The question we ask, from time to time, is “does what I’m doing make a difference.” That can lead us to the question, “What is the difference that what we do makes?”
Answering that question becomes one of the roles of research. And one of the themes we heard often at the conference was evidence-based practice in spiritual care.
Historically, evidence and spiritual care feel uncomfortable together.
How can you measure what God is doing?
How can we prove that our spiritual care is significant?
And yet, our practice as chaplains at Parkview has been influenced by external research.
One: The literature review research that a number of people did into the role of ties and contamination has literally changed the look of chaplaincy.
TWO: The external research that suggested a connection between positive hospital experiences and spiritual conversations led to our regular rounding in particular units.
Surgical 3, Oncology, 6th floor, ED. Each time we have been intentional about rounding in particular units, there has been a difference. It’s been an unresearched difference, an anecdotal change. So we don’t know that there is a causal relationship. But we do have an inkling.
When we talk about research, we’re talking about something as simple as asking a question about our practice, suggesting an answer, and measuring things before and after the change.
In the Spiritual Care discipline, there seem to be two reasons for evidence-based practice:
· It can be about justifying our existence directly. This is a big deal for Medicare reimbursement. There is a lot of conversation in Palliative care about measurement, for example. Creating standards of care and then identifying where spiritual care is demonstrably helpful.
· It can be determining whether and how we are providing the best possible help with our patients.
So, three threads of thinking related to research and what we do.
We know that a chaplain interacts with every death in a Parkview hospital in Allen County. Which means that we know that a chaplain interacts with loved ones in all but a tiny number.
· What do we know about the helpfulness of what we do?
· What do we know about the value of each of the actions?
What do we know about the helpfulness of the followup?
· What do we know about our consistency in those situations?
· What do we know about our role with staff?
· Are there variations by unit?
· Are there variations by the staff member (traveler, rookie, veteran)?
All of these are questions that could be investigated.
Which takes us to another question:
· What do we know about our interaction with the lives before death?
· Did we offer care?
· Could our services be helpful to every family and patient before death?
· Could we do things more helpfully after death if we did some kind of work before death?
And then a third area. What can we do in ICU –
It’s a place of a lot of death for us. 37% of our deaths in the first 3 weeks of July were in the ICU. It’s an area of significance.
At the conference, I heard that the more connected people are to faith in congregations where the pastor is not clinically-trained, which means doesn’t see what we see, the more likely they are to pursue aggressive care past the point where it helps.
To let God do a miracle. Because suffering is noble.
In talking with Lisa Morgan who has done research into the effects of bereavement care for ICU deaths and for ICU staff, ongoing care can help people deal with Post Intensive Care Stress Disorder (ICU-itis).
If we knew more about what happens with what we do, we could be even more effective than we are.