Hospital Chaplains Research Articles

Learning From Experiences of Feeling Heard: A Qualitative Study of Hospice Palliative Care Volunteers

Listening is central to the role of volunteers. The purpose of this study was to explore how different experiences of being listened to and feeling heard (or not) can be formative and influential for hospice volunteers in how they listen to others. What kinds of experiences have hospice volunteers had of receiving listening from others across their lifespan? What is the quality of those experiences? And how might these experiences have motivated and shaped their own listening styles, affected their capacity for listening, and influenced their approach to care in their roles as hospice palliative care volunteers? Ten hospice volunteers participated in individual, confidential, thematic and semi-structured interviews with the principal investigator who works primarily as a hospital chaplain, or spiritual health practitioner. The principal investigator adopted the approach of experience-based, body-anchored interviewing. Participants' needs for listeners and their motivations for listening to others extended from long-standing emotional needs based in formative family relationships. What does it feel like when someone really listens to you? Participants in this study talked about how they felt moved to tears, relaxed, settled, confident, empowered, joyful, embraced and loved. That is the positive power of listening that the participants and other learners can draw upon from their own experience and offer to others. Further reflection on enduring emotional needs, and experiences of feeling heard and understood can enhance approaches to teaching volunteers how to listen empathically to others. And role play might take center stage, particularly for new volunteers and other learners for whom it might be a rare opportunity to observe the modeling of good listening, and even to receive it by having a skilled empathic listener listen to them with their full and undivided attention, perhaps for the very first time in their lives.

Influences of Religion and Spirituality in Medicine

This issue examines how religion and spirituality in medicine can help clinicians develop partnerships with hospital chaplains and faith-based groups.

Doris Taylor: All Heart.

There’s an undeniable warmth to Doris Taylor, Director of Regenerative Medicine Research and of the Center for Cell and Organ Biotechnology at the Texas Heart Institute and Texas A&M University in Houston. Professionally, she may be most famous for engineering the first bioartificial mammalian heart.1 But, on a personal level, her own heart is compassionate, generous, and not remotely artificial. Taylor went through great turmoil in early childhood, but rather than mentally closing herself off to pain and difficulty, she’s endeavored throughout life to ease the pain and suffering of others. In a recent interview with Circulation Research , she explained that she does this in two ways. At a community-level, she’s an ardent advocate for social justice, spending her spare time promoting local political organizations and spearheading worthy causes, while at the global-level, her scientific research adds to the body of medical knowledge that enables innovations, improves treatments, and saves lives. Doris Taylor Her research has certainly, and consistently, broken new ground. Her pioneering stem cell research, regenerative medicine strategies, and investigations of sex-specific physiological differences have driven new lines of enquiry in cardiovascular disease research and have also challenged established attitudes toward how such diseases might be treated.2–6 I was born in San Francisco and I had a twin brother. We were born very prematurely and, in those days, premature twins didn’t live, so neither of us were supposed to survive. My mother told us that the doctor came in and told her, if she was religious and believed in doing something for the end of life, she should do it for us. So, she called the hospital chaplain and he came, but then, according to my mother, the minute he left the room, my brother and I rallied. It was as if we’d …

Denominational Ministry in a Changing Society: A Phenomenological Study of the Attitudes and Beliefs of Hospital Chaplains in Northern Ireland

The recent history of Northern Ireland society is one in which denominationally-defined communities have been losing identity in favour of more fluid, diverse and secular forms of social interaction. The practice of hospital chaplaincy reflects this social transition: it is faced with the challenge of redefining itself in non-sectarian ways, as expressed in the migration of hospital chaplaincy from a denominationally-based to person-centred model of care. Six semi-structured interviews were conducted with a representative sample of chaplains working in Health and Social Care (HSC) Trusts in Northern Ireland (NI). Using interpretative phenomenological analysis (IPA) ten key themes were identified that fell into three areas: training for chaplaincy, the delivery of chaplaincy and the relationship between chaplains and the institutions of church and hospital. The themes shed new light on how chaplains are negotiating this transition from a denominational to a post-denominational context; and the tensions and pitfalls they encounter.

