Roundtable's Preliminary Report

Introduction

In early February 2005, CHA convened 15 ministry colleagues who represent various disciplines in Catholic health care — including executive leadership, clinical applications, sponsorship, operations, pastoral care, mission leadership, theology, and medicine — to discuss spirituality in the workplace. Sr. Joyce DeShano, SSJ, facilitated the discussion.

The purpose of this meeting was to bring people with diverse health care roles together to consider systematically:

• Who facilitates and cultivates the overall spiritual life of Catholic health care workers
• What is meant by spirituality and the role it plays in the workplace
• Why it is vital for Catholic health care
• How it is integrated into the culture of health care today and in the future

Specific objectives were to:

• Raise participant commitment to fostering spirituality in the workplace
• Highlight the connection between fostering workplace spirituality and respecting and supporting the dignity of employees
• Recognize and appreciate the constitutive function of workplace spirituality to the mission of Catholic health care, particularly as it impacts patient care
• Recognize that spirituality in the workplace is an ongoing activity always open to improvement and change. It is a perpetual process of becoming; a continual unfolding of the human spirit
• Provide information regarding training to provide the necessary skills for facilitating spiritual growth, vis-à-vis experiential learning process
• Assist in developing a network of resources in the area of spirituality

Outcomes proposed included:

• An "at-a-glance" description of what we mean when we say "spirituality," that is expressed in a simple, easy-to-communicate format
• A brief statement that describes a "comprehensive vision of workplace spirituality" in Catholic health facilities
• A collection of ideas that could be implemented in Catholic health care facilities that support the spiritualities of the staff
• A wish list of workplace spirituality resources that could be developed by CHA
• A brief action plan for an ongoing collaborative effort to develop spirituality workplace resources
• Ideas generated from a brainstorming session for the development of a spirituality website for health care workers
• Attendees leave energized, renewed, and equipped in their commitment to support workplace spirituality in their respective institutions

Words Summarizing Spirituality

The forum began with participants summarizing in one word — "spirituality." Responses included:

• Relationships
• Presence
• Purpose
• Connectedness
• Joy
• Openness
• Truth
• Freedom

Spirituality Statements

Participants then formed groups and created brief statements/descriptions of spirituality in the workplace, including:

• Spirituality is an ongoing journey toward wholeness.
• Spirituality is that which gives meaning and purpose, allowing us to become the best of who we are.
• Workplace spirituality fosters a culture grounded in the organization's mission and values thereby allowing employees to find meaning in their work.
• Spirituality is the practice of staying consciously connected with what makes us alive with ourselves, with one another and with the great other.
• Spirituality is the innate experience of relationships to God, to self, to others, to creation, that gives meaning and purpose to life

Overall thoughts on statements:

• In each one we're talking about the intention — something that brings us to more wholeness.
• Intentionality; purpose is meaning — purpose and meaning.
• Inherent in all of them is relationships, whether stated or not stated; it's a journey

Understanding the Problem

A recurring theme during the roundtable discussion was the complexity of implementing, or getting employees interested in, spirituality. Here are some of the major root causes, or challenges, identified by participants:

• People confuse spirituality with religion.
• Language — "spirituality in the workplace" might not be the right phrase.
• Lack of common understanding of the term HR response to term spirituality — some go running out of the room.
• Levels of sophistication — the more sophisticated people are, the more uncomfortable they can become when using "God" language or sharing — leads to less involvement from top.
• Management must lead the initiative.
• Tapping into the hunger for spirituality — it's there, how can it be brought out?
• Providing structures and processes that allow for spiritual formation (especially for new executives) — and systems to support the expectation of spiritual formation.
• Getting physicians, and especially non-employed physicians, to participate in activities/initiatives that promote the spirituality of the workplace.

Successful Practices for Fostering Workplace Spirituality

Much of the roundtable was devoted to surfacing ways in which the leaders attending had successfully fostered workplace spirituality — both those implemented under the term "spirituality" and those that brought about spirituality in the workplace without actually labeling the initiative as such.

Examples of activities and responses include:

Daily Spirituality in the Workplace Prayer E-mail
The prayers are taken from all different traditions — B'hai, Islam, Christian, Catholic, etc. An attachment allowing for the prayer to be posted and shared is included.

