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

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 follow through with prayer when the patient declined her offer. In this instance, we only know what was written. We can only guess what the entire story might be. Nurses Spirituality Article

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You are reading page 3 of The Nurse's Role in Providing Spiritual Care - Is It OK to Pray?

VickyRN, MSN, DNP, RN

49 Articles; 5,349 Posts

Specializes in Gerontological, cardiac, med-surg, peds.

Excellent free resource: Incorporating Spiritual Beliefs Into End-of-Life Care

Quote

What are key issues for patients and families in EOLC? Not surprisingly, spiritual beliefs greatly influence the death experience and decisions made at EOL. Much literature focuses on the role of the nurse in the use and termination of life support, and volumes are available on spiritual care. However, relatively little is written on the influence that spiritual beliefs have on the decisions patients and families make at EOL. Yet, a knowledge of these beliefs is essential to assisting the patient and his or her family in making choices about care.

Clearly, resources are needed to help healthcare professionals care for patients near EOL. Specifically, more definitive documentation tools are needed for gathering data related to EOLC decisions. This article addresses key issues in EOLC and offers a new assessment GUIDE to facilitate spiritual assessment so that patient and family wishes can be better represented in EOLC.

https://www.nursingcenter.com/pdfjournal?AID=835474

Columnist

tnbutterfly - Mary, BSN

83 Articles; 5,923 Posts

Specializes in Peds, Med-Surg, Disaster Nsg, Parish Nsg.

Thanks, Vicky, for the wonderful resource.

For additional discussion please see Spiritual Beliefs and End of Life Care.

RN2Adore

11 Posts

Specializes in Tele/Cardiac.

My life without God...whoa! Without God, my colitis the night before by NCLEX would have killed me. Without God, the thought of giving labor even after studying L & D well in nursing school would have landed me in the OR for a C-section. Let me put it this way. For every moment in my life that I felt afraid or vulnerable, I turned to God to get me through it. That belief that a higher power is listening and is looking down on me allows me to go on, even if my issues are minute or silly. If I feel that spirituality is such an important part of my health and well-being, why would I find it wrong to pray with a patient if they request it. It may be all they have or all they need to get better. Whatever happened to holisitic care and caring for the patient as a whole, not just their illness or signs and symptoms?

Columnist

tnbutterfly - Mary, BSN

83 Articles; 5,923 Posts

Specializes in Peds, Med-Surg, Disaster Nsg, Parish Nsg.

There are many patients we see on a daily basis that feel just as you do, RN2Adore. To them, God plays a major supportive role in helping them cope with the stressors of hospitalization. For us as nurses to overlook that important aspect of their care....spiritual support....would be a huge disservice to those patients. We must be astute in assessing their spiritual needs and knowledgeable about how to meet those needs.

Specializes in Med/Surg/Peds ortho and tele.

I worked the Adventist Hospital and it seems that people are the same everywhere I work. I wait until they bring up a concern then ask if they want prayer.

VickyRN, MSN, DNP, RN

49 Articles; 5,349 Posts

Specializes in Gerontological, cardiac, med-surg, peds.

As a nursing instructor, this issue of prayer with patients took a totally unexpected twist, when one of my young nursing students (early 20's) stated she had prayed with her assigned patient's roommate and asked me if this were OK. The roommate had asked the student for prayer and the student was more than happy to oblige. I answered in the affirmative - of course it is all right - you are addressing the holistic needs of a patient, and a very lonely one at that.

Specializes in L&D.
tnbutterfly said:
This brought up much discussion about whether or not offering prayer falls within the scope of the nurse while providing spiritual care. Is it appropriate for nurses or doctors to pray with patients? Should a nurse ever offer to pray with a patient without a specific request from the patient or the family? How can a nurse appropriately provide spiritual care? Or should that aspect of care be left to the chaplain?

#1 we have no chaplain. period. So leaving spiritual care to that nonexistent person is not an option.