Movement, Materiality, and the Mortuary: Adopting Go-Along Ethnography in Research on Fetal and Neonatal Postmortem

This article explores the use of the go-along method in research that takes place “behind closed doors” drawing on qualitative research on postmortem imaging. Often favored in community and urban studies, go-along consists of mobile interviews and observations with respondents in their own environments. We conducted go-alongs with various professionals—from pathologists to hospital chaplains—in a range of settings. We also tracked different forms of materiality in and out of the mortuary space. As the article seeks to show, go-along allowed us to appreciate the complex and mobile nature of postmortem, situating it within the wider landscape of bereavement and memorialization. It also enabled us to illuminate the ways in which the mortuary as a place cannot be fixed “indoors,” but rather, is continually remade through different types of practice. Our analysis emphasizes the value of using go-alongs in indoor settings, and further reinforces a fluid conceptualization of place.

Attitudes Towards Hospital Chaplains Among Neurological Critical Care Unit Clinical Staff (P4.333)

Attitudes Towards Hospital Chaplains Among Neurological Critical Care Unit Clinical Staff (P4.333)

Integrating Spiritual Care During Interprofessional Simulation for Baccalaureate Nursing Students.

Interprofessional educational experiences for baccalaureate nursing students are essential to prepare them for interprofessional communication and collaborative interprofessional teamwork. The aim of this descriptive qualitative study was to understand the experience of baccalaureate nursing students utilizing the hospital chaplain while caring for a suicidal patient in the emergency department during simulation. The need for interprofessional education is documented in the literature, but there are very few comprehensive, successful projects integrating spiritual care for nurse educators to use as models. This project can serve as a model of a successful interprofessional education initiative involving preprofessional nursing students and chaplain services. Overall, nursing students found the learning experience to be beneficial in preparation for professional practice on a collaborative interprofessional health care team.

Collaborating With Hospital Chaplains to Meet the Spiritual Needs of Critical Care Patients.

There are many opportunities for critical-care nurses to collaborate with chaplains in an effort to provide spiritual care for patients and their families. By recognizing the educational requirements as well as the unique roles of board-certified chaplains (BCCs), the critical-care nurse will view them as respected members of the health care team. This collaboration positively impacts the work environment and creates a holistic space for healing for patients, as well as the health care team. As nurses, we must educate and inform novice nurses about the important role of BCCs on the interdisciplinary health care team. Critical-care nurses need to incorporate the BCCs' contributions into the patient plan of care during bedside report in a way that helps the nurse understand the connection between the patient's spiritual health and his/her experience as a patient.

Sweet Delight and Endless Night: A Qualitative Exploration of Ordinary and Extraordinary Religious and Spiritual Experiences in Bipolar Disorder

ABSTRACTThe authenticity of religious and spiritual experiences during mania is an important subject for bipolar patients. The exploration of such experience in bipolar disorder is the central point of this qualitative study. A psychiatrist and a hospital chaplain conducted 35 semi-structured interviews with recovered participants, recruited from mental health care institutions in the Netherlands, the patients’ association and via the internet, about their religious and spiritual experiences during illness episodes and in stable times. A variety in types (such as divine presence, unity, mission, meaningful synchronicity) during mania was reported, which were on a sliding scale with experiences/views in stable times in more than half of the interviews. During depression, absence of religious or spiritual experience was predominant. The reported experiences were viewed by most participants as both authentically religious or spiritual but also related to the disorder, requiring therefore language that transcended medical terminology. Also indicated is the relevance of the results for fundamental discussions about the nature or religious experience.

Book Review: The Diener: Poems

Diener: Poems. By Martha Serpas. Baton Rouge, La.: Louisiana State University Press, 2015. 78 pp. $17.95 (paper).Martha Serpas's new poetry book, draws on a pastoral tradition that associates obligations of Christian with caring for flocks in pastures. This tradition originated in Bible, which construed pastor according to its Latin definition; pastor originally meant or who provided food. When prophet Jeremiah declares, I will give you pastors according to mine heart, which shall feed you with knowledge and (Jer. 3:15 KJV), he makes use of ancient association of and shepherd. As if fulfilling Jeremiah's promise about pastors, Jesus in John's Gospel assumes role of the good shepherd who feeds his flocks with spiritual understanding and giveth his life for sheep (John 10:11 KJV). Having worked as a hospital chaplain, Serpas gravitates to this pastoral tradition, and as an environmental activist she stresses importance of actual pastures-and of natural world in general-that must be kept healthy to feed flocks.Serpas s book begins with an introductory poem, The Diener, which focuses on related concepts of health and wholeness, and way an individual's body, like world's body, is an ecosystem in which different parts must work together as a whole for there to be health. As director of a morgue, Serpas s is all too familiar, with parts breaking down and wholes dying and decomposing. If one endorses Serpas's proposition that God's image is (p. 1), which she asserts before giving a catalog of body parts, one should also endorse ideal of composite whole. We like to see ourselves as whole, she writes, diener piling legs on a cot / despite pruned artery, tied and cut (p. 1). Like Frost counseling his readers to drink and be whole beyond confusion with a makeshift communion goblet like Grail at end of Directive, Serpas throughout Diener directs those who find their lives in confusing fragments to pursue ideal of wholeness. At times, her urge to counsel makes her didactic. Education is answer / to our social woes, she says at start of Pearl Snap (p. 10), a poem drawing on her experiences as a hospital chaplain. Poems such as Badlands, in which a patient tattooed with wolves boasts he is an atheist, or Asperges, in which a nurses washes a dead baby boy whose green skin sloughs off // like bruised fruit skins (pp. …

