Professional Chaplaincy

What Is Happening to It During Health Care Reform?

Larry Van De Creek

• Publisher: Routledge
• Year: 2020
• eBook ISBN: 9781317956846
• Edition: 1
• Topic: Theology & Religion
• Subtopic: Religion

Choose innovative strategies for ministering to patients, families, and staff in a time of change! In the scramble to cut health care costs and the need to make every penny count, the hospital chaplaincy program is at serious risk for being trimmed or eliminated. Professional Chaplaincy: What Is Happening to It During Health Care Reform? offers a clear look at the current situation and positive suggestions for showing administrators just how essential chaplaincy is.This essential volume includes original research showing the specific consequences of the new emphasis on economic rationalism, as well as moving firsthand accounts of the effects of downsizing and budget cuts. An Australian case study catalogs and analyzes the outcomes of a drive for cost efficiency in a hospital chaplain department. A thorough literature review provides opportunities for chaplains and administrators to investigate the value of pastoral care in hospital settings.Professional Chaplaincy includes practical suggestions for ways to respond to budget cuts, such as:

• redefining the scope of your ministry
• strengthening community ties
• ministering to staff worried about heath care reform efforts
• offering new programs to enrich spiritual life
• documenting pastoral care visits
• researching the value of chaplaincy to the well-being of patients and families

Professional Chaplaincy offers positive ways that hospital chaplains can take action in response to the new health care paradigm. This informative book will assist you in developing future plans for maintaining and improving your hospital ministry.

CONTRIBUTIONS

My Experience with Health Care Reform

Charles B. Terrell, MDiv

SUMMARY. Health care reform efforts have personal and professional implications as well as consequences. This case study describes the author’s experience with suddenly losing his chaplaincy position because of budgetary constraints. Methods of coping with the trauma are described. [Article copies available for a fee from The Haworth Document Delivery Service: 1–800–342–9678. E-mail address: <[email protected]> Web-site: <http://www.haworthpressinc.com>]

KEYWORDS. Clergy, chaplain, pastoral counseling, pastoral care, health care reform

For me personally, health care reform began at three p.m. on December 7, 1998. That is when my pager sounded, asking me to call the Pastoral Care Department. When I returned the page, the Director said that something had come up and that he needed me to come to his office. I was providing follow-up support from a weekend on call to a family with a loved one in the Intensive Care Unit. The patient’s condition was deteriorating and the family was struggling through a decision about terminally weaning her from ventilator support. I asked if it could wait until the family had reached a decision and he replied that I needed to come immediately. I was puzzled; this was unusual. I asked if he could give me some idea as to what this was about and he replied that it was not something he wanted to discuss on the phone. I left the family, saying that I had been called away and that I would return as soon as possible.

Arriving at the Director’s office, I found him sitting with the Administrator who oversees pastoral care and I began to wonder if there was a problem with some other on-call occasions I had during the weekend. To my complete surprise, the Administrator told me that two staff chaplain positions, including mine, were being eliminated immediately. My colleague and I were permanently laid-off. We could leave now or chose to work through December 31; regardless of our choice, they would pay us through the end of the year.

For the next hour, I experienced almost all of the so-called “stages of grief” compressed into a swirl of surreal emotions. I was shocked; I was in denial; I bargained; I felt depressed; I felt angry; I felt nothing; I felt afraid, I felt so alone. I did not, however, achieve acceptance.

Neither the Administrator nor the Director could adequately explain the rationale for the decision. The Administrator stated that the organization’s projected deficit was so bad that cuts had to be made somewhere. One nurse case manager was also laid-off. No one else in this Administrator’s area was affected by the cost reductions.

I left the department offices at four p.m. and went, in a daze, to my office. I paged my colleague who had been informed a few minutes earlier than me and she came to my office where we did a mini-de-briefing, attempting to support and encourage each other as much as we could. Our family situations are different-I am nearly 49, married with two college-age children; she is sixty, widowed, and anticipates retiring in two years. Nonetheless, the pain and hurt were equally severe. How could this be? Pastoral care was well integrated throughout the hospital; she covered the ICU, the Ortho-Neuro Unit, the Oncology Unit, and the Transitional Care Unit. My areas included the Behavioral Health Unit, the Coronary Care Unit, the Cardiac Step-Down Unit, and Cardiac Rehab Stress Management Education, and Surgical areas. With the Director, we shared in overnight and weekend on-call rotations and in supervising 35 Stephen Ministers who gave spiritual care to patients referred to us by Home Health and the Outpatient Social Workers. Five Stephen Ministers also provided weekly visitation on the in-patient areas. Another Stephen Minister coordinated the two on-going Bereavement Support groups for the community. Neither she nor I could fully grasp that our participation in all these healing ministries was ended.

