Restoring the Healer: Spiritual Self-Care for Health Care Professionals
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Restoring the Healer: Spiritual Self-Care for Health Care Professionals
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Overview
Yet, more are noticing and research confirms that self-care is needed, not only for personal sanity but also for quality of work. Unwell medical professionals are not the best at treating others. And this self-care includes not just rest, food, and water, but a deeper care, one that tends the spiritual side as well.
To both the spiritually active and the spiritually resistant, hospital chaplain William Dorman offers a guide to understand a more comprehensive, full-bodied self-care. Each chapter begins with case studies, concrete experiences that help unpack abstract concepts which bring much needed peace to stressed individuals. Dorman also structures each chapter to end with prayers and action steps, which offer more concrete ways to care for the self.
From working as a hospital chaplain for over 18 years, and serving as the director of chaplaincy services for the largest integrated health care system in New Mexico, Rev. Dorman recognizes the stresses that come to those who have made it their profession to heal others. Healers need healing too—and this guide is the first step.
Product Details
| ISBN-13: | 9781599474946 |
|---|---|
| Publisher: | Templeton Press |
| Publication date: | 02/28/2016 |
| Series: | Spirituality and Mental Health |
| Sold by: | Barnes & Noble |
| Format: | eBook |
| Pages: | 212 |
| File size: | 490 KB |
About the Author
Read an Excerpt
Restoring the Healer
Spiritual Self-Care for Health Care Professionals
By William E. Dorman
Templeton Press
Copyright © 2016 William E. DormanAll rights reserved.
ISBN: 978-1-59947-493-9
CHAPTER 1
Embrace Awe
The more you are able to pay attention to your world, the more you will behold marvels. Wonder is an everyday experience. A good number of instances of wonder are quite ordinary and might go unappreciated — even unrecognized. Some of these experiences are of a larger scale and are of such dimensions that it is hard for them to escape notice or be dismissed. In either case — from the small to the sizeable — being attentive is the window through which we behold such moments. These experiences are the primary basis for spirituality. In such times, we discover the Transcendent Source of Life and find our lives reshaped and redirected.
Awe offers you an opportunity to sense mysteries beyond your comprehension. It speaks of the unknown and touches you in your depths, moving you to moments of deep contemplation and reflection on this mystery we call life.
Whether a person's response to wonder and awe evokes a religious (spiritual) or philosophical response, fascination is alive and well in the hearts and souls of all who gaze upon the beauty, intricacy, expanse, and depth of life. What follows is an amazing story of a "just in time" discovery.
John's Story: Routine Miracles
John had been scheduled for a routine surgery, a hernia repair. During the requisite presurgery workups, doctors discovered an aortic aneurism. The health care team moved into high gear. John and his family were informed of the aneurism and the need for immediate surgery to correct this life-threatening situation. With John's consent, he was taken to the presurgery area to be prepared for the new procedure.
Without the need for the hernia repair, the aneurism on his aorta would have continued to remain an undetected condition, one with the potential to end John's life suddenly and unexpectedly. John and his family were relieved and grateful that this threat had been identified and corrected. It was a moment of wonder and gratitude for them.
It is beyond knowing how John's aneurism remained intact until he scheduled his hernia repair. This one instance can be multiplied as you recall similar such moments of unknown reasons.
Healers are drawn to health care by its myriad wonders. You are intrigued with the human being — muscles, nerves, joints, organs, biology, chemistry, cells, wellness, disease, emotions, thoughts, and therapies. Through the course of your training, wonder may prompt you to focus on one aspect of human well-being, which you choose as your specialty or subspecialty. Some healers concentrate on an organ or system: lungs, kidneys, or hearts. Others develop an interest in patient populations: newborns, cancer, aging, diabetics, closed head injuries, spinal cord injuries, amputees, or behavioral health. No matter your specialty, you are filled with a hunger to know more so that you may improve the well-being of those patients who require help from your field of health care.