Nurses’ Roles in the Spiritual Care of Patients with Terminal Illness

Traditionally, issues of religion or spiritual care are left to hospital chaplains in missionary hospitals and some first-world hospitals where chaplains are a part of holistic multi-disciplinary hospital care. In other instances, the patients are merely left on their own to call in their spiritual or religious leaders to attend to them during visiting hours. This paper posits that spiritual care of patients, especially terminally-ill ones, belongs to nurses too. Unfortunately, many nurses working with patients approaching the end of their lives might feel illequipped to recognize and respond to such spiritual needs. This paper seeks to equip front-line health care providers, especially nurses, with an actionable and practical guide to assist in identifying spiritual need in their patients and to feel confident in their ability to provide it. It focuses on terminally-ill patients who are expected to die in the near future, however much of the content is relevant to other situations such as sudden death.

Hospital Chaplains: Through the Eyes of Parents of Hospitalized Children.

Chaplain services are available in 68% of hospitals, but hospital chaplains are not yet incorporated into routine patient care. To describe how families of hospitalized children view and utilize hospital chaplains. Telephone survey with 40 questions: Likert, yes/no, and short-answer responses. Parents visited by a hospital chaplain during their child's hospitalization in a tertiary care center. Descriptive statistics were used to characterize the sample. Nonparametrics were used to compare religious versus nonreligious parents. Regression was used to identify independent predictors of a chaplain visit positively influencing satisfaction with hospital care. Seventy-four parents were interviewed; most were 25-50 years old, and 75% felt their child was very sick. Children ranged from newborn to adolescence. Forty-two percent of parents requested a chaplain visit; of the 58% with an unsolicited visit, 11% would have preferred giving prior approval. Parents felt that chaplains provided religious and secular services, including family support and comfort, help with decision making, medical terminology, and advocacy. Chaplains helped most parents maintain hope and reduce stress. Seventy-five percent of parents viewed chaplains as a member of the healthcare team; 38% reported that chaplains helped medical personnel understand their preferences for care and communication. Most parents (66%) felt that hospital chaplaincy increased their satisfaction with hospital care. Families play a fundamental role in the recovery of hospitalized children. Parents view hospital chaplains as members of the healthcare team and report that they play an important role in the well-being of the family during childhood hospitalization. Chaplains positively influence satisfaction with hospital care.

Effect of an educational intervention in “spirituality and health” on knowledge, attitudes, and skills of students in health-related areas: A controlled randomized trial

Background: To date there have been no randomized studies that assess whether “Spirituality and Health” (S/H) programs are, indeed, effective, or not. We sought to evaluate if an intervention in teaching S/H fosters competence changes in healthcare students.Methods: A randomized controlled trial was carried out. Students were randomized into two groups: an Intervention Group (a theoretical-practical course in S/H) and a control group (waiting list). Students’ S/H knowledge, attitudes, and skills (through a simulated patient) were assessed.Results: A total of 49 students were evaluated. Students in the intervention group received higher scores on knowledge tests, felt more comfortable and prepared to talk about religious/spiritual beliefs with patients, more readily recognized importance of hospital chaplains, and more frequently held the opinion that addressing spirituality is important. Furthermore, a breaking down of S/H barriers was identified. Students also demonstrated more ability in obtaining a patient’s spiritual history when compared to the control group.Conclusions: There were some differences on knowledge, attitudes, and spiritual history skills between students who participated in the S/H teaching strategy and students who have not been exposed to the theme. These results might foster discussion for the development of new educational strategies about the subject.

Integrating Spiritual Care into Palliative Consultation: A Case Study in Expanded Practice.

