Yesterday's New York Times had an interesting article on clergy burnout. The article spoke of the rising rate of "obesity, hypertension and depression" in clergy. There are a lot of reasons - lifestyle changes, the speed of modern life, the need to be present to our congregants 24/7 - but the one reason the article focuses on the most is the need to take more time off.
It can be tough to take time off sometimes, even when you take time off. When I was a congregational rabbi, I had to leave contact information when I went away whether my absence was business (convention) or personal (vacation.) That was a long time ago. I was a solo rabbi of a small congregation. I don't know what things are like now in small congregational life, but I can remember the tremendous feeling of freedom the first time I took a vacation after leaving my pulpit. No one knew where I was going (except family) and no one knew how to reach me (except family.) It was the feeling of freedom that let me know that my previous vacations had not, fully, been vacations. This was before the internet, before cell phones, before BlackBerrys and instant messaging and email, before the expectation of immediate responses to questions or needs. The contact information was for deaths or major crises. Still, the expectation was that in an emergency I'd come back.
I've had other jobs in the Jewish community that also came with expectations of long hours, contact during vacations to deal with crises, and the need for immediate responses to unexpected events. I was definitely burnt out when my last job ended. One of the nice things about the brief unemployment after that job was the chance to relax, reflect, catch up, and go away without worrying what I'd find on my desk when I returned.
Something I really appreciated when interviewing for hospice jobs was the concern about self-care. Our work can be difficult and some days, overwhelming. We're with people at some of the worst times in their lives. We help them try to make sense of what's happening, find meaning in loss, and craft the story of the life that's ending and their new world on the other side of loss. Each hospice interview I've had included questions like: "What will you do to take time for yourself?" "How do you think you'll be able to leave this work behind?" "What do you do for fun?" "When do you relax?"
In my job, when I'm on - I'm on. But when I'm away or off for a day or not on-call over the weekend - I'm off. There's no expectation to check in, no need to leave contact information, no worries about what will be on my desk when I return. We cover for each other. We make sure the work is done. We understand the need to take vacation time; to get away, to recharge ourselves, to rejuvenate. We may not do it as well as we could - we still need help and support to eat healthy food, to exercise our bodies, to challenge our brains, and to look for the everyday miracles that fill our world, but I know that I am much healthier as a rabbi in this job than I have been in others.
Tuesday, August 3, 2010
Thursday, July 29, 2010
yarmulke
In addition to the times when wearing a kipah leads to serious discussions or requests for additional support (or "courtesy visits" as one of my fellow chaplains refers to them,) there are the unplanned moments of humor.
At the second facility they were playing Christmas music ("O Holy Night" when I walked in) even though it was a hot, late spring day. I reported to my colleagues afterward that apparently I was only "alert and oriented x 1" that day. Which is to say, I knew my name, but it seemed that I didn't quite know the date (December? May?) or the place ('Happy Dawn Assisted Living'? A-rabb-ia?)
Some days all you can do is laugh.
- I'm sitting at the nurses' station at an unnamed nursing home working on my visit notes. A patient (not one of mine) comes up to talk with me. The back story, which I find out later, is that she noticed the kipah and asked one of the facility nurses who I was. The nurse told her: "That's the rabbi."
- Patient: "Oh. You're Jewish." Me: "Yes." Patient: "I thought you just liked to wear doilies on your head."
- I'm visiting a patient in a "memory unit" in an assisted living. A staff member comes up to me and notes that several of the women have noticed my headcovering. They are wondering where I'm from. A quick series of responses runs through my mind. I can't say, "I'm from "We Care For You Hospice" because that would violate HIPPA rules and patient privacy. I don't really want to say, "I'm from the "We Care For You Agency" for similar reasons. (Although I wear a name badge and most of the staff know where I'm from.) I could say, "I'm from 'Hometownville'," but I don't really think that's what they're asking. So I go for what seems to me to be the simplest answer:
- "Just tell them I'm a rabbi." Staff member: "What?" Me: "I'm a rabbi." The staff member walks over to the residents and says: "She's from A-rabb-ia."
