Skip to main content
×
Home
    • Aa
    • Aa

Documenting presence: A descriptive study of chaplain notes in the intensive care unit

  • Brittany M. Lee (a1), Farr A. Curlin (a2) and Philip J. Choi (a3)
Abstract
Abstract Objective:

To clarify and record their role in the care of patients, hospital chaplains are increasingly called on to document their work in the medical record. Chaplains' documentation, however, varies widely, even within single institutions. Little has been known, however, about the forms that documentation takes in different settings or about how clinicians interpret chaplain documentation. This study aims to examine how chaplains record their encounters in an intensive care unit (ICU).

Method:

We performed a retrospective chart review of the chaplain notes filed on patients in the adult ICUs at a major academic medical center over a six-month period. We used an iterative process of qualitative textual analysis to code and analyze chaplains' free-text entries for emergent themes.

Results:

Four primary themes emerged from chaplain documentation. First, chaplains frequently used “code language,” such as “compassionate presence,” to recapitulate interventions already documented elsewhere in a checklist of ministry interventions. Second, chaplains typically described what they observed rather than interpreting its clinical significance. Third, chaplains indicated passive follow-up plans, waiting for patients or family members to request further interaction. Fourth, chaplains sometimes provided insights into particular relationship dynamics.

Significance of results:

As members of the patient care team, chaplains access the medical record to communicate clinically relevant information. The present study suggests that recent emphasis on evidence-based practice may be leading chaplains, at least in the medical center we studied, to use a reduced, mechanical language insufficient for illuminating patients' individual stories. We hope that our study will promote further consideration of how chaplain documentation can enhance patient care and convey the unique value that chaplains add to the clinical team.

Copyright
Corresponding author
Address correspondence and reprint requests to: Philip Choi, Division of Pulmonary and Critical Care Medicine, Duke University Medical Center, Box 102355, Durham, North Carolina 27710. E-mail: philip.choi@duke.edu.
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

A.B. Astrow , A. Wexler , K. Texeira , (2007). Is failure to meet spiritual needs associated with cancer patients' perceptions of quality of care and their satisfaction with care? Journal of Clinical Oncology, 25(36), 57535757.

W. Cadge (2009). A profession in process. Chaplaincy Today, 25(2), 2627.

L.B. Carey & J. Cohen (2015). The utility of the WHO ICD–10–AM pastoral intervention codings within religious, pastoral and spiritual care research. Journal of Religion and Health, 54, 11721187. Available from http://link.springer.com/article/10.1007%2Fs10943-014-9938-8#page-1.

P.J. Choi , F.A. Curlin & C.E. Cox (2015). “The patient is dying, please call the chaplain”: The activities of chaplains in one medical center's intensive care units. Journal of Pain and Symptom Management, 50(4), 501506.

R. de Vries , N. Berlinger & W. Cadge (2008). Lost in translation: The chaplain's role in health care. The Hastings Center Report, 38(6), 2327.

G.L. Engel (1977). The need for a new medical model: A challenge for biomedicine. Psychodynamic Psychiatry, 40, 377396.

H.R. Goldstein , D. Marin & M. Umpierre (2011). Chaplains and access to medical records. Journal of Health Care Chaplaincy, 17(3–4), 162168.

G. Handzo (2011). Spiritual care for palliative patients. Current Problems in Cancer, 35(6), 365371.

J. Hunt & M. Cobb (2003). The quality of spiritual care: Developing a standard. International Journal of Palliative Nursing, 9(5), 208215.

K.R. Jankowski , G.F. Handzo & K.J. Flannelly (2011). Testing the efficacy of chaplaincy care. Journal of Health Care Chaplaincy, 17(3–4), 100125.

M.E. Jensen (2002). Language and tools for professional accountability. Journal of Health Care Chaplaincy, 12(1–2), 113123.

J.R. Johnson , R.A. Engelberg , E.L. Nielsen , (2014). The association of spiritual care providers' activities with family members' satisfaction with care after a death in the ICU. Critical Care Medicine, 42(9), 19912000.

D. Katerndahl & D. Oyiriaru (2007). Assessing the biopsychosociospiritual model in primary care: Development of the biopsychosociospiritual inventory (BioPSSI). The International Journal of Psychiatry in Medicine, 37, 393414.

C.D. MacLean , B. Susi , N. Phifer , (2003). Patient preference for physician discussion and practice of spirituality. Journal of General Internal Medicine, 18, 3843.

K. Malterud (2001). Qualitative research: Standards, challenges, and guidelines. Lancet, 358, 483488.

G. McCord , V.J. Gilchrist , S.D. Grossman , (2004). Discussing spirituality with patients: A rational and ethical approach. Annals of Family Medicine, 2, 356361.

T.S. O'Connor (2002). The search for truth: The case for evidence-based chaplaincy. Journal of Health Care Chaplaincy, 13(1), 185194.

C. Puchalski , B. Ferrell , R. Virani , (2009). Improving the quality of spiritual care as a dimension of palliative care: The report of the Consensus Conference. Journal of Palliative Medicine, 12, 885904.

M.C. Shinall Jr., J.M. Ehrenfeld & O.D. Guillamondegui (2014). Religiously affiliated intensive care unit patients receive more aggressive end-of-life care. The Journal of Surgical Research, 190(2), 623627.

J.T. Wagner & T.L. Higdon (1996). Spiritual issues and bioethics in the intensive care unit: The role of the chaplain. Critical Care Clinics, 12, 1527.

J.A. Williams , D. Meltzer , V. Arora , (2011). Attention to inpatients' religious and spiritual concerns: Predictors and association with patient satisfaction. Journal of General Internal Medicine, 26(11), 12651271.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Palliative & Supportive Care
  • ISSN: 1478-9515
  • EISSN: 1478-9523
  • URL: /core/journals/palliative-and-supportive-care
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords:

Metrics

Full text views

Total number of HTML views: 7
Total number of PDF views: 124 *
Loading metrics...

Abstract views

Total abstract views: 742 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 22nd June 2017. This data will be updated every 24 hours.