Referrals to health care chaplaincy by head nurses: situations and influencing factors.

To determine in which situations head nurses refer patients to health care chaplains and to detect significant influential factors, 192 head nurses from 117 health care institutions in the German part of Switzerland were surveyed with regard to situations in which they refer to a chaplain. On average, head nurses refer "often" to a chaplain in their daily work in situations where patients are dying or need religious-spiritual service or support, but they refer only "rarely" to a chaplain in situations where patients or their families express negative feelings or where other psychosocial needs are present. Moreover, the religiosity of head nurses, working in a general acute care hospital and a positive evaluation of the chaplaincy services determine significantly whether a head nurse calls for a chaplain in a particular situation or not. For quality improvement of chaplains' work, health care chaplains have to integrate themselves into the care team. On the contrary, standardized referral processes between chaplains and nurses as well as physicians have to be elaborated to reduce subjective factors (eg, the religiosity of the nurse) from the process of referring.