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16. Spirituality

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Keeping the faith

Introduction

The varied and creative examples of how wards meet patients’ spiritual and religious needs (see below) illustrate that this is yet another area where inpatient staff try energetically to make patients’ admissions as meaningful and therapeutic as possible. These efforts are essential for reasons of:

  • Therapeutic outcomes
  • Regulatory compliance
  • Safety
  • Patient satisfaction

Whether or not a patient has overt signs of a particular faith, they may still have a cultural or spiritual connection to a religion and this can become more significant for many people in times of stress, such as admission to hospital. For many people, an all-encompassing belief that is specifically non-religious, such as humanism, may be an essential part of their way of seeing the world.

Where people are from a minority faith, such as Judaism or Islam, they may have different requirements and ways of expressing this according to their cultural and social background.  If in doubt, it’s usually best simply to ask. Families and friends can be very helpful about what aspects of faith or spirituality are important to the patient.

Most patients appreciate staff interest in their spiritual beliefs and practices, and as far as they are able, to answer questions about what would help them sustain these while they’re in hospital. If a person uses particular words to describe their beliefs, for instance if they refer to ‘faith’ rather than ‘religion’,  it is a strong indication that they may prefer these to be used in.

The sorts of questions that staff use to open discussion include:

“Would you say you have a particular faith?”

“Do we need to understand anything about your faith/religion to make your stay in hospital more comfortable?”

“Would it help you to talk with someone from your faith?”

As the many examples below illustrate, staff are thoughtful and creative in ways of meeting patients’ spiritual needs, for example:

  • Help with specific kinds of personal care – the opportunity to wash in a certain way, for instance
  • Making sure that staff of the same gender as the patient are available where intimate care is needed
  • Availability of particular clothing, such as head coverings
  • Availability of religious jewellery or artefacts, such as a rosary or prayer mat
  • Access to books relating to their faith
  • The opportunity to talk with a chaplain or representative from their faith
  • The opportunity to pray according to their faith in the way their faith requires
  • The opportunity for quiet, reflective time – which some patients may think about as ‘meditation’ or ‘mindfulness’
  • The availability of creative activities, such as art, to express their spirituality
  • The opportunity to celebrate festivals – you can ask the hospital chaplain and leaders at local places of worship about these and ideas for how patients may be able to celebrate while in hospital
  • Access to a sacred space and, where appropriate, the opportunity to visit the local place of worship with a carer
  • Encouraging families and friends to bring in food – during Ramadan, for instance.
  • Ask whether there is anything that would make patients feel more comfortable and at ease while they are on the ward.
  • Some patients may want to become more in touch with their religion, faith or spirituality during their stay in hospital and therefore their wishes, needs or requirements might change.

Ward examples

Staffing

  • One of the nursing team is the ‘spiritual and pastoral care link worker’ for the ward.
  • Each ward has a spiritual healthcare representative.
  • Unit nurse attends the hospital spirituality group providing suggestions on how to engage with patients’ spiritual needs.
  • The chaplaincy team offers a wealth of knowledge about different faiths and religions, acting as a resource for staff.
  • The Anglican chaplain is part of our acute care forum.
  • Some of our chaplains are trained in counselling and can be utilised for emotional support – not just religious and pastoral care.
  • We’re hoping that a chaplain will be coming onto the ward on a weekly basis to co-facilitate a group focused on sharing beliefs, values and views etc.
  • Chaplain visits.
  • Photos of each of the chaplains is displayed on the wards, with clear descriptions including their name and religion.
  • Our specialist unit for acutely ill deaf patients, an Anglican chaplain who can use British Sign Language attends once a month.
  • The Therapeutic Liaison Worker is also ‘Spiritual and Pastoral Care Link-worker’.
  • The chaplain co-facilitates a group focused on sharing beliefs, values and views etc.
  • The Therapeutic Liaison Workers create displays on different seasonal festivals (like Diwali) and organise ward-based events with cultural food etc.
  • Some of the chaplains are trained in counselling and can be utilised for emotional support – not just religious and pastoral care.
  • All Staff are trained in Belief and Recovery.

