Health Care Provider and Faith Diversity: First Draft
“Spirituality is the aspect of humanity that refers to the way individuals seek and express meaning and purpose and the way they experience their connectedness to the moment, to self, to others, to nature, and to the significant or sacred” (Pulchalski & Ferrell, 2009).
INTRODUCTION
It is important for the professional nurse to recognize the unique spiritual beliefs and individuality of each patient and family who enters the hospital setting. Nurses have a great opportunity to facilitate their patient’s complex spiritual and religious needs in the face of crisis. Fulfilling these needs has a highly influential impact on patient outcomes and can increase the patient’s ability cope with their human circumstances. The importance of the patient’s belief system should not be underestimated, and the beliefs of the nurse should never be imposed on a patient, especially during such a vulnerable time as this. If the nurse maintains a level of respect for the patient that transcends their own ideology, they can honor and promote the dignity of the patient. This paper reviews some of the basic Christian beliefs in comparison to three other religions with respect to illness, its meaning, cause, treatment and outcome for the hospitalized patient. In commitment to providing patients with relationship-centered care, this author closes the paper with a summary of her own personal beliefs related to spirituality and health care. No individual belief should be considered right, wrong, good or bad. Instead, the professional nurse considers the spiritual assessment to be a sacred conversation that provides them with valuable details for providing excellent patient care. This aspect of the nurse’s role is worth mention for the reason just explained, as well as to lessen the chance for “cross-cultural misunderstandings” (Lipson, Dibble, & Minarik, 2002, p. iv). Individual beliefs and views on spirituality and religion are born out of each human being’s unique life experience (Maurer & Smith, 2009). These views can be of a religious or a spiritual context, or they may involve a perspective that does not include spirituality or religion at all. Conducting a comprehensive spiritual assessment honors the dignity and self-worth of each patient. For some, it may even promote the best possible outcome. Individual questions during the spiritual assessment might include asking whom or what provides the patient with strength or hope. The nurse might also ask if the patient’s faith and/or religious services are helpful in coping with their illness. Religious services for the hospitalized tend to include the use of prayer, meditation, visits from clergy, rituals and rites. These can all be critical components to the patient’s healing process depending on their beliefs and values. When it comes to formal religion, three fourths of the adult American population state they are affiliated with a Christian religion. This includes Protestant, Catholic, Mormon, and Orthodox Christians. The remaining one-quarter of America consists of persons who are unaffiliated with any faith at all (about 16% percent) and those who practice non-Christian beliefs, such as the Zen Buddhist, the Muslim and the Hindu (The Pew Forum on Religion & Public Life, 2007). While it is important for the nurse to build upon a general understanding of common religious views, one needs to remain aware of the growing number of Americans who claim to be unaffiliated with any belief in religion or spirituality at all. These individuals may choose to call themselves atheist or agnostic (2007), and they should be recognized for their beliefs as well. Buddhists practice a spiritual approach to life that focuses on working towards the attainment of a clear, calm state of mind, undisturbed by worldly actions. Their journey involves successive rebirths into a human life until they reach nirvana or enlightenment. Christians believe in one God who is the Trinity, three in One. They believe that prayer and faith in God’s Will and Mercy carries them through their struggles and suffering. Despite the fact that both of these religions value prayer and outcomes empowered by forces greater than themselves, they also both respect the gift of modern technology and advanced medicine. Any decision or consent either a Buddhist or a Christian might make to allow extraordinary or aggressive health care measures to be taken are viewed as an individual choice, and they are usually supported. Buddhists give focus to maintaining “mindfulness” and often prefer to meditate during times of crisis. For this reason, it is not uncommon for the Buddhist patient to request peace and quiet. The value that is placed on remaining mindful during all of life’s experiences is likely to influence the Buddhist patient’s decisions regarding pain medication and sedatives, and therefore, patient education may require more detail and time (Ehman, 2012). Additionally, some Buddhist patients can be very modest with regard to being cared for by a member of the opposite sex. This discomfort should be handled by the healthcare team appropriately. Buddhists practice a spiritual approach to life that focuses on working towards the attainment of a clear, calm state of mind, undisturbed by worldly actions. Their journey involves successive rebirths into a human life until they reach nirvana or enlightenment. Christians believe in one God who is the Trinity, three in One. They believe that prayer and faith in God’s Will and Mercy carries them through their struggles and suffering. Despite the fact that both of these religions value prayer and outcomes empowered by a Higher Power, they also both respect the gift of modern technology and advanced medicine. Any decision or consent either a Buddhist or a Christian might make to allow extraordinary or aggressive health care measures to be taken are viewed as an individual choice, and they are usually supported. Buddhists give focus to maintaining “mindfulness” and often prefer to meditate during times of crisis. For this reason, it is not uncommon for the Buddhist patient to request peace and quiet. The value that is placed on remaining mindful during all of life’s experiences is likely to influence the Buddhist patient’s decisions regarding pain medication and sedatives, and therefore, patient education may require more detail and time (Ehman, 2012). Additionally, some Buddhist patients can be very modest with regard to being cared for by a member of the opposite sex. This discomfort should be handled by the healthcare team appropriately. Buddhism focuses on mastery of a central practice that leads to attainment of a “clear, calm state of mind undisturbed by worldly actions and full of compassion” (Difference