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Chaplaincy in Palliative Care Settings

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Post Self care death
Author: Mardi
Date: Apr 8, 2009 12:17 pm
Management has asked that we create a way to acknowledge deaths and provide care for staff. Staff have said they do not want any "touchy feely, kumbayah stuff". Does you program have any routines that allow staff to process the death of a patient? Thanks, Mardi
Replies: order by [Date] [Author] [Subject]
Re:Self care death (by Baratone on 04/08/2009)
At IDT we have someone read all of the patients that died since the last meeting and have a moment of silence. We also send around a card for everyone to sign to give to the family.
+ Re:Self care death (by shsmith on 04/08/2009)
We have kept a journal in the break room for writings about patients. Sometimes a story gives insight into the patient's philosophy. Sometimes it's just a simple "I remember her wonderful smile." Sometimes a funny incident. Writings aren't just about patients who have died but also about those who continue to live. Response to this seems to be cyclical. Some-times no writing for a while, sometimes a lot.

When things have been particularly difficult, I offer a "rock session with the chaplain." I spread an assortment of river stones on the breakroom table. Staff members chose a stone that represents a personal struggle or someone who is affecting them in a special way. Sometimes people feel overwhelmed and take a whole handful.

After a short reflection, they put the rock in a bowl of water in the center of the table as a way of releasing or diluting the burden. Sometimes people just rush in, select a stone, hold it briefly, and then drop it into the water. Often they sit down and talk things over with me. This helps not only with acknowledging sadness but also in dealing with all sort of frustrations, staff conflicts, and personal concerns.

Suzanne Hilton Smith
Martha Jefferson Hospital
Charlottesville VA
Re:Self care death (by jdurnil on 04/08/2009)
Our team created psychosocial rounds which happen 2x a month. The tam gets together and discusses difficult cases or deaths and how it impacts them emotionally. Jim
Re:Self care death (by Tim_Ford on 04/08/2009)
We have an annual memorial service at which we read the names of every patient that died on the unit in the past 1.5 years (~350 names) plus a few that we remember every year since we opened. For some staff this is an important catharsis. The staff that hate the 'kumba-ya' stuff (and we have plenty who do) simply do not have to come or participate. Others that appreciate it help read the names. The ritual around the reading changes each year (candles, stones in water, etc...)


We are firm believers in frequent informal check-ins with staff. My chaplain position was specifically written with lots of room for this kind of spontaneous staff support. Then we also have weekly clinical didactics that can be used to deconstruct heavy cases and get feedback.

With the current economic climate, staff support has been a larger issue than usual. Many are seeing their friends and family lose their jobs which is straining their usual resiliency levels.


Hope this helps!

Tim Ford
Palliative Chaplain
VCU Massey Cancer Center

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