Pre-conference preparation

The faculty meets thirty minutes before the participants arrive for final instructions and to pray. The faculty consists of an overall Chief Facilitator, two or three actors from the hospital staff and a table discussion facilitator for four to five participants. Include a chaplain and an experienced nurse at each discussion table. It is best if the nurses have participated previously in their staff program. Physicians who have previously participated should facilitate the table discussions. If you have never offered this program, have a special session so the facilitating physicians can experience it in advance. Because physicians facilitate small group discussions infrequently, review the mechanics of facilitation before the participants arrive.

Vignettes & Dialogue

The program was originally entitled “Spirituality and Disease Management”, but “Bedside Spirituality” describes it better. Participants scrutinize critical physician relationships in the hospital, namely the relationships with patients, patient’s families, other health workers, and other physicians. They explore spiritually depleting physician behaviors, namely proselytizing, addictions, staff abuse, and the use of medically futile treatment. Staff members act out short vignettes. Then questions and dialogue bring out stories that teach the best behaviors. Physicians, like most people, tend to modify their behavior toward the group norm. Since physicians rarely have conversations like this, they are not clear on the group norm or even what one or two other physicians are doing. These conversations accomplish much. A seasoned facilitator is a must.

Spirituality and Disease Management

Several members of our mission team noted that a didactic approach often closes the door to spiritual conversation and limits the development of excellent practices. In response selected members of our hospital staff developed a day-long retreat for nursing teams that included ample time for reflection and storytelling. The architects of the program comprised about 15 people including nurses, chaplains, physicians, managers and human resources specialists. Realizing that physicians will act more readily on truths that they discover themselves and on truths that are endorsed by physician colleagues whom they trust, we deleted much of the didactic material from the nurse program; we shortened the retreat by half to make it accessible for physicians. Attendance was best when we held the program between 4:30 p.m. – 8:45 p.m. and included dinner. A safe environment is needed for the dialogue. While cerebral physicians usually talk at the “head” level, this dialogue effectively encourages physician conversations at the “heart” level. Storytelling nearly always brings best practices to the surface.