At the second facility they were playing Christmas music ("O Holy Night" when I walked in) even though it was a hot, late spring day. I reported to my colleagues afterward that apparently I was only "alert and oriented x 1" that day. Which is to say, I knew my name, but it seemed that I didn't quite know the date (December? May?) or the place ('Happy Dawn Assisted Living'? A-rabb-ia?)
Some days all you can do is laugh.
Wednesday, July 21, 2010
Where did you get your faith?
One of my patients and I were talking about faith today. He was born Catholic but no longer practices. He had told our nurse that he believed in God and would be happy to have me visit. He's not much for talking - he told me that and told me that his voice was wearing out from talking with me (and there really wasn't that much talking.) Then he asked, "Where did you get your faith?"
Wow. I needed to think about that one. Where did I get my faith? I got it in part from my parents who joined a synagogue and sent me to religious school. I got it in part because I looked around at how the world works and knew there must have been something (someone) who created it. That was about as much as I could come up with during the visit. We talked a bit more - about people whose faith teaches them that there will be a reward after this world, about my belief that what's important is not whatever comes next but what we do here. He was tired, so I asked if we could talk about this more at our next visit. He agreed.
Before I could write a visit note or even begin to process the visit, my phone rang. I was needed somewhere else -- 50 + miles away.
I love driving. It gives me time to think, to ruminate, to dream. I've been known to miss a turn I know well because I'm mentally writing a sermon (or now a blog post) while I drive. So, with 50 + miles of highway I had plenty of time to think about where I got my faith. The more I thought, the more I think that my first answer -- my synagogue -- was more true than I realized. I don't remember a lot of details about what I learned in Sunday School, but I remember some formative experiences there. In sixth or seventh grade we studied comparative religion. At the end of the course, we had to write an evaluation. I wrote that we should have had teachers or guest speakers from the different faiths, because the teacher, Mr. H., "couldn't answer all my questions." Mr. H. wrote in reply, "God Himself couldn't answer all Chana's questions." It was in my synagogue and youth group that I learned I could ask as many questions as I wanted and that there were a lot of texts that spoke to my concerns. It was in my synagogue that I found a community, teachers, rabbis, mentors. It was through the synagogue that I went on to advanced Jewish learning and had pivotal experiences, including significant time spent in Israel.
Where did I get my faith? I got it from Jewish texts, from Jewish experiences, from friends, and from my rabbis. I get it through the work I do and the people I meet. And today I was reminded that in the work I do, I get so much more than I give.
Wow. I needed to think about that one. Where did I get my faith? I got it in part from my parents who joined a synagogue and sent me to religious school. I got it in part because I looked around at how the world works and knew there must have been something (someone) who created it. That was about as much as I could come up with during the visit. We talked a bit more - about people whose faith teaches them that there will be a reward after this world, about my belief that what's important is not whatever comes next but what we do here. He was tired, so I asked if we could talk about this more at our next visit. He agreed.
Before I could write a visit note or even begin to process the visit, my phone rang. I was needed somewhere else -- 50 + miles away.
I love driving. It gives me time to think, to ruminate, to dream. I've been known to miss a turn I know well because I'm mentally writing a sermon (or now a blog post) while I drive. So, with 50 + miles of highway I had plenty of time to think about where I got my faith. The more I thought, the more I think that my first answer -- my synagogue -- was more true than I realized. I don't remember a lot of details about what I learned in Sunday School, but I remember some formative experiences there. In sixth or seventh grade we studied comparative religion. At the end of the course, we had to write an evaluation. I wrote that we should have had teachers or guest speakers from the different faiths, because the teacher, Mr. H., "couldn't answer all my questions." Mr. H. wrote in reply, "God Himself couldn't answer all Chana's questions." It was in my synagogue and youth group that I learned I could ask as many questions as I wanted and that there were a lot of texts that spoke to my concerns. It was in my synagogue that I found a community, teachers, rabbis, mentors. It was through the synagogue that I went on to advanced Jewish learning and had pivotal experiences, including significant time spent in Israel.
