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Patient Advocacy and Grief Consolers in the Health Care Field

Internship
Coliseum Medical Center
Supervisor Mrs. Franchetta Trawick
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Abstract

My name is Jessika Smith. I requested my internship with Mrs. Trawick Franchetta

through the Coliseum Medical Center on February 11, 2021. I was giving the position along with

three of my peers on March 2, 2021. For my internship experience I was given the task of

researching the Piedmont Healthcare System. My overall topic for my 12 week summer

internship was Patient Advocacy and Greif Counselors in the Healthcare Field. This research

report is 75 pages with three sections entitled Patient Advocacy Organization, Grief Counselors,

and Interviews.
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Table of Contents
Abstract…………………………………………………………….……..…………………page 2
Macon, Ga………………………………………………………………………………….page 5
Coliseum Hospital………………………………………………………….……………….page 6
HCA Healthcare……………………………………………………………......……………page 7
Piedmont Healthcare ………………………………………………….……………………page 8
Number of Employees…………………………………………………………….………page 9
Number of Physicians…………………………………………………………….………page 10
Bed Size…………………………………………………………….……………………page 11
Newborn Deliveries…………………………………………………………….………..page 12
Emergency Department Visits……………………………………………………………page 13
Impatient Admission……………………………………………………………………page 14
Correlation between Emergency Department Visits…….…………………………………page 15
Impatient Admission vs. Surgery……………………………………………………….page 16
Violent Crimes Rates vs. ER Visits……………………………………………………….page 17
Patient Advocacy Organizations………………………………………………………….page 18
Patient Advocacy………………………………………………………………….……….page 19
Ambulatory Surgical Centers………………………………………………………………page 20
Birthing Centers……………………………………………………………………………page 21
Blood Banks………………………………………………………………………………..page 23
Clinics and Medical Offices……………………………………………………………….page 25
Education Centers………………………………………………………………………….page 27
Dialysis Centers……………………………………………………………………………page 28
Hospice Home………………………………………………………………………….......page 29
Hospitals……………………………………………………………………………...…….page 30
Imaging and radiology centers………………………………..……………………………page 31
Mental health and addiction treatment centers…………………………………………….page 31
Nursing Home……………………………………………………………………………..page 35
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Orthopedic and other rehabilitation centers………………………………..………………page 37

Urgent Care………………………………………………………………………………..page 39
Telehealth………………………………………………………………………………….page 41

Grief Counselors in the Healthcare Field…………………………..………………………page 43

How to Become a Grief Counselor………………………………………………………...page 44
Diagram Kubler Grief Cycle………………………………………………...……………..page 45
Diagram 7 Stages of Grief …………………………………………………………..…...page 46
Types of grief………………………………………………………………………………page 47
Types of grief counselors…………………………………………………………………..page 49
Outside Sources……………………………………………………………………………page 52
Chaplain Interview Questions…………………………………………………………….page 53
Pastor Interview Questions……………………………………………………………….page 62
Social Interview Questions…………………………………………………………………page 65
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Macon Georgia

Macon, Georgia, also known as Macon-Bibb County, is located near the Ocmulgee River.

Macon, Ga, just recently elected Lester Miller as their new mayor. The nickname of the city is

"The Heart of Georgia." In 2019 there was an estimated population of 153,159 people. In 2012

Macon consolidated the city of Macon and Bibb County, making the city Georgia's fourth-largest

city. There are several colleges and universities as well as museums and tourist destinations.

According to the 2019 census, 86% of people age 25+ with high school diploma, and 25.4%

have a bachelor's degree. According to 2010 census, Macon has 38,444 households, 24,219

families residing in the city. Out of the households, 30.1% had children under the age of 18

living with them, and 33% married couples living together. There are 67.94% African

Americans, 28.56% Whites, and 0.02% Native Americans. The median age was 34 years; for

every 100 females, there are 79.7 males. Also, According to the 2010 Census, the median income

in the city was $28,366, versus the state average of $49,347. There are 24.1% of families and

30.6 of the population live below the poverty line, 43.6% of those individuals are under the age

of 18, and 18.4% is over 65. In recent years the city has experienced an increase in premature

death through homicides. In 2020 Macon, Ga experienced 38 homicides. These numbers started

to increase before 2018. Thirty-nine point four (39.4%) of people in Macon, Ga, use public

health coverage like Medicare, VA, or Medicaid, while 15.1% of people have healthcare. There
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are six hospitals in Macon, Ga, one trauma center hospital. The Level I trauma center in middle

Georgia is located at Atrium Health Navicent, also known as The Medical Center.

Coliseum Medical Center

The Coliseum Medical Center is managed under HCA Healthcare. The health system also

operates the Coliseum Northside Hospital and the Coliseum Center for Behavioral Health, all

located in Macon, Ga, and serves surrounding middle Georgia communities. The health system

has been serving Macon for over 40 years. Both of the hospitals offer complete services and

provide medical and surgical operations for patients. All staff and doctors are trained to provide

advanced health care treatment options to all patients regardless of race, gender, or religion. In

addition, each hospital has areas in cardiology, birthing, emergency care, inpatient/outpatient

surgery, and psychiatric care.

The Coliseum Medical Center has 310 beds, including 40 beds for the behavioral facility, also

known as the Coliseum Center for Behavioral Health. The Northside Coliseum has 104 beds. In

addition, the Coliseums have an ambulatory center and three operating rooms. Coliseum Health

also has a medical staff specializing in family practice, orthopedics, pediatrics, and neurosurgery.
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HCA Healthcare

HCA Healthcare manages 168 hospitals in 20 states and the United Kingdom. HCA healthcare

operates nine hospitals in eight communities in Georgia, serving 775,000 patients each year.

Georgia is home to the county's largest burn program. The Joseph M. Still Burn The HCA

Healthcare System manages a center located in Augusta. This hospital treats patients from over

32 states. Their mission is "Above all else; we are committed to the care and improvement of

human life." In addition to hospitals, they also manage surgery centers, free-standing emergency

rooms, urgent care centers, diagnostic and imaging centers, walk-in clinics, and physician

clinics. HCA Healthcare system servers over 35 million patients each year, employing 280,000

people. They pay taxes which helps revitalize communities. In Georgia, the HCA healthcare

invested 115 million into Georgia communities through taxes to support schools, police, and

road work. In 2019 HCA spent over $4.2 billion on land, buildings, and equipment. They also

reinvest in technology, physician specialists, and research at all their hospitals and facilities.
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Piedmont Healthcare

Piedmont Healthcare is a non-profit system. This means they do not have to pay taxes in local

communities. The healthcare system manages 11 hospitals, 35 urgent care centers, 25 Quick

Care locations. The Healthcare system will gain over 2,600 employees from both Coliseum

Hospitals in Macon and two other hospitals, Eastside Medical Center in Snellville; and

Cartersville Medical Center in Cartersville, in the purchase deal, finalized July 31. Piedmont

Healthcare system served over 2.7 million patients.

Out of all the 11 hospitals, staff perform 88,368 surgeries, deliver 16,746 babies, provide one

million outpatient services, complete 382 organ transplants and handle more than 627,230

emergency room visits. Their mission is to "build their reputation of excellence and enhance

their services to deliver a whole new level of care while discovering new treatment options

through technology and tools to give patients the information they need and their voice to choose

their healthcare".
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Piedmont Atlanta Hospital has the most number of employees which is expected because of the

city of population, while Piedmont Mountainside has the least number of employees.
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The number of employees at all the hospitals is an estimate and is greater due to the number of

student workers and internship opportunities given to local college students. Piedmont Atlanta

has the largest number of employees while Columbus Regional Northside and Midtown has the

same number of employees because individual can be employed at both hospitals and used when

they one needs helps.

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Piedmont Mountainside has the least number of hospitals bed size while Piedmont Atlanta has

the most beds.

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Piedmont Atlanta Hospital had the most newborn deliveries the other five hospitals Columbus

Northside and Midtown, Athens Regional, Fayette, and Henry also had high rates of newborn

deliveries. Piedmont Mountainside had the lowest rates of newborn deliveries with 304.
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Piedmont Columbus Northside and Midtown had the highest number of emergency room

department visits, then Henry Hospital Stockbridge with 87,171 visits. Piedmont Walton

Hospital in Monroe, Georgia had the lowest number of ER visits.

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While Piedmont Atlanta had low number of ER visits they had the highest number of impatient

admission follow by Athens Regional. Piedmont Walton Hospital had the lowest number of

impatient admission.
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This chart shows if there is a correlation between emergency department visits and surgeries.

There was no correlation between the amount of surgeries and the number of ER visits a hospital

received each year. For example Piedmont Atlanta had the highest number of surgeries while

they had low numbers in emergency department visits.

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This chart show made to see if there is a correlation between impatient admissions versus

surgeries. There is no correlation between impatient admissions versus surgeries. Piedmont

Midtown and Northside also had the same amount of surgeries and impatient admission. Those

were the only two hospitals that had close numbers in both categories.
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This chart was made after each hospital community assessment reported violence as the

leading cause of premature deaths in their cities. There were no correlation between violent

crime rates and ER visits. This correlation could be effected because there is only one trauma

hospital in the Piedmont Healthcare system and they are a level two. Since these hospitals do not

have trauma centers their emergency rooms do not see serve cases of violent cases.

Patient Advocacy Organizations in the 14 Healthcare Facilities

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Patient advocacy is defined as an area of specialization in health care concerned with

advocacy for patients, survivors, and caregivers. The patient advocate can be an individual or an

organization. This organization specializes in patient advocacy often deals with a specific group

of disorders, but this is not always the case. These organizations provide individual advocates

services. Advocacy activities include patient rights, patient privacy and confidentiality, informed

consent, patient representation, support, and education of patients, survivors, and their care. Most

patient advocates work for healthcare facilities that are responsible for patient care. There are 14

healthcare facilities ambulatory surgical centers, birth centers, blood banks, clinics, and medical

offices, education centers, dialysis centers, hospice homes, hospitals, imaging and radiology

centers, mental health and addiction treatment centers, nursing homes, orthopedic and other

rehabilitation centers, urgent care, and telehealth. This paper will research how each of these

healthcare facilities advocates for their patients. 

