Centre for Paediatric Spiritual Care blog

Reflections on our multidisciplinary spiritual care module

David Baker As a keen motorcyclist, I'm careful to ensure I don't leave my fifteen-year-old 'bike too long with old petrol in the tank because, if I do, chances are it won't start.  Similarly, as a fifty-something youth worker with over 25 years of professional experience, I think it's more important than ever to freshen up my knowledge and skills-base to ensure I'm not "running on old fuel".

Working with adolescents in an acute health-care setting presents a curious mixture of challenge, reward and opportunity for the youth worker.  We are engaging with young people and families in some of life's most difficult circumstances every day; And yet it is the critical nature of this environment that means that young people are often ready to 'open up' and place their trust in us far more quickly than would normally be the case.

"Spiritual Care" is, therefore, core to our service delivery on a daily basis.

I'm halfway into the advanced module in Multi-disciplinary Spiritual Care with Sick Children and I have to say that the combination of teaching, research, group-interaction and 1:1 support is incredibly exciting for me, professionally and personally.  In its focus on the interaction between child/adolescent development, spiritual development and professional practice/ethics it is both affirming and informing my practice.

In short, it's exciting to be a student again and I definitely feel that I'm taking on some 'high-octane' learning and development alongside some great fellow students.

David Baker, a CYM graduate, is Senior Youth Worker at Birmingham Children's Hospital.

For further information about the course please email sallynash1@nhs.net

Ruth Radley, Honorary Chaplain/Child and Community Lead, talks about the benefits of using Russian dolls in spiritual care

NN was admitted to our hospital suffering from a neurological illness. Her parents shared with Chaplaincy staff that this was affecting her personality, she was acting in ways that were not really her. Unsure of whether NN herself recognised this fact, I went with some plain wooden Russian dolls to use in a new Spiritual Care activity, I had asked her previously if she would like to do something with them, and she agreed.

I went in and sat down, she excitedly told me about her home visit over the weekend, then I produced the dolls with a whole host of craft materials, pipe cleaners, glitter, googly eyes, ribbons, tissue paper, feathers….and gave her free reign to decorate how she felt like doing so. We talked about being in hospital, and how that, or things that make us ill can make us feel like different people, how about choosing some different emotions she feels and decorating a doll with each one.

I also suggested that if she wanted, one of the dolls could represent God. NN was from a family with a strong faith, although she didn’t choose to do this. She readily and eagerly agreed to doing this, and immediately pointed to different dolls giving an emotion for each one, before setting to work decorating them.

First came Happy NN, the biggest doll. This surprised me since I knew she did not like being in our hospital at all – she had shared on several occasions. ‘When do we see Happy NN’ I asked – she looked at me, with a twinkle in her eye, ‘at home and at school,’ she said.

Encouraged that her first choice was happy, we chatted a bit more before she decided to move onto doll number 2, ‘excited NN’. Another surprising choice for me, we chatted about this doll, and she comes out when there are parties to go to and such like. It soon becomes even clearer that NN was suffering just by being in a side room, alone with only family members, and separated from friends and family, who she was desperate to be reunited with.

The third doll, in the middle was sad NN. Sad NN is seen when she argues with her friends and when NN was in hospital, especially when she had to take some large tablets – something that she has struggled with since admission. They are hard to swallow and leave a bad taste in your mouth,’ she said with a sigh. I asked what we could do to make that better, and she pointed to some strawberry milkshake that she takes immediately afterwards.

Interestingly, Sad NN still had a feather in her hair (like all the other dolls). I pointed this out, NN looked at me and said, ‘yes, because even sad NN has happy moments sometimes.’ This led onto a conversation about how it’s OK to feel both those feelings at the same time, and how the Psalmist in the bible often did just that in the same Psalm, happy one moment and really sad or even angry the next.

Nervous NN came next, interestingly still with a smile. ‘Oh,’ I said, ‘Nervous NN is still smiling.’ ‘Yes,’ came the reply immediately, without thinking about it, ‘because nervous NN hides it so you will never know.’ I asked if there was anyone that nervous NN could share her feelings with, happily she shared her parents and some friends. I asked if there were any doctors and nurses she could sometimes share with, she felt that there was. It was OK to be nervous about things, especially when we do not know what is happening.

Finally, we saw fun NN. Over time, I had seen this child become more confident in her surroundings, and change a little from a quiet girl, not sharing much, to one who would giggle and share more about what she likes and dislikes, so it was good to see ‘fun NN’ appear in the line-up.

