By Sandra Lucas, MDiv, BCC
Chaplain D.W. Donovan, who recently assumed the role of vice president for mission and spiritual care at Providence Regional Medical Center in Everett, WA, is convinced that truly effective chaplains have to be bilingual, speaking the language of both ministry and medicine and “merging them in a fluid and natural way.” He also suggests that moving toward evidence-based ministry isn’t as difficult as some chaplains may think.
Donovan is the author of “Assessments” and co-author of “Creating and Implementing a Spiritual Care Plan” in “Professional Spiritual and Pastoral Care: A Practical Clergy and Chaplains Handbook,” published in 2011 (see book review in this issue of Vision). He also served as a consultant for the book.
Before moving to Washington, Donovan was director of mission leadership and spiritual care at Providence Holy Cross Medical Center in Mission Hills, CA. Board certified since 2001, Donovan has served in hospital chaplaincy since 1997. He has been active in NACC in a variety of roles, including serving on the NACC Standards Commission and Ethics Commission. He was committee secretary and general editor in the writing of the “Common Standards for the Certification and Practice of Chaplaincy.”
He and his wife Terrie have three children, including twins who were born in October 2012.
Q How did you come to be involved in serving as a consultant for the new anthology “Professional Spiritual and Pastoral Care?” What was it like being involved? What do you hope others will find of value in the book?
A Stephen Roberts, creator and editor of the book, had hoped from the beginning to have this book reflect the diversity and common ground of our profession. Thus, he sought to develop an advisory board that would reflect engagement in the profession from multiple perspectives, including that of Catholicism and the NACC. I was honored when George Handzo, of HealthCare Chaplaincy, suggested that I might provide such a perspective.
My hope is that the book will become the standard textbook for Clinical Pastoral Education and continuing education programs, as well as an indispensable reference for the more experienced chaplain. The early part of the book lays out a strong foundation for chaplaincy through both narratives and didactics. Later chapters apply those principles to specific situations and are extremely helpful reading. I hope others will come to see the book not only as an important step in the development of our profession, but also as representative of the many ways in which tremendously gifted chaplains touch patients, families, staff, and entire organizations on a daily basis.
Q In your article “Assessments,” you write that every profession today is becoming “more focused on measurable outcomes, grounded in an ethical mandate to be good stewards.” How can chaplaincy move to evidence-based ministry?
A Moving towards evidence-based ministry may sound more difficult than it actually is. All of us want to provide a valuable service but figuring out how to measure that value is not always easy and some may even find it difficult to believe that our work can be measured.
At a practical level, aligning our best practices and metrics with that of the organization helps demonstrate the impact that chaplaincy can have on the organization, including financially. At a moral level, we should be doing everything possible to ensure that our patients receive the best possible care.
Some early research has explored how the ministry of the chaplain can reduce length-of-stay and even turnover among the nursing staff. While additional research is clearly required, these are metrics that appear on virtually every system dashboard and provide an opportunity to demonstrate the impact of the chaplain on existing metrics.
Q Your article includes a list titled “Top Ten ‘Thou Shall Nots’ Related to Documentation.” No. 1 is “Thou shall not confuse a pastoral assessment with a list of faith-based interventions.” Can you explain why it’s critical to distinguish between the two?
A In our lives as chaplains, the “tools” that we employ (and I do not mean to use the term disrespectfully in any way) should be in response to a particular assessment and in support of a larger goal. Perhaps a few of us have made the mistake of walking into a room and, upon being immediately asked to pray, begin doing so. Later, we discover that our prayer, while perhaps appreciated in its intent, did not address the issues that the patient and family were actually concerned about. It only takes a few times making that mistake before most of us begin to respond, “I’d be honored to pray with you. Can you help me understand what is happening so that I can pray in a way that would be meaningful to you?” In other words, the tool that we use is only properly understood in the context of our assessment.
A chart note focused solely on the intervention might read: “Responded to request to pray with patient and family. Offered prayer at the bedside and assured them of my continued prayers. Please notify Chaplaincy Services if further needs arise.”
Simply put, the assessment should inform and guide both what tools you select and how you use them and the note that follows should describe the complexity of this work. Why did you pray with the patient? What pastoral issues had you identified that you hoped to name and address? Did the prayer end the conversation and help bring closure? Did it engage the participants in additional conversation, allowing issues to be addressed more openly?
Many of us have complained over the years that no one reads our notes. I would suggest that they will be read when they include a solid assessment of the situation in a way that helps the physicians and entire clinical team better understand the unique dynamics of that situation and help to advance the plan of care. And they will appreciate your work much more when they understand the complexity of what you actually do.
Q In your article, you include examples of questions to invite engagement. I’d like to ask you one of your own questions: “If you could take off a full year to do whatever would be most meaningful for you, what would you do?”
A I’m a huge fan of John L. Allen, who many of you may know from National Catholic Reporter or his weekly articles titled “All Things Catholic.” John does a tremendous job providing insights into the humanity of the Catholic Church, with an analysis of the major issues that is, in my opinion, second to none. Not only does he take complex issues and explore them in a balanced fashion, he also takes complex people and helps “bring them alive” for those of us who will never meet them, but whose lives are affected by their decisions. I’d re-read everything John has ever written (I have copies of most of it!) and catch up on his more recent work that I haven’t had a chance to enjoy.
Oh, and I’d sleep A LOT. Between wonderful opportunities to minister within Providence and being a husband and father to three wonderful boys (including newborn twins), I could use a few naps!
Q Finally, can you share with us something about your role as a mission leader? How does your experience in, and passion for, pastoral care inform and shape your work in mission?
A I am tremendously grateful to Sister Colleen Settles and to Providence Health and Services for providing me with the opportunity to serve in this role. Sister Colleen also came into the mission role through chaplaincy and she and others showed me through their own style of ministry how the role could be simultaneously pastoral and administratively effective.
I have always said that truly effective chaplains had to be bilingual, speaking the language of both ministry and medicine and merging them in a fluid and natural way. Similarly, the mission executive has to speak both of those languages, but also have at least a basic understanding of clinical and organizational ethics, organizational development, finance, leadership formation, and a sprinkling of other languages in order to be most effective. To me, and I talk about this in Chapter Four of the book, being a good chaplain means that you are an integrated part of the healthcare team. In very similar ways, I would hope as a mission leader to be experienced both as an active contributor to the work of the executive leadership team as well as being a true pastor to the community.
In all honesty, I have only been in this role for three years, so I’m still learning what it means to be a mission leader. I am grateful to have served in two roles where the mission and chaplaincy roles were combined, as that has allowed me to continue the work of pastoral care that I love so deeply, while also using a broader range of skill sets through work at the executive level. I’ve been very lucky.
Sandra Lucas is regional director of spiritual care for Humility of Mary Health Partners in Youngstown, OH, and a member of the NACC’s Editorial Advisory Panel.