Ambulatory Surgical Centers

Ambulatory surgical centers are also known as ASC. These facilities perform surgeries

that do not require hospital admission. ASC is cost-effective and offers a convenient

environment. Patients who chose to have surgery in an ASC arrive on their procedure on the day

of their procedure and have their surgery in a fully equipped operating room. Each patient

recovers under the care of nurses without hospital admission. Ambulatory surgical centers can

perform surgeries in different specialties or offer only one specialty. These specialties can be eye

care or sports medicine. ASC is not be used as health clinics, urgent care centers. This center

cannot provide diagnostic or primary health services. All the patients that the ASC treat have

been to a health care provider, and their healthcare provider selected surgery as a treatment for
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their condition. Johns Hopkins Medicine Ambulatory Surgery Centers have a list of patient rights

and responsibilities. This has been broken up into four sections respectful and safe care,

informed consent, effective communication and participation in your care, privacy and

confidentiality, and complaints and grievances. The topic Respectful and Safe care has eight

bullet points. The three most crucial bullet points are: patient advocacy under the issue respectful

and safe care is: be given considerate, respectful and compassionate, be treated without

discrimination based on race, color, national origin, age, gender, sexual orientation, gender

identity, or expression, physical or mental disability, religion, ethnicity or language care, and be

given care in a safe environment, free from abuse and neglect (verbal, mental, physical or

sexual). Under the topic of effective communication and participation in your care, the three

most important for patients to know are getting information in a way you can understand. This

includes sign language and foreign language interpreters, as well as vision, speech, and hearing

aids provided free of charge, be involved in your plan of care and treatment, and involve your

family in care decisions. The topic of informed consent there is only three bullets: Give

permission (informed consent) before any non-emergency care for procedures requiring

informed consent, including risks and benefits of your treatment, alternatives to that treatment,

risks, and benefits of those alternatives, agree or refuse to be part of a research study without

affecting your care, and agree or refuse to allow pictures for purposes other than your care.

Privacy and Confidentiality topic covers all patients they have privacy and confidential treatment

and communication about your care, and be given a copy of the HIPAA Notice of Privacy

Practices. Under the topic Complaints and Grievances, there were only ways that a patient could

file a complaint. ASC only provides individual patient advocacy. 

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Birthing Centers 

According to the Coliseum Health system, birthing centers provide personalized care

during each trimester a women experience. The labor and delivery process women will go

through is the most important. This is part of the Coliseum Health system women's health

services. Coliseum has highly trained maternity specialists and gynecologists/obstetricians

(O.B./GYNs). This health system is committed to making sure women, and their babies "have

the best experience possible". The maternity program also known as the birthing centers offer

24-hour anesthesia coverage, availability of certified nurse midwives, bilirubin screening, birth

plan assistance, lactation consultant on staff, maternal-fetal telemedicine for high-risk

pregnancies, neonatologist on-call 24 hours a day, patient-focused support for postpartum

depression, prenatal classes and hospital tours, private labor, delivery & recovery (LDR) suites,

private postpartum rooms, and universal hearing screen program. This beautiful occasion can

become a tragic event for mothers and their infant children. The Center for Disease Control and

Prevention states that 3 in 5 pregnancy related deaths could be prevented, no matter when they

occur. Seven hundred pregnancy-related deaths happen every year in the United States: 31%

during pregnancy, 36% occur during delivery or the week after, and 33% happen one week to a

year after delivery. Heart disease, stroke, infections and severe bleeding caused 1 in3 or 34%

pregnancy deaths. Doctors and nurses have neglected patient advocacy for mothers in so many

cases. The death of a love one is very tragic and can happen to any family. The daughter-in-law

Kira Johnson, age 39, of the T.V. Judge Glenda Hatchett, died in April 2016. Mrs. Johnson went

in for a routine c section of her second son. She was bleeding internally after the c section. Her

husband calls for help multiple times advocating for his wife's pain. The hospital allows ten

hours to pass until they return her to surgery.

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Mrs. Johnson lost 12 hours of blood after giving birth. According to the CDC reported

data that Black and American and Indian/Alaska Native women suffer from racial disparities.

This group of women is about three times more likely to die from a pregnancy-related cause than

white women. During the COVID-19 pandemic, The American College of Obstetricians and

Gynecologists join the American College of Nurse-Midwives, the American Academy of Family

Physicians, and Society for Maternal-Fetal Medicine to insure pregnant patients that all nursing,

physicians, certifies nurse midwives, and certifies midwives will care for patients and their

families. They have devolved a healthcare team focusing on patient advocacy during prenatal,

delivery, and postpartum care. This team is committed to delivering care in the safest, respectful,

and appropriate way. They will also provide critical support to women whose birth depends on it.

There are two patient advocacy groups for birthing centers and mothers, and they are the Georgia

Chapter of Postpartum Support International and Family Birth Center Navicent Health. 
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Blood Banks 

Blood banks are labs that make sure donated blood or blood products are safe. The blood

samples that pass for safe use is used in blood transfusions and other medical procedures. The

duties of blood banks are to type the blood and test for infectious diseases. According to the

American Association of Blood Banks, 36,000 units of blood are needed every day. There are

13.6 million blood units donated each year. There are 6.8 million blood donors volunteers. One

unit of blood is broken down into four-part blood cells, plasma, cryoprecipitate AHF, and

platelets. This can help several patients who are indifferent needs. Blood banks have patient

advocacy guidelines in place. Blood donors must be at least 16 years of age or following state

laws. Donors must be in good health and weigh at least 110 pounds. Before donors can donate

blood, they must pass the physical and health history exam given before donation. The blood

banks have ten patient advocacy groups through Blood and Beyond Organization. These 11

groups are dedicated to supporting families impacted by chronic diseases and are undergoing

regular blood transfusions. The Blood Cancer Association is for patients affected by blood

cancers or other blood-related disorders. They have staff that study physiology of blood, also

known as hematology. This is a non-profit organization located nationwide for patients that are a

member of other umbrella organization overseas. DEGETHA & FRIENDS (German Society of

Thalassemia and all rare diseases) supports mental health patients affected by rare diseases. The

Federation of Sickle Cell and Thalassemic Patients SOS GLOBI brings 19 local associations

together, helping patients and families affected by Sickle Cell and Thalassemic, two genetic red

blood cell diseases. The Greek Thalassaemia Federation (EOTHA) brings together 26 local

Thalassemic Associations. This organization represents 5,000 patients and their families. Lyle-

Danish Patient Association for Lymphoma, Leukemia, and MDS, is for patients and relatives
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affected by lymphoma and leukemia. MDS Alliance is an umbrella organization that helps

patients, whether they live to have the best multi-professional care. SAM is an association for

rare anaemias in the country of Germany. This organization is for children, adults, and relatives

suffering from chronic rare blood diseases like Diamond Blackfan anemia. DBA is a blood

disease that affects infants. DBA causes low red blood cell counts (anemia) without affecting

other blood components like platelet count and white blood cells.

MDS Patient Interests Community is an organization for patients, relatives, friends,

nurses and doctors in Germany. Thalassaemia International Federation, also known as (TIF) is a

non-profit, governmental organization found in 1986. A group of patients and parents founded

TIF in Cyprus, Greece, the U.K., the USA, and Italy. Today this organization has over 200

patient and patient advocacy organizations in 60 countries. United Onlus – Italian Federation of

Thalassemia, Rare Hemoglobinopathies and Drepanocytosis united local and regional

organizations. Their mission is to protect patients globally with Thalassemia, Drepanocytosis,

and rare anemias blood diseases. In addition, this organization protects patients' rights to

healthcare, access, social equality, and job opportunities. 

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Clinics and Medical Offices

Clinics and medical offices is a facility dedicated to diagnosis and treatment of patients.

Most people go to a clinic for doctor appointments and checkups. Clinics and medical offices can

be privately own by a physician or a group of physicians, while others are owned corporately by

my healthcare system or hospital. Clinics can be specialized in different areas like dental,

physical therapy, or pediatrics. Clinics are designed to allow experts to give patients preventative

care and diagnoses in a convenient setting. Now people can find "walk-in" clinics which have

made clinics more convenient. People can find these "walk-in" clinics in grocery stores, malls,

and now airports. The "walk-in" clinics can provide patients with flu shots and write

prescriptions without seeing their primary doctor. These "walk-in" clinics have been favorable to

patients on speed, convenience, and lower cost.

There are five patient organizations Medical Care Advocacy, Patient Advocate

Foundation, Patient Representatives, and Clarity Patient Advocates. According to the website,

The Medical Care Advocacy Group helps adults and children "navigate…complex and often

confusing medical system". Representatives provide services like geriatric care, care

management, patient advocacy. Geriatric care representatives help families navigate the

healthcare process, understand complicated terminology, collaborate with medical professionals,

devolve care plans for their loved ones, asking questions and receive. Care management

representatives attend patient's doctor appointments, review their medication lists, arrange

medical care conferences, accompany patients to medical facilities, and provide long-term care if

needed. The patient advocacy team helps patients decide procedures and treatment, explains all

medical options, cost-effective choices, and informs patients of all opportunities and risks.

Patient Advocate Foundation is a national non-profit organization that provides professional

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management to patients dealing with chronic, life threatening, and debilitating illnesses. The

foundation's mission is to "improving health care access, quality and affordability through

policies, programs, and practices that optimize the experience and outcomes for patients and

caregivers" (). Recently there have been additional areas add to the foundation to help patients.

The areas are Case Management Services, Co-pay Relief Program, Financial Aid Funds,

Scholarship, and National Financial Resource Directory.  

Clarity Patient Advocates offers one-on-one personal advocate staff members "seek out

options to overcome insurance denials, healthcare access issues, and medical debt crisis

challenges" (). Co-Pay Relief Program provides financial assistance to patients who meet

specific qualifications. If a patient receives financial aid, it helps pay for prescriptions or

treatment that is need. The relief program also helps with out-of-pocket costs that the insurance

company requires before surgeries. In addition, the financial aid funds give patients grants for

outside medical expenses. Patient Advocate Foundation provides young adults scholarships to

their desire college who have experienced the impact of a chronic illness or life-threatening

disease. The National Financial Resource Directory helps patients dealing with healthcare needs.

This directory provides national and regional resources to improve access to quality care and

decrease financial issues of medical treatment for patients.

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Education Centers 

Education centers educate the public on various topics like diabetes, sexually transmitted

diseases, obesity, and other medical-related topics. The majority of education centers partner

with the federal program called Area Health Education Center. According to the website Health

Education Center, the program was created in 1973 to "encourage medical schools to increase

the number of students and residents trained in rural communities." 

