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Vol. 19, No. 5
September/October 2009
Vision is published six times a year by the
National Association of Catholic Chaplains.
Its purpose is to connect our members with
each other and with the governance of the
Association. Vision informs and educates
our membership about issues in pastoral/
spiritual care and helps chart directions for
the future of the profession, as well as the
Association.
ISSN: 1527-2370
Executive Editor
David A. Lichter, D.Min.
Editor
Laurie Hansen Cardona
lcardona@nacc.org
Graphic Designer
Gina Rupcic
The National Association of Catholic
Chaplains advocates for the profession of
spiritual care and educates, certifies, and
supports chaplains, clinical pastoral
educators and all members who continue
the healing ministry of Jesus in the name of
the Church.
NACC Editorial Advisory Panel:
Sr. Michele LeDoux Sakurai; Michelle Lemiesz; Linda
Piotrowski; Rev. Freddy Washington, CSSp;
and board representative Norma Gutierrez,
MCDP.
NACC National Office
4915 S. Howell Avenue Suite 501
Milwaukee, WI 53207-5939
(414) 483-4898
Fax: (414) 483-6712
info@nacc.org
www.nacc.org
By Michelle Lemiesz, M.Div., BCC
In 2002, the three chaplaincy services departments within the Mount Carmel Health System in Columbus, OH, participated in an individual and system departmental assessment in order to evaluate how our departments measured against Trinity Health’s “Standards for Spiritual Care.” Each standard was analyzed individually and the evaluation produced a collective examination of how spiritual care was being delivered within the system at each site. The analysis result was to assist in goal formation for each of the hospitals’ chaplaincy services departments.
Perhaps the most glaring observation uncovered by the assessment was our hospital-centric ministry with its focus on inpatients and staff. Little to no support was provided to outpatient care areas and there was no communication between the department and numerous physician offices on each of our campuses. This article focuses on how Mount Carmel East responded to that challenge, and how that changed the focus and perception of our department.
At the time the assessment took place, construction was occurring on the Mount Carmel East campus. There would be increased service lines in cardiology with the inclusion of open heart surgery, and the maternity unit was expanding. Outside the hospital, additional buildings were popping up. These housed inpatient services as well as new physician offices. As a department, we decided that our initial outreach would bridge communication with the physicians who practiced on our campus. I obtained a list from our medical staff office of all physicians on staff and sent a letter introducing the department, our expertise and the various services that we offer in the hospital. I suggested that we could provide spiritual support to those patients who they deemed appropriate right from their offices.
The initial result was silence, and there was no way to gauge whether the letters were actually seen and read by the physicians or simply discarded by office staff. Approximately three weeks after the letters were sent, I received a call from a renal specialist who had an outpatient dialysis clinic on our campus. He shared with me a bit of the clinic’s history, the type of patients being served, and the dynamics that occurred with the staff. I told him that I would be happy to come to the clinic and meet the staff in order to discuss services we could offer. That initial contact proved fruitful, and a week later I began to make weekly visits to the clinic.
Dialysis patients have to focus their lives around their dialysis schedules. Activities are planned based on their knowledge of how they will feel both before and after a treatment, and most of them deal with life and death questions on a daily basis. It is not uncommon for them to come in for treatment and find out that the person usually next to them has been hospitalized or has died. These are men and women who spend often three 8-to-10 hour days with one another consistently; in many ways they become family, and that family is extended to the staff caring for them. Ministry to these patients is deeply needed, and in time I began to hear their stories, their hopes and their fears. We had memorial services for their friends and made cards for those in the hospital. We prayed and worshipped together, we talked and sat in silence, and we grappled with the ultimate question of eventually terminating dialysis and allowing death to occur.
Whenever a dialysis patient was admitted to our hospital, our department was notified and pastoral care was then provided here. It was wonderful for the patients and for me to have connection and history, and the insights I was able to contribute to the multidisciplinary team could never have been gleaned if we had waited and just visited this person in house. Never before did the seamless flow of continuity of care seem so fluid and the result was greater support for the patient both in and out of the hospital.
While I was engaged in the formation of the relationship between the clinic and the department, I also began working with the outpatient pulmonary rehabilitation group. Each group went through an 8-week program that focused on members’ ability to cope with chronic obstructive lung disorders and improve their lives. I was part of a multidisciplinary team that presented classes focused on the totality of the patient; my class was in “the spiritual dimension of chronic illness” and eventually a section on advance directives was included. While there was a common thread of concerns voiced by both the renal and respiratory patients due to their chronic illnesses, the dynamics within each group as well as the questions grappled with were unique. The work with the respiratory patients uncovered a consistent need for encouragement and collegiality and this led to the formation of a support group for patients with chronic obstructive lung issues.
Ministry outside the hospital is not done in a vacuum, and when one is working with patients with chronic illness, there is a consistent ebb and flow in which they are admitted to the hospital for an exacerbation of their illness or something else relating to it. The chaplain engaged in outpatient ministry with these patients has the unique opportunity to form relationships that flow back and forth from the hospital to the outpatient setting. In this time of short hospital stays, this type of connection is invaluable.
In the current economic milieu, it is of utmost importance for hospitals to be recognized for excellence in service. Data has suggested that an encounter a person has as an outpatient can form a lasting impression about the effectiveness and credibility of that institution. Chaplaincy services can become an integral part in the formation of customer loyalty and satisfaction. These two criteria form part of the equation in providing for the financial solvency of an organization. Chaplains have the skills to be part of the financial health of an organization; the challenge is how to demonstrate it in a way that administrators understand. Ministry with outpatients may prove to be a good place to start.
Michelle Lemiesz is director of chaplaincy at Mount Carmel East and Mount Carmel New Albany Hospitals, in Columbus, OH.