The Role and Benefits of Spiritual Care in Healthcare

Spirituality simply refers to how we find and make meaning in life in the essence of our humanity. Spirituality is at the center of everything we do, but it is only one component of faith and religion. It is the human ability to transcend any experience or circumstance yet find hope, purpose, and meaning as we seek to see beyond the situation. That is the core of spirituality, where we root our lives in our beliefs, practices, and values to create meaning.

Spiritual care is a spiritual practice offered in many healthcare settings to support those coping with the complexities of life and health. In a healthcare setting, spiritual care is essential to the services provided to patients, families, and staff. This work is done through the work of professional chaplains. Many hold a common misunderstanding regarding the role chaplains play in the healthcare environment. It is often thought that the purpose of a chaplain is mainly to offer prayer at the end of life. However, in today's healthcare arena, chaplains are called upon to journey with patients and families as they adjust to illness and diagnoses and to be the bridge between the medical staff and the family's beliefs and wishes. Chaplains help those they encounter find meaning as they navigate life situations. Additionally, chaplains offer significant support to staff and physicians to help mitigate workplace stress and anxiety.

Chaplains work with people of all faith backgrounds and even those who profess to be agnostic or atheist. One of the strongest skills a chaplain can provide is active listening. Patients and families often engage in God talk, which alerts chaplains of their spiritual distress. Questions such as "why have God abandoned me? Or why is God punishing me?" may arise. Other signs of spiritual distress may be visible, including hopelessness, anger, sadness, despondence, loss, emptiness, and despair. The chaplain offers hope, comfort, support, connection, and compassion in such times.

Most chaplain's follow Fowler's Stages of Development to provide spiritual care for adult and pediatric patients. This is important because children are not small adults. Spiritual care from birth through the end of life occurs in developmental stages and should be addressed accordingly. Following developmentally appropriate measures helps ensure that all patients have a developmentally appropriate sense of what is occurring in their lives. Chaplains help these patients and families create goals and plans of care in accordance with their values, beliefs, and concerns.

In large, chaplaincy is a professional discipline that requires very specific training. Chaplaincy requires a Master of Divinity and, for most hospitals, at least four units or one year of Clinical Pastoral Education (CPE). This educational standard prohibits some hospitals from accepting clergy who lack formalized training to become volunteer chaplains. Since unique and spiritual assessments are performed, this structure upholds the competencies of professional chaplaincy according to the Board of Chaplain Certification (BCCI), the Association of Professional Chaplains (APC), and other spiritual care accrediting organizations. This affords chaplains an opportunity to be an integral part of interdisciplinary teams as plans of care are made. This also helps incorporate spiritual well-being into the multi-disciplinary approach to holistic care. Additionally, a chaplain's work is authenticated in the electronic medical record, where all other disciplines document care. 

Chaplains are advocates, working to ensure the equitable and inclusive treatment of patients and families and to ensure a safe work environment for staff. Many chaplains work with administrative, medical, and psychosocial teams to address social determinants of health and biases that influence decisions and barriers to healthcare, particularly for those with complex medical needs. Another function of chaplains is to provide pastoral counseling. Although many institutions provide professional counseling through the Employee Assistance Program (EAP), many in the workplace prefer spiritual support. Chaplains offer that support, whether it is a personal or workplace concern.

The reality is when an individual is admitted to the hospital, the entire family unit, social concerns and complex relationships become part of the hospitalization. A chaplain is able to sit with the patient and/or family individually and collectively to assist them in finding spiritual grounding. The same is similar for staff. People cannot always compartmentalize their personal concerns when they come to work. Chaplains provide support when staff receives difficult news through a phone call or text when they are overwhelmed and when a situation in the hospital or the community shakes them to their core. At such times, debriefings are a valuable tool in a chaplain's arsenal. Chaplains hold team or individual debriefings to help decompress or deescalate staff and families' spiritual and emotional distress.

The current trend in spiritual care is to provide trauma-informed ministry. The past two and a half years of the pandemic have been traumatizing in one form or another for most people. The pandemic has un-layered a barrage of mental health concerns. It has also brought the importance of spiritual well-being into many healthcare conversations. We have seen an uptick in mental health needs in both the pediatric population and adults. Additionally, the number of attempted and completed suicides has risen. Trauma-informed ministry allows chaplains to interact with patients, families, and staff from the perspective that each has experienced a physical or emotional event that has caused despair, pain, grief, and suffering. In providing trauma-informed ministry, chaplains offer safe spaces to provide comfort and compassion without re-traumatizing the individual.

Lastly, chaplains are the spiritual voice of influence in a healthcare setting. They can offer daily words of encouragement, invocations, dedications, blessings, and religious rituals. You may find the chaplain providing words of inspiration and guidance on community engagement, giving a faith perspective on current events, advocating for social justice, shaping culture, team building, and resilience training. Chaplains educate nurses, interns, residents, fellows, faculty, and other staff in being culturally/spiritually sensitive and appropriate.

Offering a robust department of spiritual care is a healthcare asset. Healthcare systems that provide continual services help create a culture of holistic care for patients, families, and staff. The extra support that chaplains give can help improve the patients' and family members' healthcare experience.