In the latest installment of our conversations with Fort Worth newsmakers, Lee Ann Franklin, executive director of JPS Spiritual Care and Ethics, discusses what it means to be a chaplain.
This conversation has been edited for length and clarity. For a longer version, please listen to the audio file attached to this article.
Alexis Allison: So, Lee Ann, you are the executive director of spiritual care and ethics at JPS Health Network. First, can you tell us what that title means and what you do?
Lee Ann Franklin: I have the privilege of leading a team of chaplains. What we do is we provide emotional, spiritual and ethical support to staff, patients, family members and visitors.
Allison: Can you tell us a little bit more about what it means to be a chaplain? Maybe some listeners have heard that word but don’t really understand what it entails.
Franklin: I’m happy to elaborate on that, because there are so many misconceptions about what it means to be a chaplain. When I was first starting out as a chaplain, I would enter patients’ rooms and they would be like, ‘Oh, my gosh, they’ve sent the chaplain! I thought I just had bronchitis. I’m going to die!’ Or they think that we’re just there to, with the Bible and a prayer, maybe make them feel guilty for not going to church. And so if we come to an atheist or somebody of a different faith, they think, ‘No, thank you, don’t impose your faith on me.’ It’s none of those things.
We know that, when you’re coming into a hospital, or a clinic, or behavioral health setting, it is stressful. It brings up all kinds of emotions. We are just there to provide care. We know that healing is mind-body-spirit. It’s not just about the body. It also involves your mindset, how you’re thinking about things. It brings up your beliefs — your beliefs may be changing, and we’re just there to provide that evidence-based support. To walk alongside staff members, patients, their family members, every step of the way to make sure that we are helping to create the best environment for healing for all.
Allison: Can you give an example of a service or of how you would approach someone seeking emotional, spiritual and ethical support?
Franklin: Yes, we have an assessment model that we follow. With every single person we meet, whether it’s a team member, family member, or staff member, first of all, we just try to take in who they are — who’s before us. Every single person is unique, every single family is unique, every single staff member is unique. So we just want to get to know them.
And then as we’re getting to know them, their culture, their beliefs, whatever they want to share with us. We’re listening for what they need, we’re listening for their immediate needs, we’re listening for what their hopes are. And we’re listening for what their resources are.
We don’t come in like we’re going to rescue them for anything. We know that people come in, and they have their own resources. And so we’re wanting to help them to articulate what they need in this moment, what their hopes are, and then how we can help partner with the resources that they already have, how we can provide additional resources, but then come up with, ‘What’s our mutually determined plan? What is going to help this meet your needs now and in the long term?’
So we set up a plan together, and then we help to carry out that plan. Then we measure, ‘Have we been effective in this visit? What do you need next? How have your needs changed as a result of this? How can we do a follow-up?’
Allison: Without providing personal details, would you be able to share an example of a plan of care that you helped develop with a patient or their family?
Franklin: Every pregnant mom wants to walk out with a baby in their arms. But if a baby has to go to the NICU, and the mom leaves, then our wonderful women’s services chaplain will meet with the mom before she goes home, and have a plan for when this mom or dad is not there. Then (the chaplain) will pray for the baby in a way that’s meaningful to that mom, according to her faith beliefs, and then when the mom’s not here, she’ll know that (the chaplain) and the other care team is watching over. Then when she does come to visit, she can call and know that the chaplain will meet up there to provide that support. And if she wants the baby to be blessed or baptized, we can arrange for that and surround the baby with that kind of care. So that’s just one instance.
One of the wonderful things about JPS is we have chaplains on site 24 hours a day, seven days a week. Whether the outcome is happy and hoped for or whether it’s not the outcome that people are hoping, we know that we’re on holy ground, and we just want to accompany the patient and the family and the staff, attending to their emotions and providing that care exactly in the way that they need it.
Allison: Can you tell me about some of the faiths that your chaplain team can help patients navigate?
Franklin: I am so proud that I have a wonderfully diverse team. We have nine chaplains on our team: (One chaplain) is from Nigeria, (another) is from India, and we range in age from young 30s to over 70. And we have myriad faiths on our team, including a Zen Buddhist priest. We know we are a public hospital, so we support people of all faiths and people of no faith.