Where did I get my faith? I got it from Jewish texts, from Jewish experiences, from friends, and from my rabbis. I get it through the work I do and the people I meet. And today I was reminded that in the work I do, I get so much more than I give.
Monday, July 19, 2010
kipah / yarmulke
I wear a kipah when I'm at work. Some days it's just part of my work wardrobe, like my name badge. Of course, I do like to match it to my clothing or the season. It's been awfully hot lately, so I've been wearing my summer "watermelon" kipah.Whenever I wear it, someone will do a double take and ask "Is that a watermelon?"
That's not the usual response. Usually, at least initially, people say either "Why do you wear that?" or "I didn't know women could wear one of those." To the "why" question I respond that I'm a rabbi (while in my head, I hear Kol B'Seder singing "The Kipah Song" - "Kipah, yarmulke, shows the world you're a Jew.") It may seem like a simplistic answer, but on days when a facility social worker or activity staff member chases me into the elevator or out of the building "Rabbi, can I talk with you a minute," the kipah as identification serves its purpose. They know who I am. They spot me by the brightly colored, crocheted head covering. Whether it's a question about one of my patients or, more typically, a request that I visit a Jewish patient who's not on hospice, or blow shofar, or supply holiday music or readings, the kipah assures that they notice me. "I've been hoping to catch you." "I'm so glad I saw you when you walked by." In the busy nursing home world, the sight of my kipah reminds them that they had a question for me.
The "I didn't know" or the "You must be Jewish" comments lead to theological discussions or educational opportunities. I never know where those discussions will go. The timing isn't always convenient and sometimes the topic doesn't lend itself to a quick answer, but the kipah gives me the chance to have conversations that would otherwise pass by.
There's another reason for the kipah. It reminds me that I'm a rabbi, that I represent the Jewish community - sometimes to people who have never spoken to a Jew. The kipah reminds me to be aware of what I say and what I do. While I certainly don't speak for the Jewish community, a person's encounter with me may form their impression of who a Jew is or what a Jew believes or how a Jew acts. The kipah is my reminder of the responsibility that comes with my title and the work I do.
And then there are the unexpected comments, the unplanned moments, the laughter that sometimes comes my way because of the kipah. But that's another post.
That's not the usual response. Usually, at least initially, people say either "Why do you wear that?" or "I didn't know women could wear one of those." To the "why" question I respond that I'm a rabbi (while in my head, I hear Kol B'Seder singing "The Kipah Song" - "Kipah, yarmulke, shows the world you're a Jew.") It may seem like a simplistic answer, but on days when a facility social worker or activity staff member chases me into the elevator or out of the building "Rabbi, can I talk with you a minute," the kipah as identification serves its purpose. They know who I am. They spot me by the brightly colored, crocheted head covering. Whether it's a question about one of my patients or, more typically, a request that I visit a Jewish patient who's not on hospice, or blow shofar, or supply holiday music or readings, the kipah assures that they notice me. "I've been hoping to catch you." "I'm so glad I saw you when you walked by." In the busy nursing home world, the sight of my kipah reminds them that they had a question for me.
The "I didn't know" or the "You must be Jewish" comments lead to theological discussions or educational opportunities. I never know where those discussions will go. The timing isn't always convenient and sometimes the topic doesn't lend itself to a quick answer, but the kipah gives me the chance to have conversations that would otherwise pass by.
There's another reason for the kipah. It reminds me that I'm a rabbi, that I represent the Jewish community - sometimes to people who have never spoken to a Jew. The kipah reminds me to be aware of what I say and what I do. While I certainly don't speak for the Jewish community, a person's encounter with me may form their impression of who a Jew is or what a Jew believes or how a Jew acts. The kipah is my reminder of the responsibility that comes with my title and the work I do.
