 12/1/2004
Vol. 1, No. 21
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Professional
Practice |
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Rev.
James
Stapleford
on
writing
a
response
to Just
Write!
I
Just Wrote!
Dear
Martha,
It
is
an
interesting
proposition
that
you
consider —Just
Write.
Most
of
the
Chaplains
that
I
know
have
written
for
years.
They
have
written
sermons,
in-service
lectures,
prayers,
verbatim,
letters,
budgets,
accreditation
self-studies
and
many
more
things.
I
myself
have
written
several
articles
only
to
receive
rejections
notices
or
notices
that
what
I
had
to
say
just "didn't
quite
fit." In
addition,
I
find
myself
so
busy
that
I
don't
have
a
lot
of
time
to
write,
re-write,
and
then
re-write
what
I
have
to
say
to
make
sure
that
everything
is
proper
and
in
order.
I
think
that
another
issue
is
that
most
of
us
see
ourselves
as "poets" and
not
authors.
I
make
the
distinction
here
between
poets
and
authors
in
the
sense
that
a
poet
is
more
of
a
storyteller
or
seeks
to
know
the
intuitive
self
more
than
the
properly
written
and
properly
footnoted
paper
complete
with
an
annotated
bibliography.
I
do
think
that
what
we
miss
is
seeing
the
value
of
one
poet
writing
for
other
poets.
So
here
is
a
short
one:
Grace
is
a
Smile
I
have
just
returned
from
a
cruise
in
the
Western
Caribbean.
I
love
to
cruise.
I
love
the
open
water,
having
someone
make
my
bed,
cook
my
meals
and
in
general
pamper
me.
I
can
overlook
the
checking
in —along
with
3000
other
persons,
and
the
disembarking
-
Where
is
my
luggage?
It
is
those
six
wonderful
days
where
I
have
no
telephone,
newspaper
or
other
distractions
that
use
up
so
much
of
my
emotional
energy.
This
cruise
is
just
a
little
different.
I
have
been
struggling
with
my
adjustment
to
a
new
work
situation,
a
new
living
situation
in
a
part
of
the
country
that
isn't
familiar,
and
weather
that
is
hot
with
high
humidity.
I
have
not
done
well
in
this
adjustment.
The
first
days
of
the
cruise
I
was
trying
to
get
there
emotionally.
On
the
second
Formal
Night
I
was
standing
where
they
were
selling
Silver
or
Gold
by
the
inch.
You
know,
you
buy
an
inch
of
silver
for
a
necklace
and
if
you
buy
more
than
21
inches
they "give" you
the
bracelet.
As
I
was
standing
there
considering
whether
or
not
I
would
purchase
a
new
chain
for
my
cross,
I
noticed
a
little
girl
standing
there
and
she
looked
like
she
had
lost
her
best
friend.
I
spoke
to
her,
but
she
shyly
turned
away
toward
her
grandmother.
Her
grandmother
said
that
she
wanted
both
a
necklace
and
an
ankle
bracelet.
I
said
that
they
usually
give
you
the
bracelet
with
the
necklace.
However,
because
the
girl
was
only
about
seven
or
eight,
the
necklace
was
only
about
12
inches,
therefore
she
would
have
to
pay
for
the
bracelet.
Here
is
where
the
Grandfather
in
me
kicks
in.
I
told
the
clerk
that
I
wanted
30
inches
of
a
specific
chain.
When
the
clerk
asked
if
I
wanted
the
bracelet
as
well,
my
reply
was, "No,
I
want
this
young
lady
to
have
it." As
I
looked
at
the
girl,
I
saw
shock
and
disbelief
come
into
her
eyes.
When
the
clerk
measured
her
ankle
for
the
bracelet,
she
was
all
smiles
with
the
most
beautiful
dimples
that
one
has
ever
seen.
With
her
shoulder
length
brown
hair
and
deep
brown
eyes,
formally
dressed
for
dinner
in
a
long
dress
and
a
smile
that
wouldn't
quit,
it
was
a
sight
to
behold.
