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Screening for Spiritual Struggle. Judith Blanchard, D.Min., B.C.C. – Chaplain Clinical Leader. A Quality Improvement Initiative at Maine Medical Center, Portland ME Winter-Spring 2011 Judith Blanchard, D.Min., B.C.C. Chaplain Clinical Leader
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Screening for Spiritual Struggle Judith Blanchard, D.Min., B.C.C. – Chaplain Clinical Leader
A Quality Improvement Initiative at Maine Medical Center, Portland ME Winter-Spring 2011 Judith Blanchard, D.Min., B.C.C. Chaplain Clinical Leader Douglas Allan Dunlap, Ed.M., Ed.D, M.Div., Chaplain Resident
Objectives NURSING COLLABORATION – Learn how one might engage nursing staff in screening for religious/spiritual struggle.
QUALITY IMPROVEMENT –Gain familiarity with a quality improvement project for in-patient spiritual care.
Importance of Religion to Cancer Patients N=230 patients with advanced cancer. From Balboni et al, J of Clinical Oncology, 2007
Religious/spiritual struggle • may compromise recovery • may increase risk of mortality • compromises emotional adjustment to illness and quality of life Fitchett, 2012
SPIRITUAL DISTRESS “I am told that God lives in me – and yet the reality of darkness and coldness and emptiness is so great that nothing touches my soul.” Newsweek 9/3/07
Addressing Spiritual Struggle/Distress means: “…to help create an environment where what is fundamental, natural, and indigenous to the human psyche can most easily do its own work of bringing about integration, balance, and wholeness.” Michael Kearney (2000)
Nursing recruitment from: • Nursing Director recommendation • Chaplain Invitation • Peer Referral • Personal Interest – Self Referral
Current Nursing Questions: Interdisciplinary Screens: Any spiritual practices that may affect your care? No Yes ________________________ Chaplain X2951
Spiritual Screening Tool Patient Admitted: Our team is committed to the whole person. Do you have a belief, spiritual or otherwise, that is important to you? Yes No Is that helping you now? Was there a time when you did? Yes No Yes No #1 BELIEF Helpful #2 BELIEFNot Helpful #3 BELIEFin Past #4NoBELIEF Thank you. We do wish to be supportive of you. [Make SCM Pastoral Care Consult Order or call 662-2951 with referral. Note which Track patient on.]
10 Nurses Recruited and Trained 1 – Injured and unavailable 3 – No referrals (1 nurse said she had made a couple but no record) 2 – made one referral 3 – made two referrals 1 – made six referrals 14 Referrals made in six weeks
Results of 14 Nursing Referrals #1 Belief Helpful N = 7 #2 Belief Not Helpful N = 3 #3 Belief in Past N = 1 #4 No Belief N = 3
Conclusions: • Nurses are interested in their patients’ spiritual well-being • Nurses will volunteer to contribute to a project addressing SS/SD • Nurses observe spiritual distress in their patients • Protocol enabled more RN e-referrals
Participating nurses reported • the screening protocol provided terminology and a procedure that they found helpful in discussing the spiritual domain with their patients.
Screening for Spiritual Struggle and Aims for Quality Improvement
Follow up by chaplains Findings and plans for the future
We are all in this together! Questions and Answers