Scottish Association of Chaplains in Healthcare
Scottish Association of Chaplains in Healthcare
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Members of SACH
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Scottish Journal Volume 8 No. 2 October 2005 EDITORIAL Dorothy Grosvenor describes the argument that nurses need to learn about and to give ‘spiritual care in addition to bodily nursing care' as the current dominant discourse. She explores this argument in a fascinating , multi layered article which challenges any woolly or trendy thinking on this issue. Both editors have found her article absorbing, and in some ways, exasperating- in the sense that we want to shout ‘Yes!' to some things, and ‘No!' to others. (Whether we are both shouting yes and no at the same places is another matter, dear reader.) As I understand it, with apologies for any misunderstandings, the author is expressing a profound opposition to the notion that spiritual care should be looked upon as an extra, add-on dimension to patient care, and that nurses, in addition to their other responsibilities, should now be expected to deliver this spiritual care, understood as somehow higher than, superior to, other, more bodily orientated aspects of nursing care. She is wary of a scenario in which the nurse, armed with spiritual care check list and having been taught that spiritual care is necessary for everyone, should be placed in a position of subtly convincing the patient into thinking likewise, and accepting a spiritual care which the patient would not have dreamt of requesting. She questions whether the enthusiasm of chaplains over the current high profile of spiritual care in healthcare might in fact be due to our hope that the nurse might become an ally in promoting ‘spiritual care for all'. In this way, referrals will be generated, the status of the chaplain raised, and the chaplain's alarm over a shrinking constituency of those actually requesting spiritual (i.e. religious) care will be allayed. Hence the title ‘Nurses : 21 st Century evangelists'. (Editor's words and analysis). The author's own view seems to be that nurses should not be compromised in this way, and that spiritual care, if the phrase is useful at all, should not be seen as something separate, something higher, another task for nurses. She points out that experienced nurses speak of their role in terms of ‘competence, compassion and beneficence, given in a spirit of mutual humanity', and she is passionate in her belief that this is all that should be required. And, that it is enough . The work of caring- human, intimate, a task in which the spiritual and the bodily are regarded as a unity, makes any other ‘spiritual care' redundant. What nurses need is the time, the support, the resources to be nurses . Yes, yes, yes. And no. From my own perspective as a chaplain who is at times asked to talk to nurses about spiritual care, I don't see myself as one who is there to add another task for them to perform. Nor do I see the spiritual as higher than or superior to the nitty gritty of caring for embodied persons. Instead, much of my effort is directed at affirming nurses in the value and worth of what they already do, as nurses, and to point out that to care with competence and humanity is to give what I understand to be spiritual care. Spiritual care can take very practical forms (I am reminded of Rachel Stanworth's story of the lady who was asked in what way she had been cared for spiritually in hospital, and who replied ‘when I felt fevered, the nurse brought a cool pillowcase for me to rest my face on.') So why call this sort of thing spiritual care? Of course the terminology gives rise to much debate and to many attempts at definition, and yet, for me, the use of the term spiritual care for these very human and practical tasks of caring does something to preserve the sacredness, the holiness of persons, of bodies, of the material, while also seeking to give full value to such tasks. So, no more than the author do I relish the idea of spiritual care as an add on extra, perhaps subtly devaluing the other aspects of the care of persons. Nor would I be comfortable with the nurse having to act in any way as an evangelist, or an apologist for the worth of the chaplain. Yet I would want (defensively perhaps) to claim a little more elbow room for the chaplain than Dorothy seems to allow for. I would not wish to be confined to seeing only those who requested spiritual care, i.e. most likely only religious people: not only because business might drop off, but also because I do believe that all of us are at some time in our lives in need of spiritual care, understood as having to do with meaning, purpose and identity, with forgiveness, love and hope, and that at times of illness this need can be acute. And while I would agree wholeheartedly that competent compassionate nursing has a huge role to play, nevertheless I would want to maintain that by dint of theological training and reflection, the chaplain is most likely to have a perspective on these matters, on this holy/human territory, that the nurse is unlikely to have. So I would plead for a