Promoting spiritual care in the wellness continuum.
Takeaways:
- Many assume that the chaplain’s work is limited to religion. However, their work focuses on being a spiritual caregiver.
- Chaplains can be of service to patients who have questions about life, wonder about death, or just want someone to sit and listen.
- Hospital chaplains specialize in being companions to the human experience in the healthcare setting.
In caring for the whole patient—physically, mentally, emotionally, and spiritually—nurses collaborate with other disciplines. To ensure a patient’s spiritual needs are met, nurses work with chaplains and pastoral care resources.
Chaplains provide a neutral, reflective presence while practicing the art of deep listening and reverent acknowledgment; they serve as a bridge between medicine and spirituality. Brady defines spirituality as “the aspect of humanity that refers to the way individuals seek and express meaning and purpose and the way they experience their connectedness to the moment, to self, to others, to nature, and to the significant or sacred” They offer support when a patient has questions about life, wonders about death, or needs someone to sit and listen.
Chaplain education and training
Chaplains come from different faiths and have various educational and professional backgrounds. Many have advanced degrees, and some are ordained ministers. They undergo specialized clinical pastoral training through the Association for Clinical Pastoral Education (ACPE), which is recognized by the U.S. Department of Education as an accrediting agency for pastoral education. The Association of Professional Chaplains (APC), a national interfaith organization, certifies clinical chaplains and encourages research as a standard for professional competence.
Chaplains specialize in being companions to the human experience, serving as a quiet presence and using active listening and compassionate interaction skills. They also help facilitate family and medical meetings. Chaplains work in various settings, including hospitals and private homes. Some travel with first responders to accidents or neighborhoods in crisis.
Regardless of circumstance, chaplains seek to channel equanimity, grace, and patience and to connect, communicate, and conscientiously support the human experience. As members of an interprofessional team, chaplains strengthen the mind–body–spirit continuum to enhance the overall well-being of patients, families, and healthcare workers.
Patient spiritual care
According to Lucatorto and colleagues, the American Nurses Association (ANA) defines nursing as “the protection, promotion, and optimization of health and abilities, prevention of illness and injury, facilitation of healing, alleviation of suffering through the diagnosis and treatment of human response.” Health optimization, an active process, requires consistent, nimble effort. Nursing theorists have included spirituality as part of that work. Nola Pender, PhD, RN, for example, includes spiritual growth as a critical factor for overall wellness, and Johnson and colleagues state that “the Joint Commission has long held that patients have the fundamental right to considerate care that safeguards their personal dignity and respects their cultural, psychosocial, and spiritual values.” However, chaplains frequently are underused in this endeavor. Lepianka says that patient care improves when interprofessional team members collaborate, but that some team member roles, including chaplains, are misunderstood.
According to Baldacchino, the International Council for Nurses states that nurses are responsible for integrating various aspects of patient care, and the Joint Commission hospital accreditation manual notes that nurses must respect “the patient’s cultural and personal values, beliefs, and preferences…and accommodate the patient’s right to religious and other spiritual services.”
Nurse spiritual care
Not only patients require spiritual support. Chaplains help to hold sacred space for anyone who needs it, including nurses. Crane and Ward explain why spiritual care is vital for nurses: “Each individual has his or her inner constellation of beliefs, attitudes, feelings of life purpose, and coping mechanisms…Emotional and spiritual health are interrelated with the physical and mental aspects of life…A regular spiritual practice (e.g., prayer and meditation) promotes feelings of physical and emotional calmness, which affect mental capabilities.”
Chaplains provide nurses and other healthcare staff with an objective, supportive presence and help to lighten their workload when they deliver pastoral care to patients. Honoring an individual nurse’s unique spiritual needs helps complete the puzzle of caring for the whole nurse.
Spiritual care in action
Spiritual support doesn’t require a provider order, but follow your organization’s protocol for requesting a chaplain visit, which may be as simple as contacting the pastoral care or chaplain’s office and providing them with the patient’s name and room number. To promote collaboration, visit the chaplain’s office to introduce yourself and learn more about the services offered for patients and nurses. Consider asking your manager to schedule a chaplain in-service for your department. If you work in an organization that doesn’t have on-site pastoral resources, encourage conversations with administration to brainstorm how to meet patients’ spiritual needs.
You may encounter situations when a chaplain isn’t available for a patient who needs pastoral care. Ask yourself if you’re able to provide comfort. If not, consider asking a colleague or your manager to help. Taylor points out that patients won’t mind when a nurse stumbles through a prayer or other words of comfort. Knowing that the nurse cares will be enough. Taylor also notes that for nurses who are religious, offering a prayer may decrease feelings of ineffectiveness and relieve exhaustion.
Ask a chaplain
Hoffman asks, “The hospital can be a busy, lonely place…who is there to walk this journey with you?” Chaplains serve as important members of the interprofessional care team, providing solace and comfort to patients and nurses. However, many nurses and other healthcare staff don’t call on them. Some nurses want to learn about how to pray and others may want to have their hands blessed. To get answers to these and other questions and to learn more about the services chaplains offer, ask a chaplain.
Jennifer Lipski works in home healthcare with private clients in Philadelphia, Pennsylvania. Betty White is the coordinator of clinical pastoral education at the Hospital of the University of Pennsylvania in Philadelphia.
References
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Crane PJ, Ward SF. Self-healing and self-care for nurses. AORN J. 2016;104(5):386-400. doi:10.1016/j.aorn.2016.09.007
Hoffman J. Offering comfort to the sick and blessings to the healers. The New York Times. July 17, 2077. nytimes.com/2007/07/17/health/17tren.html
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Taylor EJ. Prayer: Proselytizing or providing comfort? American Nurse Journal Perspectives blog. April 10, 2020. myamericannurse.com/prayer-proselytizing-or-providing-comfort/
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Thomson SB. Stigma theory and religion in the workplace. Academy of Management Proceedings. November 30, 2017. journals.aom.org/doi/pdf/10.5465/ambpp.2010.54500931
