NACC's specialty certification elevates chaplain's role on palliative care team

December 1, 2016

By JULIE MINDA

The six-month process of earning a specialty certification in palliative care and hospice from the National Association of Catholic Chaplains was, Gary Weisbrich says, "arduous, time-consuming, reflective, affirming, challenging, life-giving and rewarding."

So, in balance, it was well worth the effort, says Weisbrich, manager of spiritual care at Providence St. Patrick Hospital in Missoula, Mont. "I feel well-rounded in the skills that I have and the confidence in having my voice heard in family discussions as well as in the interdisciplinary (palliative care) team."

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From left, Dr. Nick J. Furlong, Dr. Christopher Jons, chaplain Gary Weisbrich and advanced practice nurse Judy Gustafson take part in a palliative care meeting at Providence St. Patrick Hospital in Missoula, Mont. Weisbrich, the facility's manager of spiritual care, has earned the National Association of Catholic Chaplains' specialty certification in palliative care.
Photo by Bryant Photographics

Weisbrich was part of a 2014 group earning the NACC's specialty certification as an Advanced Certified Hospice Palliative Chaplain. As the group was earning the certification, it also was helping the NACC to test and refine its certification prior to official launch.

The credential, formally launched last year, attests to a chaplain's command of spiritual, psychological, sociological and religious disciplines and ability to apply them to palliative care delivery. It also demonstrates the person can thrive as a member of an interdisciplinary palliative care team. It shows that in the palliative care realm, the person functions well as a leader, communicator, advocate, mentor, teacher and professional, as determined by palliative care experts affiliated with NACC, who evaluate chaplains' readiness for the certification.

So far, nine chaplains have earned the certification; six of them are employed in Catholic health care.

David A. Lichter is executive director of the Milwaukee-based NACC. He says the NACC began developing the certification about four years ago in large part so that palliative care chaplaincy could achieve the professional recognition it deserves.

Lichter said the amount of time chaplains spend focused on hospice and palliative care varies widely. Many of the chaplains who pursue the certification spend up to half their time in palliative care. For some, hospice or palliative care is their primary work.

Palliative and hospice care typically are directed by interdisciplinary teams. Some chaplains had felt unprepared to play a leadership role on interdisciplinary teams with physicians and other clinicians.

Lichter expects the growth and learning involved in attaining NACC specialty certification will bolster chaplains' standing on interdisciplinary teams. That will help ensure that "the patient's spiritual, existential (and) emotional needs are represented in discussion of care plans" and that "the patient's and family's framework of meaning and life goals are included in the care plans," he said.

Weisbrich, the chaplain, says the certification curriculum changed how he views and approaches his role on interdisciplinary teams. He says in the past, on such teams, "… the physician would do most of the talking. It was intimidating at times to know when to interject or to transition into spiritual issues. It is one thing to be a part of the team and another to have an equal voice on the team."

But, he says, through education, good mentors and hands-on experience connected with the certification process, his comfort level began to grow as did his relationships with the physician, social worker, pharmacist, nurse practitioner and referring hospitalist. "I saw myself as an equal contributor to the goals of care conferences as well as in our interdisciplinary meetings.

"I realized that it was my role to introduce spirituality to our team and to make sure that we are able to talk about it and have those tough conversations so that we have some idea what our patients and families experience," he says.

There are no classes the applicants are required to take, online or otherwise, to achieve certification. However, the chaplains must present evidence that they've attended classes and other training related to palliative care chaplaincy. They may need to take courses to build their competencies, according to Lichter. Lichter says the specialty certification in palliative care and hospice provides a standardized way for the NACC to verify chaplains' competencies.

Tina Picchi is executive director of the Supportive Care Coalition, a membership organization of Catholic health care systems promoting excellence in palliative care. Picchi and the coalition helped to plan, develop, implement and evaluate the certification. She says the certification enables chaplains "to articulate their unique contribution to the interdisciplinary palliative care team, demonstrate their knowledge and expertise and reflect deeply upon their own ministry to the seriously ill and dying."

To apply for the palliative care certification program, individuals must be board-certified as an NACC chaplain or supervisor, and they must currently be practicing in the field. They also must have worked 500 or more hours in palliative care or hospice chaplaincy and have at least 10 hours of direct supervisory experience or experience providing palliative care consultation under a formal contracted relationship, Lichter said. There is a $400 nonrefundable application fee.

The NACC has application deadlines Feb. 15 and Sept. 15 annually. The application includes chaplains' written reflections on seven major aspects of their work in palliative care, including what motivated them to serve in this area, how they provide palliative care, their spiritual and theological perspectives on palliative care, how they capture a patient's story and chart it in a medical record, how they apply their own spirituality to their work, how they expand their knowledge of the field and how they teach others. They also must provide letters of recommendation.

Applicants who pass the initial screening meet in-person with an interview team in spring or summer around NACC events. The interview team is made up of board-certified chaplains in palliative care and hospice as well as a person who has been part of an interdisciplinary palliative care team.

During 50-minute sessions, the interviewers assess chaplains' grasp of the disciplines that inform palliative care and hospice, their ability to integrate their own spirituality and experiences into their work, their effectiveness in working with families and on palliative care teams and their leadership abilities, among many other factors. The interview team recommends whether the applicant should receive the certification. An NACC certification commission makes the final decision. The interview team and commission base their recommendations on the chaplains' proficiency in meeting more than two dozen criteria that fall within four major categories. Those categories are the theory of pastoral care competencies, the chaplain's identity as a pastoral care provider and the person's conduct, the person's pastoral care competencies and the person's professional competencies.

Certifications are granted for five years and are renewable.

CHA is supportive of the NACC's palliative care certification. It falls within the National Consensus Project's "Clinical Practice Guidelines for Quality Palliative Care." In developing the certification, NACC drew upon the learnings of the Association of Professional Chaplains, which instituted its own palliative care and hospice specialty certification in 2013.

Weisbrich says he believes that the NACC's specialty certification will elevate the chaplain role in palliative care and patients and families will benefit. "It … helps the team become more comfortable around spiritual issues and better able to recognize spiritual distress and involve the chaplain. It shows our interdisciplinary team colleagues the commitment we share in providing the best care possible, body, mind and spirit."

Information on the certification is available online at nacc.org, under the "certification" tab.

 

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