At
that
point,
I
wasn't
sure
who
was
most
thrilled
-
her
or
myself.
At
any
rate,
once
the
clerk
had
placed
the
ankle
bracelet
on
her
ankle
we
were
getting
ready
to
part —she
ran
over
and
gave
me
a
big
hug.
At
that
point,
I
experienced
Grace.
There
were
two
of
us
that
walked
to
dinner,
floating.
I
guess
that
we
had
something
impressive
for
dinner
that
night.
I
could
have
eaten
sawdust
and
it
would
have
been
okay.
On
my
return,
people
ask
me
what
part
of
the
trip
did
I
like
the
best,
visiting
other
countries,
shopping,
snorkeling,
what?
There
is
no
way
that
I
can
say
to
them, “Receiving
Grace.”It's
too
intimate
to
share.
Maybe
that's
the
problem
with
writing —writing
means
that
we
poets
have
to
share
the
intimacy.
D.
James
Stapleford,
D.Min.,
MBA,
is
the
Department
Director
for
Spiritual
Care
and
Education
at
Phoebe
Putney
Hospital
in
Albany,
Georgia.
He
is
a CPE
supervisor
who
has
been
supervising
for
almost
35
years.
Jim
is
the
former
Treasurer
and
President
of
ACPE.
He
is
married
to
Alberta
and
has
five
grandchildren.
His
hobbies
include
wood
carving
and
wood
turning.
Many
ACPE
people
have
one
of
his
hand-turned
pens.
Jim
is
a United
Methodist
clergy
and
has
been
in
chaplaincy
for
the
past
35
years.
Do you
have
thoughts
about
professional
practice
you’d
like
to share
with
your
colleagues?
Send
an e-mail info@PlainViews.org.
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Advocacy |
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The Rev. Dick Cathell and The Rev.
Russell Myers on the role of advocacy
in endorsement
Endorsement
and Certification in an Age of
Pluralism
Diversity has been
the topic of a fair amount of discussion
recently. Perhaps these are “growing
pains”as professional chaplaincy
matures from the narrower focus of
the past to a broader, more inclusive
approach to spiritual care. We are
also living in a time of change,
as North American society becomes
increasingly pluralistic, including
areas of the country without much
experience with diversity.
In that context, we’ve had
dialogue about chaplains’responses
to a code of ethics that prohibits
proselytizing, we’ve heard
painful stories about CPE experiences,
and we’ve been challenged to
reflect theologically about what
it means to maintain our own integrity
as people of faith while ministering
in a multifaith setting. Into that
mix we now add another element: individual
chaplains who are committed to respecting
diversity but whose congregations/denominations
do not support that view.
Case study: Chaplain Abraham is
a member of a congregation that has
recently adopted a “welcoming,
affirming, inclusive”mission
statement. This congregation is part
of a denomination/faith community
that does not support the ideals
of such a mission statement. The
denomination informs the congregation
that the mission statement is inconsistent
with their beliefs, and puts the
congregation on probation. Chaplain
Abraham’s endorsement as a
chaplain comes from the denomination.
If the congregation is removed from
membership in the denomination, the
chaplain’s certification may
be dropped, affecting her/his standing
as a chaplain.
What options does this chaplain
have?
• Leave the congregation and join another
congregation of the same denomination.
• Leave the denomination and seek membership
and endorsement in another denomination.
• If the congregation becomes independent,
the congregation could function as the endorsing agency.
What is the role of professional
chaplaincy in advocating for Chaplain
Abraham?
Advocacy responds:
Advocacy is not the same as endorsement
or certification. Endorsement is
done by faith communities and is
a part of the certification process.
It is distinct from certification,
which is done by the professional
associations.
The role of Advocacy in this scenario
is to provide support, collegiality,
networking, guidance and comfort.
In terms of direct intervention,
this is an example of a situation
that Advocacy would not be involved
in. The reason is because religious
affiliation and alignment is a personal,
heart decision. We provide pastoral
care to the chaplain, but do not
take an advocacy stance on what is,
essentially, an individual matter.
