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Azusa Pacific Professor Heading to Norway

Posted January 5, 2009

  • A breast-cancer patient asks a nurse to call her longtime pastor.

    A young man faces a serious illness or death in the intensive care unit.

    And a homeless mother fears for her child's health at a cold-weather clinic.<

    After decades in the nursing field, Pamela Cone of Glendora knows that, for most patients, comprehensive treatment requires more than a simple diagnosis or prescription

    Next month, Cone will travel to the University of Bergen in Norway on a prestigious Fulbright Scholarship to explore the spiritual side of care-giving that nurses train for during their education.<

    The Azusa Pacific University professor, who holds a Ph.D. in nursing, has spent much of her career studying and teaching on the intersection of medical science and spiritual issues.

    "A lot of times people hear the word 'spiritual' care, and they think I'm talking religion," Cone said. "And it's not that at all, though you can use a person's religious practices and beliefs to help them with their spirit. But it's really spirit care — it's the inner place of a person that can be wounded or ailing."

    According to Cone and other experts, the medical community has, in the past, neglected this side of the treatment process. In recent years, however, there has been renewed interest in a holistic approach to medicine and healing.

    "That's really where medical care is turning now," said Shirley Otis-Green, a senior research specialist in the

    Nursing Research and Education Department at City of Hope. "It's about looking at the whole person."

    At the Duarte cancer center, the Sheri & Les Biller Patient and Family Resource Center is slated to open in October. The new, dedicated facility will bring all the psychological and spiritual support services together under one roof, said Rev. Cassie McCarty, City of Hope's chaplain.

    "We are really wanting to emphasize right from the get-go that we're not just treating our patients' bodies," McCarty said. "We're treating their minds and spirits and even their families."

    But addressing a patient's spirit is a lot different than treating, say, a fever or high blood pressure

    "We can't put our fingers on it the same way we can with a pulse or something easier for our physical minds to understand," Otis-Green said

    One tool that helps medical professionals conduct a spiritual assessment on patients is commonly referred to as FICA — an acronym for Faith, Importance, Community and Application. The four-point tool was developed by Christina Pulchalski, executive director of The George Washington Institute of Spirituality and Health

    "I try to find out, first, if they have a faith tradition," McCarty said. "How does that impact their day-to-day life? ... And do they have a community around them, like a church or mosque or temple?"

    In the final step, the medical professional tries to apply these elements in the health-care setting

    Becoming attuned to a patient's spiritual needs often requires a great deal of sensitivity and finesse on the part of the caregiver

    "In nursing, we have a strong ethical stand that you cannot put your own belief system onto a patient because they are a captive audience," Cone said

    "I learned to ask them. And if they weren't accessing a faith system of their own, would they like me to share what I do when I'm having a crisis? Sometimes they would say yes, and sometimes they would say no."

    Much the way each patient's treatment plan is specialized, spiritual-care issues also vary widely from one person to the next, Cone added

    Caregivers may be asked big, existential questions about the meaning of life and dying. Or they may be looked to as simply a calming presence

    "Just being with them and holding their hand can make a big difference," the APU professor said

    Cone said nurses, in particular, have to be prepared for spiritual-care giving, perhaps more so than many others in the medical field

    "Nursing is so broad," she said. "You have to have lots of knowledge about lots of different things, and then you have to be able to think critically and put all the pieces together like a jigsaw puzzle to help the patient. You're not just diagnosing and treating the illness; you're treating the person."

    Her past research has explored what nurses and medical professionals think spiritual care encompasses, and how to meet patients' needs

    She has also worked closely with the homeless community, both as a spiritual-care nurse at a clinic sponsored by the East San Gabriel Valley Coalition for the Homeless and also in her doctoral research on the needs of homeless mothers

    "It really is a spiritual issue," Cone said, "because so many of them said they had been treated as though they were invisible. Their spirits were so hurt."

    Her own Christian foundation — Cone's parents were career missionaries in the Republic of Haiti — has lent strength to her nursing and teaching career over the years

    "Nurses with a spiritual faith of their own — and it doesn't really matter which one — are generally more comfortable dealing with spiritual-care issues among patients," she said.

    Cone traces her interest in nursing back to the age of 6, when she recalls helping her mother in a makeshift clinic under the mango trees in Haiti, the Caribbean country where Cone and her siblings were raised

    A desire for a stateside education brought her to West Virginia and then to Southern California, where she studied in nursing programs and worked in a variety of medical facilities

    After marrying, she settled in Glendora and raised three children. Cone pursued her master's degree at APU, where in 1990 she found a community of learning that revived her interest in spiritual care

    "One of the unique things that we do at APU is really provide a foundation for nurses not only to care for physical needs, but also the spiritual needs. We thread that conversation through all our curriculum," said Renee Pozza, associate dean of the School of Nursing

    Now, Cone has become the third APU faculty member to receive a Fulbright, the second from the School of Nursing, said Diane Guido, vice provost for undergraduate programs and the Fulbright program adviser at the university

    In August, Cone will begin six months of study at the University of Bergen, Norway, where she will conduct spiritual-care research, as well as teach in the university's nursing school

    "She has established herself as a top scholar," Guido said. "The Fulbright really underscores the value of the work she is doing."