BY: ROSEMARY HUME, RN, MSN; SR. SHARON RICHARDT, DC, PhD; and BETH APPLEGATE, RN, MSN
Ms. Hume is director and Ms. Applegate is program coordinator,
Seton Cove Spirituality Center; Sr. Richardt is senior vice president,
St. Vincent Health, St. Vincent Hospitals and Health Services,
Indianapolis's Seton Cove Center Seeks to Integrate Spirituality into the
"Spirituality in the workplace" is fast becoming a cliché, albeit one with
numerous interpretations, especially in health care. A quick scan of the literature
reveals articles and workshops that identify "spirituality" with sexuality,
corporate models of enhancing productivity, "soul making" in leadership and
entrepreneurship, and holistic health care. New variations and definitions of
workplace spirituality seem to appear every day. How can we hope for consistency
in understanding this important concept?
For the novice, a number of questions soon emerge. How does spirituality in
the workplace—especially the health care workplace—relate to that workplace's
pastoral care department? What is the distinction between spirituality and religion?
How is spirituality in the workplace related to "complementary medicine"? How
might it be related to "healing touch"? Is workplace spirituality related to
an interest in integrating organizational mission, vision, and values? How is
it related to stress reduction, or management, or behavioral medicine?
Is there a body of knowledge, a science that provides an intellectual foundation
for workplace spirituality? Or, on the other hand, is some of the workplace
spirituality we hear about merely a kind of pseudo-spirituality developed for
corporate reasons? Is it possible that academic courses, complete with degrees,
will eventually prepare people to be workplace spirituality specialists? If
so, what will the curriculum look like?
The authors of this article contend that a body of knowledge called "formative
spirituality" provides a foundational methodology for a holistic spirituality
in the workplace, at home, and in the wider world.
The St. Vincent Story
In 1998 St. Vincent Hospitals and Health Services, Indianapolis, formally adopted
a set of assumptions, definitions, and principles concerning spirituality in
the workplace. St. Vincent's approach may be helpful to others as they work
to discern a path forward regarding workplace spirituality. We have felt compelled
to put our program on paper so that (as the authors of a related program have
put it) "there can be criteria for the discovery and evaluation of the fundamental
insights explicitly or implicitly present in all spiritualities and especially
to clarify how special spiritualities stem from one foundational spirituality."1
St. Vincent opened its Seton Cove Spirituality Center in September 1998.2
After almost four years of experience with the center, which is based on the
art and discipline of formative spirituality, we have become aware that there
are many approaches to and various definitions of spirituality. We also recognize
that the members of most organizations come from many varied faith traditions.
We have found a definite hunger for meaning and purpose in the workplace as
well as at home. When an organization, having decided to make workplace spirituality
a high priority, opens a spirituality center, outsiders will naturally be curious
about the concepts used in that center. Those of us who launched Seton Cove
have become used to hearing people ask, "What is it?" "Why is it needed?" "Is
it worthwhile?" and "How will it make a difference?"
Organizational leaders often put a premium on the development of mission and
vision statements identifying a set of values that they want the organization's
employees to follow. They also often develop strategic plans that contain initiatives
for the organization itself to pursue. As one writer has said, "I believe that
it is possible to understand mission as more than assurance of a legacy, as
more than care of the poor or those who are marginalized, as more than just
the good intentions or motives we bring to work every day. I believe it is possible
for mission to become the principle of organizational alignment, performance,
and development."3 We contend that growth in individual and communal
spiritual maturity will help an organization stick to its mission, a mission
that has God as its central focus rather than some ideology.
We believe that an organization seeking to integrate spirituality into its
work should establish a unified foundation of concepts and constructs. This
unifying foundation can be the basis for integrating spirituality, just as it
can be the basis for integrating mission, vision, and values. Without such a
set of foundational concepts, the organization may adopt an eclectic, fragmented
approach and fail to mesh spirituality with its culture. We believe that an
organization seeking to integrate spirituality and work must have a unified
foundation for its activities and programs.
A Few Definitions
Before proceeding, we would like to offer a few definitions.
