February 15, 2019 at 9:47 am #4363
In reflecting upon the article, “Professional Chaplaincy: Establishing a hospital-based department,” I found myself needing to translate to my work in a long-term care community with a long-established program. However, the place of intersection for me was that when I assumed my position as Director of Pastoral Services I was taking on a program that had, until that time, been driven by a CPE program. With the exit of the previous Director, who as an ACPE educator, the decision was made to drop CPE and hire a certified or certification eligible person. I came to learn that a great deal of the driving force in this was a series of resident satisfaction surveys indicating disenchantment with pastoral care. Independent and assisted living residents were desirous of direct care from an established chaplain, or pastor, rather than a series of CPE students who came and went with the completion of their programs.
The journey of transition has been up and down, with budgetary constraints holding back adequate funding for pastoral care staffing. My desire would be to staff with three full-time professional chaplains–one in skilled nursing (69 beds), one in assisted living (100 residents), and one to engage the independent living community of 500-550 residents. However, we’ve never come close. I was able to have a second full-time position for one year until occupancy decline in the community and falling revenue curtailed us back to myself and one half-time chaplain. We have been able to bridge some of the gap with trained volunteers and CPE students from a nearby hospital with which we cooperate as a clinical satellite, allowing them to do some of their clinical ministry with us while enrolled in the hospital-based program. However, balancing the need for clinical chaplaincy in skilled nursing, and increasingly in assisted living, with the desires of independent residents for full spiritual life programming that includes chapel worship close to their experience in their parish church makes one a bit schizoid.
We have been able to elevate spiritual life and pastoral care ratings on annual resident satisfaction survey, so that we consistently score as one of the top three departments in the community. The nagging issue for me is a sense that the survey is not comprehensive enough to reflect the needs, many unmet, among those residents who could benefit from direct clinical spiritual care. In response to my own uneasiness, I have this year just begun an intentional project of research with the assisted living residents that I hope will provide better metrics of the spiritual needs in that population, which a generalized resident satisfaction survey may not be surfacing. Whether that kind of data will tip the balance in staff budgeting next year remains to be seen.
February 16, 2019 at 7:41 am #4365
Thank you for “translating” the article for your own work situation. It is similar to my own work setting.
You wrote: “My desire would be to staff with three full-time professional chaplains–one in skilled nursing (69 beds), one in assisted living (100 residents), and one to engage the independent living community of 500-550 residents.”
I am curious to hear more about how you came to these insights about the ideal number of staff. Was it just practical observation and insight?
February 17, 2019 at 4:19 pm #4366
Thanks for your response. Yes, my thoughts on ideal number of staff came from practical observation of how we function in those different neighborhoods. Independent living residents are far less dependent upon Bethany Village pastoral care; we are often more of a liaison with their parish church and pastor in our interaction with them clinically. Independent residents are far more focused on group life—worship, Bible study, other spiritual growth activities engaged in a larger gathering. Skilled care and AL requires one-on-one pastoral attention to a far greater degree. Much of our work in those neighborhoods has been focused on offering a confidential ear and sacred space for life review and transitional concerns.
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