When situations like this one arise,
in which there are no questions about
competence or ethics violations,
we support the ACPE Ecclesiastical
Endorsement Conflict Resolution Policy.
That policy expresses the desire
“both to respect the faith group
processes and to recognize the dignity
and worth of persons who may be temporarily
unable to satisfy conditions for
ecclesiastical endorsement in a particular
faith group.”
The Rev. Dick Cathell, Ph.D., BCC,
is a chaplain at St. Joseph Hospital,
Bellingham, Washington and is Chair
for the Commission on Advocacy for
the Association of Professional Chaplains.
He is endorsed by the Christian Church
(Disciples of Christ) and is an avid
racquetball player and guitarist. He
and his wife, Karlene, regularly explore
the San Juan Islands on their boat, "Island
Song."
The Rev. Russell Myers, D.Min.,
BCC has been a chaplain at United
Hospital, St. Paul, MN since 1993.
He is ordained in the Evangelical
Lutheran Church in America. He
is a co-author of "Providing
Spiritual Care to Cardiac Patients:
Assessment and Implications for
Practice" published in Critical
Care Nurse, Vol. 20, No. 4,
August 2000. He is also the APC
State Advocacy chair for Minnesota.
Russ is co-author of a letter to
the editor in Critical Care Nurse,
addressing the spiritual and emotional
Needs of bariatric patients. It
is online at: http://www.aacn.org/AACN/jrnlccn.nsf/Files/LettersOct04/$file/Letters
to the Editor10_04.pdf. The
original article it can be found
at: http://www.aacn.org/AACN/jrnlccn.nsf/Files/Wilmoth8_04/$file/Wilmoth8_04.pdf
Do you have thoughts about advocacy
you’d like to share with your colleagues?
Send an e-mail to info@PlainViews.org.
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Education & Research |
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Chaplain Tom Kilts on
a Planetree model of
spiritual care
An
Atmosphere Where
the Spirit is Free
to Heal
In the mid 70s, Angelica
Thieriot realized that
the focus on separating
the body from mind and
spirit in healthcare
was too dysfunctional.
She decided to take action
and from that motivation
came what is known as
the “patient-centered
approach,”or the
Planetree model of healthcare.
The Planetree model has
three essential elements
for the patient experience;
to personalize, demystify
and humanize healthcare.
To bring these elements
to life means taking
into consideration all
elements of the healing
process, of body, mind
and spirit. Planetree
facilities are attractive
to the senses; with beautiful
fountains, aroma therapy,
rooms that look like
hotel suites, it is impossible
to not notice a Planetree
facility. However, the
focus is always about
enhancing the healthcare
experience by what I
call “empowering”patients
to take part in their
healing processes.
The Planetree model
invites family members
into patient conferences
and encourages patients
to read their own charts.
They strive to make sure
that procedures are thoroughly
explained and that patients
know their right to decline
any treatment. Planetree
facilities also strive
to have the most up to
date technologies and
equipment. Having state
of the art technologies,
beautiful facilities
and a patient-centered
approach is a wonderful
way to honor both the
body and the mind in
this modern age, but
the question remains,
what about the spirit?
At Griffin Hospital
we strive to promote
what I call a Planetree
model of spiritual care.
This model is concerned
with making the human
connection to each patient
and being open to how
the spirit can help them
in their healing. To
establish the connection
needed to help others
find meaning in their
spiritual journeys, we
develop the skill of
making visits dialogical.
Inquiry in spiritual
care is a process in
which the patient is
invited to explore their “theologies”or
their symbols of the
divine. The focus is
also on “empowering”patients
to use their spirituality
as a part of their healing
process by:
•connecting
patients with their religious
resources or clergy
•affirming patients in their search for meaning
•being a listening presence
•inviting patients or family members to say a prayer and praying with them
•helping patients tap into their emotional worlds
Chaplains in a Planetree
model of spiritual care
are focused on the spiritual
needs of the patient.
