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Document No

2004          Page last updated: 6 August, 2005

Lothian University Hospitals Division

Spiritual & Pastoral Care – Operational Policy

For Urgent Support, Information, Referral A Whole-Time Chaplain is On Call 24 Hrs / 7 Days For the ROYAL INFIRMARY AND LIBERTON HOSPITAL

CALL: 07720 508 693 (requires an outside line [9])

OR VIA THE TELEPHONE EXCHANGE.

For THE ROYAL HOSPITAL FOR SICK CHILDREN CALL VIA THE TELEPHONE EXCHANGE (536 0000).

For THE WESTERN GENERAL AND ROYAL VICTORIA HOSPITALS CALL VIA THE TELEPHONE EXCHANGE (537 1000)

For Roman Catholic Calls on all sites call via the exchange.

(Further information)

Lothian University Hospitals Division

The New Royal Infirmary of Edinburgh

Operational Policy

SPIRITUAL AND PASTORAL CARE

• Introduction
• Department of Spiritual and Pastoral Care
• Organisation
• Philosophy of Care
• Mission Statement
• Religious and Cultural Diversity
• Language is Not a Barrier (Translation Service)
• On-Call
• Referral/Visiting Strategies
• Training
• Off-Site Work
• Care of the Terminally Ill
• Bereavement Care
• Sanctuaries and Chapels
• Review Plans

Introduction

Being concerned to help support the expression of human spirituality and to meet spiritual need, whether acutely felt in time of crisis, or present in the underlying anxieties of hospital life, is integral to good practice in healthcare. An open-minded understanding of human spirituality is integral to the development of a comprehensive approach in the hospital setting (“Spirituality, like pain, is what the patient says it is!” [NHS Lothian Spiritual Care Policy]). Freedom and support for the open and individualised expression of our human spirituality, whether or not it has a religious dimension and in all our cultural diversity, is a commitment of The Lothian University Hospitals Division.

This commitment has two aspects 1. To recognise respect for human values Spiritual and Religious belief and Cultural Diversity as an ever-present theme to be taken into account in all areas and activities of the organisation: to be everyone's business and not only a matter for Hospital Chaplains and visitors from Churches and Faith Communities. 2. To develop and deliver an open and inclusive service in the form of a Spiritual and Pastoral Care Department, which builds on the strengths of prior Chaplaincy provision and takes lead responsibility for encouraging an holistic, open and responsive ethos in each of the divisional hospital sites.

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Department of Spiritual and Pastoral Care

The Spiritual and Pastoral Care Service in the Division has been explicitly committed to this open approach since the previous Trust reorganisation, which created The Lothian University Hospitals NHS Trust. It is offered to the whole hospital community of patients , their families and friends, staff, visitors and volunteers in terms of the Scottish Executive Health Department Guidelines on Chaplaincy and Spiritual Care in NHS Scotland (October 2002). The guidance is available in full on the Scottish Health on the Web (SHOW) Site at www.show.scot.nhs.uk .

The Spiritual and Pastoral Care Team, consists of:

(1) Whole-time Hospital Chaplains based at The Royal Infirmary of Edinburgh (tel. 21990), The Royal Hospital for Sick Children (tel. 20144) and The Western General Hospital (tel. 31400); who work on an open basis with people of any faith or philosophy and are responsible to the whole hospital community of patients, staff, visitors and volunteers. The Royal Victoria Hospital is covered by the Team based at The Western General Hospital and Liberton Hospital by The Royal Infirmary of Edinburgh Team.

(2) Part-time and Honorary Chaplains who are available to members and to those who associate themselves with the churches, faith communities and philosophies the Chaplains represent.

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Organisation

The Spiritual and Pastoral Care Team is organised on a Divisional basis with one Lead Chaplain (Sandy Young [tel. 0131-242-1997]) and functions with a shared Philosophy of Care and Mission Statement adapted to the needs of each particular site. The Executive Manager with responsibility for Spiritual Care in the Division is The Director of Nursing Miss Isabel McCallum. Both the Executive Manager for Spiritual Care and the Lead Chaplain are members of and are responsible to the NHS Lothian Spiritual Care Committee.

Rather than developing a separate Spiritual Care Committee in the Division, Spiritual Care is subsumed in the agenda of The Diversity Inclusion Steering Group in terms of the extending Fair for All process being developed by the Scottish Executive Involving People Team. Additionally, the inclusive values common to Scottish Executive and NHS Lothian Spiritual Care Guidance have been fully incorporated into A Caring Partnership the divisional Patient and Public Partnership Strategy , with a fully inclusive philosophy of care being explicit in both Patient and Public Involvement and Diversity Inclusion strategies. A Caring Partnership which spells out divisional values and goals is an accessible document which has had its clarity approved by The Plain English Campaign (for English copies 0131-242-3385) and is available in tape, large print, Braille and various community languages (contact: Interpretation and Translation Service on 0131-242-8181 quoting ref. 02761).

The Lead Chaplain is also a member of the Multicultural Health Action Group, which brings together community , and hospital representatives in pursuit of a more joined-up service between hospital and community, particularly in relation to cultural minority communities.