Spirituality "Spirituality is what makes us distinctively human. It
is our birthright as a human person—body, mind and spirit. Rather than a doctrine,
it is a way of living that promotes an awareness of meaning in life, love, relationships
and a priority of values. It is an unfolding of our awareness of God's (or the
Mystery's) presence in our life and world and reflects our ongoing relationship
with that Mystery."4
Formative Spirituality "Formative Spirituality is a discipline, a body
of knowledge that provides a way of seeing self and others, life and world,
in the light of which we most deeply are in God. Such a way of seeing spills
over into our way of being and becoming, and subsequently into our way of doing."5
Formative spirituality has three parts: formation science, formation anthropology,
and formation theology (which is served by the first two parts).
Formation Science "Formation Science is a theoretical and practical
approach to living the life of the spirit. It is founded on the insight that
what makes us distinctively human is our spiritual dimension. It awakens us
to the deepest truth of our human existence and invites us to grow toward spiritual
maturity over a lifetime."6
Formation Anthropology "Formation anthropology is the systematic
critical study of the distinctively human empirical-experiential formation of
character and personality. It examines this formation insofar as it can be known
from the formationally relevant symbols, practices, experiences, findings and
insights of human formation history, form traditions, arts and sciences."7
Formation Theology Formation theology is rooted in our common Judeo-Christian
heritage: the Ten Commandments, the evangelical beatitudes and counsels, the
Lord's Prayer as taught by Jesus Christ, the Apostles' Creed, and the teachings
of the early church councils. Borrowing from these and other sources, formation
theology emphasizes human character and personality formation, reformation,
A faculty engaged in training for workplace spirituality will use as its primary
sources the informational and formational messages of Holy Scripture, the Eastern
and Western church fathers, Catholic Church doctrine (especially as expressed
in catechetical theology), and the basic classical as well as classical-compatible
writings of church-acknowledged saints and masters of spiritual formation.8
The Health Care Workplace and Spirituality
Many people are confused about spirituality and its relationship to religion.
In fact, one of the major hindrances to defining spirituality is its relationship
with religion. Concerning this topic, we would like to make several points.
Spirituality and Religion Spirituality is what makes a person distinctively
human. It differs from religion, which is a particular belief and faith tradition,
a social institution in which a group of people participate, rather than an
individual search for meaning. Religion is more about systems of practices and
beliefs within which a social group provides for itself a platform for the expression
of spirituality.9 Although not everyone practices a formal religion,
all people do have a spiritual dimension.
Universal Human Understanding In order for health care to be holistic,
the spiritual dimension must be integrated into it. A universal human understanding,
respectful of all faith traditions and formation traditions, should be promoted
in the workplace, so that staff, physicians, and volunteers might embrace spirituality.
A Safe, Affirming Place In order for everyone to bring his or her whole
self into the workplace, the workplace must welcome and nourish those selves.
A spiritual workplace must exhibit clear indicators (perhaps through various
rituals and rewards) that it is a safe place, a place where all are welcome
to share themselves, body, mind, and spirit. If staff, physicians, and volunteers
feel safe and affirmed, patients and their family members will be more likely
to experience holistic care.
Patient and Family Satisfaction One way of measuring patient and family
satisfaction with holistic care is through a survey developed by Press Gainey
Associates, a South Bend, IN, firm. Particularly important is the survey question
that asks whether "staff were sensitive to my spiritual and emotional needs."
Integration of the Spiritual Dimension Continuing staff education and
ongoing spiritual integration will transform the workplace into an environment
in which the culture itself is transformed and new staff, physicians, and volunteers
will seek to be a part of the culture and keep it alive with the spirit. The
spiritual dimension must be thoughtfully and carefully integrated into a work
environment that, left to itself, is increasingly dominated by a controlling,
"bottom line," linear, functional, achievement-focused mentality, rather than
by a transcendent dimension that is receptive, qualitative, nourishing, relational,
Human and Material Resources What is needed is an awareness rooted
in and shaped by the current health care structure and yet appreciative of the
countercultural importance of infusing operations with inspiration, mission,
and vision. Human and material resources must be budgeted and made available
for the work involved in integrating spirituality into the workplace. A sound
methodology will be based on the realization that spirituality in the workplace
is not a mere buzzword signifying unconnected "programs" that may or may not
have universal appeal. Such a methodology will also respect the diverse faith
and formation traditions found in the typical health care workplace.