The Health Education Center is governed by the U.S. Department of Health and Human

Services. The program's overall mission is "to enhance access to quality health care, particularly

primary and preventive care, by improving the supply and distribution of healthcare

professionals via strategic partnerships with academic programs, communities, and professional

organizations." More than 300 AHEC offices and centers serve over 85% of the United States

counties. After researching, there is one organization for patient advocacy: the Pulse Center for

Patient Safety Education and Advocacy. This is a national patient non-profit organization that

"garnered from the stories shared by patients and families about what works for them." Patients

can participate in their local community presentations, workshops and learn from other

experiences. The organization's facilitators can help train friends and family to become advanced

patient advocates for their loved ones. In addition, the Pulse Center created the Healthcare

Equality Project Program. This program is dedicated to the safety of medical care for at-risk

groups, especially those that have or could face ethnic and racial disparities for certain diseases.  
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Dialysis Centers 

Dialysis Centers are for patients with kidney diseases. There are 7,500 centers in the

United States which generate over $23 billion in revenue annually. Macon, Ga, has 21 dialysis

centers. Dialysis treatment filters and cleans a person's blood artificially, which the kidneys

cannot do. There are currently, 14% of Americans that have chronic Kidney disease. Some

people might have to have dialysis treatments three or more times a week. This will allow

patients to avoid serious complications. Dialysis Centers have become very popular, and the

demand for the facilities has increased. The increase of the facilities was to meet patient needs

and help them avoid going to a hospital. There are four patient advocacy organizations. The first

patient advocacy organization is the Dialysis Patient Citizens Organization. This non-profit

organization has more than 28,000 members. The membership included patients on dialysis and

pre-dialysis and their families. DPC provides "resources that are beneficial to caregivers,

healthcare professionals, and advocate". There are serval different ways patients can be part of

the organization besides just joining like members can be patient ambassadors, be on the board

of directors, write blogs or most importantly donate. The National Kidney Foundation gives

patients a voice, support, donors, care partners, and professionals. This community recruiter a

diverse group of stakeholders.

The National Kidney Foundation provides treatment options for patients from dialysis,

transplant pre and post-surgery, and palliative care. The foundation also provides advice to

patients about nutrition, exercise, sexual health, insurance, and vaccinations. The website was

also updated to include patients of COVID-19 that has recently become kidney patients. The

American Kidney Fund (AKF) is the nation's largest non-profit organization serving people with

kidney diseases. The ambassadors of this organization make up the advocacy network. The
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ambassadors bring awareness of kidney disease and make sure every kidney patient has access to

health care. AKF advocate for over 700,000 Americans living with kidney failure and 37 million

American's with chronic kidney disease. The ambassadors also work with legislators and leaders

to make public policy to improve the lives of kidney patients. 

The website also provides knowledge on kidney disease, kidney transplants, financial

assistance, education, research, and advocacy. Just like the National Kidney Foundation website,

the AKF also has a tap for coronavirus resources.

Hospice Home

Hospice Homecare help improve the quality of life for patients who are suffering from

life-threatening illnesses or disease. Depending on how significant a patient's condition is, they

might live in a nursing home with hospice care or a special hospice home. There are 4,639

hospice agencies in the United States and 20 hospice facilities in Macon, GA. The cost of a

patient being in a hospice facility can cost $111 to $200 a day. Hospice care does not just

provide medical support, but they also deal with emotional and spiritual support for patients and

their families. Hospice patients have a team of care providers that consist of the patient's

physician, hospice physician, nurses, home health aides, social workers, clergy, and therapists if

needed. In addition, most patients have insurance which comes as a package of benefits that

deals with end-of-life protocol. There is one patient advocacy organization, and that is the

National Hospice and Palliative Care Organization, also known as NHPCO. This organization

was founded in 1978 and is the nation's largest membership organization for providers and

professionals. The board represents members and the general public during legislative advocacy.

NHPCO help take care of people with a serious and life-limiting illness. They provide a skilled

professional that offers compassion and support to the patient and their families. NHPCO helps
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with challenges and provides expert knowledge and information that will answer the questions of

patients and their families. There are five values that the NHPCO believes in they are service

(engaging customers), respect (honoring others), excellence (exceeding expectations),

collaboration (fostering partnership), and stewardship (managing resources). 

Hospitals 

Hospitals help anyone in need of medical care, depending on the size and location of

different services. Every goal of a hospital is to save people's lives. There are always two units at

a hospital: intensive care (ICU) and non-intensive care units. ICU deals with emergencies and

life-threatening injuries that can affect a patient. The non-intensive units deal with childbirth,

surgeries, rehabilitation, and patients that have been dismissed from the ICU unit. There are

13,944 hospitals in the United States and 13 hospitals in Macon, Ga. There is three patient

advocacy group, and each one of these is non-profit organizations. The National Patient Safety

Foundation helps protect patients from harm from medical staff or employees. This organization

was founded in 1997 and partners with patients, families, the healthcare community, and

stakeholders to ensure healthcare workforce safety. The Institute for Healthcare Improvement

(IHI) was founded in 1991. The organization is supported by a collection of grants which makes

the program self-sustaining. IHI is committed to redesigning the healthcare system without

"errors, waste, delay, and unsustainable costs." Today IHI is forced on health care improvements

in the U.S. and using other countries as footprints. Every Patient's Advocate is a personal blog by

Trisha Torrey. Mrs. Torrey's blog began when she was a misdiagnosis of cancer. She empowers

health and patient advocates to improve service to patients and caregivers. Mrs. Torrey has also

written a spoke on different news outlets to discuss essential topics patients and families need to

know about the healthcare system.   

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Imaging and Radiology Centers 

Imaging and radiology centers are usually partners with hospitals and medical offices.

These centers offer diagnostic imaging services to patients. Some of these imaging includes

ultrasounds, C.T. scans, X-Rays, MRIs, and more. Some hospitals and medical offices have the

imagining center, but outpatient facilities are cost-effective and allow convenient scheduling for

patients. This enables hospital facilities to used imaging machines for patients that have urgent

cases. For example, now, some imaging centers provide ultrasounds to monitor a women's

pregnancy. There are no patient advocacy groups or organizations for imaging and radiology

centers. 

Mental Health and Addiction Treatment Centers 

Mental health and addiction treatment centers are a combination of different types of

facilities. Several different specialty treatment centers exist all over the United States. Mental

health facilities specialize in different kinds of treatment like suicide, depression, trauma, post-

traumatic stress disorder (PTSD), anxiety disorders, behavioral and many more. There are two

types of mental health facilities, inpatient or outpatient, that can help patients navigate the

treatment process stages. Some hospitals have mental health floors dedicated to patients that

need short-term treatment. Very few hospitals have long-term care facilities devoted to mental

health. Addiction and treatment centers solely deal with drug and alcohol addictions, while some

also deal with behavioral issues like gambling, shopping. There are a lot of patient advocacy

organizations. A New Path ( Parents for Addiction Treatment and Healing) is a non-profit

organization that consists of parents, citizens, patients, healthcare professionals, and community
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leaders. This team works together to educate the public media and legislators on the various

topics of the true nature of disease and addiction. This organization also advocates the

explanation of access to treatment services. They also deal with drug policies to end

discriminatory drug charges. The most popular is Alcoholics Anonymous. This program was

created to help patients that are struggling with drinking addiction get sober. A.A. was founded

by Bill Wilson, who created the philosophy and method of the 12 steps of Recovery. Other

additions groups have adopted these 12 steps like Gamblers and Narcotics Anonymous. Patients

can remain anonymous while gaining support from their peers through meetings and discussions

about their addiction. There is no requirement to A.A. besides a patient's willingness to stop

drinking. Anyone can join and commit either by voluntary or by court-mandated rehab. Drug

Policy Alliance helps regulate policies and attitudes about the harm of drug use, prohibition, and

promotion of the mind over bodies. The Drug Policy Alliance values reducing criminalization

due to drug policy. This will allow people not to be punished for what they put into their bodies.

The organization is advocating equitable and legal regulation of marijuana. They also want to

bring revenue in as new tax revenue. Faces and Voices of Recovery is a national organization of

individuals joining together supported by local, state, regional, and national advocacy. This

organization has 23 million Americans in Recovery from addiction to alcohol and other drugs.

Family and friends are part of the recovery community organization to promote the right and

resources to Recovery through advocacy. Resources include advocacy, education, and the power

from long-term recovering patients. Harm Reduction Coalition (HRC) is a national advocacy

building organization that promotes the health of individuals and communities impacted by drug

use. This organization has tools to prevent fatal overdose deaths. Last year 70,000 people died

from a drug overdose. The organization's mission is to help people who use drugs help each
 33

other. The project manager over the organization encourages communities to get naloxone.

Naloxone is a drug that can help reduced overdoses from patients that are dealing with drug use.

HRC also started the campaign of expanding syringe access for people who inject drugs. Lack of

access to safe supplies can expose people to unnecessary infectious diseases like HIV and

hepatitis C. The campaign program can help reduce this risk of infectious diseases contaminated

syringes by 50%. HRC also offers a place for addicts to connect and resources like housing,

healthcare, and drug treatment. This campaign will be launched through all 50 states ensuring

clean syringe access. Helping Others Live Sober is a resource for professionals and people who

are in addiction recovery. Its mission is to improve youth, families, and communities through

scientific information, education, and personal experiences from staff. Professionals can gain

valuable information to help patients and inform them of available resources. They focus on

teaching professionals the behavioral change process vital to a patient living sober. If a patient is

in Recovery, Helping Others Live Sober will find resources to help a person stay clean. Their

website is a tribute to the shared experiences of other recovery patients, which can help others in

their sobriety journey. The Legal Action Center is a non-profit law organization with the mission

of fighting discrimination against people with histories of addiction, HIV/AIDS, or criminal

records. The center advocates for fairer public policies for equality and justice for people with

histories of addiction, HIV/AIDS, or criminal records. Marijuana Anonymous World Services,

also known as (MAWS) is a society that serves addicts who need to know how to start a group.

MAWS provides information to groups that want to create a new district or region by sending

representatives to the MAWS Conference. Marijuana Anonymous World Services writes, and

approval literature engages in activities that help districts, regions, and groups stay connected,

untied through communication. The MAWS performs most of the background work and
 34

coordinates everything so representatives can be to meet annually. Medication-Assisted

Recovery Services (MARS) provide peer recovery support to people that are recovering from

opium addiction. There are 17 programs across the United States and two programs in Haiphong,

Vietnam. MARS also offers training and technical assistance services to patients. Narcotics

Anonymous (N.A.) was founded in 1953. This is a global community-based organization with

over 22,803 members. The organization provides recovery addiction through a 12 step program

if meetings are attended regularly. The NA holds 67,000 meetings weekly in 139 countries. The

group meeting provides help from peers and offers a support network for addicts who wants to

pursue and maintain a drug-free lifestyle. The membership is free and connects with

governments, religions, law enforcement, or medical or psychiatric doctors. The National

Alliance for Medication Assisted Recovery (NAMA) is an organization composed of

medication-assisted treatment. Medication treatment helps patients ween off of their drug

addiction because the medication will decrease their drug cravings. The most common

medication used is Methadone. Methadone is used to treat patients with opioid addiction. Today

this organization has 15,000 members all over the United States, Puerto Rico, and 12 countries.

