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Whole-Person Care

There is a spiritual care teamThere is a spiritual care team at Torrance Memorial Medical Center that can't read X-rays or ultrasounds, and they do not set broken bones. They aren't allowed to write prescrip­tions for medicines or scrub in for surgeries, but they play a unique and critical role in the outcomes of patients in every wing of the hospital. These are the whole-person healers. They write the Plan of Spiritual Care (POSC) for the patients; this is how spiritual care presents itself at Torrance Memorial.

This team is composed of two key players: board-certified hospital chaplain Rev. James Kim, MA, MDiv, DMin, who is certified in thanatology (the scientific study of death and dying), and certified hospice chaplain Tenzin Kiyosaki, MA, who is an ordained Buddhist nun. Also part of the spiritual care team are a number of volunteers who have backgrounds in spirituality as Eucharistic min­isters or representatives of their faith groups.

Both chaplains work with patients in a nondenomi­national way and pay visits to those patients who wish to meet with them. "Torrance Memorial is interested in body, mind and spirit, in terms of the healing process," says Mary Matson, director of volunteer services. "With a full-time chaplain in the hospital and a chaplain for hospice and our volunteers, we are trying to help facilitate that healing."

Rev. Kim was an ordained pastor in a Christian church before moving into the hospital setting. "You wouldn't know I am an ordained pastor until I say I am, because as chaplains, we are trained to support every walk of faith and spirituality."

"Chaplaincy is really about working with others as a profession," says Kiyosaki. "The training that we received in hospital chaplaincy was an interfaith training. We work with clergy from other traditions and are constantly with people of varied backgrounds and faiths."

It is very clear that both of these chaplains are highly respected and loved by their peers at Torrance Memo­rial-not only because of their compassion for everyone, but because the tremendous work they do each day seems like impossible work to most of us.

These two devote their lives to helping patients and families cope with what are likely the most difficult situa­tions they will encounter in their lives. Kiyosaki and Rev. Kim work every day-focusing not on just a body part that is ailing but on caring for the entire person.

In The Hospital

"My goal as a chaplain is to help each patient expe­rience the connectedness to their sources of hope and strength. In addressing spiritual needs, everyone has his or her own valuable story-meaning that everyone is im­portant and precious. I spend my time reconstructing the purpose of his or her life and reaffirming coping strategies with them," explains Rev. Kim.

Rev. Kim impacts every wing of the hospital. He starts each day with patients in ICU and oncology. Then he visits the referrals he receives from physicians and nurses. After that, he follows up with people from the day before. Rev. Kim remains on call for places like Labor & Delivery. Urgent and unexpected things come up all over the hospital, and he responds to every one.

"And then there are times when we find out [a pa­tient's] situation is not treatable. This is the most difficult time-when there are no options and there is no cure. This situation becomes both a clinical and spiritual event in the healthcare context."

Even in these times, Rev. Kim helps them find hope or contentment in the midst of frustration. "At these times, you need someone to help you find a way to honor your life. And that is the other task for me. Every patient has a unique situation, and to me, everyone is very important. And I help patients ask questions such as, "What would be the title if I write my life-book?"

 Rev. KimThis kind of duty is not for every clergyman. Fourteen years ago, Rev. Kim's son had surgery for a brain tumor. For three years, Rev. Kim and his family fought to save the life of his son before the battle was lost. As Rev. Kim and his family suffered through the grief process, his spiritual eyes opened wider.

"I was trying to figure out 'Why?' I thought I was a good man, a good clergyman. I thought if you were good, then you were rewarded with a life without grief and hard­ship," says Rev. Kim. "From the grief process, I could un­derstand deeply about human suffering and spiritual pain."

At this time, Rev. Kim began to feel a kind of calling to help people in this situation. He was led to hospital chaplaincy training, and after completing it, he worked at Kaiser for many years. Then, being the community man that he is, he realized he wanted to serve the community in which he lived-the community that educated his chil­dren. So he wanted to be here at Torrance Memorial.

The critical role that Rev. Kim plays for patients and families cannot be overstated. He explains it best himself: "I want to help patients reconnect to their strengths. They had it. But when you have an unexpected life-altering situation, you have many thoughts that are present. I remind them to start from 'What have you found in your life?' And we talk, and we reorganize the purpose to focus on why are you fighting and how your spiritual beliefs are applying to your health and treatment."