Formative Spirituality We believe that the discipline called formative
spirituality, founded by Fr. Adrian van Kaam and Susan Muto of Epiphany Academy,
Pittsburgh, offers this sound methodology.*
Seton Cove In workshops and retreats, educators at Seton Cove employ
formative spirituality in introducing physicians, hospital staff, and volunteers
to workplace spirituality. We have found that, in organizations that lack both
a general understanding of spirituality and leaders who actively practice spirituality
in the workplace, many employees avoid using the words "spirituality" and "soul."10
We believe that the two-year certification program in formative spirituality†
not only educates potential faculty and provides for their ongoing formation,
preparing them to serve as mentors and role models, it also gives health care
organizations further opportunities to integrate concepts of formative spirituality
into their everyday environment and operations. Seton Cove offers a safe and
inspirational place for this work.
Workplace Spirituality Measurements Ongoing education in workplace
spirituality is measured through patient, physician, and employee satisfaction;
program attendance; and the visible integration of the spiritual dimension into
all policies, programs, and measurements; as well as through increased staff
retention and recruitment, philanthropy, and resources made available to render
the workplace more aesthetically beautiful and quiet.
Competency of Faculty The competencies needed by a faculty person working
with the spiritual formation of individuals, groups, or organizations include
those found in a good leader, counselor, or educator. However, "to be competent
is to be willing to grow continually in the wisdom, knowledge, and skills given
to us by God, so that we can be more effective in our formation. We must point
others toward the 'more than' for which we all hunger and thirst, while remembering
that we are only servants through whom others might come to believe."11
Holistic competency of this type might provide the organization with more effective
planning, assessment, design, implementation, and evaluation of its activities.
Organizational development and instructional design competencies are also very
But the competencies involved transcend these functional tasks. A person who
integrates spirituality with his or her work will have a passion for mission
and core values and a desire to further mission, vision, and core values. Such
a person will have a spiritual life and will understand organizational structures,
facilitate, teach, network with staff, and integrate concepts and constructs.
He or she will also very likely have intuitive skills, common sense, good judgment,
patience, willingness, and mentoring ability in both mission and spirituality.
He or she will continue learning formative spirituality as it evolves—along
with role modeling, creativity, and flexibility—and will live core values to
a high degree. He or she will promote dialogue, use storytelling around vision,
share vulnerabilities as well as ideas, be a community builder, find humility
in daily activities, will not call attention to him- or herself, will be alert
to the common good, inspire others, and handle adversity.
Formation of Community One of the many outcomes of a unified approach
to spiritual formation is the formation of community. True community differs
from "team building" in that its members:
- Support each other personally and professionally
- Commit to individual and group ownership and accountability
- Strive for ongoing formation
- Continually appreciate unity in diversity
Guidance by the Holy Spirit Ultimately, we believe, the Holy Spirit
guides competence through common experience and understanding, which lead to
common judgment and decision making. In the certification program, what follows
formative spirituality is a process of common decision making and common action
in the work of a spirituality center attached to a specific health care organization.
Though we should not underestimate the importance of competency, there are,
according to Muto and van Kaam, three other dispositions of the heart that form
good faculty members for spirituality centers. Congenial persons will strive
for who they are most deeply in God and remain faithful to their call at any
moment. He or she needs the capacity to be "at home" with others, the quality
we know as compatibility. He or she must show compassion for him- or herself
and for others. The three "c"s—congeniality, compatibility, and compassion—add
up to competence and ultimate consonance. They direct our whole being toward
We noted in an earlier article, "We believe that God ultimately intends for
us lives that are whole, complete, and at peace; this happiness can only be
ours if we follow the lead of grace and begin to sound together in harmony with
the Divine Forming Mystery at the center of the field; Formation Science uses
the word consonance to capture such a transcendent way of living."13
By"center of the field" we mean that God the Mystery is at the center of our
life. Therefore, we should not place ourselves, our work, or other people at
the center of our lives. The "c"s of consonance, along with courage, direct
our whole being toward‰ integration. This belief goes beyond a merely functional
view, allowing spirituality in the workplace to develop in a holistic manner.
We have chosen a foundational framework of formative spirituality, and formation
science is part of formative spirituality that is built on a common understanding
and experience. Common experience can become common understanding, common judgment
or decision making, and, finally, common action.
