 5/18/2005
Vol. 2, No. 8
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Professional
Practice |
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The
Rev.
John
Simon
on
the
work
of
words
Caring
for
the
Caregivers:
an
E-Journal
Most
of
life
is
constituted
of
relationship.
Gravity
is
a
relationship
of
bodies;
matter
a
relationship
of
particles;
fire a relationship of substances; logic a relationship of ideas; truth
a relationship of realities;
love a relationship of spirits; religion a relationship of being. [1]
Relationship comes before task. However, the tasks involved in the pursuit
of excellence in operational and clinical outcomes in hospitals at times
take precedent over relationships. The dialectical tension in this innate
task-oriented vs. relationship-oriented culture can leave the corporate
soul anemic and in need of care. As a professional chaplain, I remain
curious. ”Where are the sacred spaces that permit us to remember
and recognize our common humanity in the pursuit of our raison d’être?”[2]
As chaplain and a director in charge of building a new Pastoral Care
Department at Vassar Brothers Medical Center, I became convinced that
if we as an organization were to reach our goal of growing from Good
to Great [3] and become a member of the 100 Best Companies to
Work For, part of the answer would be found in reclaiming the primacy
of relationships in our shared corporate life.
Sir
Thomas
More
said, "The
world
does
not
need
so
much
to
be
informed
as
to
be
reminded." [4]
The
spiritual
void
apparent,
reminding
became
essential
to
our
wholeness
of
life.
Absent
was
a
corporately
sanctioned
space
to
remember
that
it’s
the
relational
that
binds
us
together.
The
Chapel
was
not
the
answer.
A
practical
platform
(that
was
paperless)
was
prayerfully
sought.
The
scope
had
to
respect
the
dignity
and
spirituality
of
all
persons
within
the
organization
in
order
to
go
mainstream
and
remain
viable.
The
old
adage, “the
tall
tree
catches
the
wind,”aptly
applied.
It
was
a
risk
but
safety
would
have
only
secured
the
department
a
place
on
the
periphery.
Being
mindful
that
words
make
the
world
real,
I
took
up
the
work
of
words
through
the
power
of
story.
The
creation
of
the
bi-monthly Caring
for
the
Caregivers:
E-journal took
form
and
was
e-mailed
to
all
our
employees
30
days
into
my
tenure.
It
is
a
two-page
document
featuring
a
main
story
on
page
one,
the
second
page
beginning
with
a
section
entitled “For
the
Leader
in
You,”followed
by
an
interfaith
calendar
with
a
side
bar
section
detailing
departmental
information
and
quote
of
the
month.
All
stories
featured
are
copyrighted
referenced
materials
of
published
works. “People
recognized
the
voice
of
the
genuine”[5]
in
the E-journal.
One
poignant
response
was, “I
have
found
the
journal
to
be
a
source
of
inspiration
in
my
daily
work;
when
you
educate
patients;
you
are
providing
a
lot
of
emotional
support.
This
can
be
draining,
especially
when
one
feels
emotionally
drained
from
one’s
own
life.
Those
few
minutes
last
much
longer
than
the
time
to
read
them.
I
feel
a
source
of
spiritual
support
at
my
workplace –what
a
treasure
that
is!” Nurturing
relationship
is
to
nurture
spirit.
The
entire
edition
of
the E-journal can
be
found
at www.vassarbrothers.org under
Pastoral
Care.
[1]Petruska
Clarkson, "Integrative
Psychotherapy,
Integrating
Psychotherapies,
or
Psychotherapy
after “Schoolism?" In
Colin
Feltham
(ed.), Which
Psychotherapy? Thousand
Oaks,
CA:
Sage,
1997,
p.37.
[2] Raison d’être -- our reason and purpose for being.
[3] Jim Collins, Good to Great: Why Some Companies Make the Leap and
Others Don’t, Harper Business: New York, NY, 2001, p. 1-16.
[4]Robert C. Shannon, 1000 Windows, Cincinnati, Ohio: Standard
Publishing Company, 1997.
[5] Dennis W. Wiley, The Concept of the Church in the Works of Howard
Thurman, Ann Arbor: MI, UMI, 1988, p. 167.
The
Rev.
