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 4/7/2004
Vol. 1, No. 5
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Professional
Practice |
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Chaplain
Jane Mather on the virtue
of collaboration
Collaboration
as a virtue
Specialization
in medicine has become
the norm, with unique skill
sets for each medical discipline.
The result for patients
is often a fragmented plan
of care with competing
agendas. Chaplains, social
workers, psychiatric nurses
and patient relations need
to avoid this kind of competition,
which only adds to the
confusion.
Patients
admitted to medical centers
are sicker and stay fewer
days than was once the
norm so addressing core
issues quickly should be
the primary focus and not
disputes over “turf” since
the turf is the patient.
Although collaboration
skills may not be part
of our professional training,
pastoral care givers can
play a vital role in unifying
the multi-disciplined team
to provide seamless delivery
of services.
In many facilities
the chaplain and social
work departments, psychiatric
nurses and patient relations
operate independently,
often reporting up-line
to separate department
heads. This minimizes opportunities
for contact and collaboration,
aside from meetings to
discuss a range of patients
or converging to offer
our respective services
and skills during a crisis.
In our hospital,
we were fortunate that
members of each of these
separate teams were willing
to work together. We recognized
that working independently
may be adequate but an
interdependent approach
is not only better for
patients, it better serves
our various department
agendas as well! As we
all came together as a
team it became obvious
that: 1) patients, families
and staff members received
improved “customer” service
and 2) our collective voice
was stronger – and clearer
– than any one of our small,
non-revenue producing departments.
As a team
we began sharing referrals
and resources. If a chaplain
meets with a patient who
has underlying financial
issues causing great anxiety,
the chaplain makes sure
there is a social work
referral made on this patient,
too. Social workers and
chaplains now share issues
with the patient relations
department after we learned
that some patients fear
compromising their care
by complaining, but feel
safe sharing their fears
with chaplains or social
workers. In the past, these
patients might not have
expressed their complaints
until filling out their
patient satisfaction surveys
upon discharge. Now chaplains
and social workers are
part of the solution as
they work with patient
relations. Everyone benefits.
Specialized
care has a long history
in Western medicine and
turf issues among the behavioral
sciences are not minor
obstacles to overcome.
However, persons who are
suffering in body, mind
and spirit deserve a holistic
approach to their care.
The holistic model in which
caregivers work collaboratively
is beneficial for patients,
and facilitates efficiency,
teamwork, shared wisdom
and mutual growth for the
staff members involved.
Like a healthy body, the
departments at my hospital
learned that that we are
more than the sum of our
parts.
Chaplain Jane Mather, a
member of the Advisory Board
of PlainViews, is director
of pastoral care at Winthrop-University
Hospital, a HealthCare Chaplaincy
Partner Institution. Seeking
a more diverse ministry, Chaplain
Mather came to New York from
Spokane, Washington, where
she last served as manager
of pastoral services for Empire
Health Services, a two-hospital,
475-bed system serving two
trauma centers. She received
a Master of Arts in pastoral
ministry at Gonzaga State University,
where she later facilitated
the creation of a community-based
clinical pastoral education
program. A Roman Catholic lay
person, Chaplain Mather is
a member of several professional
organizations including the
National Association of Catholic
Chaplains and the Association
of Clinical Pastoral Education.
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Advocacy |
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The Rev. Lerrill J. White continues
his commentary on the status of clergy and the
IRS
Clergy
and the IRS: A Reply
In the last issue of PlainViews, I discussed the status of chaplains
as independent contractors and the clergy housing allowance as defined by the
U.S. Internal Revenue Service (IRS). At the end of the article, I invited readers
to share the advice they have received from their accountants this year.
One reader took the initiative
and spoke with the United Methodist
Board of Pensions (which handles
tax questions for their active
and retired clergy). He reports
the Board’s position is that all
clergy who are working in a church
or institution are employees, as
long as they receive a paycheck
from that church or institution.
Chaplains should receive a W-2
form, the institution should pay
half the Social Security tax, and
the institution should pay (or
designate) a housing allowance
in addition to salary.
The housing allowance must be
approved before the beginning of
the year by the board of directors
of the institution, then it is
deducted from salary, taxed at
the self-employed rate, and is
reported on Schedule SE (along
with other income and expenses).
This means the chaplain is both
an employee and self-employed (for
outside work, for which honorariums
or other payment is received).
The chaplain must file Schedule
SE along with his/her Schedule
1040, and Schedule C only if applicable
(not for salary and benefits).
Also, a chaplain does not file
Schedule 2106 if his/her institution
pays all business expenses (travel,
books, etc.).
The United Methodist Board of
Pensions provides regular updates
about tax matters important to
clergy on their website: http://www.gbop.com where
readers can access the search feature
and then ask for advice related
to the housing allowance and other
tax advice for clergy. This site
is particularly helpful in tracking
updates on housing allowance legislation
and judicial challenges.
This article should not be construed as rendering a professional opinion; rather
it is intended to alert chaplains to a possible issue of interest. Should you
have any questions about these issues, you should contact your accountant or
tax advisor. You may also want to speak with your institution’s accountant
or benefits manager.
The Rev. Lerrill J. White, Ph.D.,
B.C.C., is assistant director of
Clinical Pastoral Education at St.
Luke’s Episcopal Hospital in Houston,
TX, and has been the liaison to Health & Human
Services for the Association of Clinical
Pastoral Education and Association
of Professional Chaplains since 1983.
Chaplain White is a PlainViews Advisory
Board member.
