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Reaching In and Reaching Out: Hospital Chaplaincy as a Profession. Wendy Cadge Brandeis University
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**NOTE: This is a revised version of the slides I presented at the SCC on 2/3/09. I have removed most of the photos to make the file smaller and easier to manage. If you have questions or would like a copy of any of the articles I refer to please email me at firstname.lastname@example.org. Please appropriately cite / reference this material.
Becoming a part of the chaplaincy department at one hospital – attending meetings and retreats and interviewing the 32 staff chaplains, residents, CPE interns, and volunteers.
Interviews with 70 staff who work in one neonatal and one medical intensive care unit.Data Collected
“The hospital accommodates the right to pastoral and other spiritual services for patients” (Standard R1.2.10)
Other regulations pertain to food, education, end-of-life care, etc.
(See: http://www.uphs.upenn.edu/pastoral/resed/JCAHOrefs.pdf)JCAHO 2008 Standards
72% believe God can cure people given no chance of survival by medical science
60% of the public and 20% of medical professionals think someone in a persistent vegetative state can be saved by a miracle (Jacobs, Burns, and Jacobs 2008).Recent Statistics
Special skills and knowledge set groups apart – especially “abstract” knowledge
Groups establish “jurisdictions” or things that are their exclusive responsibility
Groups need to be able to communicate to others what their skills, knowledge and jurisdictions are.Insights from Studies of Professions
The creation of the “Common Standards for Professional Chaplaincy” was a big step.
Some Chaplaincy Departments have done little to professionalize
Other Departments have made efforts to keep up with their changing medical, spiritual and religious contextsWhere are chaplains in this process?
There is need / demand from patients, staff, and the Joint Commission.
Chaplains influence outcomes that hospitals care about (better faster healing, better coping, more and better understanding between patients/families and medical teams, fewer lawsuits).Why do hospitals need chaplains?
Engage the spiritual dimension as a resource for healing
Have no agenda / meet patients where they are
Not sure….What do chaplains do that is unique / distinctive?
Having large numbers of volunteers
Being spread thin across the hospital
Trying to get physicians involved with the department
Doing research that describes what chaplains do (rather than what influence chaplains have on patients/families)Strategies that do not increase chaplains’ resources
Have some fluency in the language of the hospital
Figure out and respond to the hospital’s problems
Have chaplains become part of protocols
Get involved in ethics work
Do some PR
Team up with others (oncology, CAM)
Support staff in consistent predictable ways
Work on interdisciplinary research projects
**Demonstrate rather than assume your value to the institution….by reaching in and reaching out.Strategies that seem to increase chaplains’ resources
Have found ways to have chaplains automatically be apart of protocols, interdisciplinary teams, committees
Are known to colleagues in the hospital not just by personal name but by group (chaplains are trusted as individuals but recognized as a group)
Are able to communicate to hospital staff, in their language, what they do (and do not do) and how they can help them. This includes not just charting but communicating through charting.
Are seen as people who help solve problems
Are able to talk about, even if they don’t have the research to show it, what they add / bring to patients / families that is unique.Qualities of a Professional Department
Some are not interested in becoming more integrated in hospitals – see their value in standing outside
Many are unclear about their goals (CPE, patient and family care, something else)
The successful strategies listed challenge existing professional hierarchies and raise questions about the future training of chaplains.Concluding Thoughts
(Source: Cadge, Wendy, Jeremy Freese, and Nicholas Christakis. 2008. “Hospital Chaplaincy in the United States: A National Overview.” Southern Medical Journal. 101(6):626-630.)