Spirituality in Patient Care

Through most of recorded history spiritual beliefs and religious practices have been assumed to play a central role in health. Religious leaders were often also seen as healers, or at least mediums through whom healing might come. The 20th century particularly saw a separation between the practice of medicine and spiritual/religious belies and practices. Harlod G. Koenig’s book  Spirituality In Patient Care: Why, How, When, and What addresses this gap and argues for the inclusion of patient’s religious and spiritual life as an essential element in “patient-centered medicine” (8). He makes use of volumes of research data to demonstrate the value of religiosity to health, and the importance of health professionals addressing this aspect of their patients’ lives.

The book outlines, as the title suggests, the why, how, when and what of including the spirituality of the patient in the treatment conversation and plan. He then proceeds to discuss some risks – i.e. some ways that religious and spiritual beliefs and practices might be problematic, and how do address these. One example is the notion that illness or suffering is somehow “God’s will” which might dispose a patient to resist treatment or might interfere with that patient’s openness and capacity for healing (108). He outlines professional boundaries for health professionals, and then spends a chapter on each of the following disciplines and how they might address spirituality in patient care: Chaplains and Pastoral Care; Nursing; Social Work; Rehabilitation; Mental Health.

His final two main chapters are spent outlining a model curriculum for including religion and spirituality in medical training, followed by an overview of beliefs and practice found in world religions. These chapters are helpful not only for medical schools but particularly for staff development and inservice training in medical facilities. Ongoing conversation is needed to develop the ability of all health practioners to address these issues effectively with patients and their families. The failure to do so can hinder the ability of patients to develop a relationship of trust with their medical team and to make full use of these resources for their progress toward wholeness.

I highly recommend this book for medical practioners as well as clergy and other religious professionals and lay leaders who function in healthcare settings or interact regularly with people in matters of their health. Below are links to chapter summary notes for use in a book club or other study.

Spirituality in Patient Care – Overview & Intro
Spirituality in Patient Care – Chapter 1
Spirituality in Patient Care – Chapter 2
Spirituality in Patient Care – Chapter 3
Spirituality in Patient Care – Chapter 4

(Other notes coming soon)

Hospital Employee Grief and Loss Support Program

We will have our Town Hall meeting with the whole staff this week to begin rolling out this program. I am looking forward to good conversation among colleagues regarding how we can better support one another. The healthier and stronger we are emotionally and as a community, the better patient care we can provide.

Leadership and Life Development Coaching. Ken G Crawford. Synchronous Life.

The following is a discussion starter for developing a support program among employees as a 40 bed hospital. If you have insights from your own experience, I would appreciate hearing them. And if you would like help thinking through your own situation, I’d be happy to share in that conversation also.

An updated summary version is available here in pdf.

Initial conversation –

In the past few months several of our coworkers have experienced the death of significant person in their lives. Others are entering a new stage of life with parents and others experiencing a decline in physical or mental health. Still others experience stress and grief related to relationship conflicts and disappointments. All of this has prompted a discussion regarding how we as a staff support one another during these difficult seasons.

Some considerations –

Work relationships are important. People spend half of their waking hours at…

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Understanding our own mortality

Elizabeth Kubler-Ross (1975) states that “We cannot give loving and caring support to dying persons and their loved ones until we have faced our own death and mortality within the depths of our being.” (Miriam Jacik 1989, 257) See “A look at death and dying” questionnaire.

Addressing our personal beliefs and experiences of loss and death.

  • What losses have you experienced in your life? (a pet, a friend moving away, loss of extended family, loss of family of origin member, loss of present family, loss of significant job, loss of home, divorce, loss of physical functioning, etc.)

What were you taught about death as a child? Was death something to be feared? Was it a secret not to be spoken of? How were the dead spoken of? Was fear connected with death?

“A person’s faith and religious belief system are often a strong source of support during illness and in the face of death. It behooves the [medical professional] to honor this reality not only in his or her own personal life but also in the patient’s life. One does not have to share the same religious affiliation to be able to understand and accept another’s spiritual orientation.” (Jacik 262)

  • How then, are we to have this conversation? Recognizing that we have already been called to consider our own thoughts and feelings regarding death, our own and more generally, how do we engage with others?

“It is important to believe that one person can help another die well, much as one would have helped another to live well….human life is temporary… human beings are mortal… the journey through life is transient.” (Jacik 263)

A statement that describes what motivates the ministry that I do.

“Healthcare professionals, being part of a society that fears, avoids, and denies death, share the same fears and attitudes about death as those they are called to serve. Overcoming such negative attitudes about death requires a personal struggle with the issues of our own mortality, reflection on our personal fears of dying, and being in touch with or formulating our personal philosophy of life. The latter entails the topics of introspection that all people face: the meaning and purpose of life, the meaning of suffering and death, personal beliefs about God or some higher being, the place of God in one’s life, the hereafter, the forms of religious expression one uses, and one’s religious belief system.” (Jacik 257)

Jacik, Miriam. “Spiritual Care of the Dying Adult.” In Carson, Verna Benner. Spiritual Dimensions of Nursing Practice (Philadelphia: W.B. Saunders 1989)

Consider also the work of

Dr. Ira Byock, MD, Chair, Palliative Medicine, Dartmouth Medical School  – www.dyingwell.org