By Gary Weisbrich
When I prepared for the advanced specialty certification in hospice and palliative care in the spring of 2014, it represented an important milestone in a multiyear journey.
In 2012, while I was working as a chaplain on an adult and perinatal palliative care team, I had chaired the NACC’s Goal Three work team along with Mary Lou O’Gorman. It was the NACC’s way of encouraging members to serve in volunteer leadership positions and get confidence and experience from seasoned mentors within the association.
That opportunity also opened the door for me to serve as a member of the Spirituality Work Group on the Supportive Care Coalition. I had the privilege to be an observer on the original SCC pilot project, “Integrating Spirituality in Goals of Care Conversations.” Through witnessing firsthand the fruits of this project, I knew that I wanted to be a part of this new effort of integrating the chaplain in the interdisciplinary team. I witnessed increased vulnerability among members of the IDT, increased opportunities for incorporating best practices, and increased opportunities for team debriefing.
Although the palliative certification process was a lot of work, I was ready to take the next step. I wanted to look at the gifts that I had to offer — my prior experience and education in hospice and palliative care. I also wanted to examine areas where I needed additional education and experience as a member of the IDT. I wanted to identify gaps and areas of growth in my ministry. I did it with the help of my colleagues and mentors and a critical evaluation of my current ministry. This step for me was both a desire (call) from within and from the outside, as I was encouraged by my peers as well.
I felt compelled to learn more about what I could bring to the IDT; how could I provide education? How could I encourage mindfulness, self-care and resilience among the team? How could I help the IDT learn about the role of spiritual care, the role of the chaplain and how to gain comfort in recognizing spiritual distress? I knew that I needed to participate with hospice and palliative initiatives within my healthcare system, as well as within the NACC and other professional organizations.
In June 2014, I submitted my materials to the Certification Commission. The interview consisted of two NACC members with professional hospice and palliative care experience as well as a non-chaplain representing the interdisciplinary focus. I successfully met the criteria — yet I realized at that moment that this was just the beginning, the first step, the tip of the iceberg. Ongoing education, continued learning, developing new skills, serving on committees, participating in networking calls, and having professionals and mentors willing to help me grow will be essential as I continue my ministry.
In September 2015, I participated in a shortened version of the original pilot project “Integrating Spirituality in Goals of Care Conversations” with the SCC. Along with a physician, RN, and social worker, we have been consulting with outpatients at skilled nursing facilities, long-term care settings, in their homes, and on occasion in our outpatient office. Our team has preserved a time for spiritual grounding prior to the visit, we honor silence as it presents in our meeting, and we explore the patient’s hopes and fears. We also make time now to debrief after a goals of care conference; we ask, “What went well? What did not go well or what could we have done differently? What did we learn about the patient? What did we learn about ourselves as a team?”
Our Acute Palliative Care team is now up and running, and my confidence as a chaplain and integral member of the IDT has increased greatly. I feel much more comfortable interacting among the other members of the IDT, as well as providers from different disciplines such as our hospitalist, intensivist, cardiologist, and oncologist teams.
One of my goals was to share our learning from the pilot project with our inpatient palliative care team. On a daily basis in our morning meeting, we weave in these new practices. I also have the opportunity now to share these practices with our palliative care steering committee.
Looking back, three years ago I never would have expected to be at this place in my ministry. I had goals, hopes, and aspirations, yet did not know how it would all come together. But what has always been important in my life is to ask, “OK, God, what do you want of me now? Where are you calling me? How do you want to use me in your ministry?” Being open to where the spirit leads was important for me in discerning the next step. Today I can sit here feeling grateful for the opportunity and thankful for the additional support, guidance, and peace, knowing that, as a chaplain, I am an equal, contributing member on the hospice/palliative care interdisciplinary team.
Gary Weisbrich, BCC-ACHPC, is manager of spiritual care at St. Patrick Hospital in Missoula, MT.
