Preparation and Use of Volunteers in Pastoral Care Settings

PREPARATION OF VOLUNTEERS Research  Solicited feedback and volunteer training programs from NACC members through its bi-monthly online newsletter “NACC Now”  Solicited volunteer traini

National Association of Catholic Chaplains

Summary of Responses from Members Regarding Preparation and Use of Volunteers in Pastoral Care Settings

I PREPARATION OF VOLUNTEERS

Research

 Solicited feedback and volunteer training programs from NACC members through its bi-monthly online newsletter “NACC Now”

 Solicited volunteer training programs from those who had programs but who did not respond to the initial invitation

 Searched the internet using the following terms and variations of those terms:

o “training of pastoral care volunteers”

o “training of chaplain volunteers”

 Utilized 17 total responses

Training Program information obtained from:

 St Joseph Medical Center – Reading, PA

 Morton Plant Mease Health Care – Safety Harbor, FL

 Bon Secours St Francis Health System – Greenville, SC

 O’Connor Hospital – San Jose, CA

 Catholic Health Services – Rockville Centre, NY

 Memorial Sloan-Kettering Cancer Center – New York City, NY

 Children’s Hospital and Health Center – San Diego, CA

 Froedtert Hospital – Milwaukee, WI

 Rady Children’s Hospital – San Diego, CA

 Children’s Medical Center – Dallas, TX

 Gaston Hospice – Gastonia, NC

 Sutter Medical Center – Sacramento, CA

 Massachusetts General Hospital – Boston, MA

 University of Arkansas Medical Center – Little Rock, AR

Results

 Nine responses with general information that summarized the

training programs

 Four responses with detailed information including orientation

manuals, training detail, and applications

 Three responses from individuals raising concerns

 Four Catholic facilities and nine Non-Catholic facilities

 Responses from varied U.S geographic locations: East, South,

Midwest, and West

Best Practices

 Job Description

 Application process

 Interview process

 Endorsement by local church

 Orientation Manual

 Mission, Vision, Values of setting

 Training class (at least 20 hours recommended)

 Required continuing education

 Health care policies and procedures (emergencies, HIPAA, infection control,, safety, ethical guidelines, etc.)

 Utilize local resources for orientation and continuing education

 Develop competencies for volunteers

 Include sessions on:

o diversity

(religious/ethnic/cultural/age/gender/orientation/disability)

o ethics

o self-care

o prayer

o active listening

o boundaries

o history of pastoral care

o pastoral identity

o spiritual assessment

o Educate on the differences between religion and spirituality

o Caution against proselytizing, evangelizing, recruiting

o Utilize case studies

o Utilize role playing and interaction during training

o Rationale for volunteers:

o Catholic – Biblical, Theological, Co-Workers in the Vineyard, Vatican II documents, Ethical and Religious Directives for Catholic Health Care

o Non-Catholic – Joint Commission on Accreditation of Healthcare Organizations: “Healthcare organizations are obligated to respond to spiritual needs because patients have a right to such services.”

Issues for Consideration Other Than Training

 How and where used?

 If being used, how ensure proper

selection/training/authorization/resourcing/ recognition (STARR)?

 What title given so as not to confuse with a Board Certified Chaplain?

 Relationship of paid staff to volunteer?

 Balancing need for volunteers with practice of hiring staff, and need for certified chaplains?

 How work with those professionally trained/certified who are

“volunteering” because they cannot get employed fulltime due to

disabilities?

 How religious endorsing bodies recognize/relate to volunteers?

 Are competencies/standards needed for volunteers?