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Philosophy of Care

Our Philosophy of Care is based on the positive affirmation of each individual; on beginning where people are, respecting whatever faith or philosophy they may have; on careful non-judgemental listening and on sharing and supporting their journey with appropriate Spiritual and Pastoral Care resources.

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Mission Statement

Members of the Spiritual and Pastoral Care Team (Chaplains) are available 24 hours a day to offer confidential, non-judgemental support to patients, relatives and staff appropriate to their life-situation and beliefs. They are available to listen, to pray or simply to wait with people according to their needs. The Spiritual and Pastoral Care Department will arrange and facilitate referrals to the accredited representatives of any church, faith group or philosophy as requested by any member of the hospital community.

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Religious and Cultural Diversity

The Spiritual Care Team includes a growing number of Honorary Chaplains and Faith Community Contacts who will advise and attend to support patients, their carers and Hospital Staff as is appropriate. All are available via the On-Call Whole-time Chaplain (Call Switchboard and ask for the On-Call Chaplain), who will liaise, advise and refer as is required.

For background understanding of Faith Communities in Scotland, the Booklet Faith Communities in Scotland, prepared by The Scottish Interfaith Council ( admin@interfaithscotland . org ) offers the general descriptions and raises the issues that the Faith Communities themselves have chosen to highlight. For information of specific concern to Healthcare Staff, the booklet Religions and Cultures, A Guide to Beliefs and Customs for Health Staff & Social Care Services ( religionsandcultures@hotmail.com ) is a helpful resource. However all guides to faith communities should be understood as resources available to help raise general awareness of the questions and issues which may arise and certainly not as catch-all descriptions of members of any of the Faith Communities of Scotland. It is important in every case to work on the basis of an open philosophy of care which respects the person/people concerned as individuals, begins where they are and proceeds on the basis of their individual life situation and beliefs.

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Language Is Not a Barrier: the leaflet ‘How to Use the Interpretation and Translation Service' is available to staff. Contact should be made via the Site Clinical Managers (RIE Bleep 1590, WGH Bleep 100, RHSC Bleep 278, Liberton Bleep 3121 909, RVH Bleep via WGH Switchboard on 6004)

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On-Call

Two On-Call Systems are available, both on a 24-hour, seven day week basis:

1. A Whole-time Chaplain is available via the numbers given above or the switchboard to the whole hospital community of patients, staff and visitors, including those of all Christian denominations and to people of other faiths and philosophies (to offer direct support or arrange referral as appropriate).

2. The Part-time Roman Catholic Chaplains are available via the switchboard to patients and relatives who are members of or who wish to associate themselves with the Roman Catholic Communion.

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Referral/Visiting Strategies

The Whole-time Chaplain will see people both by referral and by routine visiting in order to concentrate as far as possible on individuals and situations where the need for Spiritual and Pastoral Care may become acute:

By Referral: 1. Urgent requests have priority and will always occasion an immediate response from the On-Call Chaplain via the switchboard.

2. Interdisciplinary Team meetings. Chaplains contribute to and receive referrals from a number of interdisciplinary teams, working on the Need to Know principle. Transplant Unit and

Renal Unit interdisciplinary meetings

3.Church, Faith Group and other referrals are responded to on a day by day basis and as they arise out of the point of need from patients and relatives self-referring via staff.

4.Self-referrals from staff seeking confidential help and support are always welcomed by Chaplains and can be arranged via the On-Call system as well as by direct personal approach.

By Routine Visiting: 1. High acuity areas, such as ICU/ITU, HDU 's CCU and NNU will be visited on a regular basis as is appropriate and in the light of unit routines.

2. Long Stay patients and/or their relatives will be visited and offered ongoing support.

3. Patients and/or their relatives from beyond the NHS Lothian area will be visited routinely, with a particular emphasis on extended stay patients.

The Part-time Roman Catholic Chaplain relies on referrals to identify those who are members of or who wish to associate themselves with the Roman Catholic Church. These come either from planned and documented admissions information, or from patients and/or relatives asking members of staff to arrange visits during the hospital stay.

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Staff Training

The Whole-time Spiritual and Pastoral Care Team contribute to various induction and in-service training sessions for Clinical Support Workers, Nurses, Midwives, Pre-Registration House Officers and Senior House Officers , as well as to relevant aspects of university and college courses . They will gladly respond to requests for training and educational support, offered particularly in the light of the new specifically inclusive Spiritual Care Guidelines. Short Seminars and small group/one-to-one teaching sessions on themes such as Diversity Inclusion, Understanding Faith Communities and Caring for the Bereaved can be arranged for any department, ward or individual member of staff.

Student Training

Spiritual and Pastoral Care is incorporated within the teaching commitments of The University Hospitals Division, with regular input to courses for Napier University nursing candidates (e.g. Spiritual Care in Nursing, Spirituality in Cancer Care), University of Edinburgh Medical Students (e.g. Clinical Options Project 2003/4), New College Divinity Students (e.g. Easter Vacation Course) and Candidates in Training for Church Ministry (e.g. full-time summer placements).

