Nurse Base

Check the patient's admission record to determine his religious affiliation. Remember that even patients who claim to have no religious beliefs may desire spiritual or pastoral care. So watch and listen carefully for subtle expressions of this desire.

Evaluate the patient's behavior for signs of loneliness, anxiety, or fear—emotions that may signal his need for spiritual counsel. Also consider whether the patient is facing a health crisis, which may occur with chronic illness and before childbirth, surgery, or impending death. Remember that a patient may feel acutely distressed because of his inability to participate in religious observances. Help such a patient verbalize his beliefs to relieve stress. Listen to him and let him express his concerns, but carefully refrain from imposing your beliefs on him to avoid conflict and further stress. If the patient requests, arrange a visit by an appropriate member of the clergy. Consult this clergy member if you need more information about the patient's beliefs.

If the patient faces the possibility of abortion, amputation, transfusion, or other medical procedures with important religious implications, try to discover his or her spiritual attitude. Also try to determine the patient's attitude toward the importance of laying on of hands, confession, communion, observance of holy days (such as the Sabbath), and restrictions in diet or physical appearance. Helping the patient continue his normal religious practices during hospitalization can help reduce stress.

If the patient is pregnant, find out her beliefs concerning infant baptism and circumcision, and comply with them after delivery.

If a neonate is in critical condition, call an appropriate clergy member immediately. To perform an emergency baptism, the minister or priest pours a small amount of holy water into a teaspoon or a medicine cup and sprinkles a few drops of water over the infant's head while saying, “(Name of child), I baptize you in the name of the Father, the Son, and the Holy Spirit. Amen.” In an extreme emergency, you can perform a Roman Catholic baptism, using a container of any available water. If you do so, be sure to notify the priest because this sacrament must be administered only once.

If a Jewish woman delivers a male infant prematurely or by cesarean birth, ask her whether she plans to observe the rite of circumcision, or bris, a significant ceremony performed on the eighth day after birth. (Because a patient who delivers a healthy, full-term baby vaginally is usually discharged quickly, this ceremony is normally performed outside the facility.) For a bris, ensure privacy and, if requested, sterilize the instruments. (For more information, see “Circumcision,” page 775.)

If the patient requests communion, prepare him for it before the clergy member arrives. First, place him in Fowler's or semi-Fowler's position if his condition permits. Otherwise, allow him to remain supine. Tuck a clean towel under his chin, and straighten the bed linens.

If a terminally ill patient requests the Sacrament of the Sick (Last Rites) or special treatment of his body after death,
call an appropriate clergy member. For the Roman Catholic patient, call a Roman Catholic priest to administer the sacrament, even if the patient is unresponsive or comatose. To prepare the patient for this sacrament, uncover his arms and fold back the top linens to expose his feet. After the clergy member anoints the patient's forehead, eyes, nose, mouth, hands, and feet, straighten and retuck the bed linens.

Handle the patient's religious articles carefully to avoid damage or loss. Become familiar with religious resources in your facility. Some facilities employ one or more clergy members who counsel patients and staff and link patients to other pastoral resources.

If the patient tries to convert you to his personal beliefs, tell him that you respect his beliefs but are content with your own. Likewise, avoid attempts to convert the patient to your personal beliefs.