The Testimony of Graduates
The following descriptions, by graduates of the two-year certification course
in formative spirituality, may help illustrate the process leading to an experience
Common Experience/Preparation/Language of Faculty/Facilitators "I learned
the common language of spirituality [in the certification program on formative
spirituality], unfettered by my faith tradition and religious affiliation,"
said one graduate. The employees of most organizations come from a variety of
faith and formation traditions. The formative spirituality approach that we
use is ecumenical and helpful for organizations that need an ecumenical approach.
Common Framework of Formative Spirituality "This course has significantly
enriched my life in a personal and spiritual sense," said another graduate,
"and I can see how formative spirituality can be applied in my business environment."*
This framework fits the corporate world as well as the health care world. The
formative spirituality approach to spiritual integration is infused with practical,
concrete, and specific behaviors and dispositions. It fosters, in day-to-day
work and life, an integration of spirituality based on sound spiritual principles.
Common Experiences of Participants in Formative Spirituality-Based Programs
"This day was spiritually cleansing and reconnecting," said another graduate.
"[It is] a wonderful experience that touches to the depth of the soul." As the
participants and faculty experience a common language of formative spirituality
in the workplace,they work with each other toward common action. During needs
appraisal, planning, and implementation, the integration of common knowledge
and experience moves methodology toward synchronicity.
One group of students wound up writing a vision statement for their department.
Using the formative spirituality framework and such spiritual experiences as
reflection and retreat, the group found its way past various barriers and became
a compassionate presence for its organization's patients. Its members found
they could then do the work of reformation and transformation. Another group,
whose members included physicians, began identifying those times when they had
met the spiritual and emotional needs of patients or their co-workers. Common
and shared experiences helped them to move together as a group toward better
outcomes for patients and families. Those scores on the patient satisfaction
survey that related to "meeting the spiritual and emotional needs of patients
and families" increased significantly in the areas where staff and physicians
had been part of a common experience of formative spirituality.
Common Judgment/Decision Making of Participants at the Spirituality Center
"A different kind of hunger has been activated through this program," said
still another graduate. "It is a hunger for wholeness . . . through the integration
of life-giving values." Decision making around nourishment of the spirit affects
not only the individual but also other people in his or her environment and
work space. A person who is both a physician leader and an educator participated
in a project that worked to integrate mission and spirituality in the workplace
of medical students. The physician chose to change his organization's medical
education curriculum for family-practice residents. That changed curriculum
has since brought wholeness to the program, attracting to it applicants who
hunger for the integration of spirituality in their own lives and, ultimately,
in the lives of their patients and families. The curriculum has been adopted
by the organization's internal medicine program as well.
Common Action Students who participate in the sessions called "Mission
Mentoring Year Long" and "Mission Mentoring Intensive" learn how to integrate
spirituality and mission into their work-life communities by beginning with
a common set of knowledge and experience.14 During their formation
process, they identify a spirituality/mission project to work with. Leaders
who bring their staffs to Seton Cove want to move the group to a more consonant
action approach to the very complex problems they have with patient care and
patient satisfaction. Patients and families evaluate both the effectiveness
of the technology and the extent to which their emotional and spiritual needs
were supported. Staff, physicians, and volunteers all need a common approach
that is mission driven and spiritually focused and integrates strategic initiatives.
Health care organizations constantly look for ways to distinguish themselves
from competitors. At Seton Cove, some of the distinguishing characteristics
we prize are:
- Public recognition for clinical excellence. (For the past five years, St.
Vincent has been included among U.S. News & World Report's "Top
100 Hospitals;" the facility has also received awards for its intensive care
unit, stroke treatment, and joint-replacement surgery.)
- The overall trend of increase in satisfaction of spiritual and emotional
needs on the Press Gainey satisfaction survey score. (Since 1998, St. Vincent's
overall score on the question "Have we met your spiritual and emotional needs?"
has climbed from 78.2 to 82.2.)
- Overall attendance by staff, physicians, and volunteers at programs integrating
spirituality. (Since opening in 1998, Seton Cove has had more than 26,000
participants in its activities.)
- Employee satisfaction scores. (In the past three years, scores in the area
of spirituality have been especially improved.)
- Physician satisfaction scores. (Physician participants rank spirituality
programs especially high.)
- Successful partnerships formed. (St. Vincent Health has numerous partnerships
throughout a 45-county area of central Indiana.)