Results: Some employees report that they are making their own prayer books. One employee said that the prayer is like her cup of coffee and helps her to focus for the day. A growing list of "prayer partners" also receive the daily prayer. This list consists of employees who prefer to receive the prayer at home, along with friends and spouses of employees who have requested the Daily Prayer.

Drawbacks: The e-mailing has not been achieved without any conflict. There has been some. Four employees (out of 2000) asked that the prayers not be sent to "Group Everyone."

E-mail to all Employees
Asked them to respond with a favorite prayer, reflection, poem, story for inclusion in a compilation.

Results: There was an incredible response at the facility level.

Drawbacks: When implemented at the corporate level, there were zero responses received.

Orientation Exercise for Employees
Ask the question: "Why did you choose to come to work here?" as a bridge to opening up the conversation at the start of a career about the difference in environments/values at the facility as a Catholic health facility working to better the community it serves.

Results: Some new employees have expanded on the topic and set the tone for other orientation participants to gain an understanding that the organization can provide a different, more meaningful, environment to work in.

Drawbacks: None reported.

Brown Bag Lunch Series
Using the system's five core values, picked six different people from the corporate office at various levels and asked each to share how he or she learned the value. The first was respect. They shared who taught it to them, how is it expressed in this culture, how is it nurtured, how is it punished when not done.

Results: It reinforces the diversity of the experiences people come with. It allows employees to tell their stories about growing up — their personal stories about the people and places that shaped them into who each is today. It builds common ground. It has created an opportunity for narrative.

Drawbacks: None reported.

Mission Moment
At the start or close of a meeting, those in attendance are offered the opportunity to share experiences where they saw the mission of the organization being carried out. It's meant to be a way to bring forward the lived mission and is a time where examples of spirituality in the workplace are offered.

Results: Shows the value of stories. It is a built-in way/approach to show that spirituality exists. Offers examples of when someone experiences or sees through someone else's actions the spirituality that exists.

Drawbacks: It can become too superficial and too automatic.

"The Many Faces of Healing"
A resource produced to share the experiences of colleagues with others in the organization. It takes a real life experience and uses it as a springboard for helping people understand that day-to-day experiences are a testament to the values and do give witness to the mission in action. The stories are shared and then readers are asked to share similar instances they have experienced.

Results: Some of the stories shared through the three editions of "The Many Faces of Healing" have become almost legend — they still are shared by colleagues. Opens the space for dialogue between co-workers and shows examples of the values and mission.

Drawbacks: None reported.

Work Sabbath
This is a day-long retreat with about 20 employees from across the organization. Focus is on the meaning of work and the spirituality of work. The lakeside setting provides the perfect environment for some instruction time, quiet personal time, and group interaction. Questions such as "What is it that keeps you coming back here day after day, year after year?" allow for wonderful shared insights about Catholic identity and workplace spirituality. The simplicity of the day allows for interdepartmental and intergenerational sharing. This is a paid workday.
  
Because of the overwhelming response to these Work Sabbath events, a "Sabbath Re-Visited" has been designed as a follow-up day where participants create their own "Sabbath plans" and write themselves letters about their learnings and commitments. These letters are mailed to the participants three months after they participate in the event. The newest follow-up offering is an overnight Sabbath at the ocean where employees have agreed to absorb the cost of the accommodations.

Results: More than 700 employees have attended these "Sabbath" offerings including some physicians and most senior leaders. Participants volunteer to attend and word of mouth has been the best advertisement. Attendees frequently report that they feel less alone in the challenges they face in establishing balance in their busy lives.

Drawbacks: None reported.

Moment of History
A 10-minute presentation at meetings to share a story out of the organization's history. Implemented in leadership team meetings and now also at the quarterly medical staff meeting. To prepare, the presenter goes into the archives to find appropriate pictures and other historical records (such as facility histories, employees' histories) to find examples to share with meeting attendees. With the doctors, tell stories about former physicians.

Results: It has been so well received and is missed if not included.

Drawbacks: None reported.

CARE (Corporate Annual Retreat Experience)
An annual, mandatory, one-day retreat for all the leadership in the system. The event, which is a paid workday for participants, is held offsite and allows time for reflection and discussion.

Results: None reported.

Drawbacks: None reported.