Your efforts to help your patients achieve wellness succeed to varying degrees. You see some patients achieve a complete restoration of their health. These patients are able to resume their lives. At other times, you encounter those patients for whom you and your colleagues are able to provide little if any improvement in their health status.
Let's take a look at a situation where the entire interdisciplinary team was frustrated. They were stumped. No matter how much they wanted to help the patient, their efforts failed. The mood was one of discouragement. There was general knowledge about how this case would play out — and that the outcome would be a sad one. There appeared to be little if any reason for wonder in the situation.
Joanna's Story: The Gift of Breathing
Regardless of the critical care unit team's best efforts, they were unable to wean Joanna from the ventilator. The patient's mother was beside herself with worry for her daughter. The team held consultations with specialists and subspecialists from within and from beyond the hospital. At every turn, they reached a dead end. The team held several ethics consults with Joanna's family (the patient lacked capacity and her family members were her decision-makers), describing the risks and benefits as they explored treatment options. The dilemma was that the trach tube had to be removed. It had been inserted in the patient's airway for such a lengthy period of time that the health care team was concerned that the treatment itself posed a great risk to the patient.
Finally, it was agreed that Joanna would be extubated. The team explained to the patient's mother that her daughter may take no breath, a few breaths, or breathe for an hour or two, perhaps two days at most. There was a slim possibility that she would resume breathing on her own, but the previous failed weaning efforts gave little to no reason to think the patient could breathe independently.
The health care team removed the tube with the mother and other family members gathered at the bedside. The patient began to breathe. The team cautioned the mother not to pin too much hope on these early and feeble breaths. Minutes stretched into hours, and then hours stretched to the end of day one. On day two, Joanna continued to breathe on her own and appeared to be getting stronger. By the end of the week, she was breathing independently and was discharged home.
What happened? How was this resumption of breathing possible? Where did Joanna get the strength to breathe on her own after being on a ventilator so long? What the team witnessed was beyond explanation. It flew in the face of reason. No one could have predicted this outcome — and no one did! To the contrary, the family and the critical care team were resolved to what seemed to be the inescapable conclusion of this saga — the patient's death. However, discouragement and disillusionment were banished by amazement. Joanna's breathing gratefully astounded the family and the health care team.
Generally, you are able to predict, or prognosticate, the course and end of a case. Many times, you wish what was ahead for the patient was not so and that you could affect a different outcome. Every so often, what you do not expect, thankfully, is precisely what happens.
David's Story: Untangled Knots
David was admitted to the hospital complaining of severe abdominal pain. After a prompt and thorough workup, the doctors informed David that he had a bowel obstruction. The bowel had somehow developed a twist that blocked the bowel. The health care team recommended a surgery to correct this potentially life- threatening problem. Before the surgery could be performed, the obstruction unexpectedly resolved. The bowel "righted itself" and resumed normal function.
There are rare reports of such spontaneous resolution. Certainly, David and his family were relieved when the physician delivered the wonderful news! Their somber moods were replaced by marvel and gratitude.
Such moments of spontaneous resolution fill you with astonishment at the depths and mysteries of life. You wonder at the incredible resiliency demonstrated by some patients. These moments of the incredible offer you joy and gratitude, because sometimes you do not know the full story. It is important for you to maintain a certain professional and experienced uncertainty, an uncertainty that is honed on the sharpening wheel of past cases. More often than not, your prognosis is on target. However, there are those rare instances where the diagnosis and prognosis prove not to be accurate that help you preserve a small amount of respect and reservation for the fact that cases do not always turn out as anticipated or projected.
These times are opportunities for you to develop your disposition of humility. More will be said about humility in chapter 11. During this present discussion of wonder and awe, it is worth noting that humility is close by when you experience wonder. The two cases discussed earlier — Joanna's extubation and David's bowl obstruction — ended on a note of gratitude. You fully know that the opposite outcome is equally possible. There are those patient care moments when a positive outcome is reasonably expected. Those expectations may be shattered by a tragic, or at best, a limited outcome. In these instances, the wonder does not lead to gratitude, but to sorrow.
