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Buddhist Healthcare Chaplaincy Group (BHCG)

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					     Buddhist Healthcare Chaplaincy Group (BHCG)
Introduction: A working group has been meeting for the past few years developing a project for
Buddhists to make their contribution to Hospital Chaplaincy work and support patients in
healthcare settings.

Each of the major faiths has been offered the opportunity by the NHS to apply to establish its
own faith’s ‘Authorisation Body’.

Authorisation is the process whereby a faith community can indicate that individuals are suited
to represent their faith community in this work.

There is an opportunity for Buddhism to become ‘authorised’ within the next year.

Once such arrangements are complete NHS bodies can then deal with designated authorisation
bodies direct.


                   Work in Progress Document
                                         (Draft 3 – 3rd June 2007)

This document is a summary of creative work and discussion that took place at a meeting in London Sunday 18th
March 2007 with the following aims:

    To update groups new to the project on what has happened so far and why this initiative is needed.
    To gauge assent to the principle of accreditation and competencies developed and administered
   collectively
    To develop suggestions for a description of competencies
    To develop suggestions for a mechanism for accreditation

         The intention of this working document is to be a focus from which to continue developing these aims.

Document Content
   1) Structure for competencies – this is the model that the group came up with. It has been
      simplified from the scheme that came out of the documents somewhat. The more Buddhist
      aspects are highlighted in green. The other competencies are arguably common to all chaplains.
   2) Detail on competencies – which corresponds to the structure. It has been broken down into
      knowledge, skills and qualities.
   3) Accreditation of Chaplains -
   4) Issues: This is just a simple list of some of the questions that came up on the day. There could be
      more we could add here.
   5) Involving others and what next: A summary of the actions the involving others subgroup and how
      we suggested we were going to circulate the write up of the meeting.
   6) Role play: Tried and tested ‘role play’ scenarios in case they are useful for training.
                                                      Being;
   Understanding of                  Ability to                      Knowing Buddhist
                                                      Awareness,
   procedures within hospital        establish                       teachings
                                     initial
                                                      mindfulness,
   including clarity about                            presence.
   chaplain’s role                   relationships
                                                                              Being able to
                                                                              communicate Buddhist
                                                                              teachings
Interpersonal
skills
                                                                                Practicing
                                                                                together eg
                                                                                meditation

Communication                    Skillful support
skills                                                                          Support network in
                                                                                place for Chaplain




                                Reflective practice
   Detailed breakdown of elements of competencies (based on
   collective participatory exercise)
Support system

   Support network in place for chaplain
   Kalyana Mitra (spiritual friendship) from person in own Sangha (spiritual community)

Skills

   1, Ability to establish initial relationship
   Ability to:
    introduce yourself
    gather information
    identify self to staff
    create a connection with patient

   2. Interpersonal skills
   a) Interpersonal skills - Patient
   Ability to:
   Not take over
   Not project fear into patient’s own circumstances
   Be in silence with someone
   Be clear in communication with someone
   Help patient to reflect on past
   Judge the appropriateness of physical contact with patient

   b) Interpersonal skills- Hospital staff
   Ability to:
   develop relationships with ward staff
   Negotiate including making skilful complaints
   Help arrive at solution without bias

   3. Communication skills
   Ability to:
   Summarise feelings
   Communicate in English – spoken and written
   Listen
   Ask questions
   Clarify problem

   4. Communication about the Dharma

   Ability to:
   Discuss death and suicide when appropriate
   Give information/advice/doctrinal guidance
   5. Practice together
   Ability to:
   Lead and practice meditation or other practices when appropriate

   6. Skillful support - skills
   Ability to:
   Work in wider context with patient’s family etc
   Clarify situation
   Elicit issue from reluctant patient
   Balance sensitivity to patient’s values with clinical needs


Knowledge/understanding

   1. Understanding of procedures within hospital
Knowledge of NHS defined role of chaplain
Knowledge of policy of obligation to disclose information discussed with patient
Knowledge of how to gain access to clinical notes if needed
Knowledge of health and safety procedures including hygiene, restraint
Understand of decision making within hospital
Knowledge of legal responsibilities of chaplains

   2. Dharma knowledge/ Dharma Knowledge
Knowledge of perspectives on death from a range of traditions
Understanding of different traditions

Qualities

   1. Being
   Awareness including self awareness
   Sensitivity
   Presence
   Mindfulness
   Friendliness
   At ease with difficult feelings


   2. Skillful support - qualities
   Reliability
Accreditation of Chaplains
Accreditation by Portfolio
Applicants to submit portfolio in following format:
   - Application form which lists experience, training, skills and knowledge in key areas
       (approximately six key areas to be identified)
   - Supplementary materials supporting information given on application form. (this may include
       written accounts of experience, certificates, photographic or other electronic evidence of prior
       learning)
   - A three month learning journal accounting experience of chaplaincy related work in a health
       related setting (eg work as a chaplaincy volunteer)
   - Two references; reference one reflecting spiritual experience eg from head of
       tradition/order/teacher/senior member of group. Reference two reflecting professional
       experience in healthcare setting eg from senior chaplain, senior health professional, head of
       training programme if of a different tradition to reference one etc.
   - CRB checks will be done by healthcare provider in most cases

   Interview:
   Initially we would aim to establish a panel to interview potential chaplains. Each panel should be
   three people from different traditions. This would provide us with valuable learning experience in
   assessing portfolios and evaluating our assessment methods. Later we might move to other
   strategies such as sampling.

