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By Jim Coggins
VOLUNTEERS and social workers have said they will not be able to fill the gap
left by the Fraser Health Authority’s decision to eliminate a dozen paid spiritual care coordinators from its acute
care facilities.
Fraser Health president Nigel Murray announced the cuts in a November 5 report,
in which he said this “non-core service” would be provided by “social workers and volunteers from faith communities.”
But some observers questioned whether volunteers or outside agencies would be
able to fill this role as Murray suggested.
Social workers are “already stretched beyond what they can handle,” said Graeme Isbister, spiritual care director at Chilliwack General Hospital,
and many social workers “are not comfortable” with dealing with spiritual issues.
They are already dealing with increasingly complex social issues, he said, and
about nine of 200 social worker positions were eliminated in other recent cuts.
Gloria Woodland, the former director of spiritual care for Fraser Health, said
the decision was odd for an organization that prided itself on caring for “the total person.” She added it is unrealistic to think that others can easily replace the
spiritual care practitioners, who all had at least a master’s degree and often additional training in areas such as end-of-life issues.
Arden Krystal, vice president of clinical operations for Fraser Health, said the
authority has “vibrant spiritual care volunteers.”
However, Woodland noted that those volunteers all took a six-week training
course administered by the spiritual care practitioners and their work was
coordinated by the practitioners.
Now they will be coordinated by the volunteer managers who oversee other
hospital volunteers. It will also be difficult for “faith communities” to fill the gap.
Hans Kouwenberg chaired the inter-faith spiritual care advisory council in
Abbotsford, which advised Abbotsford hospital on the hiring of its spiritual
care practitioner John Haycock and helped design the “sacred space” at the new Abbotsford hospital. However, he said, the council later disbanded
since “Fraser Health ignored us in recent years.”
Church volunteers
Kouwenberg said his church, Calvin Presbyterian, has a “pastoral care team” of volunteers who visit hospitals and care homes, but the church sent all of
them for training administered by Haycock.
These “denominational volunteers” are different from hospital volunteers, organized by and accountable to
churches rather than Fraser Health.
Another problem, said Kouwenberg, is that hospitals are limiting access to
patients. About a year ago, citing the recently passed B.C. Freedom of
Information and Protection of Privacy Act, Fraser Health began denying
religious representatives access to patient lists.
Previously, a Presbyterian minister would be given a list of patients who had
listed their religion as Presbyterian.
Philip Crowell, a member of the executive of the B.C. chapter of the Canadian
Association for Pastoral Practice and Education, said the change was instituted
to protect patients from “proselytizing [attempts to convert patients] in a multi-faith climate.”
Crowell noted “most hospitals don’t even ask for religious affiliation” any more.
Mitch Borrows, chair of the Abbotsford Christian Leaders Network (ACLN),
dismissed the privacy concern since hospital forms used to include a box where
patients could say whether they wanted a visit or not.
Under the new system, churches don’t know one of their members is in hospital unless the patient or a family member
contacts the church. And this doesn’t happen if the patient is incapacitated, there are no family nearby or “the family don’t realize how important religion is in mom’s life,” said Woodland.
Nurses and other hospital staff will call a church if the patient requests it,
but often it was the spiritual care practitioner who asked patients if they
wanted a visit.
Problems for churches
While churches may pick up some of the slack in regard to their own members,
they have no access to the increasing number of people who have no church home,
said Borrows. He said the ACLN would look at trying to fill the gap, but noted
it is already committed to supporting the local food bank and addressing
homelessness.
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Even if the ACLN offered to fund a chaplain, Borrows wondered, “Would Fraser Health recognize someone we assigned?”
The local hospital used to give passes to pastors, allowing them free parking,
said Borrows. Now pastors have to buy a pass, and there is only one pass
allowed per church. Other pastors at a multi-staff church have to pay for
parking.
It was also the spiritual care directors who led grief support groups and
arranged for faith groups to offer regular religious services in hospital
chapels.
Groups such as the ACLN will still be willing to offer those services, said
Borrows, but there will be no one to coordinate it.
Fraser Health “hasn’t looked at everything we do,” said Woodland. She noted studies that show patients who were visited daily by a
spiritual care practitioner went home more quickly, required less pain
medication and made fewer demands on nurses.
She also noted that spiritual care practitioners had 1,500 one-on-one sessions
with staff last year, often helping them deal with “bad days” when a patient has died. This is far cheaper than the staff member calling in
sick the next day or having to go to a psychologist at hospital expense, she
said.
Model program
Ironically, before the cuts, Fraser Health was known for its “strong focus on spiritual care,” said Woodland.
In 2005, Fraser Health commissioned Woodland, then a spiritual care practitioner
at Langley Hospital, to study its spiritual care program in comparison with
other jurisdictions across Canada.
As a result of her study, Fraser Health accepted the principle that “every patient needs spiritual care”; increased the number of practitioners from seven to 17; and created the
regional spiritual care position.
Spiritual care was given equal status with other health care disciplines, and
spiritual care practitioners were considered “part of the team.”
Woodland used to receive requests from across the country from health
authorities wanting to learn from the Fraser Health model. “This is the loss of a national resource,” she said.
An indication of how important they consider their work, said Woodland, is that
even though the practitioners were told they could go home November 5, they “continued to answer their pagers” and worked until they were formally finished November 10.
Kouwenberg suggested the Fraser Health decision is short-sighted because it does
not recognize the many contributions that faith groups have made to health
care.
“Spiritual care has been devalued,” he said, and “faith has been marginalized.”
Fraser Health serves 1.5 million people in British Columbia’s Lower Mainland. The cut was one of many designed to reduce the authority’s $2.48 billion budget by $160 million.
Even though the B.C. government has given Fraser Health a 20 percent funding
increase over three years, it is struggling to keep up to demand for its
services.
The region is growing rapidly, and the authority has $2 billion in building
expansion projects under way. The cuts to spiritual care will save about
$650,000.
Spiritual care practitioners will still be involved in residential and hospice
care, but because some of them worked in acute care as well, their positions
may be reposted as part-time positions.
December 2009
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