John
Simon,
M.Div.,
M.T.S.,
BCC,
is
Director
of
Pastoral
Care
at
Vassar
Brothers
Medical
Center,
a
HealthCare
Chaplaincy
partner
hospital.
A
native
Texan,
he
has
been
engaged
in
ministry
for
17
years
10
of
which
have
been
in
healthcare
chaplaincy.
An
ordained
Baptist
minister,
Rev.
Simon
entered
ministry
from
a
previous
career
in
internal
auditing.
He
has
served
in
various
senior
leadership
positions
in
the
parish,
non-profit
administration
and
hospital
contexts
in
TX,
CT,
CO,
and
PA.
Clinically
trained
with
8
units
of
clinical
pastoral
education,
Rev.
Simon
is
board
certified
through
the
Association
for
Professional
Chaplains.
His
educational
background
includes
a
bachelors
of
business
administration
in
Accounting
with
a
minor
in
Marketing
from
Prairie
View
A&M
University
in
Prairie
View,
TX;
a
Masters
of
Divinity
degree
from
Yale
University
Divinity
School
in
New
Haven,
CT;
and
a
second
Masters
in
Theological
Studies
with
distinction
from
the
Iliff
School
of
Theology
in
Denver,
CO.
Additionally,
Rev.
Simon
completed
two
additional
years
of
graduate
research
at
the
University
of
Denver
in
the
area
of
religion
and
social
change.
He
integrates
his
diverse
background
in
education,
experience
and
professional
training
in
his
ministry.
The
results
have
positively
impacted
the
relationship
between
the
medical
institution
and
faith
communities
in
which
he
now
serves.
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. Susan Wintz
on a different way to look at JCAHO
JCAHO
is Professional Chaplaincy's
Friend
The Joint Commission
for the Accreditation of Healthcare
Organizations (JCAHO) is a much-discussed
entity within professional chaplaincy.
Perspectives differ from whether
interacting with JCAHO is a thorn
in the flesh of chaplains or an opportunity
to be proactive about the work that
we do. This writer takes the latter
perspective.
According to the Strategic Plan
of the Association of Professional
Chaplains, it is part of the responsibility
of the Commission on Quality in Pastoral
Services to “champion APC representation
to JCAHO, the COMISS Network on Specialized
Settings, and other professional
healthcare organizations.”Over
the past three years, this has been
done in a variety of ways, and the
Commission’s relationship with
the Joint Commission has grown to
benefit the profession of professional
chaplaincy.
I believe that JCAHO is our friend
because their standards provide chaplaincy
departments with the opportunity
to articulate and advocate for the
work that chaplains do as members
of the interdisciplinary team. They
lead us as we develop standards of
practice, policies, and other documents
similar to those of other disciplines
within our organizations. Additionally,
they provide us with opportunities
to share those documents and engage
in dialogue with surveyors and with
our interdisciplinary colleagues
before, during, and long after the
survey itself is completed.
The key, however, is that we have
to be proactive. We need to take
responsibility for our work by choosing
to participate fully in survey preparations
rather than attempting to avoid the
process. It is essential that we
step up to the plate of professionalism
and identify the ways in which we
are collaborative members of the
team rather than attempting to argue
that our role is different or unexplainable
in clinical language. We need to
do the work necessary to prepare
documents in line with those of the
other discipline and participate
in planning meetings. Just as importantly,
we need to seek out opportunities
to be involved in surveys and speak
up to questions asked rather than
hiding in our offices or the back
of the room.
We also need to be collaborative
in how we speak about and engage
the Joint Commission. While it is
true that stronger language in the
JCAHO standards about the role of
the clinically trained, professional
certified chaplains would advocate
even more for our presence within
healthcare organizations, we need
to be aware that change comes slowly
to regulatory agencies. And change
IS happening.
The Quality Commission is actively
engaged in dialogue with the Joint
Commission, and was sought out for
input when an article was recently
written about how organizations can
evaluate their spiritual assessment
process. Conversations are occurring
regularly about how we can be involved
with and contribute to the survey
process both locally and nationally
as well as articulating more clearly
about the role of professional chaplains.,
This dialogue is mutual and empowering.
Advocacy being done by the Quality
Commission is taking place for our
profession as a whole, not simply
for one single cognate group. It
is the responsibility of all of us
to be proactive, positive, and collegial
in our relationships with the Joint
Commission and in our conversations
with each other. JCAHO truly is our
friend.
