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SPIRITUAL CARE
MAKING HEALTH CARE WHOLE
Integrating Spirituality Into Patient Care
By Christina Puchalski and Betty Ferrell
266 pp., West Conshohocken, PA: Templeton, 2010, $34.95, softcover.
Review: Making Health Care Whole is a welcome resource into the repertoire of spiritual care resources, from the work of Puchalski, a physician, and Ferrell, a nurse, and numerous spiritual care experts through the National Consensus Project for Quality Palliative Care (NCP). Although coming out of palliative care, the authors speak to spiritual care in all areas of clinical practice, especially for those who are seriously ill. Topics address the huge significance of spirituality and how to address spiritual care through a coordinated interdisciplinary approach. Puchalski and Ferrell discuss the roles of all members of the healthcare team and how they relate to spiritual care, but see chaplains and "spiritual care professionals" (clergy, spiritual directors, pastoral counselors) as central to the spiritual care plan. They state, "The work of spiritual care is done by all members of the health care team. This includes being a compassionate presence, doing a spiritual history, and integrating spirituality into the patient's treatment plan. However... chaplains are the spiritual care professionals who work with other members of the team to diagnose spiritual distress, develop the treatment plan, provide spiritual counseling, and follow up on spiritual issues" (p. 61). They emphasize interdisciplinary coordination and offer models for care that include spiritual history taking, assessment, treatment, spiritual counseling, documentation, and education and training for all members of the healthcare team. They carefully and sensitively explore myriad issues related to spiritual care.
A difficulty Christians will have with this book is a resistance to employing religious practices in spiritual care unless the patient initiates or requests the practice. The authors rightly recognize the power imbalance between patient and clinician and how clinicians can wrongly influence vulnerable patients. They strongly (and rightly) emphasize to "follow the patient's lead" (pp. 40-41), carefully explaining how this is enacted in everyday practice. I wholeheartedly agree with the authors' careful approach to spiritual care, the critical importance of patient consent for spiritual interventions, and their concerns about proselytizing in the clinical setting. Christians should always follow the patient's lead and never impose their beliefs on patients; if a patient is uncomfortable with a spiritual discussion the clinician should stop and sensitively offer to be available later if the patient desires, and ask if they would like a spiritual care professional to visit.
What I struggle with is the authors' blanket prohibition to suggesting or offering religious practices except when the patient asks. For example, they recommend a clinician should not offer to pray for or with a patient unless the patient asks for prayer, except under very special circumstances (i.e., patient cannot speak and known to use prayer). Furthermore, they suggest clinicians not pray in private for patients except in congruence with the patient's beliefs (p. 50). I would never offer prayer with or for a patient unless I had developed careful rapport, after careful listening, and sensing the patient was open to (or wanted) prayer, but I believe there are times clinicians can initiate the offer of prayer. Patients may not request prayer because they are uncomfortable asking for such an intimate act or because of the power imbalance the authors describe. These recommendations leave me wondering, where is the leading and role of the Holy Spirit in spiritual care?
I applaud the sensitivity and breadth of this book in addressing spiritual care. The authors acknowledge real-world problems and issues (like giving lip service to spiritual care but only asking patients if they have a religious preference or church) and offer valid solutions. I can follow the author's recommendations much of the time, but I can't agree that we should never offer faith-related discussions and interventions. Christian clinicians can learn a lot from the book, but also should spend time in private prayer and Bible study to explore the appropriate use of faith and religion in spiritual care.-KSS
EDUCATION
GIVING THROUGH TEACHING
How Nurse Educators Are Changing the World
By Joyce Fitzpatrick, Cathleen Shultz, and Tonia Aiken
262 pp., New York: Springer (with the National League for Nursing), 2010, $50.00, paperback.
