The healing power of presence
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The Healing Power of Presence. Malcolm L. Marler, D.Min., BCC Director, Pastoral Care. A Story of Presence. “She slowly dipped a cloth in the soapy water, squeezed it out and showed me how to gently remove the debris.

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The Healing Power of Presence

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The healing power of presence

The Healing Power of Presence

  • Malcolm L. Marler, D.Min., BCC

  • Director, Pastoral Care


A story of presence

A Story of Presence

  • “She slowly dipped a cloth in the soapy water, squeezed it out and showed me how to gently remove the debris.

  • Then she dipped a fresh cloth in the water, squeezed it out, and handed it to me. “That’s right Mama.” She cooed as I swabbed my 6’4” baby.”


Overview

Overview

  • Strategies and resources for meeting emotional and spiritual needs

  • How to be sensitive to the spiritual needs of someone different than your own.

  • Understanding Presence

  • Why questions are more important than answers.


Joint commission journal on quality and safety december 2003 volume 29 number 12

Joint Commission Journalon Quality and SafetyDecember 2003, Volume 29 Number 12

  • Press Ganey’s “Patient Satisfaction Survey”

  • Literature review of over 100 studies.

  • Evidence reveals parallels between spiritual and emotional needs (needs intermingle)

  • Caring for both includes: support, empathy, comfort, affirmation, attentiveness to patients’ unique needs.


Joint commission journal on quality and safety december 2003 volume 29 number 121

Joint Commission Journalon Quality and SafetyDecember 2003, Volume 29 Number 12

  • Are patients’ emotional and spiritual needs important?

  • Are hospitals effective in addressing these needs?

  • What strategies should guide improvement in the near future and long-term?


Joint commission journal on quality and safety december 2003 volume 29 number 122

Joint Commission Journalon Quality and SafetyDecember 2003, Volume 29 Number 12

  • Are emotional, spiritual needs important?

  • (“Degree to which hospital staff addressed your emotional/spiritual needs”)

    • Patient satisfaction is significantly correlated with

      • Staff response to concerns/complaints

      • Staff effort to include patients in treatment decisions

      • Staff sensitivity to the inconvenience of hospitalization

  • Impact on health outcomes

  • Impact on hospital finances

  • Emotional distress accompanies hospitalization


Joint commission journal on quality and safety december 2003 volume 29 number 123

Joint Commission Journalon Quality and SafetyDecember 2003, Volume 29 Number 12

  • Are hospitals effective in addressing these needs?

    • Patients experience emotional distress in hospitalization

    • Patients’ and/or families’ needs are handled in a timely, considerate, and empathetic way

    • All tests, interventions, and treatments are explained in emotionally sensitive and supportive decision-making process

    • Staff demonstrably provide empathetic emotional support


Press ganey degree to which hospital staff addressed your emotional needs

Press Ganey - “Degree to which hospital staff addressed your emotional needs”

86.2 mean, 1342 responses

54th percentile vs. UHC, 2nd Quarter 2012

81.6 mean (1347 responses)

9th percentile vs. UHC, 2nd Quarter 2010


Joint commission journal on quality and safety december 2003 volume 29 number 124

Joint Commission Journalon Quality and SafetyDecember 2003, Volume 29 Number 12

  • Suggestions for improvement

  • Basic emotional and spiritual care resources

    • Books, multimedia, support groups, music

    • Meal choices for each religion

    • Quiet secluded space (chapel, meditation)

    • Chaplain/Pastoral Care Team

    • Community outreach to faith groups, volunteers

    • Nurses trained to provide prayer


Joint commission journal on quality and safety december 2003 volume 29 number 125

Joint Commission Journalon Quality and SafetyDecember 2003, Volume 29 Number 12

  • Suggestions for improvement

  • Multidisciplinary Emotional and Spiritual Care Quality Improvement Team

    • Coordinate resources

    • Organizational learning of communication skills

    • Senior leadership must empower the team to carry out organization wide improvements

    • Structured interventions, relaxation techniques, stress management education, counseling, yoga, meditation, massage therapy, access to internet


Joint commission journal on quality and safety december 2003 volume 29 number 126

Joint Commission Journalon Quality and SafetyDecember 2003, Volume 29 Number 12

  • Suggestions for improvement

  • Standardized Elicitation of Emotional and Spiritual Needs

    • Require spiritual screening to identify needs

  • Responses to Patients’ Concerns/Complaints

  • Staff’s efforts to include patients in treatment

  • Staff sensitivity to patients’ hopes, dreams, likes, loves, family, roles.


The healing power of presence

What Do Patients Mean by Spiritual?Baylor Health Care System, Mark Grace, VP of Mission and Ministry, 2011

  • We had always asked the question, “Staff worked to meet your spiritual needs.”

  • Spirituality is a critical element of the wellness equation; a holistic, patient centered approach.

  • Asked patients in a random telephone survey, diverse population from 15 units of hospital


What do patients mean by spiritual

What Do Patients Mean by Spiritual?

Baylor Health Care System

  • To be treated with dignity and respect

  • To be treated with compassion and kindness

  • To be valued as a person

  • For staff to be sensitive to my feelings about my illness and hospitalization

  • An environment that encourages hope


What do patients mean by spiritual baylor health care system

What Do Patients Mean by Spiritual?Baylor Health Care System

  • Begins with the care patient receives, extends beyond religion

  • Including patients in treatment decisions

  • Responding to emotional needs

  • Responding to patient concerns, complaints

  • Safe and secure environment, privacy

Interdisciplinary


Focused priorities baylor health care system 2011

Focused PrioritiesBaylor Health Care System, 2011

  • Focus on facilitating a dialogue with patients related to spiritual needs.

  • Learning to convey compassion, empathy, and how to recognize spiritual distress.

  • Removed “spiritual needs question,” identified three top priorities that influence

    • Meeting emotional needs

    • Responding to concerns and complaints

    • Include patients in decisions about treatment


What is presence

What is Presence?

  • Henri Nouwen,

  • Catholic priest, psychologist (1932-1996)

    • When someone comes to us in pain, something in us wants to reassure the other and to move away from the pain.

    • Real healing is overcoming this mutual avoidance and being together where it hurts. Sharing pain.

    • Trust becomes possible when someone stays with us in the pain. Allow the question to be there.


What is presence1

What is Presence?

  • Margaret Guenther, PhD, MDiv.

    • Episcopal priest, author of Holy Listening, Spiritual Director (1929 - )

    • We often confuse healing with curing

      • Curing - often do something

      • Healing - a certain passivity, willing surrender

      • Hope, not foolish optimism

    • Listen, listen, listen

      • Accept the comfort of silence

      • Avoid fixing, go where we are led

      • Willingness to be touched, vulnerability


What is presence2

What is Presence?

  • Karen Stanley, RN, MSN, AOCN, FAAN

  • Palliative Care Nursing Consultant

  • Requires knowing oneself

  • Affirmation and valuing

  • Acknowledging vulnerability

  • Intuition

  • Being in the moment

  • Serenity


Discussion

Discussion

  • When have you experienced someone being “present” to you?

  • Or when you have observed another being present to someone?

  • What was different about this experience from routine encounters with others?

  • What was “healing” in the encounter?


Discussion1

Discussion

  • “Managing Up” -- Who are persons you know at UAB Hospital who are a healing presence to others?


Follow up

Follow Up

  • Powerpoint and other references for this presentation can be found by the end of the today at:

  • http://uabpastoralcare.org

  • Click on the “Employees” tab, then choose “Psychosocial Spiritual Grand Rounds.”


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