Vol. 22, No. 3
MAY / JUNE 2012

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Accountable in Acute Care



Standards 1 and 2: Assessment and plan seen as tandem aspects of chaplaincy art

Standard 3: Charting can allow meaningful stories to shape patient care

Standard 4: Claiming a place at the table, contributing to the plan of care

Standards 5 and 6: Concerning ethics, confidentiality, what seems obvious is often complex

Standard 7: Respecting diversity means being cognizant of multiple traditions, calling in others when needed

Standards 8 and 9: Chaplain often viewed as organization’s pastor

Standard 10: Chaplain leaders promote chaplaincy, provide education, support colleagues

Standard 11: Assumptions on care delivery punctured; quality rises

Standard 12: Chaplains can take measured steps toward research expertise

News & Views



Of human bonds: A trip to China, Mr. Loy, and the silent treatment


Regular Features



David Lichter, Executive Director

Q & A with Marie Coglianese, BCC, and Sister Cyrilla Zarek, OP, BCC

Research Update

Seeking, Finding

Book review:
The Emperor of All Maladies


Calendar of Events
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Healing Tree


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prayers for healing (members/subscribers)

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Standard 7: Respecting diversity
means being cognizant of multiple
traditions, calling in others when needed

By Elaine Chan, MSW, MDiv, BCC

Standard 7. Respect for Diversity: The chaplain models and collaborates with the organization and its interdisciplinary team in respecting and providing culturally competent patient-centered care.

For the past nine years I have served as a staff chaplain at Beth Israel Brooklyn. The hospital is under Jewish auspices and serves an ethnically and religiously diverse population. In my work I seek to model what a Roman Catholic or Christian is, someone who ministers to whoever is in need. I do so while “respecting and providing culturally competent patient-centered care” as noted in this Standard. I will share a few of my experiences.

In the first situation I ministered to a Chinese-speaking woman whose husband had had a severe heart attack. I was asked to attend an ethics meeting to discuss taking him off life support. My official role was interpreter, but what I ended up doing was advocating for the wife and serving as a cultural broker between the wife and the hospital staff. The wife wanted to know what his chances of recovery were before she made the decision. Since the attending physician spoke Chinese, I encouraged her to ask him directly but she felt awkward about doing this. The meeting was conducted solely in English. I interpreted what the doctor said but then asked her to speak to him directly. She then questioned the doctor and he responded directly to her in Chinese. Hearing directly from the doctor gave the wife the peace of mind that she was making the right decision to take the husband off life support. The patient was taken off life support. I stayed with the wife and son and supported them throughout.

Another time I had an Orthodox Jewish patient who was a Holocaust survivor. He had been in and out of the hospital and was discouraged because he was not getting better. He expressed a desire to die at home. His wife was also a Holocaust survivor and did not feel she could physically take care of him in his weakened state. She was very stressed by his illness. Their only son had died a few years earlier, so she was going to be alone when he died. Whenever she saw me in the hallway she would ask me to come in. We hardly spoke about her faith or the Holocaust. Rather my visits pertained to his condition and her feelings about what was happening. Despite religious, cultural and age differences, we developed a strong connection. One time I wanted to say goodbye but she asked, “Where are you going, my little chaplain?” After three times of my trying to leave and her asking this question, she finally let me go.

I was making my rounds one morning when I learned that the patient had died. In the Jewish tradition a person who has died is not to be left alone. The wife was outside speaking to staff when I found her. I stayed with the body until the Chevra Kadisha or the Jewish burial society came to wrap the body and say the prayers.

I was making my rounds one morning when I learned that the patient had died. In the Jewish tradition a person who has died is not to be left alone. The wife was outside speaking to staff when I found her. I stayed with the body until the Chevra Kadisha or the Jewish burial society came to wrap the body and say the prayers.

Patients and their family and friends appreciate that I am cognizant and attentive to specific religious practices for their tradition, such as calling the Chevra Kadisha. Once a month I participate in orientation for new nursing staff and share some thoughts regarding cultural and spiritual/religious diversity. When I am on the floors, I also answer questions from staff regarding different faith practices.

In my work, I seek out volunteers of various cultures and faiths to minister to patients of diverse backgrounds. For instance, I have had Muslim student volunteers as well as imams visit with Muslim patients. Priests and rabbis should take heart that they are not the only ones whom I persistently call to see patients! I greet Muslim patients with the Arabic salutation of “peace be with you.” One time I gave a Muslim patient a Koran that he had asked for. In a subsequent visit he told me that seeing me gave him encouragement. Sadly, he died unexpectedly shortly thereafter.

Roman Catholic patients are culturally diverse. Once I had an elderly Haitian patient who was upset about being in the hospital and was creating quite a stir. The staff, which included Haitians, did not know what to do. Haitians usually have close-knit families. I called the patient’s family whom I had met previously. A grandson answered and said his mother was going to the hospital later on. I told him that later was no good. Someone had to come “now!” I put the patient on the telephone to speak to the grandson. She was comforted by a familiar voice. The nurse let the patient sit by her side, until the daughter came shortly thereafter. A crisis was averted!

As a chaplain I minister to and am respectful of other faith traditions and cultures. When I started I often heard staff say that I was unlike any other chaplain they had encountered. One said chaplains were male and taller. Others said they did not know there were Chinese Catholics. Still others said that Catholic chaplains do not see non-Catholics. While this is not true of my predecessor, I have heard this in other situations. Some also are taken by my prayers. When I pray I do not use only the Our Father or Hail Mary, I will say an extemporaneous prayer which is tailored to what the patient or family member has told me. For my part, I am most grateful for the opportunity to minister to folks at a critical moment in their lives, to interact with folks of various faiths and walks of life, and to demonstrate my faith through my actions.

Elaine Chan is chaplain at Beth Israel Brooklyn in Brooklyn, NY.


Read the next article in this series:
Standards 8 and 9: Chaplain often viewed as organization’s pastor

 

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