BY: BR. EDWARD SMINK, OH
Br. Edward Smink, OH, is senior vice president, mission integration, Dubuis
Health System, Houston, and a National Association of Catholic Chaplains–certified
chaplain.
A Texas System Practices What It Calls "Co-Ministry"
SUMMARY As responsibility for mission shifts from religious to lay leadership, sponsor-secular
partnerships and new models of governance help to ensure that Catholic health
care facilities continue the healing ministry of Jesus. By appointing lay mission
directors and developing programs that support the work of health care professionals
and associates "in the trenches," the sponsors of Catholic health
care facilities are embedding particular values and behaviors in their organizations. The miracle of Catholic health care invites women and men of different faith
traditions to participate in and contribute to the values, culture, and mission
of the Catholic health ministry. Mission "in the trenches" is longer reserved solely for sponsors
and religious congregations. By establishing and recognizing the essential services
provided by interdisciplinary spiritual care teams and empowering patient caregivers
with the knowledge and tools necessary to fulfill their specific responsibilities,
the healing presence of God is made known to those who seek our care and observe
our actions. |
One of the many lived traditions of the religious men and women who have forged
and shaped Catholic health care in the United States is their partnerships with
the laity. Years before the winds of Second Vatican Council inspired more collaboration,
partnerships with secular physicians, nurses, and other health care professionals
were not only common but also essential to the survival of the health care ministry.
Although the fact was not officially recognized at the time, each such person
became a co-minister and partner of the religious institutes in extending the
healing mission of Christ.
It is no wonder that mission integration and Catholic identify are today given
renewed attention. I remember speaking recently to a sponsor of a large Catholic
medical center, a woman religious who also happened to be the facility's
vice president of mission integration. She spoke of the many changes in health
care, as well as of a fear that the culture and spirit of the hospital and sponsoring
community could be lost.
This sister's community had founded the hospital more than 100 years before.
I remember gently taking her hand and asking her, "Do you mean to tell
me, after all these years of working together with so many wonderful and dedicated
health care professionals, that some of the spirit of your charism did not rub
off on them? In fact, did not God send many doctors, nurses, therapists, technicians,
and ancillary personnel to carry on the mission of this hospital—men and
women who already had the charism deep within them?" The sister smiled,
and her eyes filled with tears as she began to name person after person who
had contributed to her congregation's mission and to the ministry of the
church. She realized that her facility's mission would survive and adapt
to new challenges as it always had throughout its history, although it would
do so with different models of sponsorship, governance, and lay participation.
The "Business" of Mission
Of the many challenges involved in the "business" of mission,
two readily come to mind. The first concerns the recognition by the laity of
their unique role as partners and co-ministers with the sponsors in their universal
call to holiness and participation in the mission of the health care ministry.
Responsibility and accountability for mission is the work of each associate
and participant who serves. The words of Jesus in the Gospel of John are simple
and to the point: "Those who see you, see me, and in seeing me, see the
Father who sent me" (Jn 14: 9-11). Each person, no matter what his or her
specific role or position in the health ministry, incarnates again, in his or
her work, the presence of a loving and compassionate God.
The second challenge is how the sponsors of the health ministry continue to
develop new models of governance that encourage and empower the unique partnerships
they have with the laity. One example of these new partnerships is the development
and training of lay leaders to fulfill the role of mission director, a position
once held only by a member of the sponsoring congregation. Another is the development
of programs to support those working "in the trenches." The work of
each congregation is the work of the church, and this work is accomplished through
the tireless effort and dedicated service of health care professionals and associates.
The Mission of Integration
The lived experience of those "in the trenches" is the heart of
mission. It is what we believe in. This is expressed in the collective vision
statements that become enfleshed in particular values and behaviors. These values
are the "how" of what we hope to accomplish in what we say we do.
This is the business of mission. It is about operations in all the multifaceted
details, challenges, and complexities involved in providing patient care and
building healthier communities. These actions express the mission in action.