Nicotine Anonymous (N.A.) is a global community-based organization founded in 1953. N.A.

offers addiction recovery through the 12 step program and regular attendance at group meetings.

The group meetings provide patients with help from peers and offer a support network for

addicts who wish to live drug-free. Nicotine Anonymous holds 67,000 meetings weekly in 139

countries. There are over 22,803 NA members, and membership is free. Physicians and Lawyers

for National Drug Policy (PLNDP) is a non-partisan group with nations leading physicians and

attorneys. Their goal is to promote and support policy and treatment options. PLNDP advocate

for policy decision and encourage local professional partnership in states and communities.
 35

SMART Recovery helps patients recover from all types of addictive behaviors like drug abuse,

gambling, and addictions. This is a non-profit organization for patients to focus on ideas and

techniques to help change a person's life. The recovery process helps a patient transform their life

of self-destructive and unhappiness to constructive and satisfying. Once a patient becomes

familiar with SMART, they will be free from their addictive behavior. The organization

encourages recovery patients to become a volunteer, which will expand the number of offered

meetings. Stamp Out Stigma is a partner of the Association for Behavioral Health and Wellness.

The organization focus on reducing the stigma surrounding mental illness and substance use

disorders. The campaign techs people and transform their knowledge on mental health and

addiction. Stamp Out Stigma uses the three R's method recognize, reeducated, reduced. The

campaign wants to educate the public on recognizing the high prevalence of mental illness and

substance abuse disorders. Then the campaign will reeducate the public: friends, and family on

the truths of mental illness and addiction. This will reduce the stigma on mental illness and

substance abused disorders. Mental health and substance use disorders are more prevalent than

heart disease, diabetes, arthritis, and other diseases.

Nursing Homes 

Nursing homes offer living arrangements for patients who need medical assistance but

are not severe enough for hospitalization. Some nursing homes specialize in speech and

occupational therapy. Other nursing homes try to provide patients with an at-home atmosphere,

which are apartment styles with medical staff on hand. Nursing homes help patients with

injuries, illness, and postoperative care to recover outside of the hospital. Some nursing homes

can offer long-term medical care that can be simple to complex. Some patients can become

residents of nursing homes long-term, weeks, or months. The majority of residents at nursing
 36

homes are 65 years of age, making up 80% of patients. Just because 80% of residents at nursing

homes are 65 years of age, younger patients have long-term illnesses and need care beyond what

their families can provide. There are 20 nursing homes in Macon, Ga. Nursing home care costs

can range from $116-$240 per day. Families trust that nursing homes provide their loved ones

with quality care. Still, nursing home abuse and neglect have risen, giving rise to many different

advocacy groups and government monitoring agencies. Each of the fifty states, Puerto Rico, and

the District of Columbia have at least one agency devoted to nursing homes and patient

advocacy. The agency handles oversight of eldercare and advocacy for elderly residents. They

can also assist families in deciding which facility best meets their loved one's needs. The state

agencies can help resolve problems with the treatment their love one is receiving at their nursing

home. The two Georgia agencies that assist in patient advocacy in nursing homes are the Georgia

Department of Community Health and the Georgia Health Care Association. The Centers for

Medicare and Medicaid Services provide a Nursing Home, Compare Tool on the federal level.

Families' members can use this tool for selecting a suitable nursing home facility for their loved

one. The Administration on Aging has the mission of helping elderly individuals remain

independent in their homes and communities. The administration focus on cost-effective long-

term care and safe, livable communities for elderly individuals. The National Citizen's Coalition

for Nursing Home Reform (NCCNHR) headquarters is located in Washington D.C. According to

the NCCNHR website, the organization was formed in 1975 to address issues like inadequate

staffing in nursing homes, poor working conditions, maintenance of residents' rights,

empowerment of residents, and support for family members. The NCCNHR also addresses

resident neglect at nursing homes, resulting in poor care, like bedsores, dehydration,

incontinence, and contracture of resident's muscles. The Leading Age-Formerly and the
 37

American Association of Homes and Services for the Aging help individuals and their families

through a membership-based non-profit organization. There are 5,700 members within the

organization. The organization provides services for adult daycare, home health, community

services, senior housing, assisted living residences, and nursing homes. The Ombudsmen: Front-

Line Advocated for Nursing Home Residents provides families with Elder Law Attorneys in

Macon and surrounding counties in Georgia.

Orthopedic and other Rehabilitation Centers

Orthopedic and other rehabilitation centers are significant for patients that are dealing

with muscles and bone issues. Orthopedic medicine deals with people's muscles and bones, while

physical therapists see patients for problems dealing with muscles and bones. Orthopedic centers

can deal with athlete's injuries or patients with disabilities. They can diagnose issues and offer

evaluations such as prevention, treatment, and rehabilitation. Train specialists work with the

patient's bone, tendon, ligament, muscle, and joint to achieve assessment and give a patient a

diagnosis. There are many different names for orthopedic centers, depending on their

specialization. They can be called outpatient physical therapy centers, pediatric physical therapy

clinics, sports medicine centers, or geriatric physical therapy clinics. Rehabilitation center allows

patients to receive different types of therapies to help return them to their regular abilities after

an illness or injury. Rehabilitation centers can provide physical, occupational, and speech

therapy which can help people gain skills they need to move, work or speak in their daily lives.

The doctors and staff at the rehabilitation center work with patients to help them recover after an

illness or accident. They specialize in assisting patients to gain 100% or close of their mobility

independence as possible. In return, outpatient rehabilitating centers help relieve the number of

patients on the hospital rehabilitation floor. There is 30 physical rehabilitation center in Macon,
 38

Ga, specializing in different therapies. There are two patient advocacy organization groups for

rehabilitation center patients. The Ortho Forum is the nation's largest orthopedic group, with

many privately owned orthopedic practices in the United States. Ortho Forum was formed to

help doctors meet and face challenges in today's health care environment. Each member is the

task and selected to participate in activities that will advance each private orthopedic practice.

These advances provide local and regional markets, innovation, business ventures, networking,

which improves and advances orthopedic practices all over the U.S. Ortho Forum advocates the

cost-effective delivery of patients needing orthopedic medicine. The second patient advocacy

group is the Orthopedic and Back Pain Center of America. This organization helps people

connect with physicians to provide a solution to their joint, neck, and back pain in their local

area. In June 2017, the Orthopedic and Back Pain Center of America added a new network

member, the Dallas PRP, and Stem Cell Institute. PRP stands for platelet-rich plasma. This

comes from the patient's blood and decreases pain, and stimulates healing whenever it is injected.

This is call stem cell therapy which is used to regenerate and heal tissue to treat degenerative

conditions. This could help patients that are suffering from painful conditions like arthritis. The

15-minute procedure uses the patient's own blood or stem cells from their bone marrow. A lot of

patients experience decreased pain after the surgery, which could be delayed for years. 

Urgent care
 39

Urgent care, also known as (U.R.) facilities, serve people in local communities'

healthcare needs that are not severe for a visit to the emergency room. The healthcare situation

the patient is experiencing is severe, and they cannot wait for an appointment at their primary

doctor's office. Most parents use urgent care for their sick children so they can receive a

diagnosis and relief from their symptoms. Staff at urgent care are experts in acute care. They can

diagnose, set broken bones, provide treatment, and test: blood, urine, and strep. If a patient's

problem is too severe, the urgent care doctor can call for an ambulance or refer them to a hospital

or specialist. There are over 9,000 urgent care centers in the United States. In 2021 89 million

patients visited an urgent care center. Urgent care centers are financially better than a person

going to an emergency room. In fact, urgent care centers have shorter wait times than emergency

rooms. The emergency room should only be used in cases of true emergencies. This can allow

emergency room hospital staff to provide urgent care to patients in "true emergencies". There are

three patient advocacy urgent care organizations. Care Coordination and Patient Advocacy is

Secure Health patient advocacy services. The expert medical staff includes Registered Nurses

(RN), Licensed Nurse Practitioners (LPN), Certified Case Managers, and a Board Certified

Physician, all of whom understand benefits, claims, and network plans, including multi-tiered

benefits and PPO networks. All members are eligible and is covered by the member's health

plan. The organization offer education to patients on their condition, encourage medical

compliance, ensure transplant network is in place, assist in follow-up appointments, negotiate

with out of network providers, and coordinate aggressive cost for dialysis services. Secure

Health Medical Review ensures a patient's plan covers claims presented for payments. They also

make sure that claims will not be classified as experimental, investigational, or cosmetic, making

certain healthcare costs covered.

 40

The Urgent Care Association, also known as (UCA) is the most significant trade and

professional association in Urgent Care and was founded May 7, 2018. More than 3,700 member

centers represent urgent care clinics and business professionals from the United States and

overseas. Their mission is to work together to educate Congress and other policymakers on the

urgent care industry. Emory Healthcare provides patient relations through their Office of Patient

and Family Advocacy. The office handles complaints related to healthcare services within

Emory Healthcare. Patients and family members can make complaints via letter, personal visit,

telephone, or email. There are 12 departments, all having patient advocacy peroneal on staff.  

Telehealth
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Telehealth has become very popular, especially during the pandemic. By 2022 telehealth

will reach 2.8 billion dollars, according to Grandview Research. Telehealth, also known as

telemedicine, is a remote digital healthcare facility. This digital healthcare facility uses electronic

communication via technology to provide healthcare to people of long-distance. People who stay

in rural areas lack access to physicians and specialty clinics. Telehealth can be used by people

due there physical location, ability, living arrangement, or lack of transportation. Healthcare can

be expensive, and technology advances devolved telehealth to push lower costs. Patients who use

telehealth can video chat live between physicians, or ill patients can wear a device that a medical

team can monitor. Some doctor offices use telehealth for quick consultations. Patients can

schedule appointments and log into the web service. The doctor or nurse practitioner can

prescribe medications, give advice or recommend more medical care of organizations and

advocacy groups providing information and support to people that are interested in telemedicine.

