Monday, May 16, 2011

Chaplaincy competencies

The 'competency framework' is a fairly new way of describing what used to be listed as the 'skills, knowledge and attitudes' expected of a professional worker. A good 'competency framework' has the virtue (perhaps) of helping the developing practitioner to visualise herself doing real-life things, so she can grow into the job in an organic way, rather than trying to bolt together bits of attitude, bits of practical know-how, and bits of theory when faced with an angry mum, a frightened child, or a patient vomiting blood.

Here's a list of chaplaincy competencies we were recently invited to dissect. I should stress that these were not proposed as THE competencies training was intended to develop in us; more a stepping-stone towards thinking through our own. I quote (and my musings are in italics):

"The chaplain can demonstrate.............."

Hang on a minute! Who is going to be watching this demonstration, and in what circumstances? Will the observer watch me over minutes or hours of performance, will I know I'm being watched, shall I have any warning or preparation, and how will the fact of my being observed affect what I do? More important, how may the observation affect my performance? Even more important, how may it affect the experience of anyone with whom I am transacting? By what criteria of competence will my performance be judged? Am I to know how they will be applied? And what assurances am I entitled to about the competency of anyone who judges me? Or am I just being my usual narky, paranoid and bloody-minded self? Some of these questions may be answered when we get to what it is I am supposed to be demonstrating competency in........

"1. Good grounding in one Buddhist tradition, with evidence of regular practice and doctrinal knowledge."

I wonder how one can demonstrate "good grounding" in a Buddhist tradition. Maybe one could ask a higher authority for a reference stating that "I hereby testify that So-and-so, whom I have known for what you will probably agree is a a respectable length of time, has a good grounding in the X tradition in which I am an accredited position-holder, as is suggested by my titles and honorifics, or you may just know by my name that I'm important enough not to have to declare them."

Evidence of doctrinal knowledge is another matter, although one may have written a book of doctrinal exegesis, or obtained a degree or other academic honour that fills the bill. Evidence of regular practice is a toughie, I would have thought. Leaving aside what constitutes practice, what are the acceptable criteria of regularity? This question has always perplexed nursing records, as it also vexes definitions of constipation.

Clinical evidence demonstrates that, although most individuals evacuate the large bowel regularly once or twice a day, for a sizeable minority a regular bowel-movement occurs once in every three or four days; and for a few, the call-to-stool prompts a trip to the lavatory weekly or at an even longer interval. As for height and formal intelligence, the normal range of regular evacuations is distributed on a Gaussian curve, rather like bell-jar. One might conjecture that regular practice (whatever practice means) shows a similar distribution. But does every observer of competency know that? Not many nurses are well-informed about bowel-movements. Some still expect everyone to "go every day" (or need an aperient).

"2. Knowledge and use of appropriate liturgy and ritual in healthcare settings".

Ah, ritual! Everyone knows that you have to squirt your hands with alcohol gel as soon as you walk into a hospital ward, and sometimes as soon as you get out of your car in the car-park, so that you don't carry germy MRSA into the clinical environment. Most people like doing this, as it helps to dispel the feeling of total uselessness that comes over us when we visit a hospital. There's something brisk and business-like about walking down the corridor rubbing your hands together, sniffing the un-germy smell of alcohol, feeling your hands cool and capable. One can almost imagine a junior nurse opening doors for one, holding out your surgeon's gown, passing the sterile scalpel, respectfully inclining her head and lowering her lovely gaze above the snowy mask.....

Of course, we'll get on to Buddhist ritual and liturgy on another occasion (to be continued).....

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