American Society of Regional Anesthesia and Pain Medicine February 2018 - 31

Integrating Spiritual Care in an Acute Pain Service

S

pirituality is the aspect of humanity
that refers to the way individuals
seek and express meaning and
purpose. Spirituality frames the way
"people experience their connectedness
to the moment, to self, to others, to
nature and to the significant or sacred."1
Spirituality has been described as a
dimension of life and what it means to be
human.2 We are more than psychological,
social, and physical beings; we are also
spiritual beings. Therefore, when faced
with a medical illness or injury, a patient
not only needs medical care to address
a diagnosis and treatment but will also
benefit from spiritual care to aid in overall
spiritual well-being.

Adrianne Dyer, MAPS, BCC
Spiritual Care Provider

Spiritual well-being is a multidimensional
construct that includes a sense of
meaning and purpose, inner peace, strength, and comfort.3 Spiritual
well-being is recognized as an important indicator of quality of life,
and the importance of spirituality in holistic patient-centered care
is being increasingly recognized.4
INTEGRATING SPIRITUAL CARE IN AN ACUTE PAIN SERVICE (APS)
The Harborview Medical Center (HMC) is a 413-bed, level 1 trauma
center located in the center of Seattle. It is part of the University
of Washington. As a county-owned and safety-net hospital, HMC's
mission is to provide a significant level of care to low-income,
uninsured, and vulnerable populations. The HMC APS provides care
to a high number of patients with complex pain conditions across
multiple key clinical services,
including perioperative,
emergency, trauma, medical,
and palliative care services.

Debra B. Gordon RN, DNP, FAAN
Co-Director

Ivan Lesnik, MD
Chief and Co-Director

Harborview Integrated Pain Care Program
Harborview Medical Center
Anesthesiology and Pain Medicine
University of Washington
Seattle, Washington

while hospitalized, often short-circuits the reflective process and
can lead to a desire to pursue an unrealistic immediate quick fix
or resolution with pain medications. When patients experience
pain, they may feel a sense of loss of control, become concerned
about the source of the pain, experience isolation, or become
overwhelmed when the pain becomes dire or chronic.5 The
treatment of pain from a purely pharmacologic standpoint is rarely,
if ever, transformative. In the words of Richard Rohr, "If we do
not transform our pain, we will most assuredly transmit it."6 This
phenomena points to the vital need to practice more holistic care.
Pain and suffering are multifaceted; leaning into pain and suffering
is the key to moving through it. Understanding the broader context
of pain and suffering that
patients experience is
necessary to help in the
transformation of pain.7

"Spiritual care aims to empower patients
to discover, claim, and rely on their inner
religious or spiritual resources as integral
and valid treatment interventions as part
of a multimodal plan of care."

Although many hospitals
have dedicated spiritual care
services with assignments
to intensive care units or
palliative care services, our
program is unique in having
a dedicated spiritual care
provider as an integrated member of an anesthesiology-based
APS. Our rationale is that the experience of pain is biopsychosocial,
rooted not only in physical sensations but also emotional, cognitive,
spiritual, and social elements.
Traditionally, an APS focuses on pharmacologic management
and regional analgesia offered by physicians with limited
interdisciplinary and integrated services. Acute pain, experienced

When people encounter
a medical condition,
sometimes the impact of
their experience can lead
to a spiritual struggle. Like
approaching a fork in the
road, patients may engage
with their medical reality that leads them to a place of renewal,
growth, or change. On the other hand, a medical situation can lead
patients to despair, hopelessness, and meaninglessness.2
In response to spiritual struggles, patients may need to confront what
they have held as significant or sacred and perhaps need to let go,
reframe, or reengage their spiritual resources in a new way.2 In that
movement of change or transformation, patients may feel afraid and

American Society of Regional Anesthesia and Pain Medicine
2018

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Table of Contents for the Digital Edition of American Society of Regional Anesthesia and Pain Medicine February 2018

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American Society of Regional Anesthesia and Pain Medicine February 2018 - No label
American Society of Regional Anesthesia and Pain Medicine February 2018 - 2
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