No one likes receiving bad news. This is especially true of bad news relating to your health. It can be difficult processing the emotions of facing change and loss.
My own grandmother suffered a stroke over six years ago. I remember it was a scary time for the whole family because we thought it was the end of her life. My loving grandma, who gave us doughnuts for breakfast on Saturdays and let me get sugary cereals at the grocery store, just lay there, unable to speak to me. Luckily for us, that wasn’t the end. Grandpa was able to take care of her for a while before hospice had to be called in to help.
From my experience, whenever it was time to call hospice, that was just a fancy way of saying, “let’s keep them comfortable until they die.” But for my grandpa, the hospice professionals were invaluable. The care they showed to both my grandparents in such a hard time of their lives let the rest of us breathe a little easier. We knew they were being taken care of when we had to drive back home to Tennessee. My grandmother has been gone for five years now, but I am forever grateful that my grandparents were never alone and had help in the last years of her life.
Given this experience, I was interested to learn that Loma Linda University Health (LLUH), in partnership with the Versacare Foundation, has proposed to develop a new curriculum for training health professionals in spiritual care competencies. LLUH is well known for being a religious institution where spiritual care is promoted and valued, and it has been home to pioneering leaders in whole person medical care, such as Wil Alexander. The training program would be another step in this direction.
A vice president for twenty-one years at the North American Division of the Seventh-day Adventist Church, Debra Brill was a member of the Versacare Foundation board and a passionate advocate for the program. (She died on Sunday after a three-year battle with cancer.) Speaking about Versacare’s support for its development, Brill expressed the profound importance of spiritually integrative care for patients and families facing a cancer diagnosis. “A cancer diagnosis is stunning. The mind says it’s not real, the heart fears it, the scope of emotions is numbing,” she said. “We fortunate ones find remarkable, caring teams of professionals ready to customize a plan to kill the disease and we are grateful. But in my three-year survivor journey, no one is asking how I feel about my hopes for quality of time or spiritual goals of care.”
“LLUH is creating a major spiritual care education curriculum focused on practical training to benefit clinicians and their patients. From a junior faculty to surgeon, the infusion nurse and radiology technician, all can learn how to confidently ask patients dealing with serious illness about decisions greatly affecting their well-being,” said Brill. “This interdisciplinary method will equip providers with words and understandings not provided in their specialty training. Our hope is that a culture of integrated spiritual care can be adopted by Adventist Health, with an aspiration for international expansion, which Versacare strives for in our most valued projects.”
In recent decades, medical education has moved to integrate spiritual care into its training curriculum in response to growing research in the field of spirituality and health. Between 1995 and 2011, for example, the number of medical schools that integrated spirituality in their training programs increased from 3 schools to 75% of schools. Still, clinicians often self-report that they don’t feel fully trained to provide spiritual care, according to the LLUH proposal. Thus, the new curriculum will focus on increasing the knowledge and confidence of trainees and employees.
A psychiatrist and director of oncology supportive care services at Cedars-Sinai Medical Center in Los Angeles, Deane Wolcott is enthusiastic about the LLUH-Versacare partnership. Wolcott, who is also a member of the Adventist Health Simi Valley hospital board, has extensive experience with implementing care for cancer patients. “I worked for a company that developed and managed hospital cancer programs around the United States,” Wolcott said in an interview with Spectrum, which also receives some grant funding from Versacare. “My job was developing what we came to call ‘supportive care services’ for Cedars Sinai and at each of these cancer centers.”
Effective communication improves patient and family satisfaction as well as decreases clinician burnout, Wolcott added. When a patient is facing a serious illness, spiritual beliefs often impact the decisions they make and greatly affect their well-being during treatment.
Participants in the proposed LLUH curriculum will complete a questionnaire to assess their knowledge and comfort level with having these spiritual conversations with patients. They will then learn the skills they need to help address patients’ spiritually rooted distress and access spiritual resiliency. The goal is improved quality of care.
The proposed program has three phases. The first phase includes the research and development of pre- and post-training questionnaires, lectures, patient-clinician simulations, and the implementation of the curriculum for residents, fellows, junior faculty, nurses, and nurse practitioners across several cancer specialties.
Teaching and mentoring will be provided by an experienced interdisciplinary palliative medicine team including physicians, nurses, chaplains and social workers who have extensive training in this area. Attendees will listen to prepared presentations as well as participate in small group discussion about the material. They will also engage in patient simulations with trained actors where they will need to respond to spiritual questions and distressed patients. Finally, they will be given feedback in a safe learning environment where they can openly share their experiences.
Phase two will expand the spiritual care curriculum to other LLUH fellowship programs to include: Anesthesia, Cardiology, Advanced Cardiology, Emergency Medicine, Geriatrics, Gastroenterology, Infectious Diseases, Nephrology, Pain, Pulmonary & Critical care, and Critical Care Nursing. Each participant will complete an evaluation survey, and the curriculum will be revised to fit the various specialties.
Phase three will include reviewing lessons learned from the LLUH deployment of the spiritual care curriculum and offering learning from the program to other Adventist health systems. The program plans to work through the Adventist Bioethics Consortium, a collaborative international network of Adventist health and church institutions designed to enhance service in biomedical ethics, and the Global Health Institute, an organization that provides international medical service opportunities.
LLUH and Versacare’s hope is that once this curriculum has been established, it will be offered to other clinicians involved in caring for patients with serious illnesses other than cancer, such as heart failure, liver failure, kidney failure, dementia and other progressive neurologic conditions. Ultimately, a teacher-training program will be developed with the aim of delivering the curriculum to other Adventist health systems.
“I’m really glad that Versacare took this on," said Wolcott. “Loma Linda came up with a plan that I think is on target. I hope that they will fully acknowledge Debra Brill and her visionary role and really help to create this vision and move forward with the system. As we’ve said, I really hope this will have a genuinely profound impact on how we deliver spiritual care to not only cancer patients but others as well.”
“In my view,” Wolcott went on to say, “the Adventist health system at large needs to not only continue to be philosophically committed to the importance of spiritual care as part of care, but needs to really educate its faculty and healthcare professional students about the current standards of care in this area. It’s one thing to have a philosophical commitment; it’s another thing to have a sophisticated model of doing it effectively. That’s been my passion.”
As someone who had family members go through difficult health issues like severe stroke and dementia, I hope this program is able to help many families going through similar situations. There is a lot of stress involved when dealing with health problems and the situation can be dramatically made worse or better depending on a healthcare professional’s ability to attend to the patient’s spiritual needs. I’m grateful LLUH is making an intentional effort to further improve such care.
Jacklyn Frias is a freelance content creator and streamer, as well as the content creator for Spectrum’s TikTok account @adventist_tea.
Photo by cottonbro studio: https://www.pexels.com/photo/a-doctor-talking-the-patient-7579831/
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