- Financial indicators. (Over the past two years, financial indicators have
suggested that St. Vincent Health is a well-run system.)
- Charity care and community benefit. (St. Vincent Health invested more than
$50 million in charity care and community benefit in 2002.)
- Leadership development/formation. (Leaders from all over central Indiana
attend Seton Cove's "Mission Mentoring Year Long" and "Mission Mentoring Intensive"
programs during the summer months. During these sessions, each leader completes
a project integrating mission or spirituality in his or her workplace.)
At St. Vincent Health, our common experience, understanding, decision making,
and actions have shown us that a strongly identified foundation in formative
spirituality—one, that is based on a set of guiding definitions, principles,
and key elements concerning spirituality and spiritual formation—is vital for
the facilitators and faculty who work here. The design and implementation of
the system's activities and programs flow from this foundational work.
As Muto and van Kaam have written, "Formative spirituality transcends many
popular contemporary meanings of the amorphous term 'spirituality,' [which]
often refers only to an emotional climate to be filled with all sorts of badly
defined concepts in accordance with the dreams and wishes of those who use this
vague term arbitrarily."15
Because faculty need nurturing through a formative process of the individual
in alignment with the formative processes of other people, these processes necessarily
involve communal relationships and community building. Those who attend a certification
course in formative spirituality are prepared in common experience, common language,
and common judgment; and they ultimately come together in creative preparation
of transcendent activities that are a common-action approach, not one that is
disjointed and multifractional in nature.
It has been our experience that when a faculty has been prepared with a common
understanding of formative spirituality, it is able to plan, design, and implement
activities and programs that are not only congruent with the organization's
direction and destination statement but are also based on a common set of foundational
concepts and constructs of spirituality acceptable to all participants, no matter
what their faith or form tradition may be. As programs are designed, the faculty
have a common basis for deciding whether to use specific videos, quotes, reflections,
and prayers that connect to the wholeness of the common experience and understanding.
Seton Cove's overall action is thus consonant and in balance, rather than eclectic
and potentially disjointed.
We would like to hear from other people who are trying to integrate spirituality
into their workplaces. Are they, for example, using a single approach to spirituality
or a combined approach? We hope to continue this dialogue as we move forward
with this work of spirituality in the workplace.
- Susan Muto and Adrian van Kaam, Epiphany Certification Program Workbook
Module VI, Epiphany Association, Pittsburgh, 2002, p. 4.
- See Sharon Richardt, "A Clearing in the Woods," Health Progress,
March-April 2000, pp. 21-21.
- Gerald T. Broccolo, "Integrating Business and Spirituality," Health
Progress, May-June, 2002, p. 36.
- Daughters of Charity of St. Vincent de Paul, Spirituality and Spiritual
Formation: On the Path of Wholeness, Daughters of Charity East Central
Province, Evansville, IN, 1996, p. 3.
- Susan Muto and Adrian van Kaam, Formation Guide for Becoming Spiritually
Mature, Epiphany Association, Pittsburgh, 1991, p. 6.
- Muto and van Kaam, Formation Guide.
- Muto and van Kaam, Epiphany Certification, p. 51.
- Muto and van Kaam, Epiphany Certification, p. 2.
- J. Dyson, M. Cobb, and D. Forman, "The Meaning of Spirituality: A Literature
Review," Journal of Advanced Nursing, vol. 26, no. 6, pp. 1,183-1,188.
- See I. Mitcoff and E. Denton, "Finding Meaning and Purpose in One's Work:
Spirituality in the Workplace," The Newsletter of Trustee Leadership Development,
- Muto and van Kaam, Formation Guide, p. 142.
- Muto and van Kaam, Formation Guide, p. 90.
- Muto and van Kaam, Formation Guide, p. 89.
- Mary Elizabeth Cullen, Sharon Richardt, and Rosemary Hume, "Mentoring Mission
Leaders of the Future," Health Progress, September-October 1997, pp.
36-38, 43; and Sharon Richardt and Jude Magers, "Spirituality for Lay Leaders,"
Health Progress, November-December 1997, pp. 18-19, 34.
- Muto and Van Kaam, Epiphany Certification, p. 135.
Copyright © 2003 by the Catholic Health Association of the United States
For reprint permission, contact Betty Crosby or call (314) 253-3477.