partnership of equals between nurse and chaplain, in the task of caring for persons. As far as the teaching of spiritual care is concerned, while the very attempt to do so means that to some extent an artificial split has to be made between the bodily and the spiritual, I still see it as useful for those nurses who are not confident in this area, and who would benefit from focussed reflection upon ‘inner needs'. These are a few random reactions to an intriguing contribution to this edition of the journal. We hope that some of you will be similarly intrigued, and that you would consider putting together a response. I have concentrated on one contribution. Let me commend to you an edition of the journal which contains much to promote considered reflection, in the hope that you will find your own rich seams. Full Text
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CONTENTS Nurses: 21st Century Evangelists? Pages 3-8 Abstract: This article discusses the outcomes of a doctoral study into why nurses are asked to give spiritual care to patients. Tensions between bodily nursing care and spiritual care were explored in semi-structured interviews with eighteen experienced nurses. Interview materials were interpreted within feminist frameworks of caring and spiritualities as patriarchal constructions rooted in Christianities. Themes of nursing care described as spiritual demonstrated that body/spirit dualisms persisted despite secularisms. However, since spiritual care remained a confused and nebulous concept, how the addition of spiritual care by nurses will remedy the stresses and distressed described in the study is questioned. Key Words: caring, feminist,gender, nurse, religious, spiritual, suffering Dorothy Grosvenor is lecturer in the School of Acute and Continuing Care Nursing, Napier University, Edinburgh. MEASURING THE EFFECTIVENESS OF CHAPLAINCY: WHAT TO AUDIT Pages 9-13 Abstract: The authors introduce a form of audit as a response to the question ‘What should be audited in spiritual care?' Using a Systems pattern already established in other departments, focus groups were held to indicate needs and wants of the client group. This led to an examination of methods already in use and a comparison of the two. The biggest challenge revealed was access and referral to the service. Assessment of client satisfaction should take into account clients' needs. Some forms of measure are helpful others may be harmful. All information must then be used. The department now has clarity on what should and should not be measured to provide an effective service. Key Words: Systems Audit, method, challenge, measures Jim Duffy is Lead Clinical Governance Facilitator and Gillian Munro is Head of Department of Spiritual Care for NHS Tayside. Full Text From ‘Pastoral Contacts' to ‘Pastoral Interventions' Lindsay Carey, Mark Cobb and David Equeall Pages 14-20 Abstract: This research collates statistical results of pastoral care contacts undertaken at the Sheffield Northern General Hospital and the Royal Hallamshire Hospital over a twelve month period. The data was found to provide an important overview of chaplaincy work that can be used for future pastoral care management and developing better data collection and quality assurance measurements. The data was subsequently categorised using the World Health Organization (WHO) Pastoral Intervention (PI) Codings to explore the use of a newly developed universal coding system that might allow national and international data collection and comparison. Overall the data from the Sheffield Teaching Hospitals' pastoral data base was found to be easily transferable to the WHO PI codings. This report of the research offers recommendations for recording chaplaincy activity that at present is unrecorded and by doing so might reflect a more accurate picture of the role and demands of chaplaincy services. Lindsay Carey, M.App.Sc, is National Research Officer for the Australian Health & Welfare Chaplains Association on secondment to the Chaplaincy Department, National Health Service, Sheffield Teaching Hospitals, Sheffield. Mark Cobb is Senior Chaplain and Director of Professional Services at Sheffield Teaching Hospitals, National Health Service Foundation Trust, South Yorkshire. David Equeall is Chaplaincy Manager, Sheffield Teaching Hospitals, National Health Service Foundation Trust, South Yorkshire Bereavement assessment in palliative care – identifying those ‘at risk' Pages 21-25 Abstract: Bereavement care is well established as an essential element of palliative care. However, whether or not there is value in risk assessment tools to predict bereavement outcomes is open to debate. Members of multidisciplinary palliative care teams and nurses in particular are encouraged to provide high quality physical, psychological, social and spiritual care to patients and their families/carers, care that should include bereavement care. This article offers an analysis of traditional and contemporary bereavement theory, considers the use of a risk assessment tool to enable health professionals to make decisions as to whether an individuals may be at risk of a complicated