(Indebted to Research/Analysis of Susanne Chawszczewski, Ph.D., NACC)

II USE OF VOLUNTEERS

Programs Responding Regarding Use of Volunteers

 Genesis Medical Center, Davenport Iowa

 Oakwood Southshore Medical Center Trenton, MI

 Riverside Methodist Hospital, Columbus, OH

 Brackenridge Hospital, Austin, TX

 St Martha's Regional Hospital, Antigonish, NS, CANADA

 Catholic Health Services, Long Island, NY

 Banner Health System, Mesa, AZ

 University of Chicago Hospital, Chicago, IL

 St Mary’s Medical Center, Duluth, MN

 Cheyenne Regional Medical Center, Cheyenne, WY

 Monongalia General Hospital, Morgantown, WV

Modes of Use

1 Program with three uses:

o Extraordinary Ministers of the Eucharist: 

 Come forward from the Catholic parish communities

 Trained and commissioned in keeping with Canon Law and Diocesan Policy

 Specific Diocesan permission sought

 Assume responsibility for maintaining their continued education and renewed commissioning

o The Befriender Program:

 Can come from any faith community within the larger community, including Jewish, Moslem or other Eastern Religions

 Undergo a 20-week course of formation and training to prepare them to meet patients and family members as

"living documents" with unique stories

 The Befrienders are taught to listen and respond to the patient's or family member's stories, needs, concerns, etc. 

 Befrienders trained not to bring an agenda of information seeking, problem solving or faith sharing, but will actively listen and respond in reflecting faith if this is raised by the other person

 Referrals for specific Chaplain interventions are made as appropriate

o Grief Recovery Program and Rick's House of Hope:

 Generally come from Befriender program and receive additional training in grief work

 Deals with adults in grief including those with addiction and behavioral health (psychiatric) issues

 Also offers assistance for those healing the grief of past abortions or fetal/neo-natal death

 Rick's House of Hope is a specialized program to assist children dealing with grief and loss, including divorce

 Both programs are headed by Chaplains who remain available as resources for referral and intervention as necessary

o All three models of Volunteer service within Spiritual Care work under the direction of the Staff Chaplains

o Volunteers receive regular debriefing and mentoring services from Chaplains both for support and accountability as well as for the continued integrity of the programs themselves

o These three models of volunteer support in Spiritual Care greatly increase the scope and number of services that can be provided

2 Program run by sole staff chaplain in a 150 bed community hospital

o One person with "staff" of 26 volunteers valued very, very highly

o Organized in three different groups:

 Eucharistic Ministers, 7 (one each day) recruited from local parishes, already trained as an EM in the parish

 “Day 2" Volunteers, 12 volunteers, sees each patient on Day

2 and completes a specific Day 2 Spiritual Assessment (form available)

 Forms come off chaplain’s computer each morning, 7 days a week, pre-populated with data on each Day 2 patient (Most mornings there are about 50 or 60!)

 Go through extensive training, including role playing these visits so that they become comfortable with the scripting at the top of the page and so that they can conduct the visit without referring to the paper They understand that the visit is PERSON led, not PAPER led and any notes are made in the hall way rather than the room

 While a process is not in place for staff referrals and consults, since program was implemented about a year ago, the number of referrals received has nearly quadrupled and they are meaningful and appropriate referrals

 These Day 2 volunteers are a crucial part of our department

 CPE trained Volunteer Chaplains Currently 5 Volunteer Chaplains

 There is one spot for a CPE intern here Rather than external CPE students looking to pursue a career in chaplaincy, active Spiritual support volunteers know that this spot is open to them should they decide to

"go deeper" in their ministry

 Once they have completed a unit of CPE and several

of them have completed more than one unit then they may use the title "Volunteer Chaplain" (The title is inherited;

 This also allows them to see referrals and for those who are able, to take call The chaplain still personally visits the physician referrals and volunteers refer more complex or delicate situations, but they are able

to handle most of the referrals in a way that seems to please both patients and staff

o Results: with ONE FTE and these volunteers the program is able to:

 Provide 24/7 coverage There is ALWAYS a CPE trained chaplain available

 See new referrals within 24 hours

 See all referred patients on a (nearly) daily basis when necessary

 In the past year, scores on the Press Ganey "Emotional Needs" question have moved from the 30th%ile in the national Press Ganey database to the high 90s where they seem to be holding

 One chaplain could never provide the level of coverage that the team is able to offer patients and staff

 Allows chaplain to focus energy on those who present genuine crisis and challenge, and also to work much more with clinical staff

 Chaplain also able to represent "the Pastoral Voice" on many system and site wide task forces and groups while still knowing that the patients are visited and cared for. 

