Spiritual Care in Nursing

• A dying patient request that the nurse pray with him. The nurse is not accustomed to praying out loud but is comfortable praying silently. What is the best approach for this nurse to follow to pray with this patient?
• The nurse should select a formal prayer or Bible passage to use to pray out loud.
• The nurse should defer to the patient's request to pray.
• The nurse should inform the patient that she pray for the patient but not with him.
• The nurse had asked the patient's roommate to pray with the patient

• The nurse is caring for a critically ill patient, who informs the nurse that there is a conflict between her spiritual beliefs and a proposed health option. What is the nurse's role in this situation?
• Assist the patient in obtaining information to make a informed decision
• The nurse has little role in this situation because it is best managed by the physician
• Provide a subjective opinion on the appropriate course of action
• The nurse should provide examples of ways other patients from various religions handle the situation.

• A nurse who provides care on a palliative unit of a hospital is aware of the importance of spiritual assessment and the integration of spirituality into patient's care. What assessment questions should the nurse use in an effort to determine the patient's spiritual beliefs?
• Do you hold a belief in the afterlife?
• What church do you normally attend?
• Are there any spiritual or religious beliefs or practices that are important to you?
• If you had to identify yourself as either a religious person or spiritual person, which would you choose?

Spiritual Care in Nursing

A Diverse Heritage

Hope Through Compassion

• A systematic reflection for growth toward wholeness that is found in all of the major religions of the world.

• Built on the core concepts of faith, love, and hope

• Integrative energy capable of producing internal human harmony or holism.
• Transcendent reality, which draws strength from inner resources
• A sense of inner knowing
• Creates a set of belief and values that influence how people conduct and live their lives.
• Compassion- A way of living born out of awareness of one’s relationship to all living creatures, a sensitivity to the pain and brokenness of others.

What is Spirituality?

A Sense of Meaning

• A Diverse Heritage

• Hope Through Compassion

• A Sense of Meaning

• Can be defined from both a religious and secular perspective.
• All humans have the potential for spirituality and spiritual growth
• Spirituality is relational
• There is a necessary link between religion, moral norms, and spirituality.
• Spirituality involves the lived experience; it is a way of life.

Therapies

Spirituality: Religious Vs. Secular Perspective

Spirituality

Prayer

Religious

• A Journey that takes place over time involving the lived experience
• Life is full of ups and downs, twists and turns, and waysides
• Individuals are most vulnerable when ill
• Presents time for personal and spiritual growth
• RN’s have the unique task of working with clients through this time

Nurses must learn to treat the patient holistically, physical, mental, social, and spiritual

• Spiritual discipline practiced by many traditions
• Cultural and religious
• Helps patients to reach out to God
• Prayer
• Clarify each patient’s need for prayer
• Facilitating the practice of prayer for a client is important in helping care for their spirit
• Self awareness & self-care, trust building, giving hope & a caring communication
• Ask pt. what gives them comfort/strength/peace
• Pray with humility, love, & compassion
• Prayers that express love & support or that seek forgiveness of self & others are powerful messages to their recipient.

Spiritual Care in Nursing

Nursing Practice

and

Spiritual Wellness

• Often entails a set of beliefs that help to explain the meaning of life, suffering, health, and illness.
• Spirituality does not always mean religious practice
• Almost all religions are working to seek similar answers:
• Why are we here?
• What does this all mean?
• What if anything, are we supposed to be doing with our lives?
• Research suggests that religion has a positive influence over the physical health but there is no link as to why.

Relaxation Response

• Take time to feed your own personal spirit
• Pray, meditate, take a walk
• Find a sense of sacredness to infuse everyday life with meaning
• Allow for time of self restoration

Spiritual Tradition in Nursing

• Defined differently by all individuals
• Made up of a multitude of parts (patches) to make up a person (ball)
• All are interrelated as they are stiched together
• Share equal importacne because they cannot function in isolation
• Each piece can be torn but repair can take place
• Typically unexpected and out of our control
• Leaves individuals looking for purpose

• Betty Neuman & Jean Watson: Acknowledge the impact of spirituality in their theories
• Spiritual healing takes a broad view & includes enhanced comfort & an inner peace with disability or death.
• Jean Watson
• Identifies the awareness of the clients’ and families’ spiritual and religious beliefs as a responsibility of a nurse.
• Nurses should appreciate and respect the spiritual meaning in someones life regardless of how unusual ones belief.

• Remembered Wellness
• Ability of individual to participate in their own healing through prayer or meditation
• Placebo Effect
• Speaking positively about treatment
• Nocebo Effect
• Negative energy
• Negative placebo
• A Quiet Focus/Peace Through Awareness
• Quiet meditation on a word or image that is spiritually meaningful to a person
• Listening technique

Secular

Spiritual Practices in Health and Illness

Human Energy System and the

Soul

• The spiritual path is a life path
• Take time to reflect on your OWN spirituality
• This is the first step into understanding someone else’s spirituality
• Bringing our spiritual gifts to the workplace assists us in NOT imposing our values on others
• Welcome challenges

Theraputic Touch

"A soccerball takes many kicks during the match -here the match represents the arena of life and the ball represents our spirituality or the individual."

• A set of positive values
• Love
• Honesty
• Truth
• Chosen by the individual to ultimately become that person’s supreme focus of life and organizing framework.
• Leads to self-actualization

• An alternative healing modality that is thought to redirect the human energy system
• Consistent with the science of unitary human beings developed by Martha Rogers to assist in healing
• Defines persons as energy fields in interaction with the larger environmental energy field

• Most religious traditions include a concept called “the soul.”
• “Not a thing, but a quality or a dimension of experiencing life and ourselves. It has to do with depth, value, relatedness, heart, and personal substance.”
• The quest for understanding or insight about major life questions.

NANDA Nursing Diagnosis

Questions Related to Practice

Barriers to Nurses

Spiritual Care

Interventions

Nursing Diagnosis

• Fear that knowledge base is insufficient
• Fear of where spiritual discussions may lead or imposing own values on others
• Lack of awareness of your own spirituality
• Differences in spirituality between nurse & client

• Be aware of YOUR OWN spirituality
• Be present
• Support patients in spiritual distress
• Referral to the hospital chaplain/support group
• Know your comfort level with prayer/praying with others as surveys reveal most Americans pray

• North American Nursing Diagnosis Association (NANDA) recognizes spiritual distress as a nursing diagnosis
• Defined as, “disruption in the life principle that pervades a person’s entire being and integrates and transcends one’s biological and psychosocial nature.”
• May occur in relation to separation from religious or cultural supports, challengers to beliefs and values, or intense suffering.

Example

Characteristics of

Spiritual Distress

• Concerns with the meaning of life and death
• Anger toward God
• Concerns about the meaning of suffering
• Seeking spiritual help
• Altered mood and behavior