Paediatric Chaplaincy Network Meeting

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Paediatric Chaplaincy Network Meeting

• Spiritual Care for Sick Children and young
  people Good practice in relating to children
  and young people

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Paediatric Chaplaincy Network Meeting

• The spiritual needs of sick children and
  adolescents in a paediatric hospital context
  outcomes and reflections from a participation
  project
• Revd Paul Nash, Revd Kathryn Darby, Dr Sally
  NashChaplaincy, Birmingham Childrens Hospital,
  Steelhouse Lane, Birmingham, B4
  6NH.paul.nash_at_bch.nhs.uk, kathryn.darby_at_bch.nhs.
  uk, s.nash_at_stjohns-nottm.ac.uk.Birmingham
  Childrens Hospital and Midlands Centre for Youth
  Ministry.

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Paediatric Chaplaincy Network Meeting

• Birmingham Childrens Hospital
• 260 beds
• 2,500 staff
• located in the centre of Great Britains second
  largest city
• Birmingham population 2008 - 1.02 million
• 22 are 0-15 years olds(higher than national
  average)
• multi-faith, multi-cultural context

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BCH Participation Project

• many of your orgs with have them
• different to research, less regularised but same
  good principles consent, open environ.
• inductive and deductive
• pilot resources / ideas
• Context whole family whole org.
• How 1-1, small groups
• Where School, wards, clubs, play centre,
  patient participation groups
• Write up as case studies and triangulate to each
  other and spirituality theory
• Try ideas with well CYP groups

• Ideas we started with
• Art, music, beads
• Journal / scrap book
• Play / Godly Play
• Stories
• Pictures
• Blobbys
• Activities
• Pets as therapy
• Remember a time when.
• Parents questionnaire
• Staff questionnaire
• List is endless

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Paediatric Chaplaincy Network Meeting

• An Action Research Project
• staff, children and young people work together
  to improve spiritual and religious care
• core activities are reflection, research and
  action and outcome is improved practice
• project approved by the relevant hospital
  authorities
• briefing session for staff and volunteers
  developed a feedback form
• voluntary informed ongoing consent
• activities took place in an open environment and
  the parent was present if the child wanted this
• a convenience sample was used consisting of 12
  encounters.

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Our 6 Ps

• Places
• Parents
• Patient issues
• Participation activities
• Principles and practices
• Products

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Participation activities

• sought to facilitate ways into the inner world,
  to explore and understand the spiritual self.
• range of resources to use were developed by the
  team
• team used activities that built on their own
  strengths and interests where appropriate

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Principles and practices of spiritual care
for sick children

• Create spaces for spiritual care to occur and
  relationships to develop
• 2) Empowerment is a core underpinning value of
  spiritual care
• 3) Offering episodes of spiritual care
  reflects the often integrated nature of
  assessment and intervention and the element of
  reciprocity
• 4) Developmental and learning context is
  important to understand in choosing activities,
  resources and language
• 5) Identity may have a heightened significance
  in sickness
• 6) We need to connect and build on existing
  spirituality and if appropriate faith
• 7) Meaning making helps children and young
  people articulate, identify and understand their
  spiritual needs
• 8) Spiritual care occurs within and by a
  community and can offer windows of normalization
• 9) Metaphor is a significant tool for spiritual
  care
• 10) Concrete and visible expressions and
  reminders of spiritual care are important

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Principles and practices of spiritual care
for sick children

• Create spaces for spiritual care to occur and
  relationships to develop
• attitude of openness and acceptance
• attentive listening, rapport, trust, acceptance
• offering choice, autonomy and gaining consent
• involves a relationship with the patient and
  often their family

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Joes postcard
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Joe remembers
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Principles and practices of spiritual care
for sick children

• 2) Empowerment is a core underpinning value of
  spiritual care
• best practice in spiritual care is empowering
  patients to choose, ask, understand and express
• keep checking that they still want to continue.

