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Bullet Point Spiritual Assessment

Bullet Point Spiritual Assessment . Gordon J. Hilsman, D.Min. Franciscan Health System Tacoma WA. Objectives. Focus on documenting spiritual assessments as professionally collaborative

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Bullet Point Spiritual Assessment

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  1. Bullet Point Spiritual Assessment Gordon J. Hilsman, D.Min. Franciscan Health System Tacoma WA

  2. Objectives • Focus on documenting spiritual assessments as professionally collaborative • Value spiritual assessment as a major, perhaps the primary component of patient oriented health care experience • Consider bullet points as a style of charting spiritual assessments

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  4. To Assess or to Sedate? • Sedere – to sit, remain, take a seat, perch • Sedare – settle, allay, calm down, (sedate, sedative, sedation) • Ad – next to, right up close (adjust, adorn, adhesion) • Assess - Ad+sedeo= to sit next to, to consider together – implies depth

  5. Rapport- First Three Minutes Creatively establishing a helping relationship in ways that are: • Beyond social • Time/space-creating • Transcendence allowing • Profoundly accepting • Earthily engaging

  6. Communicating about Spiritual Care The art of Combining: • Creativity regarding human perspectives • Substance, worth reading/considering by other clinicians • Usefulness to colleague chaplains and interdisciplinary teams, for patient care

  7. Clinician (Greek – clinos = bed) A professional prepared to use direct observation, developed frameworks of understanding, and pertinent data in order to fashion interventions of assistance to people in serious need.

  8. Why Bullet Points? • The day of a physician • The day of a nurse • The day of a social worker • The day of a chaplain

  9. Types of Listening • Diagnostic • Personal / Pastoral • Collaborative • Intimate Love

  10. Bullet points are efficient, focused, useful, easy to comprehend and the most likely way to slice through to the human side of other interdisciplinary team members who are intensely engaged in completely different professional missions and assessment frameworks.

  11. Bullet points are: Efficient Focused Useful Easy to comprehend Effectively penetrating for other IDT members

  12. Narrative and 3 or 4 Bullet Points • Intro narrative: Why did you converse with this patient / family? Who is this patient/family (Capture the soul)? How did this patient/family relate to you? • Assessment: 2 to 4 bullet point issues that surfaced in the conversation? • Functions: What did you do to help this person/family? • Plan: What do you plan to do to help this person/family?

  13. Assessment What issues surfaced or were dealt with in the conversation?

  14. “Without agenda???” This is not your first unit of CPE!!!

  15. Spiritual Assessment Framework A basic structure with which to organize spiritual care work for enhancing patient care through interdisciplinary and intra-disciplinary communication

  16. Professional vs. Interdisciplinary Assessment • Assessment frameworks for certification • Assessment frameworks for data collection • Assessment frameworks for interdisciplinary teamwork

  17. Paragraph chart note: I saw this patient at the request of her father who I had met in the hallway. She is a 57 year old widowed Philippine woman with a daughter in California and a son that lives in town. She spoke in sad tones about her nagging knee pain leading to tomorrow’s surgery and her mother who died in February. She has been crying this morning, somewhat overwhelmed by her inability to lift her grandson and by her grief over her mother’s death. I listened, facilitated her grieving and prayed with her, though she is currently not practicing her Catholic heritage. I will suggest the evening chaplain drop in on her for further support. She declined my offer of her being visited by a priest.

  18. JACHO Ready Spiritual Assessment Form What are the needs? What did we provide? What is the plan of care?

  19. Chaplain Focused Bullet Point Note • 57 year old widowed Pilipino woman with a supportive father and a son living here, and a daughter in California • Teary today, open and verbal with me about her life situation. Pt aware of surgery and its implications, fairly hopeful of a favorable outcome to improve her life. • Mother died in February, knee pain prevents her from lifting her grandson. We began grief work. • Appreciates prayer though she is currently not practicing her Catholic heritage. Declined being visited by a priest. • I will continue grief work tomorrow and suggest the evening chaplain drop in on her for further support.

