By Gordon Hilsman
When Albert Schweitzer accepted the Nobel Prize in 1953, he commented that “humanism, in all its simplicity, is the only real spirituality.” In the best sense of the word, humanism is not anti-religious. Pope Francis openly and passionately touts what has long been called “Christian humanism” in his recent talks.
While medical practice and nursing care have always been quite humanistic, hospice and palliative care are radically personalizing that care. Hospice assists people with the “dying role” near the end of life, while palliative care teams engage people around the messages they receive from their suffering and their goals for the last phase of living. As a result, spirituality in the clinical setting is moving, thankfully, toward more personally humanistic perspectives. Chaplains, especially those who want to work in hospice and palliative care services, will need to be fully on board with them.
Interdisciplinary staff’s new ways of relating to patients require new competencies for spiritual caregivers, who sometimes struggle to partner with interdisciplinary teams. Over the past two years, the NACC has responded to this need for new competencies by establishing its process and standards for certifying hospice and palliative care chaplaincy specialists. Those of us involved in that development have used the project to learn and revise materials and the process along the way. We’ve had to ask repeatedly such questions as: What standards need to be changed? What competencies can best provide focus to certification teams? What materials would be best required to assess the new competencies?
Some elements have remained the same, however. We have been persistent about a face-to-face group interview as a requirement. We’re not convinced that these important abilities can be assessed carefully enough by writing or even by a phone interview. Too often, medical practitioners have found some fully certified chaplains offering little help to them in their patient care. Having chaplains certified as specialists raises the motivation to consolidate learning and skill in these specialist areas. Ultimately, carefulness about authorizing Catholic chaplains to function as specialists will bolster the confidence of practitioners, administrators, and the public in our competence.
In order to optimize the assessment of applicants’ relationships with interdisciplinary team members, we’ve also insisted that all certification teams be multidisciplinary, i.e., include at least one appropriately experienced clinician from another discipline, so far either a physician or a nurse.
Other elements of certification we’ve deliberately kept are that preparation include some clinical supervision focused on hospice and palliative care work; the importance of what an applicant writes in the medical record to represent her/his care; some academic study; examination of how an applicant has grieved her/his own major losses; and observations of how the applicant relates to the certification group as model of their human-to-human interactions with patients and families.
The task force began its work in 2013 and has used interdisciplinary members of the National Coalition for Hospice and Palliative Care in its formative stages. The Certification Commission has now certified seven specialists from six states. Some of these are now assisting the commission to continue enhancing the processes and are providing education to other chaplains interested in these specialties. You can meet some of them in their writing in this issue of Vision.
Gordon Hilsman, BCC, is an ACPE/NACC supervisor in Fircrest, Washington.
