This qualitative study focused on investigating healthcare professionals' experience of working with terminally ill patients for the purpose of developing a program for building multi-spiritual competency. The literature review highlighted the lives and needs of terminally ill patients, the incorporation of spirituality into the healthcare system, and multi-spiritual competency. In addition, six healthcare professionals currently working with terminally ill patients were interviewed. Seven themes emerged from the interviews: (a) autonomy and choice; (b) common spiritual needs; (c) addressing spirituality; (d) the influence and role of families; (e) transpersonal experiences; (f) building spiritual competency for healthcare professionals; and (g) healthcare reform. Clinical implications suggest spirituality plays an important role in the lives of dying patients. Healthcare professionals are encouraged to see multi-spiritual competency as an integral component of clinical competency when treating the terminally ill. Multi-spiritual competency requires the study of different religions, cultures, and spiritual practices, and the development of an appropriate skill set for clinical practice as well as an attitude of cultural and spiritual humility. A program for building multi-spiritual competency begins with a commitment to self-evaluation and self-critique by the healthcare professional of one's own beliefs and biases with the intention of developing an honest and respectful relationship with the patient as the goal.