Showing posts with label spiritual care. Show all posts
Showing posts with label spiritual care. Show all posts

Monday, December 21, 2009

Vancouver Sun Article by Douglas Todd December 21, 2009

http://a123.g.akamai.net/f/123/12465/1d/www.vancouversun.com/health/Douglas+Todd+Fraser+Health+firing+spiritual+care+directors+step+backwards/2366332/douglastodd1108.jpg

The Fraser Health Authority's decision to terminate 12 spiritual care directors is a sign it is not operating at the highest levels of medical innovation.

To put it more bluntly, the sudden firing of the spiritual care coordinators is a strong indicator that the Fraser Health Authority's leadership is living in the Jurassic Age, when dinosaurs roamed.

Fraser Health's administrators appear painfully ignorant of contemporary scientific research into healing.

They don't seem to realize that, since 2001, more than 5,000 research studies have been published showing a strong correlation between patients' spirituality and their physical and mental well-being.

But Fraser Health does not appear to respect this university research into how spirituality and religion have been shown to, among other things, reduce patients' physical and mental disease rates and the time they spend in hospitals.

Instead, Fraser Health also has been slashing what it questionably calls other "non-core" services, including social workers/counsellors, addiction programs and psychiatry for troubled youths.

There is no doubt strong pressure on rising health care costs.

But those pressures have precious little to do with non-denominational spiritual care coordinators, who used to be known as chaplains.

The high price tag for medical care has mostly to do with the ever-rising expectations of the public and the escalating cost of technology -- equipment and diagnostic testing -- as well as drugs, not to mention the often high earnings of many physicians, medical specialists and administrators.

With Fraser Health running an annual budget of $2.48 billion, it appears short-sighted to chop 12 spiritual care directors trained in supporting people with all kinds of grave illnesses.

The $650,000 the spiritual caregivers collectively earn is less than 1/4,000th of the Fraser Health's $2.48 billion annual budget, which apparently has to be trimmed by $10 million due to provincial government shortfalls.

There has been an outcry about the November firings by an unusual coalition of religious and secular leaders, according to Christoph Reiners, pastor of Peace Lutheran Church in Abbotsford.

The loose coalition includes mainline Protestants, Catholics, evangelicals, Sikhs, Hindus, Muslims, New Democratic Party MLAs and regional mayors. But the coalition has been told by Fraser Health CEO Nigel Murray not to waste their breath.

Nevertheless, Murray and his advisers would do well to catch up on the extensive scientific research outlined in the seminal book, Spirituality in Patient Care, by Dr. Harold Koenig, a Duke University psychiatrist who has arguably done more than anyone to gather academic data on the positive benefits of integrating spirituality into clinical practice.

Spirituality in Patient Care, for instance, cites a major study in the New England Journal of Medicine showing that 90 per cent of medical patients report using religion and spirituality to cope with and make sense of physical illness. Forty per cent said it's the "most important" way they do so.

Additional studies, including at Duke Medical Center, have found that people who receive spiritual or religious support are less prone to disease, and spend fewer days in hospital on average than non-religious people with the same acute or chronic conditions.

Spirituality in Patient Care also points to dozens of studies showing North Americans who feel sustained by their religious convictions and communities are inclined to live longer and suffer less from depression, anxiety, suicidal tendencies and addictions.

Despite this overwhelming data linking a vibrant spirituality with good health, Koenig is realistic enough to recognize spiritual care coordinators are not a panacea for all that ails patients.

Not every patient wants spiritual support, for instance. Sometimes, as Koenig says, religion can get in the way of healing, including patients who take an unhealthy fatalistic view that their disease is "God's will" or "Allah's will" and there's nothing they should try to do about it.

To be fair, Fraser Health is not the only unimaginative medical organization in North America cutting chaplains and others, such as social workers and counsellors, who often provide spiritual and emotional back-up to patients.

These behind-the-times medical organizations are flagrantly disregarding the recommendations of major mainstream North American-wide professional bodies, including those devoted to hospital accreditation, nursing and medical education.

All these major medical bodies, reports Spirituality in Patient Care, have gone on record urging hospitals to improve spiritual care for patients, both through the use of chaplains and by heightening the spiritual literacy of physicians, nurses and social workers.

The recent research linking spirituality with good patient care points to a win-win situation.

At a relatively low cost, the majority of patients who ask for spiritual support could receive the help they need to heal.

As well, Canadian taxpayers could in the long-run save money through reduced incidence of disease and shorter hospital stays.

dtodd@vancouversun.com

Read Douglas Todd's blog at www.vancouversun.com/thesearch

Thursday, August 20, 2009

What do you do when you know your patient is going to die?

What do you do when you know your patient is going to die?
What do you feel inside?

Death is a hard thing for us to face. In the field of healthcare and spiritual care, death is a prominent player. While part of our work is to provide support and comfort for patients, family and staff involved in a death, it doesn’t seem to get easier. And when you have spent years investing your care and energy into the life’s story of a person, it is not easy to walk away unscathed.

I did not plan to get into this line of work. I did not aspire to be a “midwife for the dying”. I started my ministry career at the age of 23. I love stories. I am fascinated by books and movies. That is why I do this work. I get to hear stories from my patients and to be a part of their story. I am sure that others in this field will agree that some stories are hard to hear, while others are hard to watch. So after meeting the person and journeying with them, it is hard to not be untouched by their life. It is often said at funerals that whether we knew the deceased well, or whether we knew the deceased in passing, the fact that they are gone from this earth will have an impact on us. What that is I do not know. I think that some deaths are harder to deal with than others, for the attachments that come from the relationships. While we maintain the professionalism and boundaries, I think that there are some lives and deaths that impact us more than others. So when you have invested time and energy, and the story has taken its hold, how do you feel when you know that your patient is going to die? What do you do?

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I have given this some more thought. The question of "what do you do/feel when you know that your patient is going to die?" A lot of people find it interesting that I refer to them as "MY" patients and commented on this. I realize that I am not a doctor nor am I the primary caregiver who influences the success of their treatment, but considering the area of expertise and the time that I have invested in the relationship, I will think of the individual as "my patient". So hence I suppose that the attachment that one feels to the person who is dying is of consideration in the matter what one thinks or feels when you know that they are dying.

The relationship of caregiving is very intimate. In pastoral/spiritual care, people will bear their souls to another who is virtually a stranger. Hence the depth of the relationship and the content can have influence to the emotions of the care provider when the patient's condition deteriorates. I have had various patients that I have known for numerous years. It is a different reaction for one to die versus another, and I think that it is dependent on the type of relationship that has been cultivated and whether or not the death was anticipated.

So I pose the question to my fellow chaplains/spiritual care providers, what is your reaction when YOUR patient dies? What do you do? What do you feel?