Tagged: Week 1 discussion
February 12, 2019 at 3:25 pm #4334
The assignment for this week is to read, reflect and posts your thoughts, questions, examples, etc. to the two articles.
The first article is written by two well-known names in the spiritual care professional world. It draws on experiences in the field and offers a best practices way of building or developing a spiritual care program. It is a traditional approach and builds on business principles. Obviously, administrators are persons with education in business. This approach uses those principles to “speak their language”. Your thoughts experiences in response to this article…
The second article is a difficult read for those who haven’t been introduced to systems thinking. I hope you can plough through it because I have found that it is another way of thinking and acting in strategically tending to systems. From personal experience, I have seen these principles fleshed out in all of the systems in which I have been involved with leadership, including in the leadership of the Oates Institute.
Please remember that in order to receive 12 hours of CEUs at the end of the third week, you need to read all of the resources, posts your reflections about the readings and respond to other participants’ posts each week.
Next week, Feb. 19, Tuesday afternoon 3 – 4 pm EST, we will have Larry Gray live via Adobe Connect (more about that later). The interview will be live and will consist of about 30 minutes of Larry’s story and the remaining time for Q and A. The interview will be recorded for viewing later if you can’t make the live presentation. After completing an M. Div., Larry completed an internship in pastoral care in Oklahoma City, He accepted a position as staff chaplain at the Lexington Baptist Hospital where he began to be involved in other initiatives in the hospital while serving as staff chaplain. Gradually, he took on more administrative duties and began a leadership program. Eventually, Larry completed a masters in hospital administration and accepted a position as the hospital administrator at one of the Baptist hospitals in Kentucky. He now serves as the President of the Louisville Baptist Healthcare in Louisville. Please plan to join us for that informative dialogue.
February 12, 2019 at 5:15 pm #4339
The first article while focusing on how to start a chaplaincy program, I still found helpful re-orientation and reminding of focus for already established programs. The first step described – focusing on the organization’s mission and strategic goals – is one I think is helpful to periodically go back to even for established programs. I’ve noticed where I am at, in the last year with our new director as he has had us as a department explore parts of the mission and how it relates to what we do, that we have been able to get invitations to leadership meetings to introduce new staff care initiatives and doors I had thought would never open (such as trying to get a specific spiritual care screening question changed) may be starting to crack open a bit. I’m still very much a worker bee so I don’t know how much of a place at the table we may get eventually, but I am more encouraged than I have been in a while.
The second article was very much an enjoyable read and gave me many aha moments. My hospital is a magnet hospital which means involving nurses in leadership, research, and performance improvement is big, we have unit based councils and nurse led leadership councils. And yet we are a very structured hierarchy and I have learned going up the chain of command is critically important to getting anything done with full buy in and support. It feels like a weird mix some days.
My first impressions from this second article is that this idea of complexity leadership is very process oriented where observation is important along with not rushing to action but working with the system in place and the experiences and ideas that the workers with in the system raise. It feels very intuitive to me as a chaplain who is almost always focused on working the process of shepherding people to the outcome hoped for and desired rather than forcing a quick solution.
As I read through the article it became clear to me that the idea is to see the system as a living organism rather than a structured organization. I saw this to be helpful to dealing with change and making change. Living organisms grow and change, seeing a system in this way, seems to me to then lead to being able to embrace the natural evolution of the system in more helpful and end game healthy way. It seems to help, perhaps, reduce reactionary responses to change and the fear that change can create.
I think I may be starting to see some of this begin to happen where I am at. It may have happened because of our process to become a magnet hospital. I know when I first started there, things felt much more top down. I have been where I am at for 16 years now, I’ve weathered quite a bit of change.
I’ll pause here and look forward to others thoughts.
One note on next week – I will have to catch the interview from the recording, the live interview happens right when I need to be headed to an appointment.
February 13, 2019 at 11:31 am #4344
Professional Chaplaincy – Handzo, Wintz
This article gave a big-picture view of how to start a hospital based program of spiritual care. I thought it was helpful as I compared this setting to my own in a continuing care facility which has nearly a hundred year history with origins in the church.
The first challenge I face is I find myself midstream. I am not seeking to start a department. Rather I am facing years of institutional drift. Back in 1978 the Pacific Homes (a benevolent arm of the United Methodist Church) found itself in court. At the time the entire United Methodist denomination was named in the case as the litigants came after the deep pockets of the church. https://www.washingtonpost.com/archive/politics/1978/10/17/methodist-church-unit-cleared-for-366-million-suit/6ac9f10c-a8bb-4a24-a2a5-9cc8b4fccdff/?utm_term=.3c1eb49db76e
One of the results of this was that instead of being owned and operated by the church, benevolent homes and church run continuing care facilities were set up now as non-profit corporations separate from the control of the church. Since 1978, the drift away from having a priority on spiritual care began. The company continues to have a chaplain for each campus as a nod to our former connection to the church, and because most other CCRC have a chaplain. But the organization’s vision of its mission is not what it what was.
The article spoke of “focusing on your organizations mission and strategic goals.” For the most part these are now marketing strategies and building improvements.