At five p.m. I drove to the nearby bus stop to pick up my wife who was coming home from her work. After numerous deep breaths and countless repetitions of The Serenity Prayer, I collected myself and told her what had happened. Her responses mirrored many of my earlier feelings and yet as we sat in the car for several minutes, she was able to speak powerful words that have kept us going; “We’ll be okay; we’ll make it.” Such hope … confidence … trust. I was unable to generate such confidence myself; she was able to begin to nudge our focus forward to “What do we do next?”

The next day I came to work and became so powerfully aware of the blessings of being connected to the Association of Professional Chaplains and its caring leadership. The notion of being told that I could work (or not) until the end of the year and receive pay regardless of my choice felt and sounded like immediate termination without notice. I called the Association’s national office seeking advice and was helpfully given the direct office number of the President.

I dialed and he answered. After empathizing and supporting me upon hearing my story, he helped me to realize that there is a legal business tactic called “giving pay in lieu of notice,” and that’s what I had received. Beyond that help in understanding, I received valuable grace and encouragement from him during our talk. He told me that he would post my name in the national office and would communicate my need to the Board of Directors by e-mail. I received caring ministry in a time of great fear and uncertainty. Later that week, I received a moving letter and prayer from the Organization’s president-elect; several weeks later I received a call from another Board Member, telling me about an available position. He said the Board had been praying for us.

Over the next two weeks my colleague and I went about the painful process of letting the nurses and other staff members know of the decision. The outpouring of their feelings was overwhelming. People were shocked, disbelieving, angry at the Administration, seeking ways to thank us for our eight years of effective and meaningful ministry to and with them, their patients, and to families. My colleague’s last day was December 18th; mine was the 23rd. Through these closure efforts, I continued to experience a wide range of emotions. I was aware of the sincere gratitude I felt for being able to work with such tremendous people. At the same time, I also felt anger and resentment toward the Administration for discarding my vital ministry. The staff realized, as did we, that eliminating our two positions would drastically weaken the clinical services provided to patients and families. The staff had always counted on us to be there, even through the most horrible situations. Reducing the Pastoral Care team by two-thirds contradicted the Mission Statement of the hospital that pledged sincere attention to the spiritual needs of patients and families.

In our eight years, my colleague and I made meaningful contributions to hundreds of persons who were in spiritual distress. We frequently intervened to rescue the organization from potentially litigious situations through our ministry to angry patients and families. Our value to the organization could also be measured by the countless acts of good will and positive public relations that we provided to the community at large. Indeed, the groundswell of protest that the hospital received from area churches and numerous volunteers bears this out. Letters to the Editor appeared in the local newspaper; several of the Stephen Ministers wrote to Administration and voiced their displeasure. Many Alcoholics Anonymous volunteers wrote in support of my presence in the Spirituality and Recovery groups on the Behavioral Health unit and local pastors sought out Board of Trustees members. I wrote letters of concern to the two representatives on the Board; the congregation where I am a member endorsed a massive letter-writing effort at its Congregational Meeting in January. To my knowledge, no one received a reply.

Into the mixture of feelings created by this traumatic experience, there appeared yet another event that now creates the context for me to describe my use of my own spirituality to cope. During her Christmas break, our college sophomore daughter brought home a refrigerator magnet with at once a simple and profound message. It is a quotation attributed to comedienne Gracie Allen that states, “Never place a period where God has placed a comma.”

I reflect on this message as I continue living through what has become a lengthy “comma time” in my life and that of my family. There’s a sermon about spirituality in that magnet. The comma, used in grammar to indicate a pause in a sentence, symbolizes the time of waiting and transition that my family and I continue to experience. For us, this comma time means:

• remembering God’s nearness and waiting, pausing, listening, discerning, and

• diligently sending out my resume for full-time positions; going for interviews … declining some position offers, not being selected for others; calculating exactly when the last severance payment went into the bank.

• reflecting on the power of change in life. Change is a threat when it is done to me; it is an opportunity when I initiate it.

“Comma time” has also been a time of connectedness to an ecumenical placement agency where, since March 1, 1999, I have been a half-time interim chaplain to another local hospital. This hospital seeks clinically trained guidance and stability in their pastoral program consisting of eight local pastors who serve as volunteer on-call chaplains. There is also a desire by the hospital to i...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Table of Contents
• About the Editor
• Preface
• Contributions
• Observations on Books, Journals, and Articles Relevant to Professional Chaplaincy and Health Care Reform
• Current Contents in the Literature Concerning Health Care Reform of Importance to Professional Chaplains
• Index