Four-day Retreat
To follow in the footsteps of the foundress, an annual retreat is offered to employees where they travel to Montreal to retrace the steps in the life of St. Marguerite d'Youville, the foundress of the Grey Nuns. The retreat allows participants to reconnect to Marguerite and learn of her life from the elder sisters. Those who have received the four annual awards for each of the system's values (compassion, respect, excellence, and stewardship) receive the trip as a gift for themselves and a guest. Other employees may attend at cost.

Results: The storytelling provides an opportunity to connect personal stories/experiences to that of the history of the organization.

Drawbacks: None reported.

Mission-Minded Person
A pilot program in which 25-27 employees — directors, upper management, and others who have expressed interest in this area, are invited. It begins and ends with a one-day retreat and then meets monthly for 10 different modules: history and heritage, Catholic identity, ERDs, ethics, spirituality, and during the course of the year, all sorts of development projects involve participants in mission work. The purpose is not so much to identify new mission leaders as to infiltrate the organization with mission-minded persons and maybe out of that, identify somebody who also might want to go out and do mission work. It is a period of a year and participants meet once monthly for two or three hours.

Results: None reported.

Drawbacks: None reported.

Executive Succession Planning/Two-Year Formation Program
Every person in system leadership positions identified the day and year each would retire. The information was submitted, and a system bell curve was created. The formation program helps identify people to take those slots as they come open, but does not preclude recruiting new people. There are 40 full-time employees who have been chosen for the program in order that each, at some point, will be moved into a senior leadership role. Each person, in order to be accepted into the program, had to agree that if an opening comes up anywhere in the organization's territory (three states with 17 hospitals), and the position is offered, she or he can't refuse the offer. There is a whole criteria involved to participate in the program; however, and the possibility of being required to relocate kept participant numbers down. The program does not allow that someone who is not a finance officer will be made a CFO, but it might take someone who was in charge of X number of departments and make that person a COO. The program includes some formation activities, including a forum, which incorporates spirituality initiatives without necessarily naming them as such. Participants are given various assignments, and must also agree to complete a six-month internship (while still working full time in current position). It is a succession plan and a formation plan. It's an attempt to acknowledge that the organization has talented people who, with formation, can step into future leadership positions. There's no guarantee that all 40 of the participants will become senior leaders.

Results: The formation program will decrease recruitment costs.

Drawbacks: None reported.

Living the Mission Awards
People nominate for recognition those in the organization who live out the mission. Nominees are photographed, and then the photo and an excerpt from the recommendation are framed and placed on the walls of the facility.

Results: It helps people articulate what it looks like when someone is living the mission and how that gets spelled out. It also shows the diversity of ways that exist to carry out the mission. Found that not a lot of senior level people were nominated for the awards. Mostly maintenance staff and others who were exhibiting mission in a very ordinary way were nominated for recognition.

Drawbacks: None reported.

A Program for CEOs about Spirituality
A brochure on spirituality (which includes, in part, an introduction about what spirituality is, a diverse list of definitions of spirituality that includes the person's name who coined the definition, and other information) is used for the program. A PowerPoint presentation is used to present the CEOs with the diverse ways people have defined spirituality. The CEOs are then asked which of the definitions means the most or is most relevant for them as individuals. Participants then discuss, in table groups, which definition each chose and why. After discussions, program participants are offered a glimpse into how each is seen by colleagues. Prior to coming to this meeting, mission leaders of each participating CEO are asked to send two to three lines about how her or his CEO exhibits workplace spirituality. Those thoughts are printed and framed (4x6 documents) and presented by national system representatives at the program to each CEO.

Results: CEOs rarely have opportunities to learn what their mission leaders think of them, or what other people think of them, and when presented with the framed thoughts, it evoked some emotional responses from the executives who were overwhelmed by the comments of others. Found to be a most meaningful opportunity for CEOs because they learn what people are observing in them about their spirituality.

Drawbacks: None reported.

Physician News Notes
A one-page newsletter that promotes a greater understanding of mission and values in the practice of medicine. It is published three times a year. It includes a topic about a current issue and different sources for looking at the issue. It asks readers to reflect on how they, as physicians in Catholic health care, would deal with a similar situation. Information from the ERDs, some theology, and something from the AMA (just paragraphs), are included in addition to a few reflection questions. Regional mission leaders distribute the document by e-mail.

Results: Physicians have said that it is a helpful resource.

Drawbacks: None reported.