The American Telemedicine Association (ATA) is an international non-profit advocacy group.

The ATA goal is to promote medical care for consumers and health professionals using

technology. There are five objectives the (ATA) has:

 Educating government about telemedicine.

 Serving as clearinghouse for telemedical information and services.

 Fostering networking and collaboration among interests in medicine and technology.

 Promoting research and education including the sponsorship of scientific-educational

meetings and the telemedicine and e-health journal.

 Spearheading the development of appropriate clinical and industry policies and standards.
 42

The American Academy of Pediatrics has implemented telehealthcare use for after-hours

care. The AAP has six policies, all effective from different years, to manage telehealth usage.

Also, there are advocacy resources per state to focus on Telehealth Care Payment. American

Physical Therapy Association (APTA) has been advocating for Physical Therapies P.T.s, and

Physical Therapy Assistances PTAs for a long time. The most recent change the (APTA) has

provided services using telehealth. COVID-19 pandemic has given rise to patients needing

physical therapy remotely, and with the use of technology, telehealth can allow physical

therapies to provide health care services. The website includes information on how other states

can start practicing telehealth. The use of telehealth by P.T.s and PTAs can deliver care and

expand access to patients in various states. The American Academy of Family Physicians

represents 134,600 family physicians, residents, and students. The AAFP expanded telehealth

and telemedicine to enhance patient-physician health outcomes by providing timely care while

decreasing costs for patients. The academy advocates for reimbursement to payers, broadened

telehealth, provided monitoring to ill patients and educated that telehealth and telemedicine will

not lead to wider health disparities. The American Nurses Association has also implemented

telehealth and also is providing courses to patients and professionals. There are three telehealth

applications the ANA is using are: live (synchronous) videoconferencing, remote patient

monitoring (RPM), and mobile health (mHealth). The use of telehealth can save patients and

family members with high-cost office appointments and allow rural patients to see specialists

without traveling long distances.

 43

Grief Counselors in the Healthcare Field

The death of a loved one can cause emotional and physical pain that can sometimes

enable a person to function. Grief counseling, also known as bereavement therapy, is a therapy

designed to help people who have experienced a loss like the death of a partner, family member,

friend, or colleague. The therapy helps a person or family find meaning and move through the
 44

stages of grief, which will begin the healing process. Grief Counseling can help people of all

ages to cope with losing someone.

To become a grief counselor, a person usually needs a bachelor's degree in human

services like psychology, social work, or mental health. However, if a person wants to be a

professional grief counselor, they must obtain a master's degree in the mental health field.

Counselors study the stages of grief and learn different techniques to help people move through

each stage in healthy ways. This ensures that families mourn the death of their loved ones

healthy. Most counselors study the Kubler-Ross Grief Cycle, which includes 5 Stages of Grief.

The first stage is denial which includes the emotions and feelings of avoidance, confusion,

shock, and fear. The second stage is anger which a person can feel frustration, irritation, and

anxiety. The third stage is bargaining.

A person is struggling to find meaning and is reaching out to others to tell their story. The

fourth stage is depression which a person will feel overwhelmed, helpless, and can act hostile.

Acceptance is the last stage of the grief cycle in which the person explores different options

making new plans, and moving on. The modified Kubler-Ross Model has seven stages of grief,

including shock as the first stage and testing as the fifth stage. Shock includes a person initially

hearing the bad news, and testing consists of a person seeking realistic solutions to help them

move on. Grief can last as long as a person needs to accept and learn how to cope with the loss of

their loved one. This length could be days, weeks, months, or years for different people. The

amount of time a person spent grieving can be determined by their relationship with the person

they lost. There are no rules on the length of time a person can grieve; some stages might require

more time than others.

45
 46

There are five different types of grief. Normal grief is also known as uncomplicated grief.

This grief can last for six months to 2 years following the loss of a very close someone. Normal

grief has different lengths of time depending on a person's culture. During Victorian times,

normal grieve could last for four years, while Japan, Shinto practice mourn for serval years,
 47

bringing the community to gather to tell stories about the deceased. WebMD did a study in 2019

that found that over half of Americans are coping with grief after losing someone close to them.

This grieve lasted over three years. Many Americans feel after the three-year grief ends.

Complicated grief, also known as traumatic grief, a person did not know the person, but

they impacted their lives. The decease of complicated grief can be estranged father, stepmother,

or dad. Complicated grief causes a person to have to serve emotional reactions. Chronic grief is

very similar to complicated grief. Doctors believe that chronic grief results from a person

holding on to their loves one memory or any promises. Chronic grief is prolonged grief that does

not reduce over time, usually associated with a traumatic loss. Anticipatory grief is felt before

the loss of a loved one due to a terminal illness or diagnosis. This grief was experienced a lot

during the COVID-19 pandemic.

People did not know what will happen when it will happen, or how it will happen.

Anticipatory grief can cause mental and physical issues for a person disrupting their everyday

life and schedule. Secondary losses are smaller losses that result from a death of a loved one.

These losses are unanticipated changes in your life usually created by the loss of your loved one.

Some secondary losses could be lost in a job or spouse relationship or financial losses like a

home. Absent grief, a person has no grief after the death or loss of an important person. This

occurs when a person has grieved beforehand so much that they have accepted and gain a sense

of relief. The person understands that their loved one is not in pain, and doctors and family

members did everything they could, and now it is time to move on. Cumulative grief, also known

as collective grief, result in multiple death over a short time. Most people used collective grief to

talk about celebrities' deaths, but it is seen in communities with high rates of gun violence. In

most recent cases, some families have experienced massive cumulative grief during the COVID-
 48

19 pandemic. Disenfranchised grief is when society does not recognized or accept the value of

the person's loss. Many pet owners experience this type of grief because they cannot take off

from work or do not know who or how to talk to about their feelings.

There are many different types of grief counselors in the healthcare field. Chaplains do

not push any religious agenda on families or patients. Most hospitals have a spiritual care

department that provides non-denominational support to people dealing with the grief of a loss or
 49

change in their lives. Chaplains provide support to patients and families while their love one is in

the hospital. They can also help patients contact pastors for their denomination or arrange for

patient's and families' support services after the patient is discharged. Some chaplains serve as a

go-between for staff members, patients, and their families by advising nurses and doctors on

approaching the patient regarding their religious beliefs. Chaplains can also be a communicator

between a nurses and doctors at the family request. Chaplains do not always deal with grief.

They also perform celebratory events like weddings and baptisms at the hospital. Hospital

chaplains serve rounds as part of their daily duties visiting each patient in the hospital. They also

pay unique visits to patients if staff or family members think they can use their services.

Chaplains understand that all patients may not want to talk to them, but they ensure that they

know that their services are available. Chaplains do not just provide spiritual support for patients

but also make sure hospital staff know that their services are available to them. Indeed, the

avenge chaplain works for 25 hours a week, part-time, and some hospitals only have a call-in

chaplain. Most chaplains have a master of divinity or a divinity degree. Most chaplains also take

grief classes or courses to assist patients and families through the stages of grief.

Licensed professional counselor, also known as LPC, are license as mental health

professionals. Most LPCs have doctoral and master's degrees in providing mental health services

trained to work with individuals, families, and groups. These professionals can treat mental,
 50

behavioral, and emotional problems and disorders. Licensed professionals counselors are

employed in community mental health centers, agencies, universities, hospitals, and

organizations. They also work with active-duty military people and their families and also

veterans. LPC's can also help medical staff like nurses and doctors when patients pass overcome

their experience with grief.

Social work has been around for 100 years, starting with Jane Addams, Frances Perkins,

and many more. Social worker duties include understanding human development, behavior,

social and cultural interaction. Social workers work with families and healthcare institutions in

reducing the following social impacts: civil rights, unemployment insurance, disability pay,

workers compensation, reduced mental health stigma, Medicaid and Medicare, and child abuse

and neglect prevention. They are educated and trained to address their client's wellbeing against

social injustices like poverty, housing, and income issues. Social workers help seriously ill

patients receive adequate care in the medical and public health field and access public resources

like patient advocacy organizations Medicare and Medicaid, or even local services like nursing

home care. They play a role in supporting clients through the complex healthcare system

responsible for providing needed care. The majority of social workers work within the school

system, which in return works with local hospitals. Most elementary and high schools have

social workers who advocate for their students. Social workers work with schools, teachers,

parents, and staff to ensure students receive support and thrive inside and outside of school. They

develop relationships with families to extend support for mental health services. When children

are grieving, social workers step in, especially if there is a loss in a parent while in the hospital.

Social workers confront and place children temporally in foster care until they can locate a

family member willing.

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Pastors can also be call-in by the hospital per request from the patient and their family.

After speaking with Mrs. Suie Payne, who is over case management and patient experience at

Piedmont Walton Hospital in Monroe, Ga, she explained that their hospital relies heavily on

outside grief organizations and people. Mrs. Payne explains that they do have an on-call

chaplain. However, there are very few patients that depend on chaplain service. Instead, they opt

to have their pastor form their domination to come in and give grief counseling. Patients feel

more comfortable receiving comfort from their pastors who they trust. Pastors usually know

what the patients are going through because they might have stopped coming to church due to

their illness. In addition, the family might ask for special prayers or call their pastor to receive

guidance. Pastors provide spiritual and grief counseling. Most pastors are trained in pastoral

counseling, which is different than a licensed counselor or therapist. They can provide similar

services, but pastoral counselors use spirituality, faith, and theology combined with

psychotherapy. This allows people to seek assistance with personal, family, marital, and faith

issues. Pastors that give counseling of any sort have certification in pastoral counseling. To be

certificated, pastors must hold a postgraduate degree from an accredited university; some

received their accreditation from their local religious group. Most have significant education in

counseling experience, and also some possess state licenses in psychology, marriage and family

therapy, or social work.

Outside sources are critical, as mention above, according to Mrs. Suie Payne. External

sources are used to continue support for families who are grieving after their loved one had

passed. Hospital counselors and chaplains only provide counseling in the hospital, allowing

outside sources to provide counseling as long as family or person needs. Outsources are

organizations that include hospice care, Rachel gift, and pastors. At Piedmont Walton Hospital in
 52

Monroe, Ga, they use these three crucial outsources to provide grief counseling to their patients.

