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Spirituality in Nursing

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Issues Presentation

on 18 November 2014

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Transcript of Spirituality in Nursing

Relevance to Nursing
Holistic nursing through many ways:
spending time with the patient
(Rushton, 2014)

As nurses we need to respect this diversity in the same way we provide culturally competent care- adjust for a person's spiritual beliefs
What the CNA encourages nurses to do (CNA, 2010)
Myah Hopkins
Ashley Edmunds
Nicole Bussey
Laura Pack
Amanda Thomas
Jeffrey Estabrooks
By this end of this presentation you will be able to:
Define spirituality
Address the relevance of spirituality in nursing
Provide a difference between spirituality and religion
Discuss the historical aspects of spirituality in nursing
Examine the political aspects of spirituality in relation to nursing
Explore the social/cultural aspects of spirituality in relation to nursing
Discuss the importance of self-awareness in relation to spirituality
Broad Overview
Spirituality is a broad term that is often very individualized to a person's specific beliefs.
As nurses, we must be aware of what spirituality means to each client we care for as well as to be self-aware of what spirituality means on a personal level.
Objectives Continued...
Explore the four domains of nursing in relation to spirituality:
1. Practice
2. Research
3. Education
4. Administration
Analyze and discuss information gathered from key informants regarding spirituality in the community
Identify resources available for registered nurses in regards to spirituality.
Format of Presentation
Spirituality awareness activity
Prezi slide show
Video clips
Post Quiz
Spirituality in Nursing
Spiritual Awareness Activity
Definition of Spirituality
Difference between Spirituality and Religion
Historical aspects of Spirituality
Overview of main Historical Aspects
Florence Nightingale
Jean Watson's Theory of Caring
Political aspects of Spirituality
Social/cultural aspects of Spirituality
Key Points
Religious Groups in Canada
Non-religious groups in Canada
Spiritual Healing Modalities
Guided Imagery
Self Awareness in Nursing
Barriers for Self Awareness
Increasing Self Awareness and Spirituality
Key Points
Resources in regards to Spirituality for Nurses
Implications for Nursing
Key Informant
Rick Singleton
Closing activity

Post Quiz
Spirituality may be defined as "whatever or whoever gives ultimate meaning and purpose in one's life, that invites particular ways of being in the world in relation to others, oneself and the universe". Themes associated with the concept of spirituality include meaning, purpose, hope, faith, existentialism, transcendence, sense of peace and connectedness among others. Spiritual beliefs are diverse, reflecting both individual and cultural influences.

(CNA, 2010)
sometimes called
usually refers to membership and participation in the organizational structures, beliefs, rituals, and other activities related to a religious faith.

typically has a more existential and experimental focus upon an individual's internalized faith, values, and beliefs along with their consequences in daily behaviour.

There are five central features of spirituality
(Cohen, Holley, Wengel, Katzman, 2012)

Careful Nursing is a professional practice model that considers spiritual values that could be useful in assisting nurses to reach a shared understanding of spirituality and a spiritual approach to nursing practice.
Six spirituality-related dimensions and recognition of intrinsic human dignity comprise the foundation of Careful Nursing as it approaches spiritual care.
(Meehan, 2012)
Knowing your own strengths and limitations and understanding your own emotions and the impact of your behavior on others in diverse situations (WHO, 2013).
Nurses work is spiritual in nature (Koren & Papamiditriou, 2013).
Nurses are trusted and therefore many people turn to them to talk about their spiritual beliefs. Questions of mortality, suffering and the inevitability of death are often asked by clients. These questions are fundamental to the human experience and touch upon spiritual understandings of life and death (Molzahn & Sheilds, 2008).
We don't know what spirituality is
Religion vs. Spirituality; inexperience, practice setting, culture, personal comfort
We don't have the right words
Struggle with writing and articulating
Lack of education
Lacking in theories and education curricula
Someone else's responsibility
"It's clergy/pastoral care's job"
Social influence
Social, public education, legal and judicial system separate from tradition
Current health-care context
Lack of spiritual assessment and care, "have no time"

