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How do I discuss faith at work?

51app 2024; 384 doi: (Published 13 February 2024) Cite this as: 51app 2024;384:q264
  1. Abi Rimmer
  1. The 51app

While faith should not influence clinical practice, there are ways that talking about spirituality and understanding of others’ beliefs can be appropriate, Abi Rimmer hears

Advocate for patients’ needs

Mohammed Ejaz Faizur Rahman, cardiology registrar, South Yorkshire, says, “The NHS is a diverse, multicultural environment where people of all faiths and none work together. As a protected characteristic under the Equality Act 2010, people should be able to practise their faith freely without any concern of discrimination.

“From a personal perspective, I discuss faith with two distinct groups of people: patients and colleagues. Since patients often feel vulnerable and unable to advocate for themselves, it’s important for doctors to recognise their religious beliefs and accommodate them.

“This could be as simple as meeting their dietary requirements for vegetarian or kosher meals; prescribing compatible drugs, such as halal friendly medicines free of porcine gelatine; or providing pastoral care through the chaplaincy team.

“It can also extend to more complex aspects of treatment, such as blood transfusions and resuscitation decisions. The faith of a patient even plays a role after death, where an expedited burial process may have to be facilitated.

“A discussion around the faith of the patient is necessary to facilitate truly individualised care.

“Discussions about faith with colleagues should revolve around ensuring that all staff are respected and accommodated. This could include the availability of suitable dietary options at hospital cafeterias or access to multifaith prayer rooms. Consideration should be given to the religious holidays celebrated by different faiths, such as Eid, Diwali, or Passover, when requests for annual leave are made. Beliefs should also be considered when organising work related social gatherings.

“Measures that can be taken to foster an inclusive environment ultimately have a positive impact on the mental, physical, and spiritual wellbeing of a person.”

Don’t judge other people’s choices

Kathryn Leask, Medical Defence Union medicolegal adviser, says, “Being open and honest with your employers and colleagues about your beliefs means you can be supported in practising in line with them. Your views shouldn’t, however, unfairly impact the way you treat colleagues or patients, cause them distress, or deny patients certain treatments.

“Your employer can put measures in place to help avoid a situation where you or a patient feel uncomfortable or patients are inconvenienced. Workload can be planned to ensure colleagues aren’t overburdened and patient care isn’t compromised. Patients can be made aware in advance through online or printed information about any services that are not available.

“If you have a conscientious objection to a procedure a patient is requesting, the patient should be made aware of this and advised of their right to see another doctor. They should be given all the information they need to make this possible. Alternatively, the doctor should arrange for a suitably qualified colleague to take over the patient’s care. It’s important not to imply any judgement or disapproval about a patient’s or colleague’s choices or lifestyle and be careful not to discriminate against individuals or groups.

“It’s also important to familiarise yourself with the General Medical Council’s guidance on religious and personal beliefs.”

Respect others’ boundaries

Ankur Sharma, specialty trainee year 5 paediatrics, Addenbrooke’s Hospital, Cambridge, says, “Although faith is a personal matter, it can be central to many doctors’ lives. Many of my colleagues wear symbolic items that identify them as holding a particular religious belief.

“I am culturally a Hindu but do not hold strong religious views. I believe, however, that one’s faith does not have to be hidden from the world. Faith can help anchor one’s personality and identity. As long as one does not let personal faith affect professional conduct, it can be a powerful instrument of motivation and morality.

“Having said this, my surname and ethnicity can lead people to incorrect conclusions about my religious beliefs. Some may have a misplaced feeling of allegiance with me based on these assumptions and I gently have to challenge the boxes that they unwittingly fit me in.

“Today’s NHS is a melting pot of people with many faiths and cultures. I work alongside colleagues whose faith and beliefs I may know little about. While it’s important to be curious, I try to respect boundaries and avoid a clash of cultural beliefs. Of course, it doesn’t always have to be serious. Asking about festivals, clothes, and food is an excellent start to building a team that gets along well. The workplace needs to be welcoming and inclusive.

“When it comes to patients, we have to take their religious beliefs into consideration when we assess them, though I try to limit the discussion to their care and treatment. Ultimately, the goal is to build a relationship of trust, based on fairness and respect regardless of beliefs and faiths. I believe that we must challenge colleagues if their faith leads to discrimination in any way.”

Discuss spiritual needs, not faith

Joanna May Sutton-Klein, emergency medicine trainee, Manchester, says, “While medicine and faith were once intertwined, doctors nowadays toe the straight and narrow path of evidence based medicine. Medical rituals have been replaced with standardised patient pathways and guidelines. Even hospitals have been transformed from church-like institutions to laboratory-esque glass boxes.

“A focus on patient pathways might speed up ‘patient flow’ but it’s becoming clear that they can have a negative impact on our ability to heal our patients. Healing can’t be measured, quantified, or financialised but it is needed more than ever. It’s time for doctors to go against the flow and allow themselves to practise in a more holistic and spiritual way.

“This can be difficult but I find that by resisting the pressure to see patients ever more quickly I’m able to create time and space for a more holistic practice. For example, I gather chairs for the patient’s relatives and myself before a consultation, rather than standing or crouching on the floor. I try to slow down my consultations, leaving silences to be filled and creating a much deeper level of consultation than the protocols and guidelines require.

“I make sure that my patients have been offered analgesia and antiemetics and I ensure they and their relatives have a hot drink if they wish. When I sense that the patient might have expectations that I am not able to meet I try to make the time to explain why, and I try to communicate uncertainty.

“While I wouldn’t discuss organised religion with patients, where appropriate I would discuss their spiritual needs: Are they scared or hopeful? Who are they leaning on for support? What are they thinking about what’s happening? I often ask, ‘What questions do you have?’ rather than ‘Do you have any questions?’ as the former tends to draw out more from the patient. I also make use of the ability to refer to the hospital chaplaincy service.”