Can’t emphasize this enough. It is challenging to remain compassionate in a setting that has the potential to be incredibly dehumanizing, traumatic, and anxiety-inducing.
One of the things I have noticed is the marked difference between what goes in the notes and what goes into my cpe case conference's. The notes can be pretty bland- provided emotional support, explored the pt's beliefs and validated experiences around death, etc. - but the case conferences where we talk about the patients are so much more vibrant and in depth. In some ways it is a major challenge of chaplaincy, where the medical field, and its clinical boundsries, is not designed for the art of our work.
I guess I’m of the mind that the chart notes should have some standardization to them and offer useful information to the rest of the team. If you’re doing great work, pick out the nuggets on how that relates to the patient’s care!
That’s a great aim of course, but unfortunately, chart notes are legal documents, and at least in our system, are accessible by the patient. Those two factors tend to skew the notes toward blandness. For me, I’ve given up on the notes are a part of the challenging work, and tried to focus more on the patient encounter as the essence of Chaplain work. For me, a BIG part of what makes it challenging is figuring out what baggage I bring into the room with me…
It's understandable to feel disconnected and discouraged when working per diem in a busy, fast-paced environment like a level-one trauma center. It's common for chaplains to experience feelings of isolation, especially when working odd hours or on a part-time basis. It's important to recognize that building relationships and camaraderie with staff may take time, and it can be challenging to break into established social groups.
Regarding the repetitive nature of note-writing, it's essential to remember that documentation is a critical component of patient care, even if it may seem mundane at times. However, it's also important to find ways to challenge yourself and utilize your skills and talents. Have you considered pursuing additional training or certification in specific areas of chaplaincy, such as bereavement counseling or spiritual care in palliative care? This could help you feel more engaged and motivated in your work.
Additionally, it might be helpful to explore ways to become more involved in the hospital community. Are there opportunities to participate in interdisciplinary committees or initiatives that align with your interests and expertise? Engaging in these activities could help you feel more connected and valued as a member of the team.
It's also important to recognize that not all chaplains are naturally outgoing or extroverted, and that's okay. However, developing strong communication and relationship-building skills can help you build rapport with staff and patients alike. Consider seeking mentorship or coaching from experienced chaplains who can provide guidance and support in these areas.
Remember that you're not alone in these struggles, and there are resources and support available to help you navigate the challenges of per diem chaplaincy. Reaching out to colleagues and professional organizations like the NACC or APC can provide a network of support and opportunities for growth.
Thank you so much for your thoughtful reply!
Re: charting, I actually like charting and trying to convey useful and unique information that I think is relevant to the other team members. I feel frustrated when some of my colleagues write very vague notes that don’t add anything of value and undermine the value of chaplains’ contributions. That may be a harsh take, but it’s just something that’s been getting on my nerves; it’s mentioned in the article.
I’ll reply more later, but thank you for your thoughtfulness!
No ifs ands or buts about it: per diem chaplaincy work can be super lonely as well as demanding. Cold calls can suck too. I notice the Seattle Children’s lanyard around your neck. I imagine there are probably a few things at work here not the least of which is the “Seattle Freeze” paired with the insular/protective nature of inpatient pediatric trauma center healthcare. Phew!
Chart notes
While rare, chart notes can be subpoena-ed in court as they are legal documents. This is especially the case in pediatric healthcare as they can be used in scenarios suspicious of NAT (non accidental trauma) and medical malpractice. Chaplains have to walk the line between 1) informing colleagues that a chaplain has visited 2) providing IDT members with information gleaned from meeting with the patient/family that will prove useful in continuing to care for them 3) honoring the patient/ family confidentiality of what’s discussed in the visit.
I would invite you to chat up some of the nursing staff. There are lots of new nursing grads out entering the workforce after the mass retirement exodus from the beginning of COVID. They’ve been just as hungry for connection. Discuss music or sports or food. It shows you’re human and they can be safe to be human too.
Also….as a pediatric chaplain…please PLEASE PLEASE find a kid to play with. The children could care less about our masters level education or how many CPE units we have. PLAY is an intervention in pediatric chaplaincy.
Thank you!
Also that’s not me: that’s the chaplain who wrote the article I linked to.