(Molzahn & Sheilds, 2008)
Care of the Patient
Meaning and Purpose
By providing direct and intimate patient care
Relationship with Patients
Essential aspect of patient care and spirituality
Providing nursing intervention in a caring manner; caring for the welfare of the patient
Care of Self
Internal Resources
Resources that reside within, part of our personal being
External Resources (Facilitators)
People and things that provide support
External Resources (Barriers)
Persons and things that could improve the work environment and provide avenues of self-care
(Koren & Papamiditriou, 2013)
Careful Nursing
Intrinsic Human Dignity-
Central value
Unconditional love
Contagious Calmness-
Quality and importance of calmness in nurses
Great Tenderness in all things-
Having spiritual quality
Nurses care for themselves and one another-
Treating themselves and others
Intellectual Engagement-
Objective knowledge, accuracy and value of personal professional practice
Safe and Restorative Physical Surroundings-
Protecting patients from harm
(Meehan, 2012)
The social and cultural aspects of spirituality are interrelated
The CNA Position Statement enforces that nurses have a responsibility to provide culturally competent care. This includes being non-judgemental and thus being open to an individuals cultural diversity and spiritual beliefs
(CNA, 2010).
Nurses have to be aware of their own attitudes towards spirituality and the many forms they can take.
Roman Catholic
Aboriginal beliefs
Used to calm the body and focus the mind

Helps relieve stress and tension

Helps improve outcomes in health-related illnesses

Studies are currently being conducted to show the relation between the effects of meditation on the body such as the reduction of heart rate, and blood pressure
Visualization technique

Used to increase relaxation and reduce stress

Spiritual practice for the body, mind and spirit

Increases awareness of the self

Focuses on the breath, to maintain postures, and increase flexibilty of the body and mind
Spiritual practice used to connect with god, the universe or source of all creation or other non-living being
Prayer also has healing abilities as it has been shown to reduce stress associated with worry

Individuals place faith in many forms that everything will work out for the best
Common themes:

1. An art form through which one might develop spirituality
2. Spirituality or religion?
3. The need for spiritual nursing care.
Main items of Jean's Carative/Caritas Processes over time through evolution:

Instillation of faith-hope
Promotion & acceptance of the expression of positive & negative feelings
Provision for a supportive, protective, and/or corrective mental, physical, sociocultural, and spiritual environment
In local political issues with religion, a form of spirituality has been questioned
A St.john's man has raised an issue with Eastern Health about the religious symbols at St. Clare's Mercy Hospital
CNA Position Statement
ARNNL - If wondering what your obligations are to the licensure body. ARNNL has a document that states what you need to know as an entry-level RN
CNA - Position Statement - If wondering what the Canadian Nurses Association perspective is on spirituality
RCN (Royal College of Nurses) - Created an entire online resource after completing a survey for all of their members in 2010 regarding spirituality.
Spirituality Health Network- A non-profit volunteer organization that explores the integrations of spiritual practice and tradition into health care.
Difference between spirituality & religion
Incorporate spiritual care when teaching physical care; have it a part of simulations & clinical experiences
More curriculum implemented regarding spiritual care in nursing programs
Education sessions for current health care providers
Include information about different religions, cultures and spiritual practices
Implementation of a scale on spiritual self awareness
Ensure policies are in place regarding spirituality
Ensure spiritual care is accessible and available to patients and families
Difference between meditation and prayer
1. How has spirituality or religion changed in health care?
2. What kind of spiritual practices do you see in the health care setting?
3. Do you think spirituality is important in nursing practice?
4. What is your view point on the issue of religion at St. Clare's Mercy Hospital?
5. Why are ethics and spirituality grouped together?
How we incorporate spirituality into our daily lives without even knowing it:
What do we say after someone sneezes?
When something bad happens to someone, what do we normally say?
What does spirituality mean to you?
(Kreitzer et al, 2009; McSherry & Jamieson, 2011; Reimer-Kirkham et al, 2012)
(Boswell, Cannon, & Miller, 2013; McSherry & Jamieson, 2011; Wu, Liao & Yeh, 2012)
In the international forefront, the United Kingdom leads the health care industry in terms of spirituality. The Royal College of Nursing (RCN) has a published document in regards to spirituality in nursing that is very comprehensive.
(Dolamo, 2010)
(Wagner, 2010)
(The Telegram, 2013)
(CNA, 2010)
(RCN, 2014)
(ARNNL, 2013; CNA, 2010; SHCN, 2014; RCN, 2014)
(National Center for Complementary and Alternative Medicine (NCCAM), 2010)
(The Center for Spirituality and Healing, 2010
(Woodyard, 2010)
(The English Standard Version Bible, 2009
(Reimer-Kirkhama et al., 2012)
Defining spirituality (Rushton, 2014)
Nurses and patients views on spiritual care implications and which they find are most effective (McSherry & Jamieson, 2010)
Develop a standard model of spiritual care for the nursing workplace and its outcomes (Reimer-Kirkham et al., 2012)
Identify mechanisms which spirituality or religiousness exert positive effects (Cohen et al., 2012)
Develop a reflection activity for students prior to entering the clinical setting (Briggs & Lovan, 2014)
Association of Registered Nurses of Newfoundland and Labrador. (2013). Competencies
required for entry-level registered nurse practice. Retrieved from: http://www.arnnl.ca/documents/pages/Competencies_required_for_entry_level_RN_08_13.pdf

