The Critical Role of Spiritual Care in the Emergency Department.

Patients in the Emergency Department (ED) have a diverse set of spiritual challenges. As part of a clinical initiative to embed palliative care in the ED, our palliative care department looked to provide timely spiritual care (SC) to this population. We worked with three of our chaplains to identify ED-specific spiritual care challenges and benefits. Several themes arose on nuances of SC consults in the ED: quality of consults (less focused on actively dying patients, more upstream support), challenges (physical environment, staff limitations, distractions), benefits (continuity of care, support to the ED staff, high moral/spiritual distress in the ED setting, provider- rewarding care, taking advantage of long ED stays), and ways to improve (embedding SC in the ED, education on scope of service provided by SC). Addressing spiritual and moral distress is a key component of high-quality palliative care and may be a feasible patient-centered outcome to address in future research.