Participants' Personal Experiences

The importance of sharing stories — of telling the ways in which people are living out the mission and exhibiting their spirituality in the workplace — was a recurring theme throughout the roundtable discussion. To honor the importance of telling stories, a few of the examples shared by participants are included here.

• "There was a case of a gentleman who had tried to commit suicide and had not succeeded but was really PVS and he happened to be a gay man living with his partner in this community and this is not a very "gay-friendly" area. The partner was trying to help determine whether to continue treatment and had asked to see the ethics committee. Committee members, including three other-than-Catholic physicians, met, and at the close of the meeting, as the partner was preparing to go back to the burn victim, one of the physicians asked the partner if he would stay and pray. In the prayer, the doctor prayed in gratitude for the gift of love and fidelity that the patient had experienced in his life and asked God to surround him with that as he went to heaven. After the patient died, the partner came back and said that the most meaningful thing for him was not that the committee heard his ethical concern, but that we surrounded him with prayer. If I could have looked at who in that room would have initiated the prayer, I would never have picked that doctor, so there is something in true spirituality — that this is about being consciously connected to a moment that transcends ideology or theology."
• "It was an institute of humanity in the Berkshire Mountains conducted by William May. One component was ethics. He was constantly concerned about not having enough time to complete case studies on ethics. Sometimes, because we always had cocktail hours, he would say, "Well, we will do the case studies during the cocktail hours." Some of the physicians noted that they could do case studies at home, but that they could not get this other dimension — a spiritual dimension — in their daily work environment. Maybe in smaller ways, if we have the openness or the situation, where people can share and talk about who they are and what's meaningful to them, that they will open up. I think that that hunger for spirituality is there but I think the difficult thing is figuring out how to tap into it."
• "I had the privilege of attending the International Symposium on Spirituality in Business. One of the workshops that I attended was called "The Spirit of the Oil Man." John Santa is president of Santa Energy, a family-owned business in Connecticut. During his presentation, he invited attendees to ask themselves what spirituality they brought to their workplaces. His four examples of spirituality included: forgiveness, liberation, know thy people, and servant leadership. What struck me the most was when he talked about Harvard Business School doing a study of family businesses and choosing his business to participate. The university interviewed everybody in the business — his mother, the four brothers, the staff, and all these nieces and nephews who worked there, etc. When Harvard came in and asked how the business works with four brothers included, John said the one thing that came to mind was forgiveness. And he had to think of all the times he had forgiven his brothers and how they had forgiven him. I was so struck with that and I continue to carry that in my own heart and often think about how forgiveness works at our place."
• "My mom's 96-years-old and lives in a nursing home run by the Carmelite Sisters. We moved her from assisted living to the nursing home, and her sense of independence is very, very high, so there was a great resistance to the move. My wife knew the administrator of the facility. The day we moved mom there, she was actually very anxious and quiet in the car. As we pulled up, it was a fall day, and Sr. Anthony was standing outside. We opened the car door and she helped my mom stand and she introduced herself and said, "I want to welcome you home," she then hugged her and my mother started to cry. That spirit is how this institution runs, so the sense of respect for the residents — even those who are not mentally competent — is, let the residents do what they are able to do. I have never seen or felt this environment. The staff follows through. There is genuine care. They get in this sacred place that we are all on a journey."
• "Trinity has two divisions, east and west—basically divided geographically. The eastern division got together a year ago for a higher ground retreat. There were 26 people — all the CEOs from the eastern division and a bunch of corporate types like myself were invited. It was a six-day experience, and part of the higher ground thing, if you know it, is to build trust. On the fifth night, we went around the room — the circle — for sharing, and people could say anything they wanted to about themselves. I think the introductory question was something like: "What you need to know about me?" All 26 of us spoke. Not one spoke about work. Everyone spoke about childhood, their pet, their brother who died, significant relationships in their lives. It reinforced for me the need to connect at that level and how to relate."
• "There's an element of what I would call "just-in-time spirituality" in that it is not a planned program, but occurs in the normal life events of an office building, an office group, or in a clinical situation. I think people recognize it, but only when something occurs that to ignore it would be disrespectful of the individual. I have a couple of examples. These were more in corporate settings. A female employee's manager came to me and asked if I was aware that this woman's daughter was having open heart surgery the next day. This was the woman's only child, and she was a young mother, and so she was really petrified. We talked — the manager and I — and I asked what she would like to do for her employee. She felt that this woman, as a mother, needed to be supported as she goes to face the surgery. So within a very short period of time, with a picture of the child, in a small prayer room, co-workers, friends, and some other people from the organization, gathered and prayed a blessing for the child and a prayer of blessing for the mother as she prepared to face the ordeal. It ended will with the child fine and the mother thankful for the prayers. Later, when one of the mother's colleagues in that department had to leave the company because of a spouse's relocation, the woman leaving came to me and said she couldn't express what that day meant to her — to know that she worked in a place where people not only would recognize what a family was going through, but would support them spiritually. I think those kinds of opportunities come up so many times and we need to just take advantage of them. I don't think it always has to be a great big planned retreat, but that in fact, it's those daily moments that really show that the spirituality is integrated."
• "I did a prayer proxy for a colleague who was diagnosed with breast cancer and she wanted to pray so I said sure, we are going to meet here this morning, bring anybody you want. The newspapers came. People came in who were scared to death because they had never done something like this before. We moved into prayer and then asked her, how shall we pray for you? And through great tears, she was able to articulate her need. There were doctors there and people from outside the organization. It made the front page of the local paper, and the conclusion was like those of other stories: I'm so happy to work in an organization where this could happen — that there's a culture that will support something like this."

