#5203

David
Participant
@Chaplain Brinker

Jenifer wrote: I wonder if this (APC Standards) is something you could bring to your next annual eval or a goal-setting session and introduce them to your administrator?

I have brought this up for several years at my annual review. The Corporate HR person is administratively above my campus Executive Director/supervisor. HR is the one who removed me from the interdisciplinary team, electronic record interdisciplinary notes, and the care plan meetings. I receive your guidance and suggestions as thoughtful, affirming, grounded in best practices, and logical. However, at this point, it feels like a dead-end issue.
It’s interesting that this document assumes that chaplains will take a leadership role in the organization. Sometimes that is a natural fit, and other times the chaplain is seen as peripheral, right?

After several years of observing the executive administration I have come to the conclusion that they are not open to views other than their own. I find it sad in that I believe we are delivering care at a level below the standard of “best practices.” On a number of occasions I have put forward ideas for improvement and ways to reach compliance. It has gone no where. A previous campus Exec Dir hired three years told me she wanted me on the ITeam. After six months of trying to negotiate this with the corporate folks she said it was a dead issue. She is now fired and replaced. A new RN Director of Nursing in the Nursing Care Center asked my why I didn’t chart in the Interdisciplinary notes. I told her the story of how I used to do this at the request of my then Exec.Dir., but was told to stop by corporate HR. I directed her to clarify her request with corporate, this went no where also…

For a while I was angry about this and felt diminished in value. I have refocused on doing my work as best I can. I have good rapport with residents. As I may have two years until retirement, I am looking at continuing on a selectively choosing which fights are work the “leadership” battle.

Which particular standards are you most interested in developing in your setting?

I would like to have more organic, structural part in the Interdisciplinary Team communication. A first step may be to have permission to attend the weekly meeting where there is a review of resident’s transition from one status / intervention to another. Previously I have be excluded, even though the sales staff is allowed to attend this.

It’s a little surprising to me that you are not allowed access to the electronic medical record. That makes it challenging when the social worker can chart info that would be beneficial to you, and you can’t see it! Are you present in some care conferences?

I used to participate in Care Plan meetings. As stated, for five years I have been removed from them. It is interesting to me that at the time I was removed, the Activities staff were also removed from attending. In the past year, Activities staff are back in the care conference meetings. The explanation I was given was that HIPPA prohibited me from attending. I think this is false and silly.

Sharing these standards and some of the palliative care literature with your administrator might help him/her understand how chaplains are becoming more widely considered an essential part of the care team, not an “extra” or outsider.

Agreed. That was my motivation for sending white papers, research journal articles, and APC Standards of Practice to several in corporate administration. One response I received was “We are not a hospital so we don’t have to do those things.”

I appreciate the way both the standards and the Drummond and Carey article imply that as chaplains are able to articulate clearly what we do and how it is effective, we gain acceptance in the IDT. I’ve learned it also helps to very clearly collaborate with and refer to my colleagues in other disciplines.

I also appreciate this role of a chaplain. Coming from almost 40 years of parish leadership in congregations I feel I have several skills that would help this organization. I keep looking for opportunities to advocate for my work. The SW has just left so with a new hire, perhaps it will present new opportunities.
David Brinker 8/16/19