The Commission on Quality in Pastoral
Services is committed to providing
various resources to assist professional
chaplains in their work. Several
resources, including a crosswalk
for the 2005 JCAHO Standards for
Hospitals, can be found at the website
of the Association of Professional
Chaplains at http://www.professionalchaplains.org.
Click on “Professional Resources”on
the left, then on “Reading
Room.”Crosswalks for chaplains
serving in other areas, including
behavioral health and long term care,
are being developed by the Commission.
The Rev. Susan Wintz, a Presbyterian
Church (USA) minister, is a staff chaplain
at St. Joseph's Hospital and Medical
Center in Phoenix, Arizona. She serves
as chair of the APC Commission on Quality
in Pastoral Services and is a member
of the Advisory Board of PlainViews.
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 Charles Barley
on investigating how
the mind sends messages
from head to heart
Meshing
of the Stress Model
to Pastoral Care
Through
the years many people
who believed pastoral
care had a physiological
impact could not begin
to clarify the issue
for me. One connection
that I found is between
pastoral care and spirituality
through the relationship
of the patient and the
chaplain. Pastoral care
interacts with one’s
physiology in the stress
response and how one's
spiritual life is directly
and indirectly involved
in lowering stress. While
lowering one’s
stress may not be a direct
goal of the chaplain,
it is often a secondary,
and welcome, side effect.
The area where this
corresponds to both science
and pastoral care is
in the “meaning," or
what the patient and
the chaplain mutually
understand. Illness can
become a stressor magnifying
the patient’s beliefs.
As we seek to understand
how the patient interprets
various aspects of their
hospitalization, the
scientific field is concerned
with how this understanding
determines their level
of arousal. I have seen
that interpretation impacts
areas such as stress,
pain, physiology, pastoral
care, and suffering.
Interpretations become
biochemical processes
that impact the patient
positively or negatively.
Through areas such as
thought, support, prayer,
worship, relationships,
humor, understanding
and one’s worldview,
a person’s stress
level can be intensified,
modified, stabilized,
and even transcended.
Insights from the past
three decades have reflected
that for every physiological
interaction there is
a neurochemical equivalent
affecting one’s
state of being. For example,
Otto Loewi (the Nobel
Prize recipient whose
work led to a completely
renewed understanding
of the sympathetic nervous
system) demonstrated
how a thought takes on
a physiological response.
He proved that when the
mind sends a message
from head to heart, it
involves a corresponding
electrical and biochemical
message.This is significant
because biochemical messages
move faster through the
blood stream than electrical
ones moving through the
body's synapse/
dendrite system.
While “As a man
thinketh in his heart,
so is he,”(Prov
23:7) refers to ethical
or spiritual ways, I
also think of it in physiological
terms. While the Bible
presents humans as uniquely
spiritual beings, it
also offers a holistic
view of Jesus’humanity.
Consider how Luke 2:52
shows Jesus growing intellectually,
physically, spiritually,
and socially.
My CPE Supervisor used
to say, “feelings
follow thought”and “perception
yields behavior.”They
also yield a physiological
impact! After patients
define their stressor,
they assess their ability
to handle the threat.
Stress is caused by the
patient believing the
threat to be greater
than their ability to
cope. The stress response
is often reflected in
negative/destructive
emotions producing fight
or flight hormones. These
hormones translate into
an increase of adrenal
activity which can increase
stress, slow healing,
increase pain, and in
chronic situations, cause
organ damage. This, in
turn, intensifies the
chaplain’s need
to assist the patient
in dealing with such
negative emotions by
assisting the patient
in addressing the underlying
thoughts and assumptions
of the patient which
may be reflective of
conflicted relationships
among God, others, and
self; their distorted
views of God; or core
theological views of
their life and death.
Jesus’question, “Which
is easier to say, your
sins are forgiven or
you are healed?”(John
9:5) reflects that Jesus
saw no separation between
body and spirit. It also
sheds light on why some
patients may equate certain
thoughts and actions
to sin and Divine judgment.
The roots of such destructive
feelings are often reflected
by corresponding thoughts.
One of the newer pain control theories reflects the impact of the patient’s
interpretation of a stressor upon the pain experience. More importantly, the
interpretation of one’s situation has also been shown to impact the functioning
of one’s immune system in another important new field, showing the importance
of paying attention to the patient’s feelings.
