My timing was perfect. I began my formation in spiritual care at a time when this field was in the process of a great evolution. During my master’s degree in theology and religious studies, I interned on the high-risk pregnancy unit at the IWK Health Centre in Halifax. I worked alongside staff and volunteers in pastoral care who were assigned exclusively to patients of their own religious traditions.
I was the exception. My demographic was noted as “NR” on the patient admission forms, meaning No Religion. For my supervisor and colleagues who were accustomed to strictly faith-based pastoral care, I was the first of a new species in health care: the spiritual care practitioner.
That was 2009. Today, in 2023, at the McGill University Health Centre (MUHC), my colleagues in spiritual care have had many years of practice providing support for patients, families and staff of every combination of religious, cultural and social affiliation. When I joined their team in 2021, I saw that the spiritual care model had been fully realized at the MUHC.
Let me give you a picture of that model as it applies to caring for patients in palliative care.
In a given week on the palliative care unit, we will find patients of various origins, ages, gender identities, religious and cultural backgrounds and family systems, not to mention health histories and disease progressions. These elements of a patient’s world will affect their experience of the end of their lives in different ways. The experience of each patient is entirely unique.
The role of spiritual care is to offer the kind of presence and attention that can provide a space for patients to express all the dimensions of their experience that they wish to share. The spiritual care practitioner illuminates the patient’s experience and thereby strengthens their understanding of themselves.
Sometimes a patient’s religious practice or tradition provides them with connection, direction or solace, or a way of interpreting their experience. When a patient requests prayer, ritual or the presence of a religious leader, I am honoured to facilitate these needs and nurture these aspects of their spiritual lives.
In palliative care, we have the enormous privilege of accompanying patients towards death. In our work with patients, we learn about the sacred time that will come in all of our lives. We witness many forms of suffering as well as relief from suffering. We see pain, regret, sorrow and fear as well as love, joy, release and transformation. Often we see all of this at once.
As a spiritual care practitioner, I make room and hold space for whatever a patient is experiencing in the moment. I offer my presence without anxiety or judgment about the patient’s experience.
Without an agenda, without deciding what a patient should think or feel, I hold up a mirror so that they can see themselves. This simple act can yield profoundly healing results.
In seeing themselves, patients often experience self-awareness, self-understanding and self-acceptance. There can be an awakening of insight, tenderness, and the ability to let go. Or there can be a realization that they are stuck in a net of painful emotions. Sometimes, but not always, realization leads to self-compassion and a loosening of the net.
As a spiritual care practitioner, I can’t determine the outcome of my care. I see and make room for the patient’s experience exactly as it is, in the moment. A person cannot be wrestled into genuine change. If I try to force someone into greater acceptance of their situation, they will either resist me or pretend to go along with me. Either way, they will be left feeling more alone.
I love my work as a spiritual care practitioner in palliative care. I get to witness the tremendous richness of people’s experiences, memories, reflections and beliefs as they approach the end of their lives. I get to see life and death as they are, as people actually experience them, and my heart is stretched in all kinds of unexpected ways.