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Education & Research |
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Rabbi Shira Stern and Dr.
Tamar Earnest on why
we use “G-d.”
(The Managing
Editor has received
several inquiries
as to why PlainViews uses
G-d when referring
to the Supreme Deity.
She asked PlainViews Advisory
Board member Rabbi
Shira Stern to comment
on this practice.)
Why
G-d?
It is said that each
word, each vowel, each
consonant in the Torah—the
Five Books of Moses—has
a special meaning and
a special purpose.
Words are very powerful,
whether in Hebrew or
Latin or … English,
regardless of whether
they are spoken or
written.
It goes without saying, therefore, that any mention of the Divine name requires
the utmost care, lest we inadvertently misuse or overuse the term. In Hebrew,
the most sacred of G-d's 70 names is YHVH, sometimes translated as Yahweh or
the most recognizable, Jehovah.
In ancient times,
when the Temple still
stood in Jerusalem,
this particular name
of G-d was first spoken,
and then eventually
whispered by the High
Priest in the Holy
of Holies, the inner
sanctum, on Yom Kippur,
a day of great solemnity
and introspection.
When the Temple was
destroyed by the Romans,
the correct articulation
of the Name was lost
as well. To ensure
we do not, by sheer
coincidence, ever say
the Word inadvertently,
Jews have created a
substitute—“Adonai”—which
we still use only in
prayer. When talking about G-d
rather than talking to G-d,
we call on "HaShem" -
literally, the Name.
G-d also further distances
us from the risk of
desecrating G-d when
papers or books that
contain G-d are discarded
or destroyed.
So why do some people
use G-d — even those
of us who do not think
that G-d can be limited
to a mere name? The
long answer to the
short question, "Why
G-d" is that this
tradition has carried
over to the English,
by habit more than
anything else, and
habits are hard to
break, the bad and
the good. We continue
to use G-d for those
who find this tradition
deeply meaningful.
It is for all these
reasons, that out of
respect to the variety
of faith practices
encompassed by chaplaincy, PlainViews uses
the term “G-d” when
referring to the supreme
deity.
May the Holy One of
blessing, Who is beyond
all description, grant
you a joyous renewal
of Spring, peace and
understanding.
Rabbi Shira Stern,
B.C.C., a member of the
Advisory Board of PlainViews,
is director of the Jewish
Institute for Pastoral
Care of The HealthCare
Chaplaincy in New York
City, and serves on the
National Association
for Jewish Chaplains’
board of directors and
executive committee.
Rabbi Stern was among
the early group of women
ordained by the Hebrew
Union College-Jewish
Institute of Religion
in 1983. She has served
as a pulpit rabbi of
the Monroe Township Jewish
Center, NJ for 13 years;
as East Coast director
of MAZON: A Jewish Response
to Hunger; and as Middlesex
County’s director of
Jewish chaplaincy for
three and a half years.
Dr. Tamar Earnest was a trauma surgeon
for 17 years in Allentown PA, and is currenlty
enrolled in The Academy for Jewish Religion
as a rabbinic student. She earned 4 units
of CPE at the Jewish Insitute for Pastoral
Care of The HealthCare Chaplaincy and is
part of the Compassionate Jewish Leadership
class at the JIPC in New York City. |
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Spiritual
Development |
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.gif) Mary Regan, Ph.D. on Diving Into
the Wreck – Part 3
Diving
Into the Wreck
– Part 3
How chaplains may deal with the risk of re-traumatization
as they listen to the stories of others
This week Mary
Ragan, Ph.D., director
of the Psychotherapy
and Spirituality
Institute in New
York City, continues
her discussion of
the traumas confronted
by chaplains and
new options for self-healing.
The essay’s title,
“Diving Into the
Wreck,” is taken
from the poem of
the same name by
Adrienne Rich, who
writes “I came to
see the damage that
was done / And the
treasures that prevail.”
Trauma work always
involves some risk
of re-traumatization
for the person who
listens to the story.
None of us comes to
the trauma conversation
as a blank screen.
We come with our histories
and our own experience
of trauma which may
be more or less successfully
integrated.
The first and most potent indicator of re-traumatization is signaled by the
response of the body. The heart pounds, the hands sweat, the face flushes,
breathing becomes shallower and thinking gets more difficult. At those moments
of regression, when the trauma that lies dormant in the helper is activated,
the only appropriate response is one of compassion and patience towards oneself.
The trauma worker may need to “take a break” from the intensity of the story,
may need to dissociate somewhat from the narrative, may need to recognize
that personal issues have now made being fully present to the traumatized
person impossible. This is neither a sin nor a crime, but simply a human
reaction in the face of what Judith Herman in Trauma and Recovery calls
“unspeakable atrocities.”
These discussions
of trauma and its aftermath
with people so intimately
involved with those
who suffer have been
a remarkable human
experience and a privilege.
Another poem by Adrienne
Rich called “Natural
Resources,” found in The
Fact of A Doorframe.
[Norton, 1984], captures
something of the experience:
My heart is moved
by all I cannot save:
so much has been destroyed
I have to cast my
lot with those
who age after age, perversely,
with no extraordinary
power,
reconstitute the world.
Mary Ragan Ph.D.,
CSW is a senior staff
therapist at the Psychotherapy & Spirituality
Institute in New York
City. She is an adjunct
faculty member at General
Theological Seminary
and Fordham University.
The subject of her doctoral
dissertation was the
psychotherapy of traumatic
grief.
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