Recognizing and addressing spiritual needs has long been identified as a key component of palliative care (PC). More often than not, the provision of spiritual care involves referral to a hospital chaplain. In this study, we aim to describe the role of a PC chaplain embedded within the interdisciplinary PC team and demonstrate how this palliative chaplain role differs from that of a traditional hospital chaplain. We postulate that integrating spiritual care provision into a PC team may offer a broader spiritual care experience for patients receiving PC and begin to delineate expanded clinical roles for the palliative chaplain.

Ethics and Oncofertility: A Call for Religious Sensitivity.

For patients of reproductive age, treating cancer may come at the price of infertility. Literature regarding fertility preservation recommendations in this population has increased significantly, but this literature too often overlooks or insufficiently considers the relevance of religious preferences. Similarly, practice guidelines do not address the role of religion in the oncofertility discussion. The acceptance of oncofertility practices varies significantly among Christianity, Judaism, and Islam. A patient's faith-based spirituality or secular morality may enhance his or her interpretation of the meaning of illness and should be incorporated into the informed-consent process. In this article, we describe the role of religious sensitivity in oncofertility care and argue for its importance in such care. We briefly summarize the views and moral reasoning about oncofertility in a few religions commonly encountered in many patient populations today. We recommend that clinicians discuss fertility options early in the decision process and, when relevant, incorporate the patient's moral and religious preferences into the treatment plan. We encourage providers to be prepared to offer resources to patients who desire moral and spiritual guidance about fertility preservation options. Hospital chaplains should be able to provide such resources.

Nurses' comfort level with spiritual assessment: a study among nurses working in diverse healthcare settings.

To gain knowledge about nurses' comfort level in assessing spiritual matters and to learn what questions nurses use in practice related to spiritual assessment. Spirituality is important in holistic nursing care; however, nurses report feeling uncomfortable and ill-prepared to address this domain with patients. Education is reported to impact nurses' ability to engage in spiritual care. This cross-sectional exploratory survey reports on a mixed-method study examining how comfortable nurses are with spiritual assessment. In 2014, a 21-item survey with 10 demographic variables and three open-ended questions were distributed to Norwegian nurses working in diverse care settings with 172 nurse responses (72 % response rate). SPSS was used to analyse quantitative data; thematic analysis examined the open-ended questions. Norwegian nurses reported a high level of comfort with most questions even though spirituality is seen as private. Nurses with some preparation or experience in spiritual care were most comfortable assessing spirituality. Statistically significant correlations were found between the nurses' comfort level with spiritual assessment and their preparedness and sense of the importance of spiritual assessment. How well-prepared nurses felt was related to years of experience, degree of spirituality and religiosity, and importance of spiritual assessment. Many nurses are poorly prepared for spiritual assessment and care among patients in diverse care settings; educational preparation increases their comfort level with facilitating such care. Nurses who feel well prepared with spirituality feel more comfortable with the spiritual domain. By fostering a culture where patients' spirituality is discussed and reflected upon in everyday practice and in continued education, nurses' sense of preparedness, and thus their level of comfort, can increase. Clinical supervision and interprofessional collaboration with hospital chaplains and/or other spiritual leaders can facilitate tailor spiritual assessment of patients based on patient concerns and view of life.

All the Comforts of Home: Transformation to a Comfort Environment in Critical Care.

All the Comforts of Home: Transformation to a Comfort Environment in Critical Care.

