Box 2. Personal reflection on the role of the hospital chaplain
“There is a difference between religious care and spiritual care. A chaplain should be able to provide both. Religious care is rooted in a faith belief and the patient or family expect ritual which might involve prayer and/or sacrament. Probably only about one in 10 people in this country regularly attend a place of worship and would expect this. More of my time is spent supporting patients, families and staff with spiritual care. If we acknowledge the true holistic approach, spiritual care should be recognised and hopefully provided not only by the chaplain, but the whole health care team.”
Reverend Nigel Griffin, Morriston Hospital, Swansea. An innovative study addressing patients’ spiritual needs incorporated the hospital chaplaincy service into the Liverpool Care Pathway (LCP) (Pugh et al, 2010). Over a period of six months all hospital patients started on the LCP were referred to the hospital chaplains. An initial visit was made and a calling card left in case further support was needed at a later date. The visit was then documented by the chaplain in the LCP documentation. The evaluation suggested that quality of care improved and there was less pressure on nurses. Although a preliminary concern was that spirituality was being imposed on patients and family members, this was unfounded and nurses felt the service was extremely valuable and should continue. Very few patients declined the offer of a chaplaincy visit and nearly two thirds requested a follow up visit. Nurses felt relatives were also less distressed following the visits.
It is outside nurses’ or doctors’ role to provide in depth religious or spiritual counselling and, when a need is identified, referrals should be made to the hospital chaplain, counsellors or psychologists (Phelps et al, 2009; D’Souza, 2007; Winslow and