Supportive Voice Vol. 10 No. 3 Fall 2004 / Winter 2005
Chairperson's Column
by Bridget Carney, RN, PhD
Bridget Carney is system director, ethics, PeaceHealth, Bellevue, WA.
"I'm afraid of dying, not of death." "I'm not ready to die!" Such statements are not uncommon from individuals with life-threatening diagnoses; perhaps they are pleas for help. Yet how well are you prepared to be present to patients who share their fears with you? Are you comfortable encouraging patients to express and explore their distress, perhaps spiritual distress, which may underly these fears? Historically, when we encountered these statements we tended to focus primarily on the clinical issues and to make a referral to spiritual care staff because they are the professionals who deal with "these problems." However, as health care providers we all have an obligation to be present to patient needs—physical, emotional, and spiritual—to the extent we are able and feel competent.
Addressing spiritual questions and concerns is not just the purview of the spiritual care staff. It is the responsibility of all caregivers. What then are the competencies needed to enable health care providers to be present and to provide holistic care, and how can they be defined and measured? This is a question that many health care professionals have asked, specifically within professional chaplaincy circles. In an effort to develop individual competencies in being a healing presence for whole person care, Supportive Care of the Dying: A Coalition for Compassionate Care is collaborating with Dr. Christina Puchalski, principal investigator at George Washington Institute for Spirituality and Health (GWish) on a two-year hospital-based spirituality initiative. Other collaborators include the Catholic Health Association, Georgetown Center for Clinical Ethics, National Interfaith Coalition on Aging, and Washington Theological Union. This project will "develop and test strategies that encourage ownership of the professional responsibility for spiritual care among all care providers." This project will also attempt "to better understand the organization values and infrastructure that support increasing the spiritual care provided by the caregivers."
In pursuing this project the sponsoring groups are insisting that the spiritual issues of health care professionals be addressed, in addition to those of patients. The sponsors of this hospital-based spirituality initiative recognize the importance of developing a program that is sensitive to the particular environment of each institution. For example, institutions committed to participation in the project include for-profit hospitals, faith-based not-for-profit hospitals, and academic organizations.
Six hospital sites have agreed to participate and have sent an interdisciplinary team of 5-6 people to a two-day retreat to learn about their own spiritual issues, as well as how to foster relationship-centered spiritual care on behalf of their patients and colleagues. Over the course of the two-year project, this team will receive consultation support, maintain journals, and receive ongoing education. The teams will participate in pre- and post-evaluations to assess eight different components that impact the ability of a health care professional to be a healing presence to patients and provide whole person care, which includes addressing and supporting the spirituality of both the health care professional and the patient.
This is a pilot project, a beginning place, for identifying the competencies needed by all health care staff for providing holistic care to patients. This pilot is distinctive in its focus on addressing the spirituality of health care providers and the competencies needed before expecting these individuals to provide holistic care that addresses the difficult patient questions about spiritual concerns.
For more information on this project, please contact the Supportive Care Coalition at 503-215-5053.
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Funding for this project is provided by Supportive Care of the Dying: A Coalition for Compassionate Care, the Catholic Health Association, and a continuation grant from the research "Spirituality in Health and Healing," Sr. Diana G. Bader, OP, PhD, principal investigator.