It is the lived-out values of each specific ministry that creates the cultural
tapestry we call the health ministry. Generation upon generation of dedicated
men and women, religious and lay alike, have participated in and given shape
to this dynamic culture that heals. It is in the unique relationship between
the one serving and one being served that healing occurs. Our faith teaches
us that this is what our ministry is about: Each person brings alive again the
healing ministry of Jesus.
This was brought home to me in speaking with the president and CEO of a Catholic
health care system. This person has lived and understood intuitively what mission
was about. But that was not her concern. Rather, she wondered if the majority
of associates who worked in the system understood that the work they did was
mission. Here lay the real challenge. Again, the question was: Was mission something
that only the sponsors and the vice president of mission were concerned about,
or was it an expressed experience of those who served "in the trenches?"
In speaking with many co-workers throughout the system, I have found that they
are most appreciative when what they are doing is recognized and they have the
support and tools to fulfill their specific responsibilities. One day I was
making rounds at one of our facilities, and paused to acknowledge the dedication
and compassion of a group of nurses and certified nurse assistants. One commented
that she was happy in her work, because it was her job to care for the patients.
This, to her, was what mission was all about. She, along with her peers, was
constantly being singled out in the patient satisfaction surveys because of
the compassion and dedication of their work. This was their lived experience
of mission in action.
The Many Faces of Spirituality
One of the unique characteristics of Catholic health care is its recognition
of holistic care—its recognition that spirituality is integral to healing.
This is realized on many different levels in a Catholic health care center.
Organizationally, the facility's official mission, vision, and values articulate
the code of ethics that identifies its Catholic character and the charism of
the ministry. Operationally, policies and procedures flow from these values
and are empowered by them. These include the guidelines of the Joint Commission
on Accreditation of Healthcare Organizations and federal and state laws and
regulations.
At the same time, each person brings his or her professional skills and competencies—as
well as his or her unique faith traditions, experiences, and spirituality—into
the workplace. These values are welcomed and become identified and integrated
into the organizational values of the health care center. In other words, spirituality
in the workplace is nothing more or less than these specific faith traditions
finding a home in the organizational values of the Catholic workplace. This
is really the miracle of Catholic health care—that it invites women and
men of different faith traditions to participate in and contribute to the values,
culture, and mission of the Catholic ministry.
Essential to mission and Catholic identity are the services provided by pastoral
and spiritual care departments. Once the role of the Catholic priest and the
religious of the sponsoring congregation alone, these services are today provided
by certified chaplains, community clergy, sacramental ministers, and volunteers,
all of whom make up a spiritual care team. Assisting them daily are other members
of the interdisciplinary team that provide referrals and assist in recognizing
spiritual care issues. Available on a 24-hour-a-day schedule, chaplains assist
in crisis intervention; provide ethical consultation; support physicians, families,
patients, and staff with family conferences; and take care of the dying besides
providing bereavement services, pastoral counseling, sacramental needs, Liturgy,
and prayer services.
It is not enough that a Catholic facility's CEO and mission vice president
ensure that adequate spiritual care is provided; its sponsors and parent system
must recognize that doing so is an essential service. Collaboration between
the vice president of mission and the director of spiritual care services is
vital. Contemporary changes in health care have given both mission directors
and chaplains pause to reconsider spiritual care and develop new models for
it. This is one of the tensions that exist today: Does the mission director
understand the unique role of the chaplain? Do chaplains understand the unique
role they play in mission?
Mission Involves Us All
Mission "in the trenches" concerns both those who serve and those
who are being served. It is caregivers who work tirelessly for the good of those
being served. Mission is the doctor, nurse, chaplain, or therapist who goes
the extra mile to achieve excellence, best-practice status, improved outcomes,
and higher patient satisfaction. Mission is the dietician and food service staff
that nourishes the body and the soul. It involves creating an environment of
safety and support though housekeeping and environmental services. It is justice
in billing and administrative services and practices.
This is and always has been the challenge of Catholic health care. Many of
those patients, families, and colleagues who observe our actions will, because
of them, come to believe in the unique presence and relationships that heal.
They will sense in us the healing presence of a God who heals.