Spiritual Care and Nursing: How Does This Work?

jeastridge, BSN, RN

"Please pray with me," my patient pleaded as I gathered up my bag and prepared to leave our admission visit. The social worker and the patient's caregiver had already stepped outside and were talking on the porch landing. I looked at my patient whose eyes betrayed fear over what was to come after being diagnosed with an inoperable and widely metastatic cancer just a few days before. Still relatively young in his late 50's, he could see and feel that he did not have long to live.

I put my things down and sat beside his bed in the chair I had occupied for the previous two hours while the hospice social worker and I went through the admission process with him. He offered his hand and I held it, praying a simple prayer for comfort and peace.

As professionals, we are called to provide care for the body, the mind and the spirit. It is not often that we are asked to do something as overt as praying with a patient-but it does happen. How we feel about this can vary widely depending on our own faith walk and what we think about sharing that with others.

Admittedly, in this particular situation, we had two hours of talking, listening, getting to know this gentleman; we knew where he was coming from. There were religious symbols in the house and he verbally confirmed his particular faith during our assessment.

Hospice may be singular in the nursing realm in that spiritual care is an expectation, an active part of what we do. But in all fields-everything from office nursing to ICU to surgery-we meet our patients in times of crisis and fear. Spiritual comfort, when requested, can be a very helpful part of excellent nursing care. In practical terms, however, the very thought of praying with someone may send shivers of unease and discomfort down the staunchest nurse's spine. What if they are Christian and we are not? Or Muslim, or Jewish or Hindu, or Buddhist, or Agnostic? How does all that work and how do we help without hurting?

There are no easy answers to this question but let's explore together some ways we can prepare to offer spiritual care if requested.

Listen first

People will very often answer frankly and let you know what would be helpful. Ask a question, "How would you like me to pray?" or "What do you want me to pray for?"Sometimes just holding their hand and having a moment of silence can bridge the space between us and our patients, helping them to know that we are on their side and will help however we can.

Plan ahead for how to respond

If you are uncomfortable with any type of faith discussion, it is important to still allow the patient to feel validated. If you are unable to pray or provide the comfort they seek, have a Plan B ready. Tell them, "I know that this is a difficult time. Let me call the chaplain to talk with you about this. Thank you for sharing with me." Thanking them for sharing helps them not feel embarrassed for asking and lets them know it's ok. In planning ahead, we might also consider using some more universal prayers, things like "The Serenity Prayer" or a beautiful poem that speaks to us or the 23rd Psalm if the patient is Jewish or Christian.

Be respectful

While providing nursing care, part of our professional duty is to give spiritual care-according to the patient's needs and beliefs, not our own. So this would not be the time to proselytize but instead, to respond according to the faith journey that the patient has expressed, letting them guide the conversation. If we believe firmly in our particular faith (and to be a good practitioners of our faith then we surely must!), it can be hard to simply accompany the faith journey without interjecting our own beliefs, but this is one of the ways we show care and compassion in providing spiritual care. We can remain true to ourselves and at the same time be true to our charge as excellent professionals who seek to offer healing to the whole patient: mind, body, and spirit.

Use the gift of presence and touch as part of the whole approach

We have all known the patient who "lays on the call bell" or calls the office every day or has 101 complaints when they talk with us. While frustration can be our knee-jerk reaction, our professionalism calls us to look deeper, to move beyond the surface complaints and to listen with the ears of the spirit, asking ourselves, "So what is really going on here? Is there something I'm missing?" Loneliness, fear, pain are all aggravated by and expressed in illness. As nurses, we cannot underestimate the power of the gentle touch on the shoulder, the eye contact, the active listening that says, "I truly hear what you are saying," or the simple, "I'm sorry you are going through this."

After our prayer, I reviewed our plan for a return visit and reminded my patient of our plan of care and asked him to call with any questions or concerns, hoping in this way to give him tools to manage his anxiety. Then I told him, "We will walk this journey with you." Those words seemed to help and I saw his shoulders relax against the pillow, the tension easing for the moment.

You may have experiences with being asked to provide spiritual care. How did you feel about it? What did you do? Do you have any tips that might help other nurses in the same position?

Spiritual Care and Nursing: How Does This Work?

Listen first

Plan ahead for how to respond

Be respectful

Use the gift of presence and touch as part of the whole approach

About jeastridge, BSN, RN

More Like This