As explained in the patient advocacy section of the research paper, hospice care help improve the

quality of life for patients suffering from life-threatening illnesses or diseases. Depending on

how significant a patient's condition is, they might live in a nursing home with hospice care or a

special hospice home. When a person is given a few months or day's hospitals will release them

to hospice care. Hospice care has professional license counselors that will help families and

patients prepare for their loved one's death. Rachel gift is a unique grief organization used by the

Piedmont Walton Hospital. The organization's mission is "no parent should suffer the loss of a

baby alone." Staff provides guidance on the path to healing. Rachel Gift collaborates with

hospitals to provide specialized bereavement care for parents who lose a child to miscarriage,

stillbirth, or infant death. In 2019 Rachel Gift served over 1200 families this year. Most hospitals

have on-call chaplains, but Mrs. Payne has found that patients prefer their pastors. Now nurses

and staff are allowed to call pastors in, or families can recommend their pastor to visit and

provide grief counseling to the patient and their families.

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Chaplain Interview Questions

Rev. Kimberly Schmitt Holman, PhD (c ), M. DIv., BCCC, CPC, Diplomate

Chaplain | Spiritual Care Services
1255 Highway 54 West | Fayetteville, GA 30214
Piedmont Fayetteville Hospital
1. What inspired you to become a chaplain?
When I was in Seminary, it was suggested that I take a unit of CPE (Clinical Pastoral Education)
which is a training program for spiritual people who want to become chaplains. It teaches a
person how to examine themselves, know themselves, so that they be open to and aware of the
needs of others. Through that internship, I did a lot of self discovery, learned much about
pastoral care, and found out, much to my surprise, that I enjoyed working in the healthcare
setting and serving people in that way. After seminary, I served in churches for over a decade,
but when the local hospital chaplain approached me and asked if I would help him, I began to get
back into chaplaincy and finished my CPE training. Eventually, I worked in chaplaincy full
time, both in hospital and hospice settings. Now I work full time at Piedmont Fayette Hospital.
2. What words of comfort would you give to a person who has been diagnosed with a
terminal illness?
Truthfully, there is not anything that can be said that softens the blow of bad news. The role of
the chaplain is not to fix, but to be present with a person or family who is facing difficult times.
When visiting with someone who has just gotten a terminal diagnosis, I would invite them to talk
about it, about what they are feeling, about their questions and concerns. I would be their
sounding board for whatever they needed to discuss. Or just sot with them while they cry. The
chaplain’s role is to be present with the person/family in whatever way they need in the moment.
3. How would you counsel a family who is anticipating grief vs. a family who is
expiring traumatic grief?
Again, what the chaplain does is very much dictated by the situation and by the family’s own
spirituality and belief system. A chaplain is first and foremost a skilled listener. People who are
grieving may not want to speak at all, but I can sit with them so that they are not alone.
For example, I once was called to the ICU to be with the wife of a man who was coding. His
heart and breathing had stopped, and the team was actively performing CPR to see if we could
get him back. The nurse introduced me to the wife by saying, “This is chaplain Kim. She will
pray with you.” The wife looked at me and said, “what can you pray for that I have not been
praying for already?” I said, “nothing. But I can sit here with you so you do not have to be
alone. She nodded, and I stayed. Her husband died, and when her family came to the bedside,
one of them wanted to pray. She looked at me, and I asked her if she wanted to take a walk with
me, and let the rest of the family pray if they wished. She nodded. I knew she was likely feeling
angry at God that her prayers had not been answered, and she did not want to pray then.
4. How would you console or comfort a family when doctors say there is no alternative
to turn life support off?
 54

Again, it depends on the family. In this case, I might encourage the family to talk about the
loved one, what their wishes were concerning life support. I would encourage, if appropriate, an
informal life review, where they tell stories about their loved one. If they are struggling
spiritually, believing that God might still heal their loved one, I might talk to them about how
transitioning from life to eternal life is sometimes the way God chooses to heal us, if that was
appropriate to their spirituality.
5. How do you use the five or seven stages of grief in your work denial, anger,
bargaining, depression, and acceptance?
Almost everyone who comes into the hospital is grieving some loss. They have, at least
temporarily, lost their health. They may be facing a new diagnosis that changes certain aspects
of their lives forever. With that comes every manifestation of grief, sometimes all in one
conversation. I work often with the staff to help them recognize grief in all of its manifestations,
but particularly when grief shows up as anger. Many times the medical staff catch the brunt of a
person’s anger and they need to know that the anger is not really directed at them.
Years ago, one of our doctors asked me to see a patient with her. She was going in the room to
tell the patient that her ultrasound showed cancer. The patient had recently lost both a husband
and son, and had just come to the hospital hours after her son’s funeral. I was there when both
the hospitalist and the oncologist spoke to her. She took the news remarkably well. She told us
that she had been feeling bad for over a year, and had suspected it was cancer. She was certain
she did not want chemo, but would just want comfort care. Two days later, the doctor called me,
in tears. The patient had yelled at her, kicked her out of the room and fired her from the case.
The patient said that the doctor had no right to tell her she had cancer – there was not even a
biopsy to prove it. I spoke with the doctor for a while that day about what had happened. The
patient’s daughter, who had also just lost a father and a brother, had not taken the news of her
mother’s illness well. The patient, out of love for her daughter, and in processing her own
multiple griefs, had gotten angry and had exploded on the doctor, not because the doctor had
done anything wrong, but because she was angry and she needed to explode somewhere.
6. How do you comfort a patient who has committed a horrific crime and is terminally
ill?
In the last stages of life, people begin to do life reviews where they go over everything that has
happened and reexamine those experiences. They may need to talk about things and may need to
seek forgiveness from God, themselves, or another. Depending on the patient’s belief system,
we can discuss themes of guilt, shame, forgiveness. But the chaplain’s role is not to provide
them an answer so much as it is to sit beside them as they figure out what they need for
themselves.
7. Should a person's religious beliefs determine how to provide comfort to them, for
example, Catholics, Muslims, or others?
Always. A chaplain should never assume that they know what another person needs or what
their beliefs are. Also, people within the same faith tradition may have very difference ideas
about what they believe and what might bring them comfort. The chaplain’s role is to step into
the patient’s world and help them use the tools they already possess to cope with their current
situation.
 55

8. How would you counsel or advise a family with different religious beliefs?
For example, a patient refuses a blood transfusion because their spouse's religious beliefs
do not allow a blood transfusion. Alternatively, a spouse refuses to let doctors give a
husband/wife blood because of their religious beliefs, not theirs.
The chaplain never imposes her or his beliefs on a patient. And the chaplain should advocate for
a patient’s right to honor their faith while receiving healthcare. In the case of Jehovah’s
witnesses, who often refuse blood products on religious grounds, if the patient refuses blood
products, it is not the chaplain’s place to try and convince them otherwise. The only time the
medical community would turn to a spouse for that kind of decision would be if the patient could
not speak for him or herself. Then we would have to comply with the choice of the surrogate
decision maker.
In the case of babies, sometimes a hospital will petition on behalf of the baby of parents are
refusing to give life saving blood products. Sometimes the court will grant guardianship to
someone other than the parents just for blood related decisions, since the baby is too young to
have an opinion on religion. But that is the only time I am aware of that any hospital might
interfere in the receiving of blood products.
While blood transfusions are more obvious ways that religion can impact healthcare, there are
others. Diet for people who are Muslim or Jewish is often an issue because we do not typically
have halal meet or kosher food. Some religious communities, such as Sikh, do not cut their hair,
which can be an issue if surgery requires a shave. Chaplains help patients and families honor
their faith as much as possible.
9. What words of comfort or support would you give a child who has lost a family
member?
Again, it will depend on the child and their faith tradition. We would talk about the family
member and how the child feels about the loss. We would talk about how it is ok to be sad or
mad and who they can go to when they are having those feelings.
10. Constantly dealing with grief in your profession, how does it affect your personal
and family life?
Self-care is very important to the chaplain. I have a close group of friends that are a great
support to me. I have a therapist that helped me get through the trauma of COVID. I try to eat
well, get good rest, laugh a lot, and do fun things. I need to exercise more, but am working on it.
11. What type of grief do you deal with most often, any on a daily basis?
Anticipating grief (terminal Ill patients , cancer) This we deal with on a daily basis.
Traumatic grief (unexpected car accidents, homicide, etc.)
Our hospital is not a trauma center, so these things are less often. In our area, car accidents and
gunshot wounds tend to be sent to Atlanta to Grady Hospital. But we still occasionally see them.
12. How long do you provide counseling to families after they leave the hospital setting?
 56

It depends on the family. We have some that will reach out for help that we might support for
weeks or months. But 95% of our services end when the patient leaves the hospital. Most have
their own support system. In the hospital setting, chaplains tend to provide crisis intervention
and spiritual care. The hospice setting is different. Hospice families are followed for 13 months
after the patient has died.

Reverend Mercy Packer-Monroe, MDiv

Chaplain

Piedmont Henry Hospital 

Chaplain Questions Part 1

1. What inspired you to become a chaplain?

I was drawn to working with people from a variety of different backgrounds and providing emotional
and spiritual support in times of need.

2. What words of comfort would you give to a person who has been diagnosed with a terminal
illness?

This would heavily depend on the individual/family. Different people need different types of
support. I listen for their beliefs, values, and what brings them comfort and draw from their own
resources. Sometimes when we are in the presence of another’s suffering we will move to comfort
out of our own discomfort or anxiety. I’ve found that patients and their families appreciate the
chance to express their fear, sadness, anger, etc. before moving too quickly to words of comfort.

3. How would you counsel a family who is anticipating grief vs. a family who is expiring
traumatic grief?

Oftentimes when folks are experiencing trauma my focus is on trying to keep them safe amidst this
heightened experience. People are extremely vulnerable, whether they are very expressive or
checked out. Sometimes this looks like offering Kleenex, water, a blanket. Sometimes not a lot of
words are exchanged.

When people aren’t in crisis, there can be more conversation about the meaning that people are
making from their situation.

4. How would you console or comfort a family when doctors say there is no alternative to turn
life support off?

This is never an easy situation. Some families will never choose to remove their loved one off life
support. This news can be met with a great deal of anger and mistrust (grief is disguise). My role is
to try to listen to where they are coming from, offer compassion, and nurture trust. Sometimes
families can hear this reality from the chaplain a little more easily.
 57

Some people have to work through feelings of guilt or worry that they haven’t tried everything. A
lot of the time, doctors will have given some indication that things might be headed in that direction
—people are sad but not surprised. It can take a while to accept this.

When families chose to withdraw life support, we can provide emotional and spiritual support. I’ll
often encourage families to share memories, talk to the patient and show them affection,
sometimes people like to play music, read scripture, or pray.

