Chaplaincy


 

9781849059763[1]

Spiritual Care in Practice : Case studies in Healthcare Chaplaincy

Edited by George Fitchett and Steve Nolan

Paperback 2015, 320pp, ISBN: 978-1-84905-976-3

It seems as if English bank holiday weekends bring out the some of the more gloomy of stories in our newspapers. I imagine journalists finishing their holidays in France have left some of these pieces for their editors to fill in copy as and when needed. Whatever the case August 2016 has brought with it some profoundly disturbing reflections on the significant financial crises that face our National Health Service. Faced with the economic realities of overspend (where the causes seem less than clear) clinicians and managers are faced with some difficult choices to make in relation to priorities in health care spending.

It is against this background that George Fitchett (working out of Chicago) and my colleague Steve Nolan offer this collection of case studies and critical reflections that speak very lucidly about what healthcare chaplains do from day to day in and through their presence and engagement in this ministry.

Take a look at the cover above and it will give you some insight into two or three of the key characteristics of chaplaincy as embodied by Steve Nolan who is pictured there. There is a quality of listening and engagement. It is done together and across professional boundaries. Look at Nolan’s hand – it appears to indicate some assertion, perhaps responding to a disagreement within that small group but with a gentle but determined sense of direction. I am guessing that the conversation focuses upon the patient and their care.

Whatever the picture conveys to you – inside the book is a treasure chest of experience. None of the authors are unafraid to open themselves up to critical self reflection. There is careful attention to experience. All of this is evaluated with responses from professionals within chaplaincy, psychology, psychiatry and nursing as together the team explores the central focus of the importance of spiritual care for healthcare. This element within the work of human flourishing is an absolute necessity and certainly not a luxury!

The book is carefully edited and I should be wanting to use some of it in facilitating learning around the nature of the pastoral and Pastoral engagement here at Sarum College. Again and again the chapters remind the reader of the vital role of story and the necessity for imagination if there is to be some measure of transformation and flourishing in both the practice and experience  of care. This is certainly Pastoral and practical theology at its very best.

 

Here is some further information from the book:
“From a 16-year-old with a belief that God would enable a miraculous recovery from paralysis, to an African man with a history of psychosis and depression whose cultural belief in witches complicated his treatment, to a dying Jewish man, aggressive and isolated due to his traumatic life experiences, each case includes insight into the patient’s needs and chaplain’s perspectives, discussion of spiritual assessments and spiritual care interventions, and accounts of significant encounters and dialogues.

The nine paediatric, psychiatric and palliative case studies and reflections in this ground-breaking book will enable chaplains to critically reflect on the spiritual care they provide and communicate their work more effectively, help healthcare professionals develop a clearer understanding of the care chaplains deliver, and provide an informed perspective for those who develop policy around spiritual care and need to make the case for chaplaincy services. ”

James Woodward

Sarum College

9781849054973[1]

Jessica Kingsley Publishers 2015; 280 pages; £19.99 ISBN 9781849054973

I review this book (the second week of July 2016) when two particular conversations were at the forefront of my mind. The first was the smooth transition between Cameron and May into 10 Downing Street and the office of Prime Minister. What followed was much speculation about who would hold some of the key offices of state including the office of health secretary. This speculation triggered a great deal of social media interest in the health service and especially some of the frustrations on the part of healthcare professionals particularly about the culture of change, resource and the over politicisation   of care in the NHS.

The second was a conversation about church growth and how we face the reality of diminishing numbers (and perhaps even confidence) in religion today. Both of these areas of thought might take up many pages of a blog but they certainly shaped by appreciation and admiration of this book of 16 essays that explore issues of how we think about and deliver healthcare chaplaincy.

Let me give you an outline of book. Its editors are leading academics in the area of health, practical theology and chaplaincy studies. In particular Andrew Todd’s work in the Cardiff Centre the Chaplaincy Studies deserves particular respect and admiration for its quality and professionalism.

The book is divided into four parts. The first part (constructing spiritual care) explores models of spiritual care; discourses of spiritual health care; models of healthcare chaplaincy and how chaplains use the Bible as interpreters in their work. The second part (negotiating spiritual care in public) explores the value of spiritual care and the need for negotiation and persuasion for its value in the public domain; some legal and policy frameworks for spiritual care; the work of chaplaincy in a multi-faith and secular environment and the particular relationship between chaplaincy and nursing.

The third part (researching spiritual care) offers an overview of methodologies for research in spiritual care; deals with the particularities of research health context; looks at the significance of volunteers in the culture of the NHS and offers a particular process of observing, recording and analysing spiritual care in an acute setting. Finally part four discusses the practice of the spiritual care in the context of suffering; opens up the much vexed question of assisted suicide; digs deep into the care of those living with mild cognitive impairment and offers experience of spiritual care in a children’s hospice.

The editors provide a comprehensive subject and author index and throughout the work there is a careful structure and system of referencing. While it is almost impossible to provide consistency across a wide range of essays and chapters the editors have succeeded in providing a very useful and significant addition to the literature in this field.

So this leads to my to opening areas of discussion. The first is developed a little in this book that needs further work. How do we deal with our expectations around care and our experience of care in the NHS? With it’s ever developing technology and increased skill and professionalism is the health service nurturing a culture within which people feel valued, understood and responded to? Put more simply – is the health service looking after people as well as it might ? Are there  some indications that despite our increased investment in resources people feel dissatisfied with the quality of engagement, support and compassion. Perhaps it is inconceivable and impossible to deliver but should we always try to start with the patient and the patient voice when developing a narrative for care? This is of course where chaplaincy is at its absolute strongest – it engagement, understanding and transformative presence in and through the attentive and caring relationship. Chaplaincy needs to beware  of its tendency to detach itself from the patient experience in the ever understandable necessity for organisational security and affirmation. The power is  with the patient! Professionalism is always grounded in the narrative of the experience of illness.

The second and I admit a less obvious area of church growth is yet another area where chaplaincy may be critical in turning around the way in which individuals and groups access the spiritual (hence my organising title).Chaplains meet people where they are and on their terms within their life experience. This is an opportunity to illuminate, enlarge and connect with the spiritual – especially in times of crisis and difficulty. It may be that chaplains are altogether best placed to keep the rumour of Angels alive through their presence and engagement. Investment in agency and chaplaincy should be a key element to the churches strategy for recovering the pastoral as part of deepening spiritual connectivity and faith.

This is a very good book and I commend it as a stimulating, resourceful and informed collection of essays on care.

James Woodward

Principal Sarum College