Eric's Story: "I'm Outta Here!"
Eric was a homeless male who came to the emergency room complaining about a cut on his forearm. What had begun as a small cut on his arm had developed into a wound with a raging infection, threatening his limb and life. Once Eric was admitted to the hospital, the health care team diagnosed the infection and began to administer the appropriate antibiotic intravenously. The antibiotic was effective, and the infection began to recede.
Feeling better, Eric stated that he wanted to leave the hospital. The health care team attempted to communicate the seriousness of his condition and the importance of completing his antibiotic treatment. In spite of the health care team's efforts to describe graphically the dire consequences of leaving the hospital, Eric was adamant about leaving.
Given his determination, the health care team presented him the "against medical advice" discharge papers. He signed the papers and left the hospital. The health care team was astonished. The patient's decision mystified them. They wondered what was so important to the patient about leaving the hospital that he was willing to put his life at severe risk. They were also left wondering about their ineffective efforts to persuade Eric to stay in the hospital.
The above clinical example is an instance of sorrowful wonder. The episode portrays those times when there are circumstances beyond the influence, and certainly the control, of the health care team. Reasoned conversation, generally effective in discussing treatment options and the accompanying risks and benefits, proved ineffective in this situation. The involved healers were both sad and perplexed.
Prayers, Meditations, and Reflections
Constancy and Wonder
Center of Constancy, I stand astounded at the predictability of life. Healing is built upon outcomes and upon replication. Constancy is not dulling — it is fascinating! May I always marvel at the way I can count on sameness. When the unusual, the anomaly, does appear, help me to be unafraid — not to be dismayed, but to be intrigued. For the beauty and wonder filling each day, I give you thanks. Especially, I thank you for my eyes, my mind, my heart, my soul — all of which are portals of amazement. Amen.
The Unexpected
Rainbow-Maker, your colorful spectrum illumines my horizon. Against my fixed horizon of constancy and routine, you cast your unexpected light show on the screens of dark clouds. Thank you for this sacred gift of wonder as I gaze upon the incredible. How can color come from such grayness? Where else in my life are rainbows gleaming, waiting for my attentive eye? While I value routine, I hunger for the color and light of the unexpected in life, those rainbow moments when I see as I never saw before. Amen.
When Things Fall Short
World-Maker, do unexpected things happen to you? Not a welcome surprise, but a shocking turn of events? Do you ever wish that some hurricanes and earthquakes were not so horrendous? Do you shrink back from the brutality that humans inflict upon one another and the planet? Did you see that coming?
I find myself dismayed, not wondering. I am in shock. I am incredulous at how the patient who was doing so well suddenly took a nosedive! I am angry, disappointed, and sad.
Unwelcome and unforeseen outcomes do appear, which in hindsight are clearer to the eye. These unexpected consequences dare me to explain how I failed to take them into consideration. Free me from hindsight's painful grip. Transform my self-berating into humility. Neither my colleagues nor I are all knowing. Help me to gain perspective on this event so that in the face of the ever-present unforeseen, I continue to be a wise and prudent healer. Amen.
Journaling
A journal is a beneficial way to meditate on the day. Writing down your thoughts puts them before you on the page, where you are able to see them. Looking at what you write permits you to gaze into your heart and soul. Let your writing be as free flowing as possible, with little — if any — self-censure. You will find a healing and a peace in getting your thoughts and feelings out of your head and heart and onto a piece of paper where they are less distressing. Your journaling creates a vista from which you are able to look down into your life's valleys, look back to where you have been, look up to life's peaks, or to look ahead into the indistinct, yet discernible, future.