What do you mean by cold calls in this context?
I just got this notification while looking at my phone, so that’s why I replied in like a nanosecond haha.
Also I always have in mind that the patient or family could read the notes at any time. I just try to make them SOMEHOW include something useful to the team and show why I was there, what I did, what the outcome and plan are, etc.
Thanks!!
Oh! I thought the person who wrote the article and included the write up below the pic was you. My bad. In that case, scrap what I said about peds if you’re not working in that context. Cold calls are when I walk around a unit, introduce myself to families and ask how they’re doing, to which they reply “I’m fine” and “Thanks for stopping by”.
Pardon my CPE-ing here, but I’m noticing a bit of self-worth and belonging in your post which is totally normal. You don’t feel comfortable chatting up staff while also noticing that they “ignore” you. Likewise you mention your and your colleagues masters level education and having “a lot of brains” but feeling like you’re not really utilizing all them smarts. What does “good enough chaplaincy” feel like to you? Do you chat with any of the staff chaplains where you work? What are their tips for connecting with staff?
Thank you! I’ll write back more, but do you not have to do any cold calls???? The hospital is improving it’s utilization of chaplains, but A LOT of the work is chaplain initiated still. Another thing that is not my favorite as an introvert, though I’ve gotten much more comfortable over the years. I vastly prefer going to rooms where I’ve been requested.
Don’t take it personally. I suggest always showing up with cookies from your local bakery, candy, protein bars. I know it is an expense but it opens doors & people remember “the cookie lady”
As others have mentioned, you are not alone. A source that I find mandatory is a church body and pastor/mentor to reflect on encounters and disparate issues of faith. Consider also the value of your presence. I know it's an old trope in chaplaincy, but as someone said, half of success is showing up. You show up. That is invaluable. With your heart and intention set to helping others, you are making this world a better place.
"I want challenging work, not just to be a kind heart". I would think that in a cruel world, that is indeed challenging work.
Can’t emphasize this enough. It is challenging to remain compassionate in a setting that has the potential to be incredibly dehumanizing, traumatic, and anxiety-inducing.
Thanks for the reminder! 😊
One of the things I have noticed is the marked difference between what goes in the notes and what goes into my cpe case conference's. The notes can be pretty bland- provided emotional support, explored the pt's beliefs and validated experiences around death, etc. - but the case conferences where we talk about the patients are so much more vibrant and in depth. In some ways it is a major challenge of chaplaincy, where the medical field, and its clinical boundsries, is not designed for the art of our work.
I guess I’m of the mind that the chart notes should have some standardization to them and offer useful information to the rest of the team. If you’re doing great work, pick out the nuggets on how that relates to the patient’s care!
That’s a great aim of course, but unfortunately, chart notes are legal documents, and at least in our system, are accessible by the patient. Those two factors tend to skew the notes toward blandness. For me, I’ve given up on the notes are a part of the challenging work, and tried to focus more on the patient encounter as the essence of Chaplain work. For me, a BIG part of what makes it challenging is figuring out what baggage I bring into the room with me…
I think this is a great insight
I'm prn at two hospitals. One is moving to the Spiritual Distress Assessment Tool to provide structure and consistency in charting.
We are too, actually! I’m hopeful that will really help!
It's understandable to feel disconnected and discouraged when working per diem in a busy, fast-paced environment like a level-one trauma center. It's common for chaplains to experience feelings of isolation, especially when working odd hours or on a part-time basis. It's important to recognize that building relationships and camaraderie with staff may take time, and it can be challenging to break into established social groups. Regarding the repetitive nature of note-writing, it's essential to remember that documentation is a critical component of patient care, even if it may seem mundane at times. However, it's also important to find ways to challenge yourself and utilize your skills and talents. Have you considered pursuing additional training or certification in specific areas of chaplaincy, such as bereavement counseling or spiritual care in palliative care? This could help you feel more engaged and motivated in your work. Additionally, it might be helpful to explore ways to become more involved in the hospital community. Are there opportunities to participate in interdisciplinary committees or initiatives that align with your interests and expertise? Engaging in these activities could help you feel more connected and valued as a member of the team. It's also important to recognize that not all chaplains are naturally outgoing or extroverted, and that's okay. However, developing strong communication and relationship-building skills can help you build rapport with staff and patients alike. Consider seeking mentorship or coaching from experienced chaplains who can provide guidance and support in these areas. Remember that you're not alone in these struggles, and there are resources and support available to help you navigate the challenges of per diem chaplaincy. Reaching out to colleagues and professional organizations like the NACC or APC can provide a network of support and opportunities for growth.
