual screening.

6. How do you feel, overall?How much pain do you feel?How peaceful to do you feel?How supported do you feel?

7. Key Questions How well do we, as chaplains, understand and utilize the right structures (such as a spiritual screenings) to focus our expertise? Are we seeing the right patients, given limited resources? Are we supporting our clinical partners to exercise their own scope of practice in caring for the whole person? What is the potential for healing, if patients and families experienced our care as a truly coordinated, team, focused on their healing?

8. Learning Objectives To understand professional and organizational responsibilities to address the needs of the whole person. To understand an interdisciplinary model of spiritual care. To understand the opportunities, barriers and implications of this model.

11. Core to Our Mission • Care for the whole person is our heritage, our hallmark and vocation in Catholic and faith-based health care. • Codes of Ethics/Scopes of Practice • American College of Physicians • American Nursing Association • National Association of Social Workers • APC, NACC, and other cognate groups

12. Barriers • Industrialization of healthcare • Specialization of disciplines • Medical Hierarchy • “Religious allergies” • Tension between being included vs. unique • Confidential vs. Privileged information

13. Barriers • Reluctance of clinical partners • Lack of time • Lack of expertise • Fear of being intrusive “That’s not my job”

15. Questions/Comments

18. From where I’m standing… Limited resources are increasing the need to collaborate if spiritual care is to be delivered to more than a small %. Palliative care is “raising the bar” for the integration of spiritual care. We have much to learn from highly interdisciplinary approaches, such as hospice. A an emerging role is for chaplains to “equip the saints” for ministry.

20. Assumptions Worth Examining “The medical system” has failed to adequately integrate the work of chaplains. Clinical disciplines other than chaplains do not have a scope of practice in spiritual care. Patients should have their spiritual needs addressed by a chaplain.

22. Questions/Comments

23. Spirituality 94% of patients believe spiritual health is as important as physical health. 77% of hospitalized patients would like spiritual issues considered as part of their medical care. 80% reported their physicians never or rarely discuss these things. King  DE, Bushwick  B.  Beliefs and attitudes of hospital inpatients about faith healing and prayer.   J Fam Pract.  1994;39:349–52.

25. “Henry”

26. Henry’s Plan of Care • Problem/Dx: Unresolved Grief • Goal: Grief Recognition/Resolution • Interventions: • Explore patient’s history of loss and meaning assigned to losses • Identify cultural and spiritual issues/beliefs rituals associated with grief • Set realistic goals • Identify and support effective coping behaviors/personal strengths/self-care

27. Who “owns” the plan of care? We all do. Heightened need for teamwork, communication, accountability. Awareness of one’s scope of practice

29. How do you feel, overall?How much pain do you feel?How peaceful to do you feel?How supported do you feel?

30. “Jerry”

31. “Jennifer”

32. Questions?