Context and Delivery

At the hospice we are working within end of life care. The context is important as these are often patients' last days. With them the MDT carry hope for and often with them (35).

The delivery of spiritual care is an interpersonal activity; it requires relationship. It is not a discreet I-Thou transaction, but a We interaction (36). Schmid (19) describes how 'response-ability is the basic category of being a person: Out of encounter arises the obligation to respond.' That response 'means service to the person out of solidarity' (19, p.2).

Spiritual Teamwork is Spiritual Journeying and Accompaniment

Many religions have a tradition of pilgrimage or journeying with others. There is much to be learned by the health care team about cooperative journeying with patients and their families. As spiritual caregivers we often find ourselves 'playing in the margins of meaning' (37). Let us be clear here. The content of this 'playing' is exactly meaning-making, even the reconstructing of meaning in the face of the traumatic, dramatic instability caused by a terminal diagnosis. Here again, spiritually-informed presencing and work begins with drawing alongside a person and accompanying compassionately in solidarity. Spiritual teamwork is cooperative, giver and receiver both being vulnerable and open to the possibility of change and growth - 'we do, we struggle to make meaning and share' (38, p.3).

Secondly, and holding to the image of journeying through what may seem a dusty wilderness, once engagement is made and the beginnings of a therapeutic relationship established, the spiritual care-giver is entering upon what Jonathan describes as 'the adventure of the unrehearsed critical conversation'.

Again, spiritual care 'often is provided by every member of the health care team' (31) and Schmid (19) makes the point that in such institutions and therapeutic disciplines that focus on individualised care, 'we need distinction and we need cooperation.' There are many kinds of roles, but they are complementary. Gordon et al (34, p.3) express this well: 'a health care practitioner's humanity, the self, is the most effective therapeutic tool that they possess.'

 
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