Spirituality & Clinical Care

POM 1 and SON2004

Course DirectorsKay Sandor, PhD, RN, LPCVictor Sierpina, MDHarold Vanderpool, PhD, ThM

WithSusie Gerik, MDElizabeth Gressle, RN, MSN, FNP-C

Roles for the Physician or Nurse

CatalystEncourages spiritual and religious questions Encourages patient’s personal discovery and dialogueStimulates social connectionNot a spiritual advisor or necessarily knowledgeable about patient’s religion

Roles for the Physician or Nurse

Secular priestTreats the “whole person” not just the diseaseResponds with compassionAffirms patient’s unique worth and dingityStands by patient in face of suffering and death

Inappropriate Roles of Physician or Nurse

Spiritual or religious teacher/leaderEthical and boundary issues

Proselytizing Power position, unequal balanceBoundariesMissionary service as possible exception

Tasks for Incorporating Spirituality and Religion into the Care of Patients

Spiritual HistoryAssess religious and spiritual issuesNot just recording their religion Determine based on patient guidance how or if to include spirituality in the interdisciplinary team approach

Continuing DialogueRelationship buildingActive listening, appropriate touchClergy consult as needed

Recognize Common Spiritual Dilemmas

Unfairness—Why me?Unworthiness—I don’t want to be a burdenHopelessness—What’s the point?Guilt and punishment—I’m being punished but I led a good lifeIsolation and anger—No one understands meVulnerability—I am afraidConfusion—Why is this happening to me? Abandonment—God (or family) doesn’t care

Taking a Spiritual History

Spiritual HistoryFAITHIMPACTCOMMUNITYASSIST

Three QuestionsWhat helps you get through the tough times?Who do you turn to when you need support?What meaning does this experience have for you?

HOPEH: Sources of hope, meaning,

comfort, strength, peace, and connectedness?

O: Organized religion?P: Personal spirituality or practice?E: Effects on medical care and end

of life issues?

SPIRITual HistoryS= Spiritual belief systemP= Personal spiritualityI= Integration with spiritual communityR= Ritualized practices and restrictionsI= Implications for medical careT= Terminal events planning