Out-of-the-Box Ideas/Wishes

• "Whine cellars." Create a small space on a unit where someone on the unit could go when he or she needed time out. It could have quiet music, an easy chair, and people would bring in homemade snack items. Employees do not have time to walk to our meditation room or to the chapel, but could find moments if space was made available on the unit.
• Incorporate spirituality/formative activities into the strategic plan and variable compensation packages for senior leadership.
• Ask patients what would help create a spiritually meaningful space for them.
• Formation of a spirituality council (not the right word for the group).
• Have the opportunity to ask a supervisor in monthly meetings not only what he or she is doing against budget or on this mission but what did each do for their staff in the last month relating to spirituality in the workplace.
• In annual self evaluations, ask people throughout the organization what it is about their work that feeds their souls — how work gives meaning to their lives. Also, ask how each has managed to maintain a balance between work and home life responsibilities.
• To have the time when it is okay not to measure everything. Not because we shouldn't be held accountable — I believe totally in accountability — but because you can't measure your heart and you can't measure your intuition and there's so many things we do that are very difficult to measure and yet sometimes we're forced into it so we're reduced to the quantitative and not the qualitative and as a consequence. I think we have minimized ministry because we have made it something that is no different from industry.
• What I would like to see is a tool box — whole range of what spirituality looks like. Having a place/resource where all of those things are there in a raw form that can be fleshed out in the organization.
• The day when the person who is responsible for mission, whether lay or religious, be given the moral authority, and recognize their own moral authority for this work. Authority does not only tie into the hierarchical church.
• I would like to have visitation time — have CHA come in to affirm and challenge. I would like CHA person to visit with administration, mission leader, and then report/discuss the good things found and suggest next step.
• Possibly see a running feature: "Nurturing Spirituality in the Workplace" — either in Catholic Health World or in Health Progress.
• Convene an annual spirituality in the workplace program — model after Johns Hopkins' annual "Spirituality and Medicine Conference."
• Complete a spiritual care assessment in primary care practices — not wait until a patient is admitted in acute care and the chaplain comes.

Overall Learnings

• You must provide the space and the time for spirituality to happen — both "just-in-time spirituality" and planned retreats and other activities.
• Organizations are people.
• This is about finding new purpose. It has to do with formation, not information.
• Spirituality is an integral part in the larger picture of mission integration and values
• Leadership formation is taking place not only at the level of VPs or senior management, but also at the next level of management — very heartening and important in terms of the next generation being prepared.
• In addition to the stories are the words — language is very important. It can be inclusive or exclusive.
• Levels of sophistication make a difference in the approach to take — have to tailor the approach for the audience/individual. Spirituality is applicable to all persons across all denomination or religions. It is not synonymous with religion. It is relational.
• When you do not have it, you know it is not there. You can feel it.
• Half the challenge we face is the serious issue of the "time thing." It's not going to be a priority unless it's a priority from top down and gets into outcomes and compensation. . . little benefit packages and all that kind of stuff.
• Is it time for us to look at our language? It may be time as Catholic health care to reflect on, reevaluate, the language that we use.