The Nurse's Role in Providing Spiritual Care - Is It OK to Pray? - page 6

by tnbutterfly 36,259 Views | 80 Comments Admin

There has been recent discussion in one of the allnurses threads about a nurse in the uk who was placed on suspension for offering to pray with a patient. In this instance, the nurse only offered to pray. She reportedly did not... Read More


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    I had a patient multiple times, frequent flyer, COPD/CHF. He was active in his church (Methodist? Presby? don't remember now), and he would often really fight to get dc'd so he could be in Sunday School. He would always tell us that he prayed for all of us every morning when he woke up. Even though I'm catholic, and he was protestant, he'd often ask me to join him in the Lord's Prayer first thing in the morning. If I could, I did. So, keep in mind, he initiated the religious aspects of the nursing care.

    One night, I got a call from a friend of mine in ICU. Mr. X was there, and he had taken a sudden turn for the worse and was dying. The family was 2 hrs away, and there was no way they could make it in time, flash edema was just coming out of the guy's mouth like a river. I got there, and he looked at me with this desperate expression in his eyes. I took his hand, placed a hand on his forehead, and told him, "Mr. X, I'm here. Do you want me to pray for you?" He blinked his eyes, and I said the Lord's Prayer. When I said "amen" he never took another breath, and flat lined...he had been waiting for someone to pray over him before he'd let go.

    Sometimes, prayer is the last nursing intervention we can provide.
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    nerdtonurse? ...........Thank you for sharing that wonderful testimony of the importance of spiritual care. Religion and religious practices played a very integral part of the spiritual well-being of this man. Because you allowed yourself to take part in his spiritual care on a daily basis, you were able to be there and offer great comfort to him in those last few minutes to allow him to experience a "good death".

    Again....thank you for providing such wonderful care! Your patients are lucky to have you.
    nerdtonurse? likes this.
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    I thought of you, and this thread last night. I was watching (ok, until I fell asleep ) a lecture from Loma Linda University's Center for Christian Bioethics a lecture presentation by an academic who, if I remember correctly, was also an RN. The lecture was about the role of health care professionals in dealing with patients spirital distress. She started by giving painful examples, ranging from the person who offers to pray to Jesus to save an athiest who is dying to the RN who who, when asked directly by a patient to pray with them answers very coldly to a physicain who ignores a patients questions with spiritual content. (These examples are part of a prior qualitative research study the lecturer did about how HCP deal with spirituality at work)

    I'm afraid I didn't catch much more, it was very late when I tuned in, but you might want to check out this center and their offerings -- it seems very much up your alley!

    If nothing else, you should check out thier website. Some of their material is available as .pdfs and videos. http://www.llu.edu/llu/bioethics/
    Woodenpug and tnbutterfly like this.
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    Sounds like that was an interesting lecture.

    Thanks for posting the link. They seem to offer quite a few lectures and programs addressing spirituality in health care.
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    Spiritual care is undoubtedley a facet of providing holistic care. Religion however always seems to invoke strong emotions of one's own identity in relation to 'God'. As much as i support the practice of being present during prayer if thats what the patient needs, I am cautious about the zeal of the nurse using the opportunity to reinforce her own spirituality in a moment that really is not about her, but about the pt. As long as the patients' need is identified and acted on appropriately, I see no reason for a nurse not to provide spiritual strength. But proselytising is out of place, and more about the nurses need than the patient. More education should be around for new nurses so they understand the rationale for spritual care from a nurse.
    Last edit by kurandagirl on Jun 24, '09 : Reason: incorrect grammer
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    I think prayer is a great thing to share with a family. I work in the middle of mormon country and am constantly asked to praticipate in blessing residents. I currently don't hold that authority in my church but generally most of our male staff are able to praticipate. It is so great i think for us to participate because it shows that familys that we are involved and we truly care about the residents.
    tnbutterfly likes this.
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    It is ONLY OK if the patient requests it. Otherwise, NO.
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    This is excellent: The Meaning of Life

    The report describes a recent incident in which a per diem nurse at Cape Cod Hospital upset a patient's family by discussing "repentance" with the dying patient in a way that allegedly distressed the patient. "Spiritual talk by nurses spurs soul-searching" explores the nature of that incident through quotes from the nurse and others involved, but it also sets the issues in context by consulting a local nurse expert: Kathleen Geagan Ryan, a hospice nurse and ordained interfaith minister. Ryan explains that nurses can provide spiritual counseling by listening and letting patients take the lead, and being sure not to do anything that could be interpreted as imposing their own beliefs, a sensitive thing given the unequal power between nurse and patient...
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    Thanks for this link, Vicky. An excellent article.

    Some other quotes from the article:
    "Nurses who talk about God and spirituality with their patients can walk a fine line between comforting the ill and stepping on theological toes."
    But it's not hard to see how this situation--which is common with dying patients who want to discuss sensitive "Big Picture issues" like "God and the afterlife" at a very difficult time--could present a great challenge.
    You cannot impose your belief in any way. My mantra is to listen and let the patient lead. ... It's not an equal relationship. If you have an agenda, patients pick up on that. I call it the truth serum of the dying person. They just see through anything.
    Good practice would seem to vary depending on the patient and the situation, and the piece might have explored just what practical training nurses get in handling these daunting situations, and whether more or different training would make sense to help nurses handle hard questions. What if the patient asks, "Am I going to hell?" Perhaps the nurse could consider the type of response often ascribed to therapists: "What do you think?" But what if the patient asked, "What do you believe about God?" A question in response does not seem adequate there. Would any honest description of the nurse's own beliefs amount to imposing them? Should the nurse simply decline to describe his own beliefs, even if that distresses the patient? Or could the nurse describe his beliefs, so long as he was careful to stress that he was not suggesting the patient should share them, but instead explore her own? At times, the divide between helping the patient explore her spirituality and offering her spiritual guidance may dissolve in practical application.
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    Just want to give an update on the incident that prompted me to start this discussion.... Nurse Caroline Petrie was suspended after offering to pray for the recovery of an elderly patient. A follow-up article was written in June, however I just now read it.

    The article is entitled Let Doctors Pray for Patients, BMA to Hear

    Here are some excerpts from this article.

    Doctors' attempts to discuss spiritual affairs with patients or to offer prayers for them should not trigger NHS disciplinary action, the British Medical Association will be told this week.
    Most of the BMA motions effectively support that position (that she could continue to pray for patients as long as she asked them first if they had any spiritual needs), but insist spiritual discussions should not be grounds for disciplinary intervention by NHS managers.
    "Offering to pray for a patient should not be grounds for suspension." Spiritual matters should be raised, it suggests, "with respect for the views and sensitivities of individuals".
    The GMC guidance is the one preferred in most of the motions before the BMA conference. It urges the department "to exercise some joined-up thinking so that while always respecting the views and sensitivities of others, there should be freedom of speech to have appropriate consensual discussions of spiritual matters within the NHS".

    Here is another related article...Doctors Demand Right to Pray

    Graham Spencer, a retired medical scientist who worked at Bristol's Frenchay Hospital, supported Mrs Petrie's case at the time and is in favour of the idea. "I can think of the time in Bristol when there was an [service] every evening from the hospital chapel, conducted by a nurse for five minutes," he says.
    Dr Stephen Blair, a member of the British Medical Association's Consultants Committee, says: "What we want to do is to reinstate exactly what has been everybody's practice for many years.
    "That is to care for people physically, spiritually, emotionally and mentally."


    Here is a short video about the discussion.
    Doctors Want Right to Talk Faith


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