As she decorated each doll I gently asked questions. It became apparent that as she was decorating, she was thinking about the questions. We often had long silences between the question and answer, not an uncomfortable one, but one which gave her time to think and express what she wanted to do, without pressure.

Occasionally a question went unanswered, it was important that she was given the time she needed to do this activity without the need for rushing. It also felt good to be expressing in the third person, for example, ‘when do we see happy NN….’ NN would often reply ‘Happy NN is when…….’ Speaking in the third person felt that it became easier to express what she wanted to do – it was about the dolls, not her directly, yet, they were her emotions being expressed.

It may have been helpful to have discussed the colours that she used for each doll – it is possible that there were also reasons for the colours which may have developed conversations further.

Finally, when all dolls were completed, we talked about all the different emotions that were represented there, and affirmed how each one was OK – and good for NN to express, and how, through each emotion, NN was still deeply loved, by her family and friends, and most especially by God.

Why use case studies in spiritual care?

Liz Bryson, a Chaplaincy Volunteer at Birmingham Children’s Hospital, has answered some of our questions about how to write a case study and why they can be helpful to read and write.

Why do you think case studies are helpful for other chaplains to read?

Case studies can be a valuable learning tool. They provide examples of good practice, and can also present challenges chaplains may face, to give instances of overcoming these situations or as a prompt for further reflection.

Hearing about the work of others is encouraging; you can find out about the good work that’s going on elsewhere, and hear about other people having similar experiences to you. I find that being informed about how other professionals in chaplaincy deliver spiritual, religious and pastoral care can enhance my openness to reflecting, developing and changing.

Did you find the process of writing a case study beneficial for yourself?

I find writing case studies extremely useful in reflecting back an ordered and constructed way. For me, it’s a way of processing work situations and it’s also helpful in identifying outcomes and further action required so these are not missed. It’s wonderfully encouraging to identify when the ordinary becomes extraordinary and there is a sense of the transcendent operating.

I also find that linking my practice to theological concepts or spirituality theories extends my academic development.

How did you identify an interaction to write about?

Every week there is the potential to write up some learning that can improve my practice, just a shortage of time to do it! After a day at work I find there are some encounters that I might be mulling over, these are good to write up. If I am buzzing with delight at seeing the enormous privilege and benefit of delivering spiritual, religious and pastoral care, if I have been challenged or find myself in a very unusual encounter, or if I have felt an encounter was particularly rich in learning outcomes then I would aim to write it up.

Do you have any tips for chaplains or chaplaincy volunteers who would like to write a case study?

Use your case study as a means to reflect and improve your learning and practice. Always anonymise your case study, and if you’re going to share it with others instead of just keeping it for your own learning, then make sure you have consent from the family [if you are submitting a case study to the PCN, please use the PCN consent form]. It’s helpful to use a standardised template that helps to record important information and enables you to think clearly and creatively. 

And finally, try it - you may be pleasantly surprised!

Sally Nash, Research Director at the CPSC, reflects on the past two years since the Centre was founded

Celebration is an important dimension to our lives and this is a milestone I am excited to celebrate. I hope we have some cake to do it with too! Our Centre is a physical room where we have lots of books and articles and artefacts some of which are the creations of children and young people we work with. For me, it is significant because we are pulling together some of the best practice of paediatric chaplains at Birmingham Children's but elsewhere too and we have the centre to disseminate it. I have been in education for more years than I want to admit to - well over 30 and you can spend so much time reinventing the wheel but having an idea which you can try out or build upon can be so helpful and inspiring.  

My broader background is in training people on degree courses to work with young people and more recently children. To be able to bring some of my knowledge and best practice principles to the work of the Centre has been a privilege. I get to apply my knowledge and experience elsewhere and to encourage others to engage in creative practice in their work. I have been able to introduce some University accredited modules which people can take at undergraduate or Masters level and am delighted that Liz Bryson, one of our talented volunteers, is coming to the Institute for Children Youth and Mission Award Ceremony to receive a Postgraduate Certificate in Paediatric Chaplaincy. Equipping and releasing people is one of my passions and giving people the opportunity to get formal recognition for this is a great privilege.  

Over the next year, we hope to complete our research into supporting siblings where one of the family has a rare disease. We have been editing a book on paediatric chaplaincy which we hope to launch in May 2018 and along with that are continuing to work on a taxonomy of paediatric chaplaincy and have articles in the pipeline on that.  

I have learnt so much through working for the Centre for a day a week but perhaps most from interviewing siblings and seeing the love, care, compassion and courage they express along with some of the more difficult realities of their situation.