1- All of this is to say that I feel at a loss as to how to call an organization to recover a vision it has left behind. I guess it is a long process of knocking on this door until someone hears and listens.
This article suggested, “identify the time is being spent and the scope of pastoral care required.” For the past year and a half I have been keeping my own metrics of visits made, classes taught, attendance at worship and devotion times, etc.
2- These are submitted regularly. So far they have not been part of any discussion or goals setting with my supervisor for improving spiritual care or addressing unmet needs.
“Chaplaincy is effective when productivity is based on identified priorities, follow inline’service assignments…”
3- Although I part of staff orientation and speak about all staff being able to refer needs to the chaplain, I can only note that in 6 years of ministry I have only have referrals from the Social Worker twice a year on average.
“Help educate staff”
4- Although I have spoken to department heads on several occasions about my ability of offer in service education for staff on a variety of topics it has never happened. I appears that clinical nurses don’t see me as qualified to address them, or the are too busy dealing with nursing skill training that my input is not pertinent.
Wow as I read what I wrote I am struck by how negative it sounds… I do enjoy my work. But it is often done disconnected in any meaningful way from the staff and from the organization. I believe chaplaincy and spiritual care can be more integrated in a care team approach. I am looking for strategies to move in that direction.
I welcome comments and insights.
February 13, 2019 at 2:13 pm #4345
You reflected on how negative your description of your setting was. I would say, there is a difference between being negative and being critically truthful. I see your description of your setting as being critically truthful. The hospital setting and understanding of importance of interdisciplinary team is different I think than the continuing care setting, so I’m not sure how applicable my experience might be. I can say I started finding the more complete integration happen when I began more intentionally interacting on a one-on-one more personal level with the staff. As they got to know and trust me with their own stuff and experience all I had to offer, they then began to trust me with their patients too. I wish I had thoughts for you on the administrative end, being a “worker bee” I have not really had a place at the table there, it has always been my supervisors having those conversations.
Any how, I do hear the seemingly eternal frustration of not being more integrated. I remember feeling that same thing when I first started here.
I wonder, what is the history of chaplains at your place – have they always been professional board certified chaplains or is that something new? I wonder if there might be some aha’s to be found in the institutions history with chaplains.
February 13, 2019 at 2:25 pm #4346
Joy, Thank you for you reflection. I am not a BCC. I have several units of CPR under my belt I have been endorsed by my denomination as a chaplain, too.
February 13, 2019 at 3:26 pm #4349
You helpfully clarified a different way of exploring my previous curiosity. Would the better question for your setting be have they previously had Professionally CPE trained chaplains before you or are you bringing a new level of professional experience that the DNA of the system is not used to having? One thing I have learned is that culture change takes a very long time.
February 13, 2019 at 7:32 pm #4351
Joy, Thank you for the clarification. Previously, Chaplains have been pastors with a seminary degree and the support of the Bishop to serve in this setting.They may or may not have had CPE experience. It is hard to access the practice of former chaplains… This non profit has two residential campuses.
At the other campus they recently hired a BC chaplain who came from a clinical hospital experience base. She is have an “adjustment” to this new context.
I don’t believe that BCC is a new credential standard they are looking for. The company also operates three LIFE centers. These are income qualified, single point of service, day facility for seniors who return home at night. Pennsylvania calls this federal program LIFE, other states usually go by PACE. In one of our life centers there is a paid chaplain. Another uses a series of volunteers. The third has none. I have reached out in person several times to our CEO, the Director of the LIFE program asking to talk about the value of spiritual care / chaplains in order to look at the quality of service we are providing. So far they have not made time to meet with me. David
February 14, 2019 at 8:09 am #4352
Your setting is so different from a clinical setting. I just want to encourage you to keep knocking on those doors. System change takes time and persistance from my experience.
February 14, 2019 at 12:59 pm #4354
Dear Strategic Thinking, Feeling Friends,
We are off to a great start with you all honestly sharing your current situation and feelings about those situations. Asking honest questions is the best way for all of us to learn and grow.
I would like to add a couple of thoughts to the questions and discussion so far. We all know that influence comes through relationships. Befriending the professional caregivers, especially those who have some power in the system is extremely important in getting some say at the leadership table. If we are just befriending them to get some favour then I would call that manipulation, but if we have a genuine interest in getting to know them and supporting them in their challenges then I call those good human relations or good pastoral care. As a 70-year-old, some of the friendships I made with physicians, nurses and administrators are still viable and meaningful today, even though most are retired. In the formative days, I would seek them out to eat lunch or breakfast within the cafeteria, take initiative toward them if I heard about a struggle they were facing, send them to thank you notes or notes of encouragement. We were recently talking about how to document staff support in my PRN chaplain position. Documentation is extremely important as well, but more about that in a moment. I said, what about sitting with a family of a dying patient for hours when as much support is given to the medical team as to the family? Is that documented as I contact or several contact hours? Of course, it is many contact hours.
Several have already mentioned documentation. That is a headache and it may seem like it is a waste of time. However, hard data can speak volumes about the value of spiritual care.
