Skip to main content

Time to Call the Hospital Chaplain


Sometime ago Don Berwick, MD spoke about 20 improvements that doctors could make in the end of life care of their patients that begins in a simple conversation. Berwick recommended the following considerations as his top three suggestions:
  1. Ask yourself as you see patients, "Would I be surprised if this patient died in the next few months?" For those "sick enough to die," prioritize the patient's concerns - often symptom relief, family support, continuity, advance planning, or spirituality.
  2. To eliminate anxiety and fear, chronically ill patients must understand what is likely to happen. When you see a patient who is "sick enough to die" - tell the patient, and start counseling and planning around that possibility.
  3. To understand your patients, ask (1) "What do you hope for, as you live with this condition,"(a) "What do you fear?," (b) It is usually hard to know when death is close. If you were to die soon, what would be left undone in your life?," and (4) "How are things going for you and your family?" Document and arrange care to meet each patient's priorities.

All too often the task of finishing the business of living gets left undone because the end of life conversation has never taken place for whatever reason.  A referral to the Clinical Chaplain would of course be an appropriate action in the hospital setting. 

Clinical Pastoral Training: University of Arkansas for Medical Sciences 

College of Pastoral Supervision & Psychotherapy 

Popular posts from this blog

Edwin Friedman Thinking Systems

What I want to do this morning is talk about how congregations function like families. I am going to do it from a variety of points of view. I’m going to begin with a fable. This one is called "Burnout" and it’s about a fish tank with a scavenger fish in it, you know a scavenger fish is supposed to keep the fish tank clean. I’m trying to be as realistic about it in my use of language as possible so I hope that you will appreciate that. Once upon a time there was a scavenger fish that lost its taste for shit. (I don’t think I have to read the rest of the fable. You all got the message already!) It was your normal, garden-variety scavenger and had never previously shown any signs of being different from the other members of its species. It lived in a normal-sized tank with the members of several schools and, from the very beginning of its association with this ecosystem, seemed always to be in perfect harmony with the environment. It never got in the way of the others and th...
1 comment
Read more

The Wounded Healer Too Wounded To Heal

“The painful irony is that the minister, who wants to touch the center of men’s lives, finds himself on the periphery; often pleading in vain for admission….He never seems to be where the action is.” I wonder if this says more about Henri Nouwen than it does about the minister’s involvement in critical and crisis situations.“ George L. Buck Ph.D. The minister, the story tells us, is sitting among the poor, binding his/her wounds one at a time, waiting for the moment when he/she will be needed. The minister is called to be the wounded healer, the one who must look after his/her wounds and at the same time be prepared to heal the wounds of others.” --- Henri Nouwen. In his article titled “Wounded Healers”, Thomas Maeder quotes a child of psychiatrists (both parents): “I Think my parents were crazy, I think that, somehow, being psychiatrists kept them in line. They used it as a protection. They’re both quite crazy, but their jobs give them really good cover.” It is no secret that the so...
Read more

Asbury Theological Seminary: How to Receive Credit for CPE Training

CLINICAL PASTORAL EDUCATION Asbury Theological Seminary  Find a certified ACPE (Association for Clinical Pastoral Education) or CPSP (College of Pastoral Supervision and Psychotherapy) training site.  ACPE website has a  list of certified training sites by states .  CPSP website has a  list of certified training sites .  (NOTE: Your denominational body usually defines which of the above training programs they prefer.) See  ACPE  or  CPSP  webpage for more information on each respective program. Apply directly to the ACPE or CPSP sites you are interested in training.  Both  ACPE  and  CPSP  website have application forms you can access. Your training site may also provide you with the application as well. ACPE and CPSP training sites may require you to pay a tuition fee to train with them. You are responsible for paying for your CPE training.  The seminary will reimburse you up to ...
Read more