  20. IDT Bullet Point Assessment Saw pt. on suggestion of her father in the hallway. She is a 57 year old widowed Pilipino woman with a son living here, and a daughter in California. She is teary today, open and verbal with me about her life situation. • Pt fairly hopeful of a favorable surgery outcome • Active grief issues, mother died in February, knee pain prevents her from lifting her grandson. • Appreciates prayer, currently not practicing her Catholic heritage. Declined being visited by a priest. Chaplain began grief work, prayed with patient, and supported. to be continued tomorrow Chaplain to continue grief work and support after surgery

  21. Reduce Defensive Entries • Excess verbiage • Unnecessary Rationalizations • Pedantic Over-explaining • Superfluous Self reference • Annoying redundancy • Subtle image enhancement • Justifications for your worth • Critique of other professionals’ care

  22. Questions about Bullet Point Assessment?

  23. One Assessment Framework Franciscan Health System – Tacoma WA

  24. Four Axes of Spiritual Needs Assessment • Emotional Support • Loss/Adjustment • Religion/Spirituality • Advocacy/Referral

  25. 1. What does this person need from me emotionally right now? 2. What losses, recent and previous, has this person experienced that continue to surface painfully at times? 3. How does this person nurture her/his own human spirit, relative to established religious traditions and apart from them? 4. What does this person need that I can’t provide?

  26. Bullet Point Issue Recording Saw pt. on suggestion of her father in the hallway. She is a 57 year old widowed Pilipino woman with a son living here, and a daughter in California. She is teary today, open and verbal with me about her life situation. • Pt fairly hopeful of a favorable surgery outcome • Active grief issues, mother died in February, knee pain prevents her from lifting her grandson. • Appreciates prayer, currently not practicing her Catholic heritage. Declined being visited by a priest. Chaplain began grief work, to be continued tomorrow

  27. Axis One:Emotional Support (Mad, Sad, Glad, Hurt, Afraid, Ashamed) What does this person need emotionally right now, (from me)? 30

  28. 1. The Crisis Need for Stabilizing 2. The Expression Need to Engage and Share 5. The Regression Need to be Empowered EMOTIONAL SUPPORT 4. The Bewildering Need for Basic Information 3. The Anxious Need of Waiting Too Long

  29. 1 - Stabilizing - Personal support when familiar patterns are disrupted by crisis events Helping people pull themselves together

  30. 2. The Expression Need to Engage and Share Supportive validating (listening) - the Need to cry, yell, share, or just tell somebody how you feel about what is happening to you

  31. 2. An Expressing person Function Desired Outcomes • Talks openly • Expresses Feelings • Cries • Relaxes • Considers Resources Supportive Validating 34

  32. 3-InformationNeed for basic information Informing in the wilderness of healthcare systems

  33. 4 - W a i t i n gUpset feelings from waiting too long in an important situation Presence and Networking

  34. 4. A person who is waitingtoo long Function Desired Outcomes • Expresses situation • Acknowledges health care system limitations • Prays • Expresses Gratefulness • Calm Presence & Networking 37

  35. 5-Empowering - Need to find and use your own best ways of dealing with difficult times Helping people extricate themselves from regressing after being overwhelmed

  36. Axis Two: Loss and Grief What has this person lost, recently and historically, that still disturbs her/him at times?

  37. 6 - Current Grief Major loss in previous 48 hours Facilitating saying goodbye to somebody recently lost

  38. 7 - Prior Grief Major past loss being currently grieved Recognizing current warm-sad memories and facilitating the past loss grief that enkindled them

  39. 7. Prior Grief Function Desired Outcomes • Mentions previous loss • Expresses emotion • Receives validation • Shares reminiscences • Cries while talking about the lost loved one • Receives referral for further grief assistance • Expresses greater hope Grief Counseling 43

  40. Grief Counseling Outcomes(%)

  41. 8 - Dying Dealing with the goodbyes of the dying process Helping people say goodbye when they’re dying

  42. 9-Life adjustmentMaking peace with a major change in appearance or function Getting used to the new way things will be

  43. Axis Three:Spiritual-Religious Care How does this person maintain and nurture her own human spirit? 47

  44. 48

  45. 10 – Religious and Spiritual InstructionNeed to learn religious/self care modalities

  46. 11 - Religious Support - Needing to feel the immediate positive presence of Transcendence “I want to feel God all around me!” 50

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