The Importance of Spirituality in Patient-Centered Care

As a first step in embracing the spirituality of others, we must first understand our own spirituality.⁵  For those who have a religious affiliation, doing so may be straightforward; for those who do not have a formal affiliation, however, it could take some time, effort, and genuine introspection.

On the one hand, we all share a common value system: we take pride in helping others, otherwise we probably would not have entered into health care in the first place. Knowing that we critical care clinicians have taken on the supremely challenging (some might say impossible) task of caring for patients when they are at their sickest, and using a combination of technology and compassion to help these patients, we must also find time to nourish our own spiritual lives. If we become overworked or exceedingly stressed—neither of which is unusual in our line of work—we might forget what a privilege it is to care for patients at their most vulnerable.

From a nursing perspective, many of the terms associated with spirituality may already be integrated into usual care: examples include active listening, therapeutic touch, and humor.⁶  In addition to being aware of and nurturing their own spirituality, nurses must practice “intentionality,” or focused consciousness.⁷  For example, it is important to enter a patient’s room with a clear mind—to be truly present. It could be as simple as taking a moment to breathe deeply before entering the room. The idea is to clear your mind and allow yourself to focus in a more singular fashion on the problem at hand. What are the concerns of the patient or his or her family? This process is not easy. There are many obstacles and interruptions, and it seems time is always of the essence. The patient may be hypotensive or in pain, the family may be filled with anger or anxiety. Focusing the mind and being present can make it easier for care-givers to drill down to the patient or family’s true concerns, and may help clinicians find more meaning in our daily lives.

Nurses can help determine whether the patient needs more spiritual care than can reasonably be provided, perhaps obtaining a clergy member to assist at that point. Really, though, it should not be an either-or situation. As nurses and doctors we ought to take a few moments to ponder the spiritual aspects of any patient interaction; doing so empowers all parties involved and has the potential to promote serenity, tranquility, understanding, and a sense of completeness.⁸ 

Many of us have trouble balancing spirituality and science, as we may not feel we are particularly spiritual people. There are those of us who embrace science as a primary life paradigm; such caregivers may become confused or conflicted when patients prefer alternative or complementary treatments in their approach to illness.⁹  A contemporary example would be that of Steve Jobs, the late cofounder, chairman, and CEO of Apple Inc, who chose alternative medicine to treat his pancreatic cancer rather than receiving evidence-based Western therapy, thereby potentially decreasing his lifespan. As treating clinicians, we often hear the patient say “I want [this or that] treatment” or “I absolutely refuse [this or that] treatment,” but we do not really understand why. Many times this request will have a spiritual or cultural background that informs it.

If we take the time to evaluate our own spiritual issues, even those of us who look at life primarily from a scientific perspective, it seems we will have a better ability to work with patients on many levels and determine why they want or do not want a particular form of therapy or path of treatment. It goes without saying that cultural, religious, and spiritual issues are relevant when dealing with end-of-life care, but all patients benefit if we broaden our cultural and spiritual perspective when we encounter situations whose context we might not normally think of as spiritual.¹⁰ 

To be successful in the ICU, we all must have a grasp of human anatomy, physiology, pathology, and pathophysiology. We must be stellar clinicians. To serve the patient and family unit in a comprehensive way, however, we must understand more than that. We must come to terms with and embrace the fact that until we fully understand the holistic perspective of each patient (and perhaps each family member), we will be unable to forge the necessary and crucial bonds of trust that are required to take our patients successfully through their stay in the ICU.

At a fundamental level, then, we seek to provide comprehensive care to critically ill patients and their families. Clearly, our most important responsibility is to rapidly recognize and treat our patients’ life-threatening disease or injury.

But there’s more. If we are to truly care for the whole patient—body, mind, and spirit—then we must venture outside our comfort zone.¹¹  We must remind ourselves that nourishing our own spiritual needs will only allow us to become more powerful advocates for patients. Doing so will help us see further and do more when our patients and their families need us the most. As challenging as our jobs are in caring for patients in the ICU, if we take the necessary time to explore the spiritual dimension of our patients and their families, we develop the potential for a greater appreciation and understanding of those we care for—as well as ourselves.