Dear Barbara, I work at an inpatient hospice facility. My question is this. Is spiritual assistance required in hospice? Also, can a Bible be offered to patients, or can they be left in a drawer in the rooms?
I’m a bit concerned that you work in a hospice and had to ask these questions but on that same note I am so glad you reached out to me for an answer.
Spiritual assistance is part of the hospice offering. It is why chaplains are part of the hospice team. HOWEVER, here is the tricky part, where we walk a thin line. We must NOT express our personal spiritual beliefs or offer specific denomination prayer books or Bibles. The hospice philosophy is not faith based.
If you are a religious based hospice, caring for people of the same faith, then, of course, you can offer support and written materials that are related to the specific belief system. Everyone there is on the “same page.” Plus, by choosing the faith based agency, everyone is expecting and wanting their specific spiritual guidance.
For the rest of the hospice agencies, non specific based hospices, they support all religious and non religious beliefs. Part of the hospice intake is asking about the patient and family's spiritual preference and if they would be interested in visiting with a chaplain or would they like their church or clergy contacted. Following the initial information gathering meeting spirituality is in the hands of the hospice chaplain.
What happens if you are a hospice nurse or CNA or social worker and the patient or family begins a conversation about spirituality? Listen, facilitate the conversation but do not share your personal beliefs. Explain that you would like to tell the chaplain about this conversation and have him/her come and visit.
As a health care worker you do not initiate a conversation about God and spiritual beliefs. It is not our role. If you observe or believe there is spiritual unrest, confusion, or you think the patient would benefit from some spiritual guidance, contact the hospice chaplain assigned to that patient/family and ask for a consult.
There tends to be such strong energy surrounding religious beliefs. Getting involved in those conversations can disrupt and confuse the end of life we are there to support and guide.
Something more... about Initiating Religious Talks in Hospice Care
The Final Act of Living: Reflections of a Long-Time Hospice Nurse goes into more detail about boundaries around this topic. As does THIS IS HOW PEOPLE DIE my comprehensive educational DVD.