Honorary/Faith Community Chaplaincy Training

A 2004 priority is to achieve the introduction of trained and supported Honorary Chaplains in all the identifiable faith and philosophical communities within practicable reach of the divisional hospitals. Where an existing pastoral care role/representative is identified by the community as already being in place, on-site induction and support will be offered in Honorary Hospital Chaplaincy. In communities where this kind of role is as yet undeveloped, community nominees will be offered training and support, including on-site placement, towards the development of an Honorary Hospital Chaplaincy for the community concerned.

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Off-site Work

Members of the Spiritual and Pastoral Care team do work off-site as follows:

•  To build and maintain active liaison with community based health care professionals, churches, faith groups and other special interest groups, such as accredited charities working in complimentary healthcare.

•  To offer confidential spiritual and pastoral care in circumstances when a hospital appointment would not be appropriate: e.g. support of staff on sick leave, bereavement support (see below).

•  To work with NHS Lothian colleagues, the National Training and Development Officer and other professional bodies in the development and delivery of the service.

•  To offer training and educational support in the area of Spiritual and Pastoral Care.

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Terminal Care

Spiritual and Pastoral Care is available by referral to all terminally ill patients and their relatives. This may mean careful listening ministry, prayer where appropriate, watching and waiting with people and also the ‘co-construction'* of appropriate religious or non-religious responses to personal needs in the context of terminal illness. Occasionally marriages are conducted at short notice in the context of terminal illness: contact the On-Call Chaplain for advice and support.

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Bereavement Care

Chaplains are On-Call via the switchboard to offer appropriate Spiritual and Pastoral Care to those facing or coping with bereavement, including supported time with the deceased, either on the ward or later at the hospital mortuary. Specialist care is offered in co-constructing* services/rituals and other appropriate verbal and active responses to need in the light of the bereaved parents'/family's own beliefs and life situations. These may include blessings and baptisms, and religious and non-religious naming ceremonies. Chaplains can also offer advice, support and referral sources to help with the planning and arrangement of funeral services (religious and non-religious) and possible sources of future help with grieving. Where it is appropriate and requested by the next of kin, Chaplains will conduct funerals and will do so in the context of the wider hospital community of patients, staff, volunteers and their families.

The booklet ‘ When Someone Has Died – Information and Support for Relatives and Friends' has been published by an interdisciplinary group of staff, having responsibility for bereavement care. The booklet gives clear guidance on the formal and practical process required and also offers a supportive introduction to coping with the difficult thoughts and feelings that are often part of bereavement. The booklet is designed to be given to relatives and can enable informed discussion with staff.

Booklets and leaflets specifically designed for bereaved parents are included in the Bereavement Packs used in The Royal Hospital for Sick Children and in the Labour Suite and Neonatal Unit at the Royal Infirmary of Edinburgh.

[ *Co-construction is a key tool for Chaplains delivering a broad and inclusive approach to Spiritual and Pastoral Care. It means that they will work with the people concerned to construct an appropriate expression of what they need to say and do, in the light of their own beliefs and life situations. For example, this could mean a religious blessing service or a prayerful act of farewell. Equally it could result in a non-religious equivalent, in symbolic words/actions or in referral to a representative of an appropriate church, faith group or philosophy.]

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Sanctuary & Chapels

The Sanctuary in the New Royal Infirmary of Edinburgh and the Chapels and The Royal Hospital for Sick Children and the Western General Hospital, are each open and available to all on a 24-hour basis. People of all faiths and those with no religious beliefs are welcome to use these spaces. They have been designed to create spaces with the special sense of otherness and calm which can make an important contribution to spiritual well being. They are offered as special places: for ‘time-out' from stressful work environments; for coping with the spiritual, emotional and psychological cost of caring (away from the bedside) and for the ongoing human need to struggle towards meaning and purpose in life and work, in sickness and suffering, in loss and bereavement, whether or not such need has a religious expression.

Holy texts from several faith communities and prayer mats are available in the Sanctuary and Chapels, as are Humanist and other non-religious resources. At the Royal Hospital for Sick Children Chapel a short service is held on Thursdays at 1pm when prayers are said for the whole hospital community. There is an open act of worship on a Sunday at 10am at the Western General Hospital. The Royal Infirmary of Edinburgh Sanctuary has a developing programme of events such as occasional acts of worship, music and art events. There are regular open acts of Christian Worship on the Wards at Liberton Hospital and at The Royal Victoria Hospital. Details of these and other worship events are available from the Spiritual and Pastoral Care office (0131-242-1990 and 0131-242-1992[fax]).

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Operational Policies Review

This Operational Policy was first published in April 2003 in preparation for the Second Phase move to the then New Royal Infirmary of Edinburgh, with a review date of 15 th January 2004. This present version has been re-written to cover The University Hospitals Division and was offered as the 2004 draft, available for consultation and comment, before being finalised and published on 28 th February 2004.

Next Review date: 15 th January 2005. Concerns/comments and questions are welcome at anytime: contact the Lead Chaplain Sandy Young on 0131-242-1997.

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