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00:00:01:27 - 00:00:24:23
Tom Haederle
Welcome to Advancing Health. Tending to the overall well-being of a patient often has emotional and spiritual dimensions as well as medical. In today's podcast, we hear from two experts about how chaplains are helping people of all backgrounds in the health care setting as part of an interdisciplinary team, making sure care is focused on the whole person.

00:00:24:26 - 00:00:50:06
Elisa Arespacochaga
I'm Elisa Arespacochaga, vice president of clinical affairs and workforce at the AHA. Today, I'm joined by Jason Lesandrini, AVP of Ethics, Advanced Care Planning, Spiritual Health and Language Access Services at Wellstar Health System; and Kelsey White, assistant professor and chaplaincy faculty researcher in the Department of Patient Counseling at Virginia Commonwealth University. And this is a discussion I've been looking forward to for a little while.

00:00:50:06 - 00:01:09:27
Elisa Arespacochaga
We're here to really discuss how they have worked to integrate chaplains into well-being programs in health care, and really make those connections across both their research and their organization. So to start off, Kelsey, why don't you start, just tell us a little bit about the work that you do and who you are.

00:01:09:29 - 00:01:33:07
Kelsey White, Ph.D.
Yeah. Thanks for having me. I'm a professor primarily these days. But my career started out as a board certified chaplain working in outpatient, a very large outpatient center as well as oncology. Fell in love with chaplaincy to the extent that I wanted to figure out how to do research about it. And from there I went to do a Ph.D. and really focus on expanding the research and the integration of chaplains in my efforts.

00:01:33:09 - 00:01:37:27
Elisa Arespacochaga
And I'm guessing that's how you got to meet Jason. Jason, can you tell us a little bit about your work?

00:01:37:29 - 00:02:08:20
Jason Lesandrini. Ph.D.
Thank you. Thank you both for being with me today. So, like you said, I work at Wellstar Health System, which is a large integrated health care system in Georgia. I've been here for about ten years and really my focus on the work I was doing originally when I came was on ethics. That's where my background is. I'm a Ph.D. in healthcare ethics from Duquesne and spent a number of years at another local system doing ethics work and as I got here to Wellstar noticed there was a need, sort of in conversations with the executives to really take spiritual health as a team and have an executive representative.

00:02:08:20 - 00:02:12:23
Jason Lesandrini. Ph.D.
And so I've been doing that eight years now is what we're going on. So I'm really excited for it.

00:02:12:26 - 00:02:24:11
Elisa Arespacochaga
Kelsey, just to level set with our audience. Can you describe a little bit the role of a chaplain within a health care organization? I think everyone may have a little bit of an idea, but not fully understand what that role means today.

00:02:24:13 - 00:02:49:15
Kelsey White, Ph.D.
Yeah, absolutely. So to kind of step back, they aren't just the folks that go in and pray, but really they're members of the interdisciplinary team who really help make sure that the health care that we provide is focused on a whole person. So they typically have a graduate level of education, clinical training, over a year of clinical training typically, board certification or certified eligible.

00:02:49:17 - 00:03:28:08
Kelsey White, Ph.D.
And then they have this expertise to attend to individuals emotional, spiritual and that interpersonal well-being. So they are trained typically to talk to all people, whether it be staff or patients or family members, about spirituality, but not just what we think of as this like religious type of topic when it comes to spirituality. But spirituality really encompasses the way we make meaning of the world around us, how we find purpose and connection, and then to deal with kind of the tough things that happen in our life that make us ask why?

00:03:28:10 - 00:03:36:07
Kelsey White, Ph.D.
And so chaplains are trained to really have those tough questions, but also to really support folks in really difficult situations.

00:03:36:09 - 00:03:57:24
Elisa Arespacochaga
As I usually say, one of the challenges and opportunities in health care is that we are with people at what may be some of the most difficult moments in their lives, and so being able to not only support their physical health and their mental health, but their emotional health and their ability to connect with them and support them as they wrestle with some of those questions I think is key.

00:03:57:27 - 00:04:21:16
Kelsey White, Ph.D.
Yeah. And I also add like because of the extensive training they've had, they're equipped to work with people from all different backgrounds and regardless of faith tradition. And I think they're really touching on these like core existential topics that are just part of everyone's natural being and that when those things are out of whack, they can end up impacting one's health, too.

00:04:21:18 - 00:04:34:09
Elisa Arespacochaga
Jason, how are you actually incorporating this amazing set of skills and resources and humans in your organization into well-being initiatives? And, you know, Kelsey, I'm sure you have ideas as well.

00:04:34:11 - 00:04:59:13
Jason Lesandrini. Ph.D.
Yeah. So it's a great question. Kelsey definitely has a lot to share about this as being a chaplain, not being a chaplain, but leading chaplains. I get to see the great work that they do. And I think here in my own organization, we have a program called CARES. It's an acronym that basically it's a sort of a response system that when sort of some type of critical incident happens, our chaplains are available 24 hours a day, seven days a week, 365 days out of the year.

