Addressing Spiritual Concerns in the Emergency Department
Jennifer Frush, BA, Duke University, MD Candidate (2021), MTS Candidate (2020), Duke University
While the importance of attending to spiritual needs in the healthcare setting has enjoyed renewed interest in recent years, there is a relative paucity of such focus in the emergency department (ED).
The ED is a unique space within healthcare, one in which patients with urgent problems meet clinicians for brief, often never to be repeated, encounters. It is the one part of the hospital whose doors are open at any time to any patient with any concern—from those needing prescription refills, to those needing shelter from the cold, to those requiring immediate lifesaving interventions. And while there has been little explicit attention paid the to the role of spirituality in the ED, this clinical context is rife with opportunities for such engagement. The Latin ospital, from which “hospital” is derived, means a “charitable institution” for the needy—a place that welcomes and offers hospitality to those in distress. That orientation itself has religious roots, and ED physicians are in prime position to extend such hospitality. Yet the ED also is experienced by many as the opposite of welcoming and hospitable. Patients often feel like they are being processed through an impersonal institution, and the pace and acuity of emergency medicine makes it difficult for practitioners to truly attend to the needs of the patients they encounter.
In this essay, we consider five different clinical vignettes that are common in the ED in order to explore how ED physicians might reasonably attend to patient’s spiritual concerns. Each vignette captures particular dynamics that characterize categories of clinical interactions in the ED. We consider these dynamics in turn and offer corollary heuristics—practical rules of thumb regarding whether and how ED clinicians might attend to spiritual concerns of their patients. While attention to spirituality should not get in the way of emergency medical care, an openness to and interest in spiritual concerns of patients allows for a more compassionate and holistic means of caring for the suffering in the ED. By engaging in spiritual concerns, ED clinicians might gain insight into the patient’s experience with illness, further allowing the physician to discover what may be most effective in restoring and preserving the patient’s health.
The ED is a unique space within healthcare, one in which patients with urgent problems meet clinicians for brief, often never to be repeated, encounters. It is the one part of the hospital whose doors are open at any time to any patient with any concern—from those needing prescription refills, to those needing shelter from the cold, to those requiring immediate lifesaving interventions. And while there has been little explicit attention paid the to the role of spirituality in the ED, this clinical context is rife with opportunities for such engagement. The Latin ospital, from which “hospital” is derived, means a “charitable institution” for the needy—a place that welcomes and offers hospitality to those in distress. That orientation itself has religious roots, and ED physicians are in prime position to extend such hospitality. Yet the ED also is experienced by many as the opposite of welcoming and hospitable. Patients often feel like they are being processed through an impersonal institution, and the pace and acuity of emergency medicine makes it difficult for practitioners to truly attend to the needs of the patients they encounter.
In this essay, we consider five different clinical vignettes that are common in the ED in order to explore how ED physicians might reasonably attend to patient’s spiritual concerns. Each vignette captures particular dynamics that characterize categories of clinical interactions in the ED. We consider these dynamics in turn and offer corollary heuristics—practical rules of thumb regarding whether and how ED clinicians might attend to spiritual concerns of their patients. While attention to spirituality should not get in the way of emergency medical care, an openness to and interest in spiritual concerns of patients allows for a more compassionate and holistic means of caring for the suffering in the ED. By engaging in spiritual concerns, ED clinicians might gain insight into the patient’s experience with illness, further allowing the physician to discover what may be most effective in restoring and preserving the patient’s health.