Protocols Are an Important Part of Any

¶ … Protocols are an important part of any organizational paradigm as they provide a set of guidelines dealing with specific topics. This prevents potential legal issues, and allows for staff to be appropriately trained on specific issues. For our case study, we will use Louisiana State University Health Sciences Center (Shreveport). The purpose of this policy is to "define the services provided by the Pastoral Services Department for patients and employees of LSU-Health Science Center (LSU Health Sciences Center, 2013). The purpose of this paper is to provide information to help revise the current pastoral care protocol at the LSU Health Science Center.

Policy Overview

Pastoral care is a model of emotional and spiritual support that in the modern hospital is non-denominational and focused on the paradigm of servant leadership. During periods of high emotional stress, tragedy or situations involving the very sick, pastoral care can provide comfort for both patients and families. For LSU Health Centers, the policy for Pastoral care focuses on the patient's and family's spiritual well-being, holds regular worship services, provides religious literature from a multi-dimensional library, is available 24 hours/7 day a week, provides support for staff during debriefing and severe crisis situations. Moreover, Pastoral Care must document spiritual assessment and reassessment plus any and all interventions in the progress section of the medical record. The care is confidential and individualized, but noted in the patient's record (LSU Health Science Center). However, there are some limitations to current Pastoral Care that should be revised. Pastoral care, for instance, is slated during daily rounds in ICU and ER areas, during visitation of new admissions or referrals or requests from staff or physicians.

Revision of Protocol

Due to busy schedules and the lack of staff within wards, it is often difficult for staff (nurses and physicians) to have time to find Pastoral Care in all situations. This paper recommends that Pastoral Care personnel be expanded to provide daily care to all units, not just ICU and the ER. In all studies reviewed, the individual perception of quality of life and overall positive attitude was higher in the populations who had a regular Pastoral Care. While certainly suggesting a real benefit to patients and families, there is also a fiscal benefit to health care organizations who provide more Pastoral Care. Patients receiving Pastoral Care tend to heal faster, require less medication and have more pain-free days than control groups. The concept of pastoral care is very much in line with the idea of servant leadership within the medical community. This holds that actionable results are achieved by giving priority to the needs of others -- or stewardship of leading by ministering to the needs of clients when they are in need as opposed to convenience of the hospital or organization (Bush, 2006).

Literature Review

Nicholas, S. (2013). Examining the Impact of Spiritual Care in Long-Term Care. Omega, 67(1-2), 175-84.

Certainly, there are times within the modern medical paradigm in which the patient or the patient's family needs access to Pastoral Care. This is particularly important now that there is a demographically aging population. One study suggests that spiritual support is a vital factor in the well-being and quality for many situations: emergencies, end-of-life issues, and long-term or palliative care situations. This study created educational materials and performed in-service training for staff at two retirement and continuing care facilities in Southern California. Surveys were used to assess patient and patient's family needs and were given prior to the implementation of a spiritual care program and then surveys taken 2 to 4 years after the programs were implemented. The study was primarily qualitative, and used anecdotal and personal impressions as part of the data set. The results of the study indicated that spiritual awareness and satisfaction increased throughout the resident population after the Pastoral Care Program was implemented and established. The longer the program was in effect the greater the interest and efficacy, as well as the view that this population was in particular need for spiritual counseling and care.

Bay, P., et al. (2008). The Effect of pastoral Care Services on Anxiety, Depression, Hope, Religious Coping and Religious Problem Solving Styles. Journal of Religious Health, 47(1), 57-69.

However, it is not just long-term or palliative care for patients that respond to Pastoral Care. In fact, in a randomized study 166 patients were observed during pre- and post- surgery, and then 1 month and 6 months later using four standardized measurements that dealt with coping skills, anxiety, hope, and coping styles. There were significant differences between groups who had positive pastoral care and those who did not. In fact, even with comparable demographics anxiety, depression and coping skills increased based on the amount of pastoral care given. Within the test, the average visit was 45 minutes and non-denominational. The final data suggests that regardless of the individual's religious affiliations, pastoral care has a positive psychological effect upon the patient's outlook, self-esteem and ability to cope with their illness or condition.