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It is vital that, as a health care professional, you are aware of the requisite knowledge, behaviors and skills that will help you manage both yourself and your patients while you provide spiritual care in addition to health care. Here are a few tips: 1. Be aware of religious, spiritual or cultural beliefs, practices and taboos. There are hundreds of RS beliefs and practices across the globe today. It is virtually impossible to know them all. However, you can greatly increase your spiritual competence by familiarizing yourself with the major world religions. • Learn how to recognize some key concepts of major world religions. This will help you know how best to communicate with your patient, as well as how to leverage the knowledge of their religion to gain their compliance with treatment interventions. Knowing your patient's RS orientation also helps you build rapport and trust with them. • Knowing a variety of RS restrictions and taboos will prove very useful to help you understand some of the medical decisions that your patient might make about the care you provide. It will also demonstrate your spiritual competence to them. • Knowing the symbols and rituals of a variety of religions and spiritual paths is a profound ways to help your patient and their loved ones connect during and after your patient's transition. Rituals, in particular, enable your patient and their loved ones achieve resolution and peace during the time leading up to transition, especially in the presence of RS distress. Be sure to have a list of a variety of religious and spiritual practitioners who can help facilitate these rituals at the appropriate time. 2. Keep your own RS beliefs and practices to yourself. Spiritual care is not your opportunity to proselytize or convert your patient to your own RS beliefs while they are psychologically, emotionally or spiritually weak. You may have strong RS beliefs and practices that you believe would be helpful to your patient; however, remember that they have the right to their own beliefs and practices too. When in doubt, practice the Golden Rule! • Avoid using your psychological authority as the health care professional to tell or convince your patient about how your RS beliefs will "save" or "protect" them from their illness or from "hell before it is too late". That is unethical. • Do not leave your RS literature or keep your RS television or radio programs on around your patient in the hopes that they will get converted, "see the light" or "know the truth". That is unethical. • Do not mock or make fun of your patient's RS beliefs and practices, no matter how strange or different they may appear to be to you. To them, it is not a joke. That is unethical. • Do not make insensitive religious or spiritual generalizations based on your patient's cultural, racial or ethnic background. That can be hurtful to them. • Do not force your patient to accept chaplain or other religious visits or literature, especially when they have indicated that they are agnostic, atheist or of another RS path different from yours. That is unethical. • Do not coerce the chaplain to visit or "talk with" your patient who has indicated that they are agnostic, atheist or of another RS path about which you are ignorant. • Do not pressurize or coerce your patient who is actively dying to quickly convert to your religion or spiritual belief so as to ensure they make "heaven" or "paradise" and avoid "hell fire" or "punishment" after death. That is unethical. Let them die in peace and on their own terms. 3. Pay attention to your patient's body language and tone of voice. When your patient is stressed, nervous, anxious or confused, conversations about RS beliefs and distress can become more challenging. This is especially important when communication via the phone and video. • If your patient has turned their face or body away from you, has arms folded in front of their body, present a tense facial expression, is wincing, moaning or crying with pain or distress, or refuses to make eye contact with you, your first line of action before having the conversation is to make them comfortable. • Practice the "Ministry of Presence". Pay attention to not only what your patient says, but also to what they are not saying. Where appropriate, ask how you can help, and follow through. Sometimes, just sitting quietly with them will help make them feel calm and comforted. • When your patient presents with RS distress, do not assume that you know what they feel or believe. Saying, "I know how you feel" may make them feel that you are being inauthentic and just talking for the sake of saying something. Give them the opportunity to tell you in their own words what is going on and how you can be of help. 4. Be humane, kind and open-minded. Your patient may share some religious or spiritual concerns, beliefs or needs that are making them distressed. Even beyond the Health Insurance Portability and Accountability Act (HIPAA) in the U.S. or similar privacy requirements in your country, it is essential that you keep your patient's religious or spiritual concerns private, unless authorized by them to share. It is the ethical and humane thing to do. • If your patient is concerned about life after death or existential issues, remember not to coerce or impose your own beliefs on them at this delicate time in their life. This is also not the time to discuss what your patient said with others who are not part of your health care team. Listen without judgment to what they have to say, and ask how they want to be supported. Bring in the chaplain or other religious person upon request or permission by your patient. • If your patient is concerned with forgiveness and reconciliation with others, help facilitate making the connections if that is what they want and if it is possible. Otherwise, ask how they want you to support them to achieve peace. • If your patient wants you to pray, read or perform certain RS rituals for them in private that are different from yours, let them know if you are comfortable with doing so or not. If you feel uncomfortable, ask your patient if it is okay for you to find someone else to help out. • If you are aware of your patient’s RS beliefs and practices, try your best to have their preferences in place within the immediate environment. This may be as simple as placing specific RS objects within your patient's reach or view, playing their preferred RS music or programs, making their RS literature available for them or someone else to read to them, or reorienting their bed or chair toward nature or a preferred direction. It may not always be possible to arrange your patient's environment to their RS preferences, due to institutional or other restrictions; in that case, explain the restrictions to them, and then explore what concessions you can get to make them feel comfortable.