by Austine Duru
The role of professional healthcare chaplains has continued to evolve. In recent years, this evolution has placed significant demands on chaplains to find creative ways to expand their reach without compromising care. Managers and directors of pastoral care services have also been pushed harder than ever to do more with less. In other places, the requirement by the Joint Commission to meet the spiritual needs of patients has stretched professional chaplains further. Relying on volunteers to meet this need has become common practice.
Volunteers provide an opportunity for professional chaplains to respond to the changes in their ministry practice that would otherwise be difficult to manage. The transformation of healthcare in the 1920s witnessed an equally transformative approach to theological education that began to focus on the “living specimen” or the human person as the subject of theology and pastoral education. This action-reflection model, now called clinical pastoral education, set the stage for healthcare chaplaincy as a profession.
The changes in healthcare in the 1980s gave rise to the term “pastoral care associates.” These are specially trained volunteers who partner with professional chaplains to provide care to patients and families. These associates receive basic training and often work in close collaboration with and are supervised by professional chaplains.
Now, we need a different breed of chaplaincy volunteers. As professional chaplains react to the new demands in healthcare, certain areas of the traditional chaplain ministry will be inevitably relegated to chaplaincy volunteers. Chances are that the new breed of volunteers might have limited supervision and may be required to use social media and smart devices. They may be increasingly exposed to interdisciplinary settings and will require some knowledge of medical terminologies and corresponding interpersonal skills. The emphasis here is on formation, which focuses on intentional, ongoing development and learning.
Studies have shown, however, that volunteers feel alone in their work and could benefit from ongoing training and professional development. Institutions need to cultivate the identity of volunteers in their role as caregivers (Skoglund, 2006). But where does one find such a chaplaincy volunteer pool, and how do you keep these volunteers engaged? How do you justify using volunteers for ministry that was traditionally compensated? And how do you build commitment to the clinical and theoretical work that is called for? These are difficult questions without easy answers.
However, to be effective, any chaplaincy volunteer formation program must meet certain minimum criteria. To date, several pastoral care centers across the nation have developed stand-alone training programs, often in collaboration with volunteer services, to meet their unique local needs. There is an abundance of training manuals for volunteer chaplains in correctional facilities and penitentiaries, but only a handful of healthcare chaplain training manuals are available. Reviews reveal some gaps in the training programs, yet some hold great promise. Here is a sampling:
1. Hands on Ministry: Texas Baptist Volunteer Chaplaincy Training Manual.
Church Ministries, 1998. This is perhaps the oldest of the resources available for chaplaincy training. This resource is limited by its focus on Christian ministry and may not be effective in a diverse healthcare setting. Unfortunately this resource is currently out of stock.
2. Volunteer Chaplain and Spiritual Support Training.
Suncoast Hospice Institute, 2012. This downloadable self-paced manual, primarily for hospice and palliative care settings, is “a training program developed to assist chaplains and spiritual care volunteers to perform their responsibilities in caring for patients and families at the end of life. The manual also includes PowerPoint slides with facilitator notes to provide hospice and palliative care volunteer chaplain training, job descriptions, documentation forms and training resources” This resource has some advantages for those who work primarily with patients and families at the end of life, but the lack of a broader application imposes a huge limitation. Also, the price tag of $100 per download is cost-prohibitive.
3. Health Care Chaplaincy Volunteer Handbook: A Training Resource.
Church House Publishing, 2001. 184 pages. $49 This chaplain volunteer training resource published by the Chaplaincy (Health Care) Education and Development Group, UK, holds some promise. It gives a taste of how chaplain volunteers are trained in Europe. This manual is practical, simple and user-friendly. The price is reasonable. It builds on the clinical method and draws on theories of volunteer recruitment and retention. It could be adaptable across various pastoral care settings and parish ministry. However, most of the materials covered are rudimentary. I am not certain that this resource will be immensely helpful for preparing chaplaincy volunteers to respond to the changing needs of healthcare in the United States.
4. Chaplaincy Care Volunteer Training Manual.
Healthcare Chaplaincy Network, New York. 108 pages. $35 Of all the manuals surveyed, this recently updated publication offers the most possible benefit. It is suitable for a variety of clinical settings and lends itself to adaptation and modification. It will be particularly attractive to those who wish to standardize or reorganize their existing chaplaincy volunteer services program. It is strong on the theoretical framework and incorporates new healthcare and HIPPA laws.
Here is a brief outline of the Chaplaincy Volunteer Training Manual:
Identifying Spiritual Distress Communication and Listening Active Listening
Non-Verbal Communication
Responding Skills
Understanding the Patient: Older Adults and Aging Issues, Individuals with Visual Impairments, and Individuals with Hearing
Impairments Visitation
Outline of a Chaplaincy Care Visit
Initiating the Visit
Guidelines for Interacting with Patient, Family and Team
Cultural Competency, Spirituality, and Religion
Assessing Your Own Cultural Heritage Exercises
Religious Diversity – Traditions on Life and Health
Death and Grief
Tasks of the Dying Patient
The Family of the Dying Patient
Grief and Mourning
Confidentiality
Confidentiality and HIPAA
Specifically for Chaplaincy Care Volunteers
This resource could be easily used as stand-alone material or as a core for a volunteer curriculum that incorporates other resources. Particularly helpful are the built-in tests that help volunteers self-assess around cultural sensitivity questions. The price tag of $35 makes it cost-effective. Above all, this manual gets closer to the idea of formation that was referenced earlier. It has been characterized by some as “CPE lite.”
Chaplaincy volunteers will continue to play significant roles in the delivery of pastoral care across the nation. It is therefore important to develop a robust formation program to equip these volunteers to meet the increasing complex demand in healthcare chaplaincy.
Austine Duru, BCC, is director of mission and pastoral care at St. Elizabeth Regional Medical Center & Nebraska Heart Hospital in Lincoln, NE.
Bibliography
Flannelly, K. J., Handzo, G. F., & Weaver, A. J. (2004). Factors affecting healthcare chaplaincy and the provision of pastoral care in the
United States (link unavailable). Journal of Pastoral Care and Counseling, 58, 127-130.
Flannelly, K. J., Weaver, A. J., Smith, W. J., & Oppenheimer, J. E. (2003). A systematic review on chaplains and community-based clergy in three palliative care journals: 1990-1999. American Journal of Hospice and Palliative Medicine, 20(4), 263-268.
Munro, G. (2013). A chaplaincy volunteer visitors service. Health and Social Care Chaplaincy, 4(2), 29-31.
Skoglund, A. G. (2006). Do not forget about your volunteers: A qualitative analysis of factors influencing volunteer turnover. Health and
Social Work, 31(3), 217.
VandeCreek, L., Siegel, S., Gorey, E., Brown, S., & Toperzer, R. (2001). How many chaplains per 100 inpatients? Benchmarks of health care chaplaincy. Journal of pastoral care, 55(3), 289-301.
Weaver, A. J., Koenig, H. K., Flannelly, K. J., & Smith, F. D. (2004). A review of research on chaplains and community-based clergy in the Journal of the American Medical Association, Lancet, and the New England Journal of Medicine: 1998–2000. J Pastoral Care Counsel, 58, 343-350.