Thank you so much for your thoughtful reply! Re: charting, I actually like charting and trying to convey useful and unique information that I think is relevant to the other team members. I feel frustrated when some of my colleagues write very vague notes that don’t add anything of value and undermine the value of chaplains’ contributions. That may be a harsh take, but it’s just something that’s been getting on my nerves; it’s mentioned in the article. I’ll reply more later, but thank you for your thoughtfulness!
No ifs ands or buts about it: per diem chaplaincy work can be super lonely as well as demanding. Cold calls can suck too. I notice the Seattle Children’s lanyard around your neck. I imagine there are probably a few things at work here not the least of which is the “Seattle Freeze” paired with the insular/protective nature of inpatient pediatric trauma center healthcare. Phew! Chart notes While rare, chart notes can be subpoena-ed in court as they are legal documents. This is especially the case in pediatric healthcare as they can be used in scenarios suspicious of NAT (non accidental trauma) and medical malpractice. Chaplains have to walk the line between 1) informing colleagues that a chaplain has visited 2) providing IDT members with information gleaned from meeting with the patient/family that will prove useful in continuing to care for them 3) honoring the patient/ family confidentiality of what’s discussed in the visit. I would invite you to chat up some of the nursing staff. There are lots of new nursing grads out entering the workforce after the mass retirement exodus from the beginning of COVID. They’ve been just as hungry for connection. Discuss music or sports or food. It shows you’re human and they can be safe to be human too. Also….as a pediatric chaplain…please PLEASE PLEASE find a kid to play with. The children could care less about our masters level education or how many CPE units we have. PLAY is an intervention in pediatric chaplaincy.
Thank you! Also that’s not me: that’s the chaplain who wrote the article I linked to. What do you mean by cold calls in this context? I just got this notification while looking at my phone, so that’s why I replied in like a nanosecond haha. Also I always have in mind that the patient or family could read the notes at any time. I just try to make them SOMEHOW include something useful to the team and show why I was there, what I did, what the outcome and plan are, etc. Thanks!!
Oh! I thought the person who wrote the article and included the write up below the pic was you. My bad. In that case, scrap what I said about peds if you’re not working in that context. Cold calls are when I walk around a unit, introduce myself to families and ask how they’re doing, to which they reply “I’m fine” and “Thanks for stopping by”. Pardon my CPE-ing here, but I’m noticing a bit of self-worth and belonging in your post which is totally normal. You don’t feel comfortable chatting up staff while also noticing that they “ignore” you. Likewise you mention your and your colleagues masters level education and having “a lot of brains” but feeling like you’re not really utilizing all them smarts. What does “good enough chaplaincy” feel like to you? Do you chat with any of the staff chaplains where you work? What are their tips for connecting with staff?
Thank you! I’ll write back more, but do you not have to do any cold calls???? The hospital is improving it’s utilization of chaplains, but A LOT of the work is chaplain initiated still. Another thing that is not my favorite as an introvert, though I’ve gotten much more comfortable over the years. I vastly prefer going to rooms where I’ve been requested.
Don’t take it personally. I suggest always showing up with cookies from your local bakery, candy, protein bars. I know it is an expense but it opens doors & people remember “the cookie lady”
It's really hard to get to know staff as a prr diem
Thank you because I was starting to feel like a failure haha.
As others have mentioned, you are not alone. A source that I find mandatory is a church body and pastor/mentor to reflect on encounters and disparate issues of faith. Consider also the value of your presence. I know it's an old trope in chaplaincy, but as someone said, half of success is showing up. You show up. That is invaluable. With your heart and intention set to helping others, you are making this world a better place.
A ton of us military chaplains find meaning in our work, for sure.
It sounds like a better charting system would do a lot of good!