New Prescriptions
How spirituality plays a vital role in today’s healthcare system.
Why am I suffering? What happens to me when I die? These questions are often posed by patients. As Canada's immigration population expands, bringing with it strong and diverse religious ties, health care providers are being asked to support and respond appropriately to patients, their families, and their varying beliefs.
But with a health care system that is presumed to be secular, what expectations are being put on the system, and what might the future look like for health care providers?
Leading the way in answering these questions is Sheryl Reimer-Kirkham, associate professor of nursing at TWU, coordinator for the health sciences stream in the ma in Leadership program, and a founding member of TWU's Religion in Canada Institute. With her recently obtained Social Sciences and Humanities Research Council of Canada (SSHRC) grant, Sheryl has embarked on a three year project to examine how religious and spiritual plurality are addressed in health care settings.
Tell us about the research you are doing with the
SSHRC grant.
The three-year project examines how religious and spiritual plurality are addressed in health care settings. In my earlier research on intercultural nursing, I found that nurses expressed uncertainty about how to respond to patients’ practices or health care choices that were typically informed by religious affiliations. This was fascinating, because the profession overall has paid attention to spirituality, but in a generic sense. So my entry into the project was around intercultural, interfaith spiritual care-giving. We study encounters between health care professionals and patients, and broaden that to understand how the health care and social contexts shape interactions.
How does spiritual and religious plurality play out in health care presently?
In many situations in health care, spirituality and religion are not acknowledged by health care professionals. This is due to various reasons: very acute and busy workloads, focus on physical curing above all else, lack of professional education about religion and spirituality, or the values and beliefs of the caregivers themselves. However, when people are faced with crises, life transitions, or death, they often draw on their faith traditions for meaning and social support. So a disjuncture exists between the context of health care, and the experience itself of being ill and recognizing the place of religion and spirituality. Layered on to this disjuncture is the large number of different faith traditions and range of spiritual beliefs and practices represented in health care, and the politicalization of religions, resulting in social tensions, and, unfortunately, at times discrimination.
Many new Canadians come from cultures where their faith is very strong. What challenges do nurses face when dealing with patients from multi-faith groups?
The diversity is reflected across patients and providers — many more nurses, physicians, and allied health professionals come from non-Judeo-Christian faiths. Health care is the one place where we do not choose who we interact with. We choose our schools, our neighourhoods, our leisure activities, but when it comes to who is in the hospital bed next to us there is no choice. This means we have a very close-quarters experiment happening that is testing Canada’s multicultural policies in an unprecedented way. Often this results in remarkable connections made across differences. Other times, social attitudes filter in about who belongs in Canada, and who deserves health care services.
What would be some practical outcomes from your research that may change healthcare?
We are exploring how religious and spiritual differences play out in health care, how health care providers make connections across differences, and how they do this well. Our research will show that who the health care provider is and what values and beliefs they hold are central to how they approach religion and spirituality. Some are cautious about crossing professional boundaries; some are hungry for conversations about values and beliefs in a healthcare system that has marginalized all things spiritual. Our research opens space for conversations that clarify the professional role, promotes self-reflection, and facilitates learning about the range of faith traditions and associated beliefs and practices now represented in our society. We also expect to make some practical recommendations about how to integrate religion and spirituality into health care services.
How do you think spirituality in health care will change the nursing landscape?
Spirituality will play an increasing role in the area of values. The nursing profession is shifting from an era focused on establishing “what do nurses know?” to “what do nurses value?” Nurses will need to be tuned in to their own values, and how they shape their practice.
How does the nursing program at TWU differ from other programs regarding incorporating spirituality and religion?
TWU’s nursing program is the only faith-based program in Canada. During the four years, students are encouraged to integrate all aspects of faith with their nursing studies for a truly transformative life experience. This integration has students asking very tough questions of life — questions about suffering, moral choices, ultimate purpose — with greater freedom not typical of many other academic settings. The program also offers small class sizes, mentoring relationships with faculty, specialty nursing courses (pediatric, maternal-child, and mental health nursing), and a strong liberal arts foundation. All of this translates into our graduates being preferred by employers. It is also why we were able to obtain the highest level of accreditation by the Canadian Association of Schools of Nursing. Our Masters of Science in Nursing program, in August 2009, will build on these distinctives and on our reputation for excellence.
by Jamie Hall ('06)
photography by Mike Rathjen ('04)
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