bereavement. Key Words: Attachment, Bereavement, Grief, Risk Assessment, Palliative Care Marie Carmichael is a staff nurse at the Marie Curie Hospice Glasgow REGISTRATION OF CHAPLAINS Pages 26-26 Abstract: A former representative for Scotland on the Council of the College of Health Care Chaplain (CHCC), and while in post, chair of the CHCC Professional Services and Registration Group, reflects on the questions, issues and process of professional registration for healthcare chaplains. The editors. Key words: : Chaplaincy, healthcare, professional, registration John Birrell is Chaplain at Perth Royal Infirmary, and until July 2005 was one of the two Regional Representatives for Scotland on the Council of the College of Health Care Chaplains. As chair of the College's Professional Services and Registration Group he was responsible for taking forward the registration agenda. The Janki Foundation: A Values Approach to Spirituality and Health Pages 29-34 Abstract: The Janki foundation is a UK based charity focusing on spirituality and health. Its modular training programme ‘Values in Healthcare – a spiritual approach' explores healthcare professionals' understanding of spirituality and personal values, and how these relate to their professional lives. Such an approach promotes self awareness and examination of core values, and helps combat the stress and low self worth which can affect HCPs. The Janki foundation holds that spiritual values are at the centre of healthcare, and affirms that the development of a values based culture within healthcare has transformative potential Keywords : Janki Foundation; spirituality; spiritual values; values in healthcare Astrid Bendomir is Janki Foundation co-ordinator Scotland, Stephanie Morrison is lecturer in the school of health sciences,The Robert Gordon University, Aberdeen. A Bahá'í approach to spirituality Pages 35-39 Abstract : This article is a brief examination of the meaning of spirituality, as gleaned from the Bahá'í writings. Familiar terms such as human nature, the human soul, and the mind are defined from basic principles and the potential powers of the human soul are discussed. The relationship of the human soul to God and the indispensable role of the Founders of the great religions as the primary link in this relationship are elucidated. The Word of God has unique transforming effect on human hearts and alone has the ability to awaken the human soul to express its potential. The purpose of becoming spiritually conscious is for humanity to prepare itself for the life beyond, which is eternal. Such a soul will achieve true happiness and liberty in this life and will, moreover, be motivated to translate that consciousness into constructive deeds for the betterment of humanity. Sepideh Taheri is consultant paediatrician,Royal Hospital for Sick Children, Edinburgh. Spiritual Health Care and the European Union (EU) Pages 40-43 Editorial Comment: Maintaining an awareness of the developments within spiritual care and chaplaincy in Scotland, the UK and in Europe is a challenge. In previous issues we have endeavoured to keep readers informed and have featured articles on registration of chaplains, standards and competencies for spiritual and religious care, agenda for change, and other key topics. With the permission of the European Network of Healthcare Chaplaincy and Fr. Stavros Kofinas (consulting editor) we are pleased to bring you details of recent developments with the European Union. The report can also be accessed on-line at http://www.eurochaplains.org/brussels05.htm . Key words: Chaplaincy, European Union, spiritual care Stavros Kofinas is Coordinator of the European Network of Health Care Chaplaincy and a Consulting Editor of the Scottish Journal of Healthcare Chaplaincy. |
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Book Reviews Pages 44-48 Befriending Death Woodward J. ISBN 0–281–05370–7 SPCK
Caring for Jewish Patients Dr Joseph Spitzer ISBN 1-85775-991-5 Radcliffe
The Cost of Certainty: How Religious Conviction Betrays the Human Psyche Young J. ISBN 0-232-52580-3 Darton, Longman & Todd Imaging Life After Death Fischer K. ISBN 0-281-05717-6 SPCK
Voices in Disability and Spirituality from the Land Down Under: Outback to Outfront Newell C. and Calder A. Editors ISBN 0-7890-2608-2 The Haworth Pastoral Press
The Spiritual Revolution Heelas, P and Woodward L. ISBN 1405119586 Blackwell Publishing
Dancing with Dementia: My story of living positively with dementia Bryden C. ISBN 1-84310-332-X (pbk) Jessica Kingsley Publishers
Practicing the Sacred Art of Listening Lindahl K. ISBN: 1-901557-90-1 Wild Goose Publications |
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THE ORERE SOURCE Abstracts from the Pastoral Care and other Healthcare Journals Page 49-55 The Rev. W. Noel Brown is a Chaplain and ACPE Supervisor, Northwestern Memorial Hospital, Chicago, and editor of THE ORERE SOURCE, a bi-monthly compendium of his abstracts from the pastoral care and healthcare literature. The summaries printed in the Journal have been selected from recent additions to the 13,600 in the database.
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