Boswell, C., Cannon, S. B., & Miller, J. (2013). Students' Perceptions of Holistic Nursing
Nursing Education Perspectives, 34
(5), 329-333.

Briggs, C. L., Lovan, S. R. (2014). Nursing Students’ Feedback to a Spiritual Health
Journal of Holistic Nursing, 32
(3), 183-188.

Canadian Nurses Association. (2010, June). Position statement: Spirituality, health and
nursing practice. Ottawa: Author. Retrieved from: http://www.cna-aiic.ca/~/media/cna/page-content/pdf-en/ps111_spirituality_2010_e.pdf?la=en

Cohen, M. Z., Holley, L. M., Wengel, S. P., & Katzman, R. M. (2012). A Platform for Nursing
Research on Spirituality and Religiosity: Definitions and Measures.
Western Journal Of Nursing Research, 34
(6), 795-817.

Dolamo, B. (2010). Spiritual nursing.
Nursing Update, 34
(4), 22-24.

Johnson, R. W., Tilghman, J. S., Davis-Dick, L. R., & Hamilton-Faison, B. (2006). A
historical overview of spirituality in nursing.
The ABNF Journal
, 60-62.

Koren, M. E., & Papamiditriou, C. (2013). Spirituality of staff nurses: application of
modeling and role modeling theory.
Holistic Nursing Practice, 27
(1), 37-44.

Kreitzer, M., Gross, C., Waleekhachonloet, O., Reilly-Spong, M., & Byrd, M. (2009). The
brief Serenity Scale: a psychometric analysis of a measure of spirituality and well-being.
Journal Of Holistic Nursing, 27
(1), 7-16.

Li-Fen, W., Yu-Chen, L., & Dah-Cherng, Y. (2012). Nursing Student Perceptions of
Spirituality and Spiritual Care.
Journal Of Nursing Research (Lippincott Williams & Wilkins), 20
(3), 219-227.

McSherry, W., Jamieson, S. (2013). The qualitative findings from an online survey
investigating nurses' perceptions of spirituality and spiritual care.
Journal of Clinical Nursing, 22
(21-22), 3170-3182

McSherry, W., & Jamieson, S. (2011). An online survey of nurses' perceptions of
spirituality and spiritual care.
Journal Of Clinical Nursing, 20
(11/12), 1757-1767.

Meehan, T. (2012). Spirituality and spiritual care from a Careful Nursing
Journal Of Nursing Management, 20
(8), 990-1001.