Hospice

Although Kiyosaki is an ordained Buddhist nun, she was born and raised in a Christian household in Hawaii, and she still very much adores some of the inspiring teachers, particularly St. Francis. "I am probably one of the few Bible-carrying Buddhist nuns around," she says. "And I am very comfortable with different faith traditions and those who profess no specific faith."

Prior to Torrance Memorial's hospice, Tenzin studied Buddhism and was ordained by the Dalai Lama in 1985 in India. She worked at a nunnery, where she studied debate, philosophy, conduct, meditation, and also taught English to the nuns. Following that, she became chaplain at the United States Air Force Academy in Colorado, where she worked with cadets.

After organizing the Dalai Lama's 2006 visit to Los Angeles, Dana Hodgdon, bereavement counselor at Torrance Memorial, asked Kiyosaki to apply for the chaplain position because there was an opening, and Kiyosaki had previously gone through some of the training for hospital chaplaincy. She applied, got the position and completed her training and national certification.

The hospital chaplaincy training taught Kiyosaki a lot about active listening. "I began to hear what someone's needs are, rather than coming in with my bag of tools and saying, 'I can help you.' I was learning to really listen to what their needs are."

A job in hospice is not for the faint at heart. Chaplaincy is a nondenominational role, but Kiyosaki finds that her Buddhist background helps directly in this setting. "The Buddha's first teachings are the four noble truths-one of them being that our lives are impermanent and death is inevitable. The time of our death is not certain. But when [death] affects us or a loved one-someone in our family, it can be very traumatic and scary."

End of life can be a time for a lot of reconciliation or coming to terms with many things. "I think that the hospice chaplaincy part is really about helping people to look at the fact that our death is a natural part of our life," Kiyosaki says. "How can we be a little more open and accepting rather than deny it, especially when the conditions are very dire? As a chaplain, I look at how I can support you so your situation is comfortable and peaceful. That is the main point. It is not about changing anyone but about having a contented heart and not carrying a lot of emotional baggage so they can really share things that they want to share with others and to be able to transition peacefully at the end of life. That part is really my work."

spiritual care Kiyosaki continues: "I help people look at issues that are going on for them and help them to speak about them. Oftentimes we hold things in our heart; we think these things, but we don't say it. Or we come to the 'I love you,' and we say, 'Oh, they already know that,' but how about sharing your love and sharing your appreciation of people hanging in with you through thick and thin through this time when you really need support-whether you are the patient or the caregiver?"

Kiyosaki calls on patients when they are enrolled in our program, unless the patient has indicated that they do not want to meet with the chaplain or they have support from their own church or temple. Then she will visit every week or two or whenever the patient would like. She, like Rev. Kim, also works on referrals from nurses and physicians.

"We [Kiyosaki and the patients and families] can get into some lively discussions and interesting topics. We can talk about what is going on in the heart, in their lives and with their families. We sometimes say a prayer, read scripture, poetry and share things that are going on that day or in their hearts or minds." This can be as much about the heart as it is about a religious tradition.
Kiyosaki, like Rev. Kim, encourages all her patients to affirm their lives, even though they are grieving. They celebrate family, children, a long marriage, things that gave meaning to their lives. In all, Kiyosaki brings her own life philosophy to share with the patients and their families in a way that helps heal the whole person.

Spirituality In The Future

Not long ago, even the best medical schools did not offer spiritual care curriculum. "Now what I hear is that the majority of the 140 American medical schools have courses on religion or spirituality," says Rev. Kim.

As the practice grows in medical schools, so does the involvement of physicians in holistic health care. The roster of the volunteer spiritual care team at Torrance Memorial is growing, and both Rev. Kim and Kiyosaki are happy about that.

On the other side, Rev. Kim also goes around to the important committee chairs, such as bioethics and palliative care, so the entire hospital is assimilated on whole-person care. His presentations onspirituality to the Torrance Memorial Versant Nursing Residency Program are part of his efforts.

Technology is also supporting the spiritual care team, with the new addition of language lines in every patient room. A language line has two telephones: one for the patient and one for the nurse or physician. The physician dials a service that translates what he or she is saying into the preferred language of the patient. "In a time of crisis, it is more meaningful to hear what is going on in your own language," says Rev. Kim. More than 170 languages are covered in the language line at the moment.

As spirituality care grows at Torrance Memorial Medical Center, Rev. Kim has dreams of opening a research center dedicated to studying data on the important work this specialty field does and propel them further into the field of whole-person healing.

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