 The caveat to all of this is that the chaplain spends a tremendous amount of my time recruiting, training, mentoring and coaching volunteers For a program like this

to work, individuals must work very, very closely. We recognize that not every chaplain wants to invest that amount of time away from the bedside Certainly no system

is perfect, but since there is virtually zero probability of hiring another chaplain, this is the next best way to ensure that the patients (and staff) receive the spiritual and

emotional support we want them to have available to them

 Finally, as we all work harder to justify our existence, the department is very, very visible within the hospital, and administration recognizes that it is essential to have a professional chaplain "holding the reins" so to speak They understand that the level of care we provide could not happen without the training and support provided to the volunteers even if at the chaplain is not at the bedside as much They see what Spiritual Support accomplishes, not just at the bedside but throughout the hospital

3 Program with volunteers trained within the pastoral care department on how to visit, etc

o Trained within pastoral care department to visit, etc.

o Group of dedicated laypersons and some retired clergy visit

o Do not have access to the patient’s chart, but make notations of their visits in a notebook in the chaplain's office

o “Supervised" by a staff chaplain, who does the screening, interviewing and training of new groups; one visitation volunteer helps with the coordination and training

o Most visit on the lower acuity units, making initial visits to introduce availability of pastoral care services

4 Program describing their volunteers as:

o Primarily communion ministers who need to be “vetted” by their parish; but chaplain does training and oversight

o Also “compassionate care givers” - individuals with experience in hospitals – administration and CPE – who came in and visited

designated patients; it did not evolve into any program

5 Program of No One Dies Alone program for patients who have no family

o For those expected to die in 72 hours and need to remain in the hospital

o 30 staff volunteers who have been trained in this program and are willing to come in when this service is requested.   This was started in April and have so far only activated this twice since then

6 Program with volunteers participating in an eight week training through the Diocese to be leaders of prayer

o Conduct Communion Services

o Scheduled on a regular basis every Sunday, and if needed, two others on call to do the communion services

o Spend time with residents, listening to stories and/or reminiscing

o Help set up and do the readings and petitions for the communion service and escort residents to and from the service

o Lead the singing at Mass on days when a chaplain cannot be there  

7 Program beginning to use "volunteers"

o Came from a Diploma in Ministry program in the diocese

o Three are now on-call once a month at this 90 bed hospital

o None took CPE units but are now learning as they go, along with a group session every couple months

8 Program using Volunteer Spiritual Care Companions

o Visit patients, residents and clients in Hospital, Dialysis Centers, Long Term Care & Rehab, Homecare, Hospice and Developmentally

Disabled

9 Program using retired ministers, active ministers and chaplains

o To "meet and greet" the first-day patients and discern whether there

are any spiritual needs to be addressed

o Full-time paid chaplain and half-time paid coordinator:

 Coordinate the program and the chaplain volunteers;

 Take referrals from staff/ volunteer chaplains

 Visit those who have been hospitalized for longer periods of time. 

10.Program called “our pastoral visitors” which trained volunteers to:

o Assist with spiritual assessment process for new patients

 Visited new admits and completed a brief spiritual screening

 Charted this along with their recommendations for follow up by the chaplains, who would then do a more in-depth spiritual assessment

o Also traditional roles as Eucharistic ministers, office helpers, and prayer leaders

o Very careful to differentiate what the volunteers did as a screening from what chaplains did as assessment, even though some of the volunteers developed a pretty high level of competence with their piece

o Having them really helped the chaplains to focus their time and

attention on those patients with the greatest need

11.Program experiencing Ministers of Care from a neighboring church (and are signed up with the Hospitals Volunteer Office) who bring the

Eucharist to patients. 

o Trained and mandated by the Archdiocese of Chicago having had 12

hours of mandatory studies. 

o Other volunteers for the department have been ones who answer

phones and perform office type duties and are assigned by the

Volunteer Office of the Hospital/Institution

o Believes anyone who has patient care contact ought to be

credentialed in the capacity in which they are ministering; otherwise,

it puts the institution at risk.  

12.Program utilizes volunteer of the Stephen Ministers © Stephen Ministry: http://www.stephenministries.org/