Assessment Who am I? Why spirituality matters in end of life care A back-to-front, post lunch presentation Dr. Simon Harrison TSSF Pastoral Care Lead, RD&E Vice President, College of Health Care Chaplains @binkle767 @WeChaplains
Assessment The key role of the Nurse Who am I? Why spirituality matters in end of life care
Assessment Who am I? Question for NURSE & for PATIENT Why spirituality matters in end of life care
Assessment Who am I? Why spirituality matters some reflections
Assessment The key role of the Nurse NMC Standards for Pre-registration Nursing Education (2010) expect nurses to assess patients spiritual needs (essential skills cluster 9, p113) within a holistic, person centred approach to care as well as demonstrating an understanding of how culture, religion (and) spiritual beliefs impact on illness and disability (essential skills cluster 4, p108). Spirituality is no longer in NMC code- but it is considered by implicit in each of the four strands. Trusts like ours also have spiritual care policies which give nursing a critical role. You also have RCN guide (2011) So: routine end-of-life spiritual needs assessment is a core nursing role
Assessing and providing spiritual care The key role of the Nurse The practice of spiritual care is about meeting people at the point of deepest need. It is about not just doing to but being with them. It is about our attitudes, behaviours and our personal qualities i.e. how we are with people. It is about treating spiritual needs with the same level of attention as physical needs. RCN (2011)
One chance to get it right- Priority 5: The key role of the Nurse an individual plan of care, which includes food and drink, symptom control and psychological, social and spiritual support, is agreed, co-ordinated and delivered with compassion. This is an MDT objective- but nurse is critical within it (chaplains can support as requested- but only useful if present or called!)
The key role of the Nurse What does spiritual needs assessment and provision look like? It is: care which recognises and responds to the needs of the human spirit when faced with trauma, ill health or sadness and can include the need for meaning, for self worth, to express oneself, for faith support, perhaps for rites or prayer or sacrament, or simply for a sensitive listener. Spiritual care begins with encouraging human contact in compassionate relationship, and moves in whatever direction need requires. NHS Education for Scotland, 2009 cited in Spirituality in nursing care, RCN (2011)
Who am I? Question for ME What we assess, and what we deliver ALWAYS depends on me and my context Do I feel comfortable going deep - or do I refer on? Is specialist input required (e.g. Chaplain, own minister) Can I make the time needed? What level of communication is there (family or patient) etc?
Who am I? Question for the PATIENT It also ALWAYS depends on the patient and/or family What do they understand by spiritual or religious care? Do they have a spiritual/belief framework? Do they want anything explicitly labelled as spiritual care? What do they want- and can I (we) do it or get it? There is always complexity for example, when family and patient are in a different spiritual place - but that s what makes this challenging and interesting!
Question for ME & for the PATIENT Often care is about active listening more than anything else Being open to spiritual issues enables us to listen to people share about spiritual issues such as their desire to connect and relate to other people, but also experience some higher or other state relating to humanity and the rest of the world. [Spirituality] is what gives our life, as an individual, meaning and purpose. It involves needs of reassurance, comfort, peace, happiness, dealing with guilt and forgiveness, listening and being listened to, feeling valued and having self esteem. From Religion and Belief Matter NHS Scotland Information Resource for Healthcare Staff
Why spirituality matters Because it addresses key issues at the end of life such as: hope and strength trust meaning and purpose Forgiveness belief and faith in self, others, and for some this includes a belief in a deity/higher power peoples values love and relationships morality creativity and self expression RCN 2011
Why spirituality matters Because there is only once chance to get it right : When there is nothing more to be done clinicallythere is always more that can be done holistically. Not by rushing around, not by measuring, not through technology. We do it well when we let new words dominate our assessment and our care. Being with, holding, stillness, tears, laughter, fears, listening. All of this is sacred territory and comes within spiritual care. All of this can transform the last few days of someone s life and those who care for them All of this is good compassionate nursing care. Just like all good care it needs assessment, provision, documentation & referral.
Thank you! Dr. Simon Harrison TSSF Pastoral Care Lead, RD&E Vice President, College of Health Care Chaplains @binkle767 @WeChaplains