It’s about creating
an atmosphere where the
spirit is free to do
its part in the healing
process, not confined
in representation to
any one form. It’s
the Chaplain’s
job in this setting to
create an open and inviting
environment where the
spirit can be talked
about, reflected upon
and prayed to, with respect
to difference and patient-centered
needs. At Griffin Hospital
we utilize our Clinical
Pastoral Education program
as a way to convey this
model of spiritual care
providing. As other pieces
of the Planetree model
have influenced other
settings, my hope is
that this style of chaplaincy
can and will do the same.
Chaplain
Tom Kilts, Director of
Pastoral Care and Education
at Griffin Hospital, a
HealthCare Chaplaincy partner
institution, in Derby,
CT, is a minister of the
Nyingmapa lineage of Tibetan
Buddhism. He is an Associate
Supervisor with ACPE, and
has been working in the
field of spiritual care
for ten years. Tom has
worked in two different
Planetree facilities, his
current position at Griffin
and at California Pacific
Medical Center in San Francisco,
CA. He currently lives
in Connecticut with his
wife and daughter
Do you have thoughts
about education & research
you’d like to share with
your colleagues? Send
an e-mail to info@PlainViews.org. |
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|
Spiritual
Development |
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The Rev.
Dale E. Wrathcford on
being a pastor, chaplain
and a human being
When
the Bread of Life
No Longer Is:
Pastoral Considerations for those Rejected by Ritual
Being diagnosed
with Celiac Sprue at
31 years of age was not
what I was expecting.
In fact, before August,
I had never even heard
of Celiac Sprue and didn’t
even know what gluten
was. I have since learned
that for most of my life
I was daily poisoning
my body.
Celiac Sprue is a deadly
disease that results
from taking gluten into
the digestive system.
Gluten is contained in
wheat, oats, barley,
and rye. Though it is
not deadly the moment
one eats it, the intake
of even small amounts
of gluten eats away the
villi in the small intestine,
leaving one unable to
gain nutrition from food
adequately. Eventually
the intake of gluten
will destroy the lining
of the small intestine,
leaving it open for carcinogens
to form cancers. Gluten
is a deadly, poisonous,
substance to me. Even
a tiny bit in contact
with my food is too much.
I learned about Celiac
Sprue, ironically enough,
after a long session
of prayer in which I
prayed for an answer
to this ailment that
was bothering me. After
prayer I read an article
about a little girl who
was refused the legitimacy
of her first communion
because she took a rice
wafer rather than the
canonical wheat. Disturbed
by the story, I researched
Celiac Sprue and what
I read filled me with
emotion. I was reading
about myself.
The transition to a
gluten-free life style
has been much more difficult
spiritually than I anticipated.
Despite the way in which
I learned of the disease,
initially I had not linked
the Bread of Life I take
in communion with my
newfound disease. I presided
at the Table the first
Sunday after going gluten-free
and did as I always do
at the Table. I said
prayers, I invited, I
remembered, I broke bread.
I also took the bread
from the Elder and ate.
That evening and the
next day I was definitely
feeling the effects of
that action but had not
connected it yet to communion
until my wife said simply, “You
know you took communion
yesterday.”At that
moment my Rolodex of
memories rolled backwards
in time to that previous
morning at the Table
and I remembered taking
the bread. I found tears
welling up in my eyes.
How could it be that
a great source of life
for me spiritually could
turn so quickly? I was
devastated. For me, the
Bread of Life no longer
was.
Though I do not personally
believe wheat to be an
essential ingredient,
I as a member of a worshipping
community who uses a
single loaf of beautifully
baked white bread for
communion, have not offered
an alternative. I could
bring rice bread for
myself, but have been
reluctant to do so. Primarily
because I’m bothered
by the idea that I am
not a part of the taking
and eating of the ONE
body of Christ symbolized
in the ONE loaf of bread.
