Supportive Voice Vol. 10 No. 1  Winter 2004

Chairperson's Corner

by Bridget Carney, RN, PhD

Bridget Carney is corporate director, ethics, PeaceHealth, Bellevue, WA.

When I last spoke to you, last summer (Supportive Voice, vol. 9, no. 3), I was in search of "revolutionaries," agents of change who would possess three characteristics: a sense of outrage, creative risk taking, and tenacity and patience. However, at the time, I neglected to mention a very important characteristic that is essential—actually foundational—to being a successful agent of change for individuals with life-threatening illnesses: spirituality. I am not referring here to the spirituality of patients or their families. I mean the spirituality of the revolutionaries themselves, the spirituality of every person who comes in contact with a person with a life-threatening illness. Why, you may ask, is this characteristic foundational? What is the significance of spirituality to what we do in our daily lives in providing care and assistance to individuals with life-threatening illnesses?

In attempting a response to these questions, I will begin with a definition of spirituality borrowed from Richard Gula: "Spirituality has to do with our relationship to what we ultimately value and with our commitment to live in a way consistent with what our ultimate love demands. . . the person we become and the choices we make express what we ultimately love" ("Spirituality and Ethics in Healthcare," Health Progress, vol. 81, no. 4, p. 2). Reflecting on this brief description of what spirituality is about, one is challenged to pause and ask, "What do I value? What do I love?" The answers to these questions are reflected implicitly or explicitly in our everyday interactions, specifically in our daily interactions with patients and families. What am I—as the nurse, physician, environmental services employee, dietary assistant, patient financial services representative, or spiritual care staff member—communicating to the patient in front of me or to the family member? Am I communicating my love, value, and respect for their human dignity, or am I simply rushing through a set of tasks in order to fulfill organizational demands for efficiency and outcomes? Am I present to them or already mentally somewhere else?

Having a clear understanding of what one values and loves—that is, one’s spirituality—has a significant positive impact on an agent of change’s ability to be present to the needs of a person with a life-threatening illness. In contrast, lacking a strong sense of our life-giving spirituality can be a significant obstacle to providing care and assistance to those with life-threatening illnesses. Can we even name what we love and value, and is it life-giving to us? If we are unclear about our own spirituality, then we are not clear about living in a way consistent with what is most important to ourselves. Without this grounding, how can we adequately address the spiritual needs of the patients and families we encounter?

"But this is not my job," you might say. "This is the job of the chaplain." My response would be that it is the responsibility of every person who comes in contact with patients with a serious illness and with their families to be present in their daily interactions. This act of being present assumes that you have a sense of your own spirituality, so that you can be present to the despair and distress of these patients, whether that present-ness is expressed verbally or nonverbally. Your act of being present will be expressed in different ways and different words, depending on your role in the organization (e.g., dietary aide, physician, nurse, engineer, environment services, or lab technician). Each of you, as you are gifted with the opportunity to encounter these vulnerable individuals and their families, must find a way to convey respect for the dignity of the person in distress.

So, as you move forward in your organization, building programs to meet the needs of those with life-threatening illnesses, remember the profound importance of nurturing the spirituality of your change agents, your revolutionaries. For if these individuals do not have a spirituality that is life-giving and sustaining, then their ability to be present to the needs of those with life-threatening illnesses will be diminished, diminishing us all in more profound ways.