5. How do you use the five or seven stages of grief in your work denial, anger, bargaining,
depression, and acceptance?

It’s helpful to be aware of different frameworks that can help us better understand the grieving
process. All of these stages are ever-present in my work in the hospital. People are negotiating all
different kinds of loss associated with illness, aging, transitions, and dying.

6. How do you comfort a patient who has committed a horrific crime and is terminally ill?

To my knowledge, I haven’t encountered this scenario. Sometimes patients want to share about the
ways they have hurt others and themselves as part of their grief process. It can be important to try
to apologize and seek forgiveness at times. We try to treat everyone with care, dignity, and respect
regardless of who they are and what they’ve done.

7. Should a person's religious beliefs determine how to provide comfort to them, for example,
Catholics, Muslims, or others?

Absolutely. No question. Emmanuel Lartey is a scholar who writes about how all people are 1) Like
all others, 2) like some others, and 3) like no other. I take this to mean that there are some ways
that we are connect as humans and have similar needs. As chaplains we hold this alongside the
awareness of different cultures, traditions, and the particular individuals who are interpreting them
and living them out (not every Christian believes and practices the same way—which is also true for
Muslims and Jews). It is important that we provide hospitality to those of all religious faiths or of no
faith. I approach my work with “cultural humility” and with the belief that people deserve to be
treated with respect for who they are and what is important to them, especially during a vulnerable
time.

8. How would you counsel or advise a family with different religious beliefs?
(For example, a patient refuses a blood transfusion because their spouse's religious beliefs do
not allow a blood transfusion. Alternatively, a spouse refuses to let doctors give a husband/wife
blood because of their religious beliefs, not theirs.)

Cultural and religious differences within families can be challenging. We are very sensitive to
ensuring that a patient’s own value system is leading the medical decision-making on their behalf.
We encourage patients to complete an Advance Directive form to designate a trusted healthcare
agent and to express their wishes regarding life support. With regard to religious groups who have
specific teachings around blood products, transplant, etc., we are often called in to help
communicate and sometimes advocate for the patient. Sometimes we will reach out to community
clergy as well.

9. What words of comfort or support would you give a child who has lost a family member?
 58

Some words might be, “I’m so sorry. I can see how much you love [patient].” I would join what
other family members might be offering (beliefs about heaven, reassurance that they are loved and
will be taken care of). It might be appropriate to talk with the family about ways they could help the
child remember their loved one and support their grief process as they grow (a teddy bear made
from their clothes, framed pictures, planting a tree, etc.). Interactions should be developmentally
appropriate. We give families resources when they have children.

10. Constantly dealing with grief in your profession, how does it affect your personal and family
life?

It can be stressful and certainly the pandemic has meant all sorts of new challenges. Sometimes I
get really scared when one of my loved one gets a diagnosis, fearing the worst based on my
experiences in the hospital. I have to be very diligent to tend to my own spiritual well-being. I don’t
take life for granted and my work helps me keep things in perspective.

11. What type of grief do you deal with most often, any on a daily basis?
Anticipating grief (terminal Ill patients , cancer) or Traumatic grief (unexpected car accidents,
homicide, etc.)
Everyday is a little different and usually a combination of cases where a loss is anticipated and
losses that are sudden. Piedmont Henry is not currently a Trauma I hospital, so we don’t see a
whole lot of serious car accidents and fatal gunshot wounds. We do see sudden heart attacks
and strokes, drug overdoses, and babies that miscarry or are stillborn. I would say most of our
work is with anticipatory grief but we are regularly involved with more acute situations.

12. How long do you provide counseling to families after they leave the hospital setting?

Our scope of care is limited to the patient’s hospitalization. It’s important to keep these
professional boundaries. Sometimes we will refer people to resources in the community to support
their ongoing journey.

Rose Archer, MDiv., BCC

Chaplain, Tallahassee Memorial Healthcare

Birth Doula, Founder of Doulas for Me

1. What inspired you to become a chaplain?

a. I always had a desire to do non-traditional ministry - something outside of the pulpit. I
decided I’d participate in a program at Duke Hospital as a Chaplain Intern and fell in love
with the work. There’s something sacred about meeting others in their most desperate
moments of need. We may not know each other, but every human is able to empathize
and recognize each other’s pain. When everyone else is throwing medical language at
you, it’s good to come across a Chaplain who helps to honor a person’s faith language
and spirituality within them.
2. What words of comfort would you give to a person who has been diagnosed with a terminal
illness?
a. It depends on their spiritual lens and faith background. I try to help the person connect
to what gives their life meaning and remind them that despite a terminal diagnosis, that
 59

source of meaning still remains. I also try to help them know that despite the diagnosis,
no one knows how much time any of us are given, so we are to treat each moment as a
gift.
3. How would you counsel a family who is anticipating grief vs. a family who is expiring
traumatic grief?
a. A family who is experiencing anticipatory grief may benefit from a Chaplain who can
facilitate conversations concerning possible family conflict and healing, such as
forgiveness of self and forgiveness of family members as a loved one approaches death.
It is also an opportunity to normalize some of the emotions one might experience during
grief such as anger, denial, and bargaining. A family experiencing traumatic grief is
facing unforeseen circumstances that most often leave them in a state of shock. As a
Chaplain who responds to the acute grief moments, perhaps my best gift to this family
who is experiencing traumatic grief is to just offer a comforting presence who is not
afraid to walk alongside them in their darkest moments when many people shy away.
Helping families to know that they don’t have to face their grief alone is essential in
building trust and establishing a relationship of care in the midst of devastation.
4. How would you console or comfort a family when doctors say there is no alternative to turn
life support off?
a. I often ask families, “What would [Patient’s name] want? Would they desire to live this
way?” I’d also help them to know that there comes a time when we have to
acknowledge that we cannot control the outcome and leave it in the hands of the
Divine. Families also struggle with guilt when it comes to extubating a loved one, so I
would also help them to know that their presence in the midst of that time is enough to
show how much they love them.
5. How do you use the five or seven stages of grief in your work denial, anger, bargaining,
depression, and acceptance?
a. When I am responding to a death, I often assess which stage of grief family members
are in, according to Kubler-Ross’s stages of grief. When patients are dealing with chronic
or terminal illness, they also may be experiencing different stages of grief. Honestly, we
are all experiencing different phases of grief as we make any transition in our lives,
whether professional, personal, or physical. The goal is to acknowledge these emotions
and see them as a way to further understand our own inner hopes and fears.
6. How do you comfort a patient who has committed a horrific crime and is terminally ill?
a. I comfort them as I would any other terminally ill patient. Many patients, including those
who have committed a horrific crime, reflect on moments in their lives that cause them
grief and heartache as they reach the final stages of life. I provide a non-judgmental
space for them to explore their emotions and work to move them towards self-
forgiveness, repentance 9if that has not taken place,) and encouraging self-worth.
7. Should a person's religious beliefs determine how to provide comfort to them, for example,
Catholics, Muslims, or others?
a. It should absolutely influence, but not necessarily determine how to provide comfort to
them. Some may identify as Catholic, but their concerns may not necessarily be
religious. The same goes for other religious identities. One’s faith background provides a
backdrop for the conversation, but it is the person who determines the flow and
 60

direction of the conversation - whether it be more religious or spiritual in nature.

Sometimes, people do not want to talk about their religious or spiritual narrative at all.
Other times, when it comes to ritual care, the Chaplain must be competent as it pertains
to various ritual practices from different faith groups and what is needed to honor the
patient's ritual need.
8. How would you counsel or advise a family with different religious beliefs?
For example, a patient refuses a blood transfusion because their spouse's religious beliefs do not
allow a blood transfusion. Alternatively, a spouse refuses to let doctors give a husband/wife
blood because of their religious beliefs, not theirs.
a. I would honor the family and/or patient’s beliefs in a nonjudgmental way. It is not my
place to tell them how to practice their faith, but rather support them whatever their
decision may be.
9. What words of comfort or support would you give a child who has lost a family member?
a. I would be transparent and compassionate with the child because children need
honesty even when it comes to death. Many times, people try to shield children from
the realities of death, but they want to know and understand what really happened to
their loved one. I would help them to know that their loved one is dead (for example,
not “sleeping”), but that even though they are dead, we still have memories and the
love they placed in them will always be available to them. I would also invite them to
write letters to their loved one and find ways to honor their own emotions as they
process the loss, whether that’s through art therapy or support groups with other
children who have experienced loss.
10. Constantly dealing with grief in your profession, how does it affect your personal and family
life?
a. There are times when I experience compassion fatigue and I may not recognize my
mood shift at first. Thankfully, my husband and children are able to help me become
more cognizant when I need to take some time to process what I’ve witnessed.
11. What type of grief do you deal with most often, any on a daily basis?
Anticipating grief (terminal Ill patients , cancer)
Traumatic grief (unexpected car accidents, homicide, etc.)
A. Anticipatory grief
12. How long do you provide counseling to families after they leave the hospital setting?

a. I do not provide counseling to families after they are no longer a patient for ethical and
professional boundary reasons. I do, however, connect patients with local resources
they can utilize if they need further support once they are discharged from the hospital.