We have an interfaith chaplain, and he is the main person who reaches out to faith leaders in the community. We partner with (them), because we know that we can’t represent every single faith or belief system that is represented by our patients and our staff, but we do have connections with them. So, if a patient is Wiccan or Jewish or Buddhist or Muslim, or Jehovah’s Witness or Church of Christ, we have different people that we can call. We like to have our patients and our faith leaders tell us how we can best serve them.
We had a patient whose belief system was that they couldn’t go to the morgue. Our chaplains handle every single body that goes into the morgue or comes out, our chaplain monitors that and oversees the morgue operations so that we can assure every family member that their loved one is going to be under our care whether they’re alive or whether they die.
For one family, it was very important that they not go into the morgue. And so we partnered with the funeral home to time it so that we could deliver the body right from the room, down the hall, to the funeral home that was going to be just at the door. And it was just the most beautiful procession. The family actually came with us and walked their beloved down through the hall and then actually the nurse, the team lead and we kind of just picked up people who cared for this patient on the way and everybody just escorted him out in his holy procession. It was so beautiful.
We had another family who, it was really important to their tradition, that there was chanting for the night after the death. Of course, we need the hospital rooms for other patients who are going to need it. So we were able to take the body to a room and invite the monks in and there was chanting all night long.
Again, every single person is different. We want to create the environment to facilitate healing, whether it’s physical healing, or the grief work that needs to happen respectfully, after a person dies. That’s our role, to create that environment.
Allison: Thank you for sharing those stories with me. You mentioned providing ethical support. Can you tell me what that looks like?
Franklin: Sure. I’m a certified health ethics consultant, certified through the Association of Bioethics and Humanities. And so I work with the chair of the ethics committee. Anybody can call an ethics consult at any time. And often what that looks like is, there’s four ethical principles: respect for autonomy, beneficence, non-maleficence, and justice.
Sometimes a patient’s wishes or a family’s wishes, which represent their autonomy, is contrary to what the physician thinks is going to be most beneficial for the patient, or it could even cause them harm. And so at that time, you can call for an ethics consult. And then again, we’re seeing what is needed in this particular situation. Every ethics situation is different. So we’ll see who we need to gather on the table, what patient or family members what, what do we need to have for medical input for the medical indications, the diagnosis, the prognosis? Do we need case management involved if it involves a discharge to the best place? And so we gather everyone around the table and just facilitate a conversation.
So, can we together, including the patient, including the family member, have the best plan of care for the most beneficent outcome? It all comes down to relationship and really getting to know, ‘What is best for this patient and their family?’
Allison: How can patients and their families access the chaplains and JPS?
Franklin: Well, chaplains are always on the floor. Five years ago when I came, we thought, ‘How are we going to have nine chaplains meaningfully care for 1.2 million patient encounters every year?’ I thought, that’s going to be challenging. So we connect with staff first. We are on the floors, having meaningful conversations with staff, supporting them. We’ll ask which patients most need to be seen.
Allison: Is there anything else that you’d like to share today?
Franklin: A lot of people don’t think about chaplains caring for staff. Our philosophy is that every single team member is going to touch so many more lives than we ever will, so if we can help keep their light lit and their bucket full, then we know that patients are going to receive excellent care.
We’re constantly coming up with new ways to serve our staff. One way that’s so popular is a ‘soul cafe.’ So there can be really difficult shifts. You know, things happen and health care workers take it to heart. So anytime, at any shift, you can call and say, ‘We need a soul cafe.’ So we’ll say, ‘What particularly do you need?’ We’ll come up with delicious coffee and hot teas with honey and warm cookies and chocolates or music or aromatherapy — we started ‘essential oils for essential workers’ — so whatever essential oil they want, put it on a little cotton round, and they can have it in their mask and take it home and put it underneath their pillow. But a soul cafe just provides a place for everybody to gather to give and receive support.
Evidence-based care is what we do, and we know that our frontline workers best receive care from each other. They’re the ones who are in the trenches with them. So we create this place to gather, take a breath, exhale and receive a little nourishment.
Alexis Allison is the health reporter at the Fort Worth Report. Her position is supported by a grant from Texas Health Resources. Contact her at alexis.allison@fortworthreport.org or via Twitter. At the Fort Worth Report, news decisions are made independently of our board members and financial supporters. Read more about our editorial independence policy here.
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