And then there are the unexpected comments, the unplanned moments, the laughter that sometimes comes my way because of the kipah. But that's another post.
Thursday, July 15, 2010
The State
One of the big concerns in nursing homes is the visit from The State. Periodically (I have no idea how often) the Department of Public Health (DPH) comes in and surveys the records, charts, and files. The goal of the nursing home is to have a survey with no deficiencies.
Ideally, all of us want to give good care. We want to be attentive to our patients' needs, caring in our interactions, manage pain, prevent falls, etc. And, of course, we want to document that we have done all of this without making every visit note sound like every other visit note. We want to individualize the care we give, even when our care plan forms don't always give us enough choice in our check boxes to show that we're doing so.
Some days it feels as though all we do is check off boxes and write narratives. Some days it feels as though we spend more time documenting what we do than doing what we do.
Yesterday, I was "snagged" by The State. As I was leaving a nursing home, a DPH worker stopped me to ask some questions. After telling her I was an outside provider, and thus ensuring that they knew there were hospice patients in the building, she asked a few questions about our patients. One of the things DPH looks at is coordination of care. Does the nursing home staff talk to the hospice staff? Do we collaborate on the care plan? Do we work in coordination or in competition?
While internally hoping that I had checked all the appropriate boxes on my forms and that my narratives were complete, I was pleased to be able to talk a bit about this nursing home. Not just because we do coordinate care, but because the staff in this nursing home are caring and attentive. They give superb care to some very challenging patients. It is one of my favorite places to visit. It was nice to be able to share this outside the circle of my co-workers (who feel the same way) and beyond the nursing home staff (whom we have also told how much we enjoy coming to their facility.)
Still, the next time DPH is in one of the facilities I serve, I hope I slip though the building without their notice.
Ideally, all of us want to give good care. We want to be attentive to our patients' needs, caring in our interactions, manage pain, prevent falls, etc. And, of course, we want to document that we have done all of this without making every visit note sound like every other visit note. We want to individualize the care we give, even when our care plan forms don't always give us enough choice in our check boxes to show that we're doing so.
Some days it feels as though all we do is check off boxes and write narratives. Some days it feels as though we spend more time documenting what we do than doing what we do.
Yesterday, I was "snagged" by The State. As I was leaving a nursing home, a DPH worker stopped me to ask some questions. After telling her I was an outside provider, and thus ensuring that they knew there were hospice patients in the building, she asked a few questions about our patients. One of the things DPH looks at is coordination of care. Does the nursing home staff talk to the hospice staff? Do we collaborate on the care plan? Do we work in coordination or in competition?
While internally hoping that I had checked all the appropriate boxes on my forms and that my narratives were complete, I was pleased to be able to talk a bit about this nursing home. Not just because we do coordinate care, but because the staff in this nursing home are caring and attentive. They give superb care to some very challenging patients. It is one of my favorite places to visit. It was nice to be able to share this outside the circle of my co-workers (who feel the same way) and beyond the nursing home staff (whom we have also told how much we enjoy coming to their facility.)
Still, the next time DPH is in one of the facilities I serve, I hope I slip though the building without their notice.
Tuesday, July 13, 2010
Signage
On a nursing home door:
"Door is alarmed."
It looked pretty calm to me. Perhaps the calm was a facade.
"Door is alarmed."
It looked pretty calm to me. Perhaps the calm was a facade.
Wednesday, July 7, 2010
Always good to laugh
A sign I saw today in a staff bathroom at a nameless facility:
ALL STAFF
WHEN your
Done using the
toilet Please
giggle the handle
or it will not
Stop Running.
So I giggled. The toilet did not find it amusing.
ALL STAFF
WHEN your
Done using the
toilet Please
giggle the handle
or it will not
Stop Running.
So I giggled. The toilet did not find it amusing.
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