Lighting a Candle
The practical value of candles has largely been lost given the modern forms of light. Apart from the power of illumination, candles continue to offer another value, that of creating a peaceful and fascinating setting. Places of worship, personal shrines at home, public shrines prompted by a community sorrow, and places where meals are served all continue to honor the value of a candle to create a certain mood.
Candles are a simple means by which you can pause, be still, and reflect. There is a ritual in the lighting of the candle (or candles) itself. After lighting the candle, let it draw you into its world of dancing light and flickering brilliance. A candle offers silence — a rare gift in today's world. It offers no image, but beckons your heart and soul to bring forth their pictures for you to behold in your mind's eye.
Light a candle. Sit back. Gaze upon it. Be silent. Be still. You will be soothed.
CHAPTER 2Heal Your Inner Healer
What is spirituality? The word is widely used and has certainly become part of the parlance within health care itself. Given its diverse and frequent appearance in conversation — written and spoken — it has multiple definitions. As a matter of fact, it has so many uses and definitions that the term is diluted, lacking the power of depth and precision required to be of benefit to conversation and thought.
Here is my definition: "Spirituality is a human's capacity to experience the Transcendent Source of Life that envelopes and nurtures all creation, offers possibilities while setting limits, and evokes a sense of awe, gratitude, interdependence, direction, obligation, accountability, and humility." (I have adapted this definition with permission from Ethics from a Theocentric Perspective, Volumes I and II by James M. Gustafson, PhD.)
In the early pages of this book, I stated that this book is experiential, not theoretical. My goal is to talk with you in terms of experience, not theory. I referenced problem-based learning earlier as the key modality for describing spirituality and dialoguing about it. Spirituality is experiential. Previously, I commented that the primary experience of spirituality are moments of wonder and awe. Spirituality arises from that foundational occurrence. The patient care example that follows provides a specific instance of wonder and awe.
Mary's Story: Final Blessing
The scene in the intensive care unit room was tragic. A young mother was dying of cirrhosis of the liver, a condition caused by years of heavy alcohol consumption. Gathered around her bed were her mother, her sister, and her two school-age sons. Mary's family was sobbing, their hearts broken. As the patient's breaths came fewer and farther apart, her mother and sister began to sing. Their singing was spontaneous, a calling to mind of a then-popular song. The song was dirge-like, a soulful mourning, their voices a muted wail. Yet, the lyrics brought hope and healing to the room. Mary's sad life was acknowledged, but her mother and sister were blessing her, singing a prayer that finally her life would know peace and fulfillment. Those members of the health care team standing in the room with the family, and those gathered in the doorway, were spellbound.
There was no doubt that Mary's life had been tortured. She had known abuse, neglect, rejection, and failed relationships. The alcohol she had turned to in search of comfort and courage had turned on her, claiming her life. Mary's mother's heart was broken for her child who never saw the simple joys of life. Yet, at her daughter's bedside, she was able to sing a song of sorrow and of blessing for this child of hers.
(Continues...)
Excerpted from Restoring the Healer by William E. Dorman. Copyright © 2016 William E. Dorman. Excerpted by permission of Templeton Press.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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Table of Contents
Foreword by Christina M. Puchalski, MD / xv
Preface / xvii
Acknowledgments / xxv
Introduction / 3
Chapter 1: Embrace Awe / 9
Chapter 2: Heal Your Inner Healer / 19
Chapter 3: Keep Tragedy in Perspective / 30
Chapter 4: See the Patient as a Person / 39
Chapter 5: Practice Self-Care / 50
Chapter 6: Make Peace with the Tragic / 61
Chapter 7: Find Balance / 71
Chapter 8: Contend with Limits and Possibilities / 81
Chapter 9: Show Compassion / 94
Chapter 10: Rediscover Your Passion, Purpose, Resiliency / 115
Chapter 11: Offer Kindness and Humility / 151
Chapter 12: Express Encouragement, Gratitude, and Humor / 165
Afterword / 179
About the Author / 181