Between, 2011). Healing and recovery for the Buddhist is promoted by awakening to wisdom of Buddha, which results in spiritual peace and freedom from anxiety (Lipson, Dibble, & Minarik, 2002, p. B6). Patients and families often prefer to chant at the patient’s bedside. This ritual is believed to help the state of mind of the ill person and to bring them good karma as well. Christians and Buddhists both believe in exuding love and compassion toward others. Both of these religions are also in agreement that life begins from the moment of conception. For this reason, they denounce euthanasia and abortion, acts that are viewed as taking another life. Buddhists believe their healing comes when they relate with their illness as an active part of their present life, instead of trying to conquer or destroy it. Buddhist’s believe that sickness must be viewed as something with which they share a relationship. In contrast, Christianity portrays an adverse dynamic between health and sickness, and views disease as something that must leave the body. A healing way to relate to sickness for the Buddhist patient would involve acceptance without resentment, gratitude for what there is, and peace in the face of demise (Difference Between, 2011). The Jehovah Witness believes in one God, although they do not believe in the resurrection of Jesus. This denomination varies from other Christian faiths distinctly with regard to the strict prohibition of receiving any blood or blood products, even their own stored blood cannot be autotransfused (Lipson, Dibble, & Minarik, 2002, p. B15). Witnesses do not accept medications or foods with blood products in them. Oddly enough, if there is a need for an organ transplant, the Witness is encouraged to decide on this based on their own conscience, and they are supported either way. Christians have this liberty with any treatment that is presented as a health benefit. A common misconception about Jehovah’s Witnesses is regarding faith-healing, which is not a belief they share. Actually, it is forbidden. Instead, Witnesses focus their prayers on God’s comfort and endurance to through their illness and do not pray for healing. Christians include God’s ability to heal in their prayer, and they believe this can be done by faith alone. There are many stories in the Christian bible that tell of Jesus’ healing power, many of which occur by faith (Ehman, 2012). Lastly, it is important for the nurse to know it would be inappropriate to console a Jehovah’s Witness by saying their recently deceased loved one is “in a better place now” because Witnesses do not believe those who die experience the afterlife immediately (2012). Important components to healing for the Atheist patient vary per individual, but many include a supportive family and the care of excellent health care providers. The atheist places the focus of their beliefs upon science, reason, and their own ability to actively seek a solution for whatever problem they may face. Atheists do not believe spirituality to be a necessary component to healing. The Atheist is likely to believe that anyone can heal with or without faith. Most online writings by Atheists vary greatly in diversity. In fact, the Atheist posts reviewed by this author were more diverse than any others. Several Atheists mention the importance of a practical, logical, positive mindset (Difference Between, 2011). Atheists approach health issues without any dependence or reliance upon a higher power, and they tend to have the ability to provide themselves with comfort and encouragement apart from faith in the unknown. They might have less restrictive beliefs about certain controversial rights and wrongs, like abortion and euthanasia. How do they justify the claim that no one has a supernatural soul? Their rationales are based upon the belief that there is no scientific evidence of anything supernatural; there is no credible evidence that humankind is a unique creation by a deity; and, there is no credible definition of a ‘soul that exists (Difference Between, 2011). During the spiritual assessment the nurse should identify what is important to the patient with regards to faith, especially if spiritual suffering is in question. Pastoral care and other resources are accessible to the nurse who is attempting to help with locating a resource for a spiritual or religious intervention for their patient. Most hospitals have pastoral care programs and other resourceful connections available. Taking the time and effort to facilitate these needs for patients can have a dramatic impact on patient outcomes. Nursing experts teach the importance of discovering one’s own personal beliefs in order to be able to journey with others during their illness. One cultural nursing education resource states that the nurse “cannot provide culturally competent nursing care in the absence of self-awareness; nurses need to acknowledge their own values, beliefs, and communication style in order to understand what they contribute to cross cultural communication” (2002, p. 2). The author of this paper identifies with a belief in God as the Creator of all. Her beliefs, however, have been in question with regard to specific aspects of the Christian religion. The Bible states that he who does not believe in Jesus Christ will not enter into heaven. Since this author has begun a career in hospice care, she has known several patients who have believed in God without acknowledging Jesus Christ, and it is difficult to consider these individuals as not being accepted into God’s Kingdom. At the present time, this question leaves her perplexed. Yet, her personal faith in the good and the love of Jesus Christ and God Almighty remain strong. Perhaps it is the Bible itself and the religious dogma that she questions. What this author does know is that God has provided her with an ability to love all of her patients with an unconditional compassion regardless of what their own faith or personal beliefs may be, and she hopes through this love, God is honored and glorified and her patients are comforted during their time of need. This author also gained valuable experience from this exercise. It provided her with a better understanding of the Buddhist, Jehovah’s Witness and Atheist’s beliefs, and it helped her to identify the disconnectedness she’s felt with her own spirituality recently. After making a career change that was a step toward her faith and spirituality, she was surprised to find herself questioning the only belief she ever felt certain of. Perhaps with time she will work this out and find her certainty in religion again. What she will continue to do for certain is make a habit of taking inventory of her beliefs regularly for her own benefit and for the benefit of her patients.