Pastor Interview Questions

Kenneth McWhorter

Pastor
 61

Questions Part 1

1. What inspired you to become a pastor?

I have always felt that I had a calling since childhood because I would look up to our Pastor and
the way that he served in the role as a counselor and shepherd for the congregation. I also
would have dreams on occasions about standing in a pulpit and preaching to people. I have a
passion to lead those who have been marginalized and disproportionally treated towards
improving their lives and seeking out a relationship with the Lord.
2. What words of comfort would you give to a person who has been diagnosed with a terminal
illness?
I oftentimes try to use various scriptures relating to healing and serve more as a listener to what
the person has to say. People need hope and inspiration rather than a doom and gloom message
in their storms in life.
3. How would you counsel a family who is anticipating grief vs. a family who is expiring
traumatic grief?
I remind them that suffering isn’t something that we should look at as God and his displeasure
towards us or that sickness is not something that we are immune from. Suffering and sickness
are a part of living in a physical body, but that God desires us to focus on our spiritual
relationship with him because our spirit is what will live eternally devoid of sickness and
suffering.
4. How would you console or comfort a family when doctors say there is no alternative to turn
life support off? I remind people that Jesus can heal any disease and that he does his best
work during our most difficult times in life. We also have to realize that it is not God’s will that
we suffer but if it is his desire that we come to him at that particular time that his timing is
perfect.
5. How do you use the five or seven stages of grief in your work denial, anger, bargaining,
depression, and acceptance?
I oftentimes try to remind people of who we are and whose we are. As people of God although
we are created with a spirit we are still beings of flesh and will have emotion. Our issues or
problems in life will come, but the question remains of how will we handled the situation when
it arises. Ultimately, it is our decision that will set us free or keep us in bondage.
6. How do you comfort a patient who has committed a horrific crime and is terminally ill?
I remind the individual that forgiveness and mercy is granted to all who have a repentant heart.
We all have sinned but because of grace we can all be saved.
7. Should a person's religious beliefs determine how to provide comfort to them, for example,
Catholics, Muslims, or others?
I believe that compassion, love that is non-judgmental, and faith will help us to look beyond
those differences and help us to see the person that is in need. We can then truly offer counsel
and help that only can be seen as truly caring for one who is dealing with a issue of concern in
their life.
8. How would you counsel or advise a family with different religious beliefs?
For example, a patient refuses a blood transfusion because their spouse's religious beliefs do
not allow a blood transfusion. Alternatively, a spouse refuses to let doctors give a
husband/wife blood because of their religious beliefs, not theirs.
 62

I could only offer to the individual consolation and concern for the current condition that their
loved one is in. The individual who is in the position of making the choice for the loved one who
is sick may be carrying out the wishes of the one who is suffering.
9. What words of comfort or support would you give a child who has lost a family member?
I could remind a child that our loved ones are only temporarily away from us and that we all will
be reunited one day. I would remind the child that he or she is a precious gift that they brought
into the world to bring light and inspiration to others.
10. Constantly dealing with grief in your profession, how does it affect your personal and family
life?
I trying to look at life in the perspective of how Christ did in knowing that we all have a purpose
and that we all are witnesses. I look at life as an opportunity to enrich someone else in life and
as an opportunity to help others. I try to encourage others and be encouraged personally
because I know that we already have so many good things to look forward to with each day and
in the future beyond.
11. What type of grief do you deal with most often, any on a daily basis?
Anticipating grief (terminal Ill patients , cancer)
Traumatic grief (unexpected car accidents, homicide, etc.)
Mostly people that are dealing with illness of some type and who have become discouraged in
their personal or loved ones lives and the depressed state that they are in when dealing with the
conditional over a long period of time.
12. How long do you provide counseling to families after they leave the hospital setting?
I call weekly and offer help as much as the individual needs whether it be over days, weeks, or
months.

James B. Singleton

Pastor

1. What inspired you to become a pastor?

 63

My call to pastoral ministry is directly related to my salvation. God saved me the desire to see
others saved.
2. What words of comfort would you give to a person who has been diagnosed with a terminal
illness?
Oftentimes there are no right words to say, just being there in the time of need is sufficient.
3. How would you counsel a family who is anticipating grief vs. a family who is expiring
traumatic grief?
Anticipating grief, is so much more complicated than facing the grief that life has dealt to you.
When someone is healing is failing, the goal is to impart hope in a seeming hopeless situation
When someone is grieving comfort and encouragement is the desired goal
4. How would you console or comfort a family when doctors say there is no alternative to turn
life support off?
Each situation is to be approached with prayer and humility, because each case is different
5. How do you use the five or seven stages of grief in your work denial, anger, bargaining,
depression, and acceptance?
In ministry you will encounter people in various stages of grief some are perpetually in a state of
grief because they are unwilling and in some cases unable to move forward
6. How do you comfort a patient who has committed a horrific crime and is terminally ill?
Counsel maybe more appropriate than comfort in this case, accepting what they’ve done and
the consequences of their actions may help them forgive themselves and move on to healing.
7. Should a person's religious beliefs determine how to provide comfort to them, for example,
Catholics, Muslims, or others?
It probably should not, but it often does, agnostics are not likely to seek or accept a biblical
resolve to life’s dilemmas.
8. How would you counsel or advise a family with different religious beliefs?
For example, a patient refuses a blood transfusion because their spouse's religious beliefs do
not allow a blood transfusion. Alternatively, a spouse refuses to let doctors give a
husband/wife blood because of their religious beliefs, not theirs.
In cases where the couple has different religious beliefs a DNR or living will is always helpful.
9. What words of comfort or support would you give a child who has lost a family member?
This is often dependent upon the age of the child and their relationship with the Pastor and the
level of family support available.
10. Constantly dealing with grief in your profession, how does it affect your personal and family
life?
Ministry in general can pull Pastors away from family in so many ways, although members of the
congregation become extended members of the family and their grief is often shared by the
level of family support available.
11. What type of grief do you deal with most often, any on a daily basis?
Anticipating grief (terminal Ill patients, cancer)
Traumatic grief (unexpected car accidents, homicide, etc.)
As the pastor of an ageing congregation as well as the son of seasoned parents, anticipating grief
is what I deal with most of all, but I have experienced each stage of grief personally.
12. How long do you provide counseling to families after they leave the hospital setting?
 64

I try to make myself accessible to families for as long as they need because there’s no time limit
on how long one grieves.

Pastor Ramey

1. What inspired you to become a pastor?

I sensed the CALL on my life to the GOSPEL MINISTRY when I was a CHILD. I had a close
relationship to GOD, in CHRIST, JESUS. I spoke at many, SUNDAY YOUTH PROGRAMS.
CHURCHES recognized my GIFT, and I was CALLED to a PASTORSHIP in 1982.

2. What words of comfort would you give to a person who has been diagnosed with a terminal
illness?
I would COUNSEL and seek to COMFORT them with the understanding that ALL SICKNESS and
DISEASE is due to ORIGINAL SIN and not necessarily THEIR FAULT. I would COUNSEL and seek
to COMFORT them with the understanding that this LIFE is TEMPORARY, meaning that ALL of
us will leave this WORLD by some means and at some particular time. I would COUNSEL them
and seek to COMFORT them with the understanding that in CHRIST, JESUS by the POWER of
the HOLY SPIRIT, they can LIVE forever. I would PRAY with them and for them that they TRUST
the LORD in all of the PROMISES He has made to those who BELIEVE on Him.

3. How would you counsel a family who is anticipating grief vs. a family who is expiring
traumatic grief?
The FAMILY anticipating GRIEF must understand FIRST that this anticipated GRIEF actually
gives them an opportunity to BETTER prepare THEMSELVES to WORK through the STAGES of
GRIEF; Not suffering the intense effects of each level of GRIEF.
The FAMILY experiencing TRAUMATIC GRIEF has no such ADVANTAGE and must be
COUNSELED aimed at STRENGTHENING them to ACCEPT WHAT THEY CANNOT CHANGE.

4. How would you console or comfort a family when doctors say there is no alternative to turn
life support off?
I would COUNSEL and seek to COMFORT THEM in understanding that there COMES a POINT
wherein the SOUL has separated FROM THE BODY, even when LIFE SUPPORT MECHANISMS
KEEP AIR flowing into the LUNGS and BLOOD PUMPING through the BODY, a POINT wherein
the WILL OF GOD should be SOUGHT and ACCEPTED.

5. How do you use the five or seven stages of grief in your work denial, anger, bargaining,
depression, and acceptance?
FAMILIES must be made AWARE that these STAGES OF GRIEF exist and that each individual
must progress through certain STAGES at his or her OWN RATE. PATIENCE with FAMILY
MEMBERS as they PROGRESS through these STAGES must be evidenced.

6. How do you comfort a patient who has committed a horrific crime and is terminally ill?
SEEKING FORGIVENESS from those on whom the CRIME WAS COMMITTED is a NECESSARY
STEP in preparing for an inevitable DEATH. SELF FORGIVENESS is also necessary to the
PEACEFUL TRANSITION of this PERSON.
 65

7. Should a person's religious beliefs determine how to provide comfort to them, for example,
Catholics, Muslims, or others?
YES, the person’s religious BELIEFS will determine their VIEWS on DEATH and THE HEREAFTER.
APPROACHING a MUSLIM with CHRISTIAN VIEWS may result in the TOTAL REJECTING of the
COUNSELING EFFORTS.
HOWEVER, if they appear to be OPEN and RECEPTIVE to OTHER VIEWS, COUNSEL and
COMFORT them with these VIEWS.

8. How would you counsel or advise a family with different religious beliefs?
For example, a patient refuses a blood transfusion because their spouse's religious beliefs do not
allow a blood transfusion. Alternatively, a spouse refuses to let doctors give a husband/wife
blood because of their religious beliefs, not theirs.
PRIORITY must be placed on the SAVING of another HUMAN LIFE. An APPEAL must be made to
their SENSE of LOVE and CONCERN for the PHYSICAL wellbeing of the SICK PERSON NOW, and
RESTORATION later.

9. What words of comfort or support would you give a child who has lost a family member?
This is always FOR ME, the most difficult COUNSELING SITUATION. Children do not
UNDERSTAND the PERMANANCY of DEATH and must be HELPED to understand that in the
ABSENCE of their LOVED ONES, there are OTHERS who will STEP UP to INSURE that they are
LOVED and NOT alone.

10. Constantly dealing with grief in your profession, how does it affect your personal and family
life?
I am BLESSED to have a WIFE who understands the demands placed on this PROFESSION who
will GO with ME WHEN, WHERE, and to WHOM I must GO as a SERVANT OF GOD or will
TRUSTINGLY allow ME TO GO. I HAVE grown over the YEARS to be BETTER EQUIPPED and
READY when the CALL is MADE. Working through certain STAGES of PERSONAL GRIEF has also
helped me to HELP OTHERS.

11. What type of grief do you deal with most often, any on a daily basis?
Anticipating grief (terminal Ill patients , cancer)
Traumatic grief (unexpected car accidents, homicide, etc.)
The most frequent kind of GRIEF that I deal with is ANTICIPATED GRIEF. It is on a much less
frequent BASIS that I deal with TRAUMATIC GRIEF.

12. How long do you provide counseling to families after they leave the hospital setting?
The TIME varies from FAMILY to FAMILY and SITUATION to SITUATION. After a FUNERAL, I
seek to find out how a FAMILY is DOING and VISITATION and COUNSELING NEEDS are
determined from that POINT FORWARD.
 66

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 67

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grief.html

About smart recovery: 4-point program®: Addiction recovery. SMART Recovery. (n.d.).

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About The Author Theo Harrison Hey there! I am just someone trying to find my way through

life. I am a reader. (2020, December 21). The five stages of Grief: Exploring The

KÜBLER-ROSS Model. The Minds Journal. https://themindsjournal.com/kubler-ross-

model-grief

About US I San Diego I a new path. anewpath. (n.d.). https://www.anewpath.org/about-us.

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