Though intellectually
I realize that the ONE
body of Christ is not
contained in a single
loaf of bread made at
the local grocer. Simply
put, I am not ready to
symbolically partake
of a single loaf when
I actually take from
an alternative loaf.
I still grieve my years
of history with a powerful
ritual that was profoundly
life changing for me,
and is still changing
me.
Due to my experience
with this ritual, I now
have a much deeper understanding
of men and women that
can not tolerate the
patriarchal language
of the Church when they
were abused at the hands
of a less than loving
male in their past. I
have a deeper understanding
of an alcoholic, that
when the Chalice touches
their lips may provide
a battle with temptation
for a larger drink. “Rituals
are dangerous,”as
writer and mentor Herbert
Anderson once told me. “They
can either fill us with
great hope and passion
for life in community
or destroy our desire
to ever take part.”I,
as a pastor and a chaplain,
am much more aware now
of the power of ritual
and how it may affect
one’s spiritual
life. I cannot take them
for granted anymore.
It is a shame I had to
be on the outside looking
in before I realized
the depth of its impact.
Rev. Dale E. Wratchford,
M.Div., CMP, is a staff
chaplain at Children’s
Hospital in Omaha, NE.
He is endorsed by the Christian
Church (Disciples of Christ).
Do you have thoughts
about spiritual development
you’d like to share with
your colleagues? Send
an e-mail of any length
to info@PlainViews.org. |
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|
EthicsWalk |
EthicsWalk addresses
spiritual care as an ethical
enterprise. It explores why
relationships between spiritual
care providers and those
they serve need protection,
and examines what that protection
entails. PlainViews invites
our readers to share their
responses to each EthicsWalk column,
which will be published in
the following issue.
If
you’d like to respond to EthicsWalk,
please send a comment of
no more than 100 words. You
can use the e-form below
(click on "hearing
from you," link)
or submit your commentary
to the editors in the body
of an e-mail (or as a Microsoft
Word attachment) sent to Info@PlainViews.org.
Please put the phrase “EthicsWalk”
in your subject line.
We look forward to hearing
from you.
Bounded
Intimacy
Codes
of Ethics and work place
policies are external guides
to professional conduct.
What are the internal guides?
How does one discern them?
How are one’s
abilities and vulnerabilities
used to assist those in one’s
care?
Power
between giver and receiver
is always imbalanced during
professional care. Fiduciary
(trust) duty requires the
giver focus the relationship
to benefit the receiver.
Ethics codes and policies
are deontological. Deontological
requirements must be balanced
with the teleological realities
of individual care receivers.
Professional judgment and
personal discernment can
never be replaced by rules.
But the anarchy of personal
desire is not an acceptable
alternative.
That
said, is there a concept
to guide how one shares the
self that enriches one’s
professional persona? Literature
in social work, psychology
and ministry suggests “boundaries”[1]
may.
Websters
Dictionary defines
a boundary as “something
that sets a limit.”Ethicist
Rev. Marie Fortune says, “Boundaries
are a means to attend to
our relative power and
vulnerability in any relationship
without doing harm.”Boundaries
promote the ethical values
of beneficence, non-maleficence,
autonomy and respect for
persons.
Aspects
of chaplaincy relationships
implicating boundaries are:
1. Intimacy: emotional, spiritual, sexual;
2. Friendship: is mutuality in relationship ever possible between professional
care provider and receiver given the latter’s heightened vulnerability?
3. Finances: should a care-giver ever borrow/loan money from a client/patient?,
be trustee for patient’s funds? Accept gifts or money?
4. Information: gathering more than is needed? Disclosing inappropriately?
5. Confidentiality: failing to know what must be shared? Failing to warn
patient of requirements to share? Chattering on the elevator? Sharing
with one’s domestic partner?
6. Promises: of more than can be delivered by the care giver’s
own skill or role, the program; the institution within which the relationship
occurs.
Are
boundaries boarders which
separate a spiritual care
giver, from those served?
Or, are boundaries points
of contact at which people
meet, but which allow the
provider safely to maintain
enough separation to focus
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