Spiritual Care
Religious beliefs can profoundly influence a patient’s recovery rate, attitude toward treatment, and overall response to hospitalization. In certain religious groups, beliefs can preclude diagnostic tests and therapeutic treatments, require dietary restrictions, or prohibit organ donation and artificial prolongation of life. (See Beliefs and practices of selected religions, pages 662 and 663.)
Because of this, effective patient care requires recognition of and respect for the patient’s religious beliefs. Recognizing his beliefs and need for spiritual care may require close attention to his nonverbal cues or to seemingly casual remarks that express his spiritual concerns. Respecting his beliefs may require setting aside your own beliefs to help the patient follow his. Providing spiritual care may require contacting an appropriate member of the clergy in the facility or community, gathering equipment needed to help the patient perform rites and administer sacraments, and preparing him for a pastoral visit.
Equipment
Clean towels (one or two) ▪ container of water (for emergency baptism), if appropriate ▪ other supplies specific to the patient’s religious affiliation.
Some facilities, particularly those with a religious affiliation, provide baptismal trays. The clergy member may bring holy water, holy oil, or other religious articles to minister to the patient.
Preparation of Equipment
For baptism, cover a small table with a clean towel. Fold a second towel and place it on the table, along with the teaspoon or medicine cup. For communion and anointing, cover the bedside stand with a clean towel.
Implementation
Check the patient’s admission record to determine his religious affiliation. Remember that some patients may claim no religious beliefs. However, even an agnostic may wish to speak with a clergy member, so watch and listen carefully for subtle expressions of this desire.
Perform hand hygiene.1
Evaluate the patient’s behavior for signs of loneliness, anxiety, or fear—emotions that may signal his need for spiritual counsel. Also consider whether the patient is facing a health crisis, which may occur with chronic illness and before childbirth, surgery, or impending death. Remember that a patient may feel acutely distressed because of his inability to participate in religious observances. Help such a patient verbalize his beliefs to relieve stress. Listen to him and let him express his concerns, but carefully refrain from imposing your beliefs on him to avoid conflict and further stress.
If the patient requests, arrange a visit by an appropriate member of the clergy. Consult this clergy member if you need more information about the patient’s beliefs.
If your patient faces the possibility of abortion, amputation, transfusion, or other medical procedures with important religious implications, try to discover his spiritual attitude. Also, try to determine your patient’s attitude toward the importance of laying on of hands, confession, communion, observance of holy days (such as the Sabbath), and restrictions in diet or physical appearance. Helping the patient continue his normal religious practices during hospitalization can help reduce stress.
If the patient is pregnant, find out her beliefs concerning infant baptism and circumcision, and comply with them after delivery.
If a Jewish woman delivers a male infant prematurely or by cesarean birth, ask her whether she plans to observe the rite of circumcision, or a bris, a significant ceremony performed on the 8th day after birth. (Because a patient who delivers a healthy, full-term
baby vaginally is usually discharged quickly, this ceremony is normally performed outside the facility.) For a bris, ensure privacy and, if requested, sterilize the instruments.
Beliefs and Practices of Selected Religions
A patient’s religious beliefs can affect his attitudes toward illness and traditional medicine. By trying to accommodate the patient’s religious beliefs and practices in your plan of care, you can increase his willingness to learn and comply with treatment regimens. Because religious beliefs may vary within particular sects, individual practices may differ from those described here.
Adventist
Birth and death rituals
None (baptism of adults only)
Dietary restrictions
Alcohol, coffee, tea, opioids, and stimulants prohibited; in many groups, meat as well
Practices in health crisis
Communion and baptism performed; some members believe in divine healing, anointing with oil, and prayer; some regard Saturday as the Sabbath
Baptist
Birth and death rituals
At birth, none (baptism of believers only); before death, counseling by clergy member and prayer
Dietary restrictions
Alcohol prohibited; in some groups, coffee and tea as well
Practices in health crisis
Some believe in healing by laying on of hands; resistance to medical therapy occasionally approved
Christian Scientist
Birth and death rituals
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