00:04:59:15 - 00:05:22:24
Jason Lesandrini. Ph.D.
No holidays, no breaks, no nothing. They are there to respond. The chaplain is the first person who gets that call. And the beautiful thing about our chaplaincy program is that our virtual care providers are on the ground, right? We're not in a telecenter responding to our team. We're actually on the ground and can be with another person, which we think is really important to, sort of, staff's overall well-being.

00:05:22:24 - 00:05:41:16
Jason Lesandrini. Ph.D.
Now, how you get in touch with them, of course, is electronically, but it's that physical presence that we think is important. You know, to Kelsey's point earlier about how do you care for this person? We care for them in the moment with them and to be by their side. And so our team, this is one big thing that we've been pushing as our team is there for others when they need them during those critical times.

00:05:41:19 - 00:06:18:02
Kelsey White, Ph.D.
At VCU we do a whole lot of different things. I like to think about them in kind of two buckets. So we've got like chaplain efforts that really focus on in real time reducing stress levels, helping manage distressing situations whether it be debriefing or giving them a moment of respite. So some people have heard of, like tea for the soul or cheek hearts, where chaplains will push them around and offer clinicians these moments to just breathe and to be reminded that they're cared for and that they're supported and that they're not alone.

00:06:18:04 - 00:06:46:12
Kelsey White, Ph.D.
And sometimes that can make a big difference in a busy day. And then there's this other group of ways in which, chaplains, I think can really impact well-being is thinking about a specific way that a chaplain can alter a workflow or a process that really shifts the burden off of other clinicians. So a really concrete example of this is, a program that was actually developed here at VCU called the Family Communication Coordinator.

00:06:46:15 - 00:07:17:23
Kelsey White, Ph.D.
And this intervention is really focused on those individuals that qualify to donate an organ. And so the chaplain comes in and to relieve some of the stress on the nurses and the physicians and the clinical team will facilitate the process between the family and the organ procurement organization. Which really can just, I mean, decrease the stress, decreases role ambiguity and helps kind of minimize all of the things that are that can be exacerbated in those moments.

00:07:17:25 - 00:07:44:01
Elisa Arespacochaga
I think that's so key. One of the challenges we keep seeing broadly in the workforce space is that need to unburden some of our team members from having to do all of the things, and how can we find those roles that and those activities that don't require a physician or a nurse to be doing it, but someone has to be part of the health system and, and be able to provide that support.

00:07:44:01 - 00:07:56:29
Elisa Arespacochaga
So I love the idea of taking advantage of that amazing set of skills and connections and really, bringing them to bear on what has got to be one of the those difficult times.

00:07:57:01 - 00:08:33:03
Kelsey White, Ph.D.
Yeah. And they're actually I talked to some chaplains recently who were part of their organizations efforts to assess for the social determinants of health. And that could be done by a lot of people. There's something about the way in which a chaplain is able to build that trusting relationship that not only helps with a specific process, but it's one less thing that the nurse has to screen for or attend to, but also those chaplains have the skills to get at really sensitive topics for patients and families.

00:08:33:06 - 00:08:47:23
Elisa Arespacochaga
Jason, talk to me a little bit about how you're connecting this great work not only to you make it available to your patients, but to the organization's mission and overall well-being for your team, for those who are doing the caring.

00:08:47:25 - 00:09:11:11
Jason Lesandrini. Ph.D.
Yeah. So here at WellStar, our mission is to enhance the health and well-being of every person we serve. And we're focused on something called People Care, which is about providing care that's unique to whoever. So it's Kelsey care, it's Jason care. It's all of our care. And look, I know this sounds silly, but I can't think of anything more people focused and thinking about how individuals deal with, mind, body and spirit.

00:09:11:13 - 00:09:29:16
Jason Lesandrini. Ph.D.
Right. And thinking about what are those individuals who have expertise in that space, and in some of the spaces that we often forget of to sort of attuned to that. And so while most of our work tends to focus on patients and their families at the bedside, there's also this other side of people care, which is about the people who care for the people care.

00:09:29:19 - 00:09:50:28
Jason Lesandrini. Ph.D.
And so, you know, we need to think a lot broader about this. Kelsey's earlier comments made me think of, you know, something that's really fascinating about working with chaplains. Sometimes it's just about being there. So, yes, the issue might be called up because of, you know, a family or a patient may be having some spiritual distress or something that's going on.

00:09:51:00 - 00:10:10:11
Jason Lesandrini. Ph.D.
But I'll tell you that the beautiful thing is when you just watch it happen, it doesn't have to be anything magical. It's Kelsey as a chaplain coming to my bedside or talking with a patient, a family. And then what do they do? They go out to the nurses station or they see the doctor who's documenting, you know, in the chart or whatever it may be, or the EDS worker and just being with them.

00:10:10:11 - 00:10:27:19
Jason Lesandrini. Ph.D.
I think that means a lot. And so when I think about how we focus on people care here and how we care for the people who care for the people that we care about, you know, that we're trying to tune to. I can't think of anything more connected than sort of the great work that our special care providers do across the entire enterprise.