Week after next, we will have a live interview with Rabbi Nadia Siritsky, VP of Mission Advance at the Jewish Hospital in Louisville. She is also head of the spiritual care team. When she arrived, she conducted a research project in the ER. The results were astounding as it documented improved staff satisfaction, improved patient and family satisfaction and other variables she can talk about.
Another research project that was conducted by the Spiritual Care team at Signature Healthcare, national long term care, for-profit system documented a number of important facts that speaks to the bottom line.
As we have all heard, hard data derived from empirical research speaks the language of administrators.
For now, finally, asking leadership, what can I help with that will make your job easier and sharing articles that are pertinent, base practice based are great ways to get their attention.
We have several others who I hope will join the discussion very soon.
February 14, 2019 at 2:28 pm #4356
You are spot on about the importance of genuine relationships. I truly believe that it is the years of developing relationships here that has given me the trust for staff to listen to me when I talk about spiritual care improvements that need buy in from other departments outside of ours. I wonder if we are looking at leading in complex systems (our second article) if it is the relationships that are built that allow for that process of leadership to work well and thrive?
February 14, 2019 at 2:47 pm #4358
Complexity Thinking – Brown
This article was stimulating because it introduced new concepts and terms to me. I had to read and reread it in pieces. As I struggled to understand what the author was addressing, I first thought of the popular notion of a butterfly flapping its wings in the Amazon setting in motion a resulting storm at sea. I recently saw a video of an astronaut giving a detailed tour of the International Space Station. That is a complicated space vehicle-“each component can be described.” Global climate change in complex-dynamic, interactive, responsive, changing, adaptive, emerging. Yes there is a difference. I also think some things have characteristics of both elements.
I recognize that as a clergy person who has served almost 40 years in highly structured denominational congregations (United Methodist Church) I have lots of experience, most of it unfruitful in bureaucratic leadership. The Myth’s on page 5 were presented over and over again as the gospel of leadership. Then my church began to use one consultant after another to bring about denominational change. Most of it still used the old myths, even though it was dressed up as solution for all our problems. I think for two decades we had an annual transformational guru who was presented as the one who had the answer. Perhaps at one time this model of leadership and change worked. It is evident to me it seldom works now.
I believe there have been many attempts to describe the mega shifts we are going through now at multiple levels in our society. The term “Knowledge Era” is a new one which is helpful in describing part of these changes.
I understand that this article is only a summary of complexity theory and provides an overview. As I was reading page 4 I wondered about some of the assumptions behind this article or perhaps underlying Complexity Leadership. It seems to me that it assumes, participants have access to the self align in dynamic creative, adaptive units….
Yes good leadership in complexity will foster the “flourishing of dynamic interactions…” But what happens when a person is not in a recognized position of organizational leadership? If an organization is bureaucratic in nature trying to cast vision, control, bring compliance, then influence others for conformity, then those who want to dynamically interact and creatively align new effective solutions are likely to see their position as one of disenfranchisement.
My application of this article to my situation is what does one do when “healthy conditions to self-organize around relevant issues” are not present. How does one move into complexity leadership as a chaplain in a single provider department working in a culture of bureaucratic, linear leadership?
Your comments and insights are most welcome.
February 18, 2019 at 12:55 pm #4372
I am a bit behind so, am hoping to get caught up some. I appreciate the discussion to this point.
David, what you shared struck a nerve with me. Thank you for sharing. When I first started and a Chaplain here at Porter, I went through a lot of what you wrote about with the same results. I just started my 24th year here and I have a good rapport with nurses, doctors and other hospital staff as well as administration and I have gotten referrals from them all. Through the years I have also met with a number of staff who are struggling with personal issues. All this started to happen when I started building relationships with the staff. I thought that if nurses and doctors where going to trust me with their patients, they had to trust me. So, I worked at getting to know them and sharing what I can do for them and their patients. When I visit a patient I share pertinent information that would benefit patient care and I raise up the human element for them. I am visible throughout the hospital and people trust my work. I kept statistics of my work and showed where I could grow the department. But none of this did any good. Though I may not have the funding I would want to grow the program, I do have support throughout the hospital on all levels and I know I valued. They know that I am available and if I miss a meeting or do not respond right away, I am taking care of people. I hope some of this is helpful.
February 18, 2019 at 1:11 pm #4374
Thank you, Joy for reminding me that the system is a living organism. I had known this, but with our former CEO that concept became clouded for me. He got word from corporate and he went with a quick solution. He would hear of a new idea and implemented it without the input of the leadership team to see how we can make it work for us. I believe our new CEO is moving us back to being a living organism. He listens to the leadership and to other associates to learn our ideas on what might work for us. He had some fixes he needed to work on as soon as he got here a year ago and is now able to focus more on who we are at Porter and how we as a team can meet corporate exceptions our way. I appreciate you raising up the Chaplain as one who shepherds people. I am part of the leadership team and I interact with my fellow leaders as we look at processes to improve the experience of people who come to us for care. They look at best practices etc. and look for a quick solution. I need to maintain my shepherding and help them remember it takes time.
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