Guard against misuse of chaplain by workers
Avoid using chaplains as primary counselor
When you think of your hospice chaplain, what comes to mind? For most hospice workers, a number of descriptions seem apt — spiritual caregiver, counselor, sage, and friend. However, for some, these words have a far more personal application, rather than being a patient-oriented description of their chaplain.
As part of the interdisciplinary team, it’s easy and appropriate for chaplains and other members of the team to develop close collegial relationships. After all, co-workers in other walks of life develop friendships that blossom outside the context of work.
The relationship between chaplains and their team members is unique, however. In times of personal or professional crisis, the hospice chaplain is often the first person other hospice workers turn to for emotional or spiritual guidance.
Because chaplains have a predisposition to reach out to help, it’s easy for workers to seek their counsel. In most cases, the loss of a patient triggers strong feelings of grief; ministering to employees, for example, is acceptable to a point.
One expert warns that hospices should evaluate chaplain-employee relationships to ensure the chaplain is not overburdened and that workers don’t cross ethical boundaries that could impede the team approach to hospice care.
"When you get the job, it’s natural to see yourself as a chaplain to the staff as well as to the patients, and before long you’re worn out trying to be all things to all people, says," the Rev. Jeanne Brenneis, MDiv, STM, director of the Bioethics Center and Chaplain at the Hospice of Northern Virginia, both in Falls Church, VA. "And then there are all the boundary issues."
It’s the blurring of boundaries that can cause problems between chaplains and their co-workers. Jay Stark-Dykema, MA, pastoral counselor with CareMed Chicago, offers these warning signs:
• A chaplain finds himself or herself counseling a worker on an ongoing basis.
• Workers without a support system continually seek the chaplain’s counsel.
• A chaplain notices that he or she is spending more time with one team member than others, perhaps diminishing his or her availability to other staff.
If a chaplain is playing the role of counselor too often with a worker, the chaplain runs the risk of diluting his or her effectiveness with the very people he or she is trying to help. "[A chaplain] would be in a dual role as counselor and co-worker and that doesn’t work," says Brenneis. "You can’t do a good enough job because there is not enough distance and objectivity."
This is not to say that chaplains should not minister to their co-workers or that hospice administrators should measure the amount of time their chaplains spend helping co-workers. Chaplains play a key role in ensuring that their co-workers’ as well as their patients,’ spiritual and emotional needs are met.
Provide encouragement
It is common for hospice workers to feel a sense of loss or grief when a patient dies. Sometimes that grief is heightened when a patient or a patient’s situation reminds workers of their own personal experiences. Caring for an Alzheimer’s patient in the final weeks of life may trigger memories of the death of a worker’s own parent from the same disease.
Often these feelings of grief, while strong, are not enough to prompt the worker to seek counseling through the hospice employee assistance program. An observant chaplain will likely notice the signs of grief the worker is experiencing or the worker will seek out the chaplain’s help.
Employee ministry allows for discussion between the worker and chaplain, enough for the chaplain to assess the worker’s problem. It’s at this point where ethical lines are at risk of being crossed.
"Support a staff member as you would any other staff," Brenneis says. "I would not put myself in the position of counseling that worker,"
What does that mean? Should hospices not allow workers to discuss their problems with a chaplain? The answer is "no," but chaplains shouldn’t be the primary counselor. Instead, experts say chaplains should feel free to help the worker identify the underlying issues that are at the root of their problems, but they should also encourage that staff member to seek counseling outside the hospice.
This is especially true in situations where the problem lies outside work, but is affecting work performance, such as marital problems, caring for a chronically ill relative, or parenting issues. While this may seem like straightforward advice, Brenneis says chaplains are often trapped by their most valued assets — their compassion and their desire to help others.
Stark-Dykema provides a real-life example of how chaplains should provide for individual needs of workers, while still preserving the boundaries of the worker-chaplain relationship:
An employee who had been discouraged by a recent reprimand approached Stark-Dykema with his problem. He complained to the chaplain that he had been unfairly treated and was misunderstood. The obvious danger is that the chaplain would be put in the position of having to take sides or, at least, leave an impression that he favors one co-worker over the other.
"I listened to his problems," he says. "I affirmed his good qualities."
The worker also reflected on his response to the situation that led to the reprimand and admitted that he could have handled the situation better. The discussion then turned to areas in which he could improve. Yet, rather than acting as the primary counselor for the employee’s journey toward self-improvement, Stark-Dykema left it to the employee to seek further counseling outside the hospice. He suggested that the employee participate in a program that focused on personal growth.
Acting as a resource for workers in need is an excellent way to minister employees. In cases where co-workers have questions about their own spirituality, for example, chaplains should encourage the worker to seek the guidance of their own minister, priest, or rabbi.
Use team approach
While individual cases need to be handled delicately to preserve professional relationships between chaplains and the interdisciplinary team members, ministering to employees is still a part of a chaplain’s responsibilities.
For example, chaplains should recognize their responsibility to bolster the team atmosphere through his or her ministry and act as an advocate for the team to help ensure that the interdisciplinary team needs are met.
Stark-Dykema recommends that chaplains play leadership roles in developing team-building activities. More importantly, the team atmosphere that a chaplain has been helping to foster can also aid in employee ministry.
Chaplains can use team meetings to openly discuss feelings of grief or distress that arise from a patient loss or other situations that may effect morale. For instance, the death of a patient that has had a significant impact on staff could be addressed during a team meeting where staff are allowed to light a candle in memory of the patient and openly reflect on personal memories each has about the deceased patient.
"You need to ask how you can love and support your fellow team members," Stark-Dykema says. "You need to promote the sense that everyone is in it together."
Chaplains can also proactively minister to their co-workers spiritual needs by holding educational inservice training on religious issues, such as different types of faiths. Chaplains can use the opportunity to get workers to reflect on their own spirituality by talking about how their own spiritual beliefs interact with those of a patient or patient’s family, Stark-Dykema says.
The bottom line for chaplains is that the misuse of their services by co-workers can have the net effect of diminishing their effectiveness with patients and their families because of overwork or burnout. Chaplains must be able to exercise professional judgement when it comes to employee ministering, yet still encourage co-workers to seek their assistance when needed.
"It’s about maintaining a balance," Stark-Dykema says, "and the bottom line is that they know I’m available."
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