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Teddys stay in hospital
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Principles and practices of spiritual care
for sick children

• 3) Offering episodes of spiritual care
• reflects the often integrated nature of
  assessment and intervention and the element of
  reciprocity

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Principles and practices of spiritual care
for sick children

• 4) Developmental and learning context is
  important to understand in choosing activities,
  resources and language
• sickness may cause a developmental issues
  disability
• potential issues around literacy, language and
  cultural and religious beliefs.

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I can make it too
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Principles and practices of spiritual care
for sick children

• 5) Identity may have a heightened significance in
  sickness
• identity is significant in spiritual care
• affirming a positive identity for a child
• names are highly important
• the vicarious patient.
• engaging with the whole family

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Principles and practices of spiritual care
for sick children

• 6) We need to connect and build on existing
  spirituality and if appropriate faith
• for some spiritual care is more meaningful if
  religious care
• think what lifts the spirits of the patient and
  build on this
• prayer may be an integral element of this
  connecting

• consider giving space for children to pray too

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Principles and practices of spiritual care
for sick children

• 7) Meaning making helps children and young people
  articulate, identify and understand their
  spiritual needs
• show and tell
• building on what has gone before
• mark significant moments
• use mapping or reflection exercises
• avoid loading the child with our expectations and
  assumptions

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There is always someone listening.
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Jules prayer

• thank you for all the children that are laid
  now in this hospital today. Make them better
  also those going through worse, and for those
  whos getting out. Thank you Lord for everything
  you did for them. Make them to thank you. Then
  show them that you exist. Show them that You are
  there for them, that Youre their Father. Thank
  you for everything that You did from when I come
  in till the last day I go away. Thank you, very,
  very much. Amen.

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Principles and practices of spiritual care
for sick children

• 8) Spiritual care occurs within and by a
  community and can offer windows of normalization
• community is a significant concept in spiritual
  care
• hospital is a new community
• finding opportunities for patients to be
  together
• windows of normalization.
• children care about other children and can be
  impacted emotionally by them

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Making friends
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Principles and practices of spiritual care
for sick children

• 9) Metaphor is a significant tool for spiritual
  care
• examples from the project include using a
  butterfly image, the story of the lost sheep,
  blob pictures.
• metaphors have the potential to nurture the child
  in the longer term

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Stories
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Principles and practices of spiritual care
for sick children

• 10) Concrete and visible expressions and
  reminders of spiritual care are important
• reminders facilitate ongoing
  reflection
• such reminders can be given purposefully
  or left for children to find
  themselves
• we leave behind who we are

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Products

• most helpful was focused activity
• useful products include
• art and craft materials
• visual stimuli
• age and developmental stage appropriate books
  and stories
• godly play resources
• songs and musical instruments
• toys that can be used in bed
• things that relate to helpful metaphors

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ISE Interpretive Spiritual Encounters

• interpretive spiritual care encounters are core
  activities first step in spiritual care plan
• in paediatrics a standard list of questions is
  not usually appropriate for assessment

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Conclusions

• changes occurred in both patient and
  practitioner experience
• there was a sense of energy and enthusiasm,
  discovery and surprise within the team indicating
  a shift in awareness and practice
• bringing resources to the bedside leads to a
  more child-centred and child-directed contact
• the intended outcome is a change in
  multi-disciplinary practice 
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Ongoing Developments

• 2 more days in 2012 trial more resources with
  other paediatric chaplains etc joining us
• Multi disciplinary meeting (psychology, Play,
  Youth Work, Nursing and Chaplaincy) to discuss
  what is distinctive and crossover in our roles
  and professions in offering spiritual care (Sept
  12 Feb 13)
• Explore wider trialling with the Paediatric
  Chaplaincy Network (GBI) from Nov 12
• Integration into daily care offered by BCH
  Chaplaincy
• Triangulate findings with teenage oncology
  research in the same subject
• More participation days in 2013
• Publication and wider distribution 2013 onwards