   Ongoing Support:
   - CPD: regular seminars/training days to be offered. In particular these will foster inter-Buddhist
     discussion.
   - Supervision as a requirement of ongoing practice
   - Need to create guidelines, complaints procedures, code of practice etc

   Portfolio Categories: initial suggestions:
   1. Experience/practicum: 3 months placement as hospital visitor or similar evidenced by
      learning journal, showing ability to reflect on and learn from practice.
   2. Buddhist Practice and Knowledge:
          a) good grounding in one Buddhist tradition supported by reference, with evidence of
              regular practice and doctrinal knowledge
          b) knowledge and use of appropriate liturgy and ritual in healthcare settings
          c) Awareness of a range of Buddhist practices relating to death; ability to offer simple
              ritual or ceremony at times of death or to accompany a Buddhist of another tradition in
              performing their chosen practice. Ability to offer other rites of passage / where
              appropriate refuge ceremonies
          d) knowledge of different Buddhist traditions sufficient to enable an appropriate initial
              response to Buddhists of other traditions
          e) evidence of network of contacts and ability to make referrals where appropriate
          f) Ability to work in multi-faith team
   3. Knowledge of NHS chaplaincy needs:
          a) Knowledge of NHS organisational practices and settings
          b) Knowledge of organisational structures within hospital chaplaincy
      c) Awareness of practical procedures on wards eg avoidance of infection transmission,
          health and safety issues
      d) Ability to negotiate complex professional relations within NHS
      e) Awareness of mental health issues and the impact of mental illness on the chaplain’s
          role
4. Ability to offer spiritual counselling and support:
      a) Spiritual facilitation, counselling or listening skills
      b) Ability to respond at different levels: spiritual, emotional, practical
      c) Ability to set boundaries and keep confidentiality
      d) Awareness of specific needs relating to terminal illness, chronic illness, incapacity and
          life change
      e) Ability to work with issues of loss and bereavement
      f) Ability to convey bad news or to accompany those who have just received such news.
      g) Ability to offer appropriate response to questions of life after death.
      h) Awareness of issues of difference, culture, disability, age etc
5. Ability to engage in ethical discourse.
      a) Ability to facilitate ethical exploration without imposing views
      b) Awareness of issues of medical ethics and breadth of Buddhist positions on matters such
          end of life, abortion, or organ donation and ability to convey such positions without
          dogmatism.
      c) Use of supervision, awareness of lines of responsibility and professional boundaries
      d) Ability to hear “confession” and respond to feelings of regret or remorse

Principles:
Non harm
Being grounded in Buddhist practice
Not pushing unhelpful views
Not being dogmatic about personal views
Patient centred
Being aware of and open to the variety of Buddhist traditions
Having links to support, own Buddhist group etc
Developing reflexive practice; awareness of own learning process

Value of having code of practice as guideline
Issues
Some issues and questions being discussed:

      What experience will the chaplain have to have? Eg years of practice, observable volunteering
       for their Sangha

      Could there be a development of a code of practice based on the competencies that they
       chaplain would sign up to.

      Do we need to clarify definitions – what is a chaplain? What is a hospital visitor, a volunteer?

      What about when people are not part of a tradition or Sangha?

      How do we involve a wide range of Sanghas? For example holding awareness raising days?

      Do chaplains have any rights or entitlement? – eg to be paid for what they do.


Strategy for involving others in hospital chaplaincy project
The group aim to enable the participation of groups by helping them to know what we are doing, sign
up and endorse the process. We have been told by the Multifaith Chaplaincy group that the funding for
developing this work in the Buddhist network has to go to one group. The Buddhist working group
would be asked to nominate representatives on to the MultiFaith Healthcare Chaplaincy group. The
group have already written to hospitals to ascertain where there are Buddhist chaplains of volunteers
available and we have received 80 replies. These are Buddhists already visiting hospitals with a remit
to provide chaplaincy.

Discussion stressed the importance of going to existing Sangha meetings/events and talking to them
about the chaplaincy project rather than expecting them to come to meetings we organise.

Action points:
    a joint bid with NBO for funding to pay a worker to outreach to different Sanghas (action:
       agenda for next meeting)
    Provide information on training and competencies (Keith)
    Information gathering from the research to find out which Sanghas are represented (Keith and
       Roger)
    Dividing up a communication tree (not relying on email) (Roger, Prasada and Dayasara)
    Build on Maharvihara link in Birmingham, develop link with Venerable Kassapa and have a
       meeting there.(Prasada and Keith)
    Hold small event at Buddhist society. (Keith and Michelle)


Next steps
Suggested the output from this meeting be circulated to other Sanghas and interested parties. We would
circulate a document including:

   1. A letter explaining the project and a brief history and rationale of it:
   2. The issues arising from the project
   3. Competencies
   4. Mechanisms for accreditation and authorisation
   5. A case study of the US experience (provided by Kate)



Suggestions for some Role Plays useful for training
I’ve just been told that I’ve got a terminal illness. I might as well top myself now rather than get to a
point where I am in constant pain. I don’t want my family to go through that either. Is it wrong from a
Buddhist point of view to be thinking about this?

I’m self employed as a carpenter. Because of the state of my back, the doctors are saying that I might
never be able to do work like that again. I’ve got a mortgage and three children. What am I going to
do?

I wanted to have my Buddha figure next to my bed but the woman opposite has been making a huge
fuss about it – saying its devil worship. What should I do?

I nearly died on the operating table and I have been thinking about death a lot. I don’t know anything
about Buddhism but I remember seeing one of those films where the person who dies, maybe it was the
Dalai Lama or someone, they came back as a different person. I’ve never really understood that – how
does it work? Do you believe that?

I want to make a confession. I’m really scared of taking any kind of medicine – always have been. So
I’ve been hiding the pills the nurse gives me under my tongue and spitting it out when she’s gone.

I’ve noticed that the nurse over there has been going round bullying all the patients including me and I
think that’s unethical.

				
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Description: Buddhist Healthcare Chaplaincy Group (BHCG)