Kirstin D. Batchelor
WJ and Paul,
Thank you for thought-provoking posts! WJ, I struggled with our intake screening in hospice as well. For most of the admissions folks, the spiritual screening was simply a matter of asking what church they go to (and often it was phrased this way, with the implicit assumption that they do go to “church”). So, as you said, education was key! Paul, is the tool you all are using (when it works) helpful in getting at more than just faith community affiliation? As you all have noted, and I agree, this is part of why it is so important to have spiritual care professionals involved as much as possible in assessing spiritual needs/pain. I liked your approach Paul in flipping it around to illustrate how we would not address medication needs. On the other hand, doing home hospice work, it quickly became apparent that whoever was in the home at the time a question or need came up was the one who was asked to address it. I got many questions about medication needs or constipation or medical equipment. I liked to joke with the RNs that of course I just told them how to take their meds. But obviously I would either call the RN/SW/Aide myself to address that with them. That said, I also talked with the team about how to handle spiritual questions that may arise in their visits. I came to see this sort of education and support as an important part of my job and my role in the team. I am thinking of a particular patient who had been very clear that she did not want a chaplain to visit. Very clear! The RN was really the one on the team that she allowed in most of the time and to whom she opened up. So I spent a fair amount of time reflecting with the RN on how she could support this patient emotionally. The RN was clear she would have preferred the chaplain to visit with this patient, as she said she was sure the source of some of her physical pain was rooted in spiritual/existential pain, but the patient was adamant about not seeing a chaplain. While I obviously was not going to train the RN to be a chaplain any more than she was going to train me to be a nurse, I was able to support the RN in doing the tough work of walking with this patient in her pain. This perhaps is also an illustration of how we might support our team members to help fortify them against compassion fatigue.
Like you, Paul, I would have liked a little more on this, though I realize it could be the topic of a full seminar in and of itself. I appreciate your honesty about there being times when you wonder about moving on to something else that is not as emotionally draining. This resonates with me, as I have been wondering this myself. When we left Minnesota a few months back and I left my job as a hospice chaplain, this was absolutely one of the things I wrestled with. Like WJ, I am wading through/sitting with a time of discernment about what is next. I struggle with how to sustain myself in ministry jobs.
Again, I appreciate both of your reflections and look forward to continued conversation!