Information and communications

  • The Trust-wide ‘Spiritual Awareness’ forum encourages local non-Christian faith communities to be aware of wards and builds links between the wards and those communities.
  • Celebrations and festivals of a variety of faiths are displayed on a special display board which is visible to all patients, and patients are encouraged to contribute artwork and other creative ideas to these displays.
  • A ‘Spiritual Awareness’ open day helps to encourage other faiths to be aware of the hospital and use the facilities.
  • Collecting information on different cultures to create a new notice board.
  • Posters of religious festival dates are displayed on each ward, all patients are encouraged to celebrate these faiths, which are often demonstrated in the cooking sessions. Birthday cakes are provided for patients and leaving parties are provided for.
  • We display multi-faith calendars, showcasing all of the special festivals and dates.
  • Staff create displays on different seasonal festivals (like Diwali) and organise ward-based events with cultural food etc.
  • Each ward has a pack all about different religions and faiths which details important information like diet, rituals etc.
  • There is a monthly multi-faith calendar provided.
  • Our chaplain is working on an electronic resource for all faiths.
  • Cultural and Spiritual File is available.

Patient experiences

  • A ‘meditation time’ session provided by a chaplaincy worker on a weekly basis. The session is publicised to service users as a ‘contemplative place to be still’.
  • We are hoping to facilitate cultural evenings where patients can prepare their traditional dish to share with other patients and staff.
  • We have set up a ‘faith room’ in collaboration with social services.
  • Our prayer room has beautiful stained-glass window, with a scene of trees, sun etc. The centrally-placed crucifix is movable, and we are going to get stencils of symbols of different faiths for walls.
  • We have a quiet room for prayer with a Bible and Koran.We have a ‘Spiritual Space’ room.
  • There is a multi faith room in each unit.
  • We are developing concept of ‘sacred space’ – provision of spiritual care rather than the provision of a room for people to pray in.
  • Arrangements for prayer mats.
  • A range of religious services are available for patients to attend either in the community or in the hospital.
  • Muslim patients can go to mosque down the road.
  • Fasting at Ramadan is accommodated. There is access to meals out of hours – microwavable meals, takeaways and families can bring in food.
  • The patients with assistance from the activities co-ordinator have produced a tapestry showing in fabric what is meaningful to each of the patients.
  • All patients have access to religious and spiritual leaders who will be asked to meet with those patients who do not have visitors, if the patient wishes. The Independent Advocate will also identify those patients.
  • Two ministers visit the Hospital on a fortnightly basis and offer an informal drop in service to all patients. Links have also been made with local Imaans.
  • Community faith festivals are displayed on calendars in Multi Faith rooms. Festivals are discussed in daily planning meetings and community meetings and patients are offered the opportunity to plan and engage in these.
  • Spiritual Assessment is completed on Admission.

Patient Examples

  • I spend time with the chaplain each week. She remains me my life counts for something because God loves me.
  • The vicar visited my ward she was very friendly and we prayed together – it really gave me a sense of peace.
  • I talked to the chaplain a lot, firstly as a religious person but then just because he was someone ‘outside’ who wouldn’t write down everything you said.
  • My yoga teacher comes on the ward each week to take me through some practice. It’s good that I can continue with it even on the ward.
Wards Are For Christmas Too
The ward put on a Christmas event for service users and visitors. This included the switching-on of lights and a festive display in the garden with a homemade snowman and lady, homemade decorative baubles and stars, a fun bingo game and a Christmas sing-a-long and buffet. Service users, visitors and staff all gave fantastic feedback!  The event created a homely, festive atmosphere and almost all of the ward’s service users got involved.
East London NHS Foundation Trust
East London NHS Foundation Trust have a very dynamic, structured approach to meeting patients’ spiritual, religious and cultural needs including a (very!) dedicated team. Here’s the excellent ‘calling card’ that members of the team give patients, and their info leaflet.

A little note from Marion Janner (founder of Star Wards)

I’m Jewish but of the very secular variety. My Jewishness is nevertheless very important to me and, among other things, is expressed by my not eating pig or shellfish. When I’m in hospital there’s a (delicious!) kosher option at every meal and St Ann’s is a very culturally switched on hospital. But every time I’m in Israel with my mother’s Orthodox siblings and their families, I think about what a very different lifestyle they lead compared to mine let alone to non-Jews’ daily routines.For example, on Shabbat, our Sabbath, my relatives don’t do anything which is construed as ‘work’. this embraces everything from not driving, using electricity or writing to not using towels or picking anything from a tree. The tree issue is unlikely to prove tricky during an admission, but the business with electricity would be important to discuss with Orthodox Jewish patients. And then I think about how a key but perhaps under-explored issue on wards is how important a part our faith plays in our lives, and the implications of this for our time on the ward.

 

 

Categories: Mindfulness, Wardipedia

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