Understanding this can
assist in bringing about
evidence-based outcomes
like: lowering patient
stress; lowering patient
pain; increasing patient
immune function; aiding
in avoiding chronic problems
leading to organ damage;
and lowering hospital
costs by lowering length
of stay.
Charles Barley is Southern
Baptist, endorsed through
the Baptist General Convention
of Texas. He is a Board
Certified Chaplain who
has been serving at Glenwood
Regional Medical Center
in West Monroe, Louisiana.
He has served as a chaplain
for twenty-five years in
Corpus Christi State School;
St. Francis Medical Center
in Monroe, LA; Glenwood
Regional Medical Center;
doing his basic and advanced
CPE training at Memorial
Medical Center in Corpus
Christi, TX.
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.
Dr. Mark LaRocca Pitts
on finding shalom with
G-d
Creating
Space for G-d
Isaac
Luria, a medieval Jewish
Rabbi and mystic, taught
that before G-d created
the world, G-d alone
existed: G-d was “all
in all”without
end, beginning, or dimensions
of any sort – Ein-Sof (lit. “without
end”), as the Kabbalah teaches.
If everything, everywhere,
and everywhen was G-d,
then where was G-d going
to find a place for a
world that by biblical
theistic definition is
the created and not the
Creator? G-d solved this
problem, Luria explains,
by retreating or withdrawing
from a part of G-d’s
Self and thereby creating
a space within the very
Being of G-d that was
not G-d. In this empty
space or vacuum, in which
the “aroma”of
G-d’s presence
still lingered, G-d then
created the world through
a series of emanations.
Into this world, G-d
then placed humans whose
souls contain a divine
spark –a
small bit of G-d’s
very Being. This divine
spark longs to be reunited
with G-d and acts to
lure us, along with the
world we inhabit, back
into divine union with
G-d.
Whether agreeing with
this metaphysical speculation
or not, it does provide
a profound metaphor that
may speak to your spiritual
journey, as it has to
mine. If, before the
beginning, G-d created
within G-d’s Being
a space for us, then
now, within our being,
we can create a space
for G-d.
In case you haven’t
noticed, with all the
advances in modern technology,
many of which are intended
to simplify our lives,
our lives have become
increasingly more complex
and busier than ever.
We feel lost and cut
off when we are beyond
the reach of our cell
phones, pagers and PDAs.
From morning until night
and even into our sleep,
we are in motion – never
resting, never slowing
down, never finding peace
and solitude. Even when
our bodies are at rest,
our minds are racing
and our emotions are
seething. Even when we
set aside time for prayer
and meditation, we fill
it with words, longings,
images and supplications.
Our world, both external
and internal, is overflowing
with events, things,
thoughts, doubts, memories,
feelings, hopes, fears,
loves, and loathings.
These and many other
things crowd out the
space where G-d is waiting
to meet us.
Creating a space for
G-d takes practice and
patience. It begins and
it ends by stilling our
bodies, by stilling our
minds, by stilling our
hearts, and by stilling
our wills. As the Psalmist
put it, “Be still
and know that I am G-d.”Or,
as the 16th century Christian
mystic John of the Cross
put it, “Silence
is G-d’s first
language.”We create
a space for G-d within
our being when we silence
all our physical, mental,
affective and willful
doings. In this silent
space, where we have
retreated beyond our
ego self and where the “aroma”of
G-d’s presence
still lingers, that which
is G-d within reunites
with that which is G-d
without and we find shalom – rest,
healing, and wholeness – first
for ourselves, and then
for our world.
Rev. Dr. Mark LaRocca-Pitts
is a Staff Chaplain at
Athens (GA) Regional Medical
Center and is endorsed
by the United Methodist
Church. Mark earned his
PhD in Near Eastern Languages
and Civilizations at Harvard
University and has worked
seven years as a healthcare
chaplain. Mark also teaches
as an Adjunct Professor
in the Religion Department
at the University of Georgia
and pastors a small rural
UM church. He is an Affiliate
Member with APC and is
a member of its History
Committee, its Commission
on Quality in Pastoral
Services, and its Continuing
Chaplaincy Education (CCE)
Reviewers Sub-Education
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