Early in his career, hospitalist Richard Bailey, MD, encountered a widow from the inner city with no family. She was blind, and had been weakened and debilitated by a very challenging hospital course with many iatrogenic complications. “I was first struck, walking into her room,” recalls Dr. Bailey, “that she had a Bible on the table next to her bed. While making conversation, I mentioned this and instinctively asked her if she needed someone to read it to her. She smiled, and asked if I would oblige. I closed the door, sat down, and read her some of her favorite passages. This went on for several days until I went off service.”
Now medical director of Inpatient Care and Hospitalist Services at Saint Clare’s Hospital, a Catholic hospital in Wausau, Wis., Dr. Bailey says he is not an overtly religious person and that his spiritual life is rather private. “But I do like to have that depth of connection with my patients,” he says.
So if a patient or a family member asks him to pray with them, Dr. Bailey does so. “I cannot separate my humanness, which includes spirituality, from my work,” he explains.
When faced with serious or life-threatening medical conditions, patients and their family members are more likely to invoke their faith to cope with the attendant anxieties.
William D. Atchley Jr., MD, medical director of the Division of Hospital Medicine for Sentara Medical Group in Hampton, Va., believes that joining his patients in prayer, when asked, “helps develop a better relationship with the family and patient.”
Many Americans tend to “live in the here and now,” notes Carol R. Taylor, RN, MSN, PhD, director of the Center for Clinical Bioethics at Georgetown University. “They usually do not ask the bigger questions so long as life is good. But when life as we know it is threatened by illness, the bigger questions can become very important: ‘Is there anything beyond the here and now? And if so, where do I stand in relation to that God or higher power?’ ”
Prayer is a common response when patients face perilous medical situations.
“The vast majority of patients who are feeling imperiled due to a severe diagnosis or potential mortality is going to be praying,” says Stephen G. Post, PhD, professor and associate director for educational programs, department of bioethics at Case Western Reserve University, Cleveland. “In a way, you can’t get away from those requests.”
Are hospitalists and their institutions fully equipped to respond to the spiritual aspect of caregiving? Some researchers note that biomedicine often regards faith and spiritual world views as relevant only when they obstruct implementation of scientifically sound medical care.1 Studies have also shown healthcare professionals are less likely than their patients to actively practice a religion.
“There’s very often a mismatch between patients and families who would value that intervention and our comfort in being able to be responsive,” says Dr. Taylor, who is also an assistant professor of nursing.
Dr. Taylor and other bioethicists increasingly urge medical practitioners to include spiritual needs when they take a patient’s history. Timely referrals to chaplaincy services, knowledge of the dominant faiths and ethnic traditions in their hospitals’ catchment areas, and improvement of interpersonal skills can allow hospitalists to compassionately and ethically address their patients’ spiritual concerns.