Spirituality is Not a Four-Letter Word

Back to table of contents Previous article Resident’s ForumFull AccessSpirituality is Not a Four-Letter WordHannah Roggenkamp,M.D.Hannah Roggenkamp,Search for more papers by this authorM.D.Published Online:7 Oct 2016https://doi.org/10.1176/appi.pn.2016.10a20AbstractIn our climate of strong religious convictions and polarizing public fights over doctrine, breaching the topic of religion and spirituality as a young physician can seem like the shakiest of shaky ground. For the inexperienced psychiatrist, the struggle is real. We are scared of offending people with any of the intimate questions we ask, and religion feels no less private than sexual history. Religion and spirituality, when approached correctly, can provide a beautiful window into the psyche of our patients. It’s also unavoidable—religious topics are an ACGME-required part of our psychiatric training.My father was a Lutheran pastor, and my mother was raised a born-again Christian; I grew up in a progressive but religious household. My father loved ministering to sick people in hospitals, and he handled parishioners’ deaths with fearless compassion. I believe I mirror some of my dedication to patient care based on his example. In times of severe illness, however, even the strongest faith can be questioned. When my mother was diagnosed with ALS, she spoke of wondering what she had done, spiritually, to deserve her fate. I think she struggled with the issue until her life ended.Despite knowing this, I don’t always ask my patients about spirituality. Why not? Too often, as trainees, we feel the need to narrow our exam to what is necessary for an assessment; we give a treatment recommendation and then move on. But religion and spirituality are at the core of most patients’ lives: a 2014 Gallup poll revealed that 86 percent of the general population is religious or spiritual. And our colleagues are, too: 76 percent of psychiatrists, according to one survey. More science: high intrinsic religiousness can predict more rapid remission of depression, especially in patients with poor physical functioning. Religious and spiritual involvement appears to buffer patients from stress, and offering therapies augmented with a spiritual component to religiously or spiritually oriented patients is associated with increased efficacy of treatment. Nonetheless, the potentially negative effects of religion should not be overlooked; we’ve all encountered the gay or lesbian patient who feels deep shame due to a prohibitive religious upbringing.So how do we incorporate religion into our training and our care? A fan of checklists, I have used the following four questions (which were developed by a consensus panel of the American College of Physicians) as a basic approach to the spiritual history:Is faith (religion, spirituality) important to you?Has faith been important to you at other times in your life?Do you have someone to talk to about religious matters?Would you like to explore religious or spiritual matters with someone?Here are some additional tips gleaned during residency:Engage hospital chaplains in your inpatient psychiatric and consult-liaison work, utilizing them for patient interviews and family meetings, when appropriate.With permission, collaborate with your patient’s pastor or spiritual guide for context and coordination. When doing cognitive-behavioral therapy for psychosis, for example, a patient with religious delusions may be able to question the delusional content more safely with his or her pastor.If a patient asks you about your religious beliefs or spirituality, deal with it like any other personal question, responding with, for example: “I’m wondering why this question came up. What do you imagine?” Once the motivation has been explored, it becomes a judgment call. Less experienced practitioners may want to avoid disclosure as a rule; however, in the right setting, it could deepen the therapeutic alliance. For example, a patient struggling with feeling internal religious judgment could have a corrective emotional experience when the therapist reports that he or she does not share that same religious judgment of the patient. In the end, every psychiatrists needs to be prepared to tackle this issue, so careful self-reflection is highly suggested.Listen to spiritual or religious concerns carefully, but avoid giving an opinion. (I have found that aligning myself religiously has the potential to disrupt the therapeutic alliance.)As residents, we are so intently focused on keeping patients alive and learning psychiatry that we sometimes miss the intangible parts of our work. Regardless of our religious beliefs, or lack thereof, patient care can be a way to serve a higher power and receive spiritual nourishment. Evidence-based treatment and spiritually informed care are compatible. As we help patients share their spiritual beliefs with us, our work becomes deeper and more meaningful and can lead us to the core of the human experience. ■Hannah Roggenkamp, M.D., is an advanced research fellow in the Mental Illness Research, Education, and Clinical Centers (MIRECC) at the Puget Sound VA Healthcare System in Seattle. ISSUES NewArchived

MIŁOŚĆ – ISTOTĄ POSŁUGI PASTERSKIEJ KAPELANA SZPITALNEGO

Duch służby i służba miłości, to dwie współrzędne postawy, które wzajemnie się przenikają i wyrażają styl kapłańskiego życia. Bez miłości bliźniego nie może być autentycznej miłości Boga, a tym samym gorliwości apostolskiej w posłudze chorym. Otrzymana konsekracja zobowiązuje kapłana do naśladowania swojego Mistrza, wyrażającej się w służbie człowiekowi, w całkowitym darze z siebie, w poświęceniu aż do ofiary krzyżowej. Podstawą miłości pasterskiej kapelana szpitalnego jest stała łączność z Bogiem. Kapelan szpitalny, aby realizować cel miłości pasterskiej, którym jest uobecnianie miłości Boga, powinien żyć w bliskiej zażyłości z Chrystusem. Miłość pasterska kapelana szpitalnego powinna realizować pewne konkretne zadania. Są nimi: pomoc w jednoczeniu się człowieka chorego z Bogiem, niesienie pomocy, usuwanie przyczyn i skutków zła, a także niesienie pomocy duchowej ludziom chorym. Do tych zadań kapelan szpitalny winien odbyć odpowiednią formację i dojrzewać przez całe życie.

Chaplains Play Important Part in Integrated Palliative Care

Chaplains Play Important Part in Integrated Palliative Care