Review: Former President Bill Clinton wrote a book entitled Giving: How Each of Us Can Change the World (2007) describing people who have given money, time, material things, skills, and gifts of good ideas. Fitzpatrick realized in reading Clinton's book that nurse educators give of themselves and encourage students to give. The National League for Nursing then issued a call for nurse educators to share how they and their students give to others. Fitzpatrick introduces the use of storytelling as an educational tool at the core of nursing, and nurse educators' stories are told throughout. Royalties help create scholarships for future nursing students.
Included are stories of leading nurse educators from past to present, influential educators in the United States, in disaster settings, and those who work globally to improve healthcare, which is the major section of the material. The stories are fascinating, relating how nurse educators initially went on a short-term experience which became a 20-year partnership. The stories demonstrate adaptability as educators went to other countries to teach and found conditions very different from what they expected. Many stories relate experiences of taking nursing students to various areas of the world and how students developed a broader view of healthcare needs. The nurse educators who traveled to Uganda discussed three principles guiding their collaboration: building on shared values and common goals, approaching situations as cultural learners, and committing to long-term relationships. These principles permeate the stories.
Readers will find fascinating stories from a particular part of the world. These accounts are only a sample of what nurse educators are giving both at home and throughout the world. Especially heart-warming is the commitment of these nurses by using their own time and resources to give to others through teaching.-Phyllis M. Jacobs, MSN, RN, Assistant Professor, Wichita State University, Wichita, KS.
PARISH NURSING
HEALTHFUL HINTS VOLUME 1
By Helen Vander Werff
45 pp., St. Louis, MO: International Parish Nurse Resource Center, 2010, $25.00 (includes shipping), softbound.
Brief: Written by a parish nurse in Wentworth, SD, this book offers a compilation of 130 paragraphs that focus on information related to specific diseases, family health hints, nutrition hints, and exercise hints for all ages. The material is designed specifically for situations when a brief piece of health information is needed such as a bulletin board, bulletin blurbs, poster, newsletters, or the bathroom mirror. Paragraph titles are indexed in the front of the book for quick, easy reference.
HEALTHFUL HINTS VOLUME 2
By Helen Vander Werff
46 pp., St. Louis, MO: International Parish Nurse Resource Center, 2010, $25.00 (shipping included), softbound.
Brief: A companion piece to Volume 1, these 130 health tips are paragraphs suitable for bulletins, newsletters, and the like, and are also indexed in the front of the book. Content focuses on mental health: depression and stress reduction; monthly health themes (two per month); and seasonal health topics related to Spring, Summer, Autumn, Winter, New Year's, Valentine's Day, Lenten, Easter, Graduation, Thanksgiving, Advent, and Christmas.
PERSONAL GROWTH
INSPIRED NURSE
By Rich Bluni
166 pp., Gulf Breeze, FL: Fire Starter, 2009, $24.95, paperback.
Review: Rich Bluni, a nurse who has worked in a variety of settings and now with the healthcare improvement organization Studer Group (Hardwiring Excellence), has prepared a rich feast for nurses to help us regain inspiration in our daily practice. The book is actually a workbook made of 23 short chapters or "Inspiration Destinations" and exercises to help readers reach each destination. The destinations range from Honor Your Mentor, Support New Nurses, Make Your Workplace More Peaceful, Appreciate Humor, to Be Welcoming of Spirit and Seek the Good in Others. The exercises range from taking 10 minutes to remember a situation where you made a difference, watching your mouth and coming up with new words, creating affirmations and using them to change your life, to making a list of "Why-I'm-Grateful-For-Being-a-Nurse."
Bluni engages the reader with his stimulating writing style, challenging nurses to reflect on who we are, what we do, why it makes a difference, and change what needs to be changed in our nursing and our lives. The goal of the book is summed up in the title, to help nurses be inspired. A portion of the proceeds are donated to the Pediatric Intensive Care Unit at Holtz Children's Hospital in Miami, Florida where Bluni once worked. A companion Inspired Journal also can be purchased, and bulk discounts are available from the Studer Group.-KSS