00:10:27:21 - 00:10:48:22
Elisa Arespacochaga
It's just so heartwarming to see the taking that moment, because, I mean, health care is a hard place to be. It's a hard place to work, but it's one that is so rewarding. And so hearing the opportunity that the chaplains can take to really sort of reground everyone in that work. Kelsey, let me ask you, I've got, sort of two options here.

00:10:48:22 - 00:11:07:19
Elisa Arespacochaga
One share a story of something that surprised you as you've been involving chaplains in this work or -otherwise it may actually be both - advice you'd give to other organizations who are looking to tap into their chaplaincy programs to support well-being. And then, Jason, I'll ask you the same thing.

00:11:07:22 - 00:11:40:07
Kelsey White, Ph.D.
The thing that I think surprises me the most when I have conversations with folks across the country is this level of innovation that chaplains are really living into in these efforts. They recognize the highly specific nature of the stress and distress they see, and can adapt in a way that focuses on their localized contexts. So if there is a certain challenge that is very... perhaps it was a community shooting, right?

00:11:40:11 - 00:12:04:08
Kelsey White, Ph.D.
So the chaplain able to really adapt and address those tensions that are arising right there, and how that affected the clinicians because they're part of the community, too, right? They're not just there at the hospital, but they live there. And then I'd also add just the way in which chaplains care for the employees and the non, like at the outskirts of health care institutions.

00:12:04:08 - 00:12:33:21
Kelsey White, Ph.D.
So there's stories about chaplains caring for security workers, teaching them how to be resilient, teaching them how to cope with intense situations. Or teaching community health workers how to engage in authentic conversation. You know, Jason talked some about just being there. And I really, I would even take it a step further. And there's something about being both physically available and emotionally available that is not unique in our everyday relationships.

00:12:33:23 - 00:13:04:18
Jason Lesandrini. Ph.D.
I think the most surprising thing that I know in the work with chaplains is this misnomer about chaplains coming to pray. So Kelsey talked a lot about this. When I've asked my colleagues across the country about it that's what they tell me, that, you know, well, we call the chaplain to come in and pray. And I just think that selling them short, just really short of the work and scope, you know, we're all trying to work together every day to operate to the fullest extent of our capabilities because everyone in health care needs it.

00:13:04:21 - 00:13:21:24
Jason Lesandrini. Ph.D.
So I think just thinking about chaplains, as folks who come up and pray with people is just way too narrow. They can do that. But man, they can do so much more if we just open the door. You know, I live by this principle about being a helper. I think they're helpers. I think that's what they actually are.

00:13:21:24 - 00:13:44:21
Jason Lesandrini. Ph.D.
And they can help people across the spectrum: the religious, the non-religious, the spiritual, the non-spiritual. My experience has shown me that spiritual care providers are probably some of the best listeners and man, I can tell you this, I need an ear more frequently than I'd like to admit. It's not a judgment, it's not a religious context, it's just a really good listener.

00:13:44:23 - 00:14:04:22
Jason Lesandrini. Ph.D.
Your second point, Elisa, maybe I could just chime in here because I got lots to say. And if people who know me across the country know that I have a hard time being quiet. So I'll say this about advice to other organizations. You know, you'd mentioned that. I think the biggest piece of advice I'd give other folks is please just ask them, that's the biggest piece of advice, is ask them for help.

00:14:04:24 - 00:14:23:10
Jason Lesandrini. Ph.D.
I think that's the biggest problem we have across this country is that spiritual care providers, chaplains, all these folks who sit in this space are not being asked to assist with this work. And wow, if they are, the evidence is just not even you can't doubt it that they can help. But they got to ask. You got to ask them.

00:14:23:10 - 00:14:35:21
Jason Lesandrini. Ph.D.
And we have to, you know, we're doing work on this on the other side is we got to have the chaplains and folks speak up. That's the other piece. You got to speak up. So we need to ask, you got to ask them what's the work that they can do? What can they do? And then hold them accountable for it.

00:14:35:21 - 00:14:45:24
Jason Lesandrini. Ph.D.
Because I think that's part of the value that chaplains can do. The literature is clear, they can help. You got to ask them to do it and then just hold them to it because it will come out, I promise you.

00:14:45:27 - 00:15:10:00
Elisa Arespacochaga
Jason and Kelsey, thank you so much for joining me, sharing a little bit about your world, and hopefully through this podcast, we're sharing with others the opportunity both for chaplains to raise their hands and for those around them to say, hey, you got a moment? Can I bend your ear? Because I think that is something we all need very much to get through health care and to be able to help others.

00:15:10:02 - 00:15:12:01
Elisa Arespacochaga
So thank you again for joining me.

00:15:12:03 - 00:15:13:03
Kelsey White, Ph.D.
Thank you.

00:15:13:06 - 00:15:14:24
Jason Lesandrini. Ph.D.
Thank you.

00:15:14:26 - 00:15:23:07
Tom Haederle
Thanks for listening to Advancing Health. Please subscribe and rate us five stars on Apple Podcasts, Spotify or wherever you get your podcasts.