Molzahn, A., & Sheilds, L. (2008). Why is it so hard to talk about spirituality?.

Canadian Nurse, 104
(1), 25-29.

National Center for Complementary and Alternative Medicine (2010) Meditation
Overview, Retrieved from: http://nccam.nih.gov/health/meditation/overview.htm

Pederson, T. (2014). Religion, Prayer Linked to Better Mood in Elderly. Spirituality
& Health. Retrieved from: http://spiritualityhealth.com/blog/traci-pedersen/religion-prayer-linked-better-mood-elderly

Reimer-Kirkhama, S., Sharmab, S., Pesutc, B., Sawatzkyd, R., Meyerhoffd, H., Cochraned, M.
(2012) Sacred spaces in public places: religious and spiritual plurality in health care.
Nursing Inquiry, 19
(3), 202-212. Doi: 10.1111/j.1440-1800.2011.00571.x

Reimer-Kirkhama, S., Pesut, B., Sawatzky, R., Cochrane, M., & Redmond, A. (2012). Discourses of spirituality
and leadership in nursing: a mixed methods analysis.
Journal Of Nursing Management, 20(
8), 1029-1038.

Royal College of Nursing. (2014). Spirituality in nursing care: Online resource introduction. Retrieved from:

Rushton, L. (2014). What are the barriers to spiritual care in a hospital setting?
British Journal of Nursing
23(7), 370-374.

Spirituality In Health Care Network. (2014). Retrieved from: http://www.spiritualityinhealthcare.net/

Taylor, E. J., Testerman, N., & Hart, D. (2014). Teaching spiritual care to nursing students: An
integrated model.
Journal Of Christian Nursing, 31
(2), 94-99.

The Center for Spirituality and Healing (2010). The Mandala, Retrieved from: http://www.csh.umn.edu/

Sweet, B. (2013, August 10th). A question of faith.
The Telegram
. Retrieved from: http://
Wagner, A. L. (2010). Core concepts of Jean Watson’s theory of human caring/caring science.

Watson Caring Science Institute
, 1-7.

Wehmer, M. A., Quinn Griffin, M. T., White, A. H., & Fitzpatrick, J. J. (2010). An exploratory
study of spiritual dimensions among nursing students.
International Journal of Nursing Education Scholarship, 7
(1), 1-10.

World Health Organization. (2014).The framework: Quality definitions and levels.
Leadership Personal
: Author. Retrieved from: http://www.who.int/management/NSHLeadershipPersonal.pdf?ua=1

Woodyard, C. (2011) Exploring the therapeutic effects of yoga and its ability to increase
International Journal of Yoga, 4
(2) 49-54 Retrieved from:

Careful Nursing
Intrinsic Human dignity-
Central value
Unconditional love
Contagious Calmness-
Quality and importance of calmness in nurses
Great Tenderness in all things-
Having spiritual quality
Nurses care for themselves and one another-
Treating themselves and others
Intellectual engagement-
Objective knowledge, accuracy and value f personal professional practice
Safe and Restorative Physical Surroundings-
Protecting patients from harm
(Meehan, 2012)
As nurses and nursing students, we must realize how integral spirituality is to the holistic care of clients. Spirituality is very individualized for each person based on their own internal belief system. Being self-aware is an essential component of not only taking care of clients but taking care of your own spiritual health as well.
Spirituality Video
Rick Singleton
Regional Director of Pastoral Care and Ethics
Telephone: (709)777-8940
Email: rick.singleton@easternhealth.ca
Post Quiz Questions
1. What are some ways a nurse can provide spiritual care in order to generate a state of well-being?

2. Who are two historical figures that have influenced spirituality and spiritual practices in nursing?

3. What are the spiritual modalities discussed in this presentation?

4. Where can a nurse go if in need of spiritual resources in health care?

5. What has been the biggest change in spirituality in health care?

6. What are the 3 ways of practicing spirituality that Rick Singleton discussed?
Full transcript