#2 As part of my admission assessment, I inquire concerning their religious preferences and if there is anything that I need to know about their spiritual or cultural practices to take good care of them. And I feel this is an important part of the assessment process. IF the patient does have a preference, I like to know a little bit more about their level of spiritual involvement. Ex. If they say they are Catholic, I ask what parish they attend. If they tell me the name of their parish, it communicates one level of involvement. If they tell me they don't have one, but they were "raised Catholic" it indicates another level. Why does this matter to me as a nurse? Let me give you an example. I work Labor & Delivery. A severely premature infant was going to be delivered shortly, a non-viable, "too early for NICU" baby. There was a chance the infant would not be stillborn, but would live briefly before dying from the prematurity. I knew the couple were Catholic. I knew they considered themselves "raised Catholic" but did not have ties with any congretation here in Las Vegas. I also knew that culturally, Catholicism was a very great influence to their parents' generation. I asked them if the baby was born alive, if they would like the baby baptized. They said it did not matter to me. I then asked if having the baby baptized would be of any comfort to their parents, the grieving grandparents. They both looked at each other like a bell had gone off in their heads, then turned to me and said, "Oh yes, please do baptize our baby. It will mean the world to my mom." The baby was baptized at delivery. And, indeed, the very devout Catholic grandparents were most grateful. (and, no, I am not Catholic. I just love to learn about other religions.)

I think the key to whether it is appropriate for a nurse to offer to pray with the patient is a full assessment of the patient and their family, and empathy for their current status and feelings. Some folks would call it "nursing judgement. Other folks would call it "listening to The Spirit". Others might call it "intuition" or "following your gut instincts."

One should NEVER shove ones own personal beliefs onto a patient in the clinical setting! There have been many times I have offered to pray with or to pray for a patient. But there have also been many, many times I have kept my mouth shut to them, and just held them up in prayer in my own heart.

Haze

rabbitgirrl

122 Posts

Specializes in Stepdown, ECF, Agency.
HazeKomp said:
They said it did not matter to me. I then asked if having the baby baptized would be of any comfort to their parents, the grieving grandparents. They both looked at each other like a bell had gone off in their heads, then turned to me and said, "Oh yes, please do baptize our baby. It will mean the world to my mom." The baby was baptized at delivery. And, indeed, the very devout Catholic grandparents were most grateful. (and, no, I am not Catholic. I just love to learn about other religions.)

I think the key to whether it is appropriate for a nurse to offer to pray with the patient is a full assessment of the patient and their family, and empathy for their current status and feelings. Some folks would call it "nursing judgement. Other folks would call it "listening to The Spirit". Others might call it "intuition" or "following your gut instincts."

One should NEVER shove ones own personal beliefs onto a patient in the clinical setting! There have been many times I have offered to pray with or to pray for a patient. But there have also been many, many times I have kept my mouth shut to them, and just held them up in prayer in my own heart.

Haze

Wow, what a great story! I hope some day that I will be able to think that fast.

Also, well put about the issue.

Of course, I pray inwardly for my pts all day, but I feel that the patient almost always should initiate or request any spiritual care given overtly. When that happens, I think it should be patient centered and never, never, never a case of the nurse imposing her beliefs on the patient.

When a patient asks me what I believe, I try to turn it back to them by asking what it is that they believe about a situation, to facilitate them working it out with whatever beliefs they have.

I don't think a nurse should be automatically fired for praying with patients, but close scrutiny about appropriate boundaries is O.K.

ICU MAN

7 Posts

I strongly believe that when requested it is OK to pray for our pts coz this is also part our nursing care in response to their need .With regards to offering a prayer to pts, I think nurses should not be reprimanded ,prohibits or get fired just because they are responding to their spiritual conviction. This should not be an issue anyway. Ofcourse there should not be a way for extremisim .To proselytes or converting someone to another religion for me is wrong, but a simple prayer to God silently or aloud would be up to us. As for me to be able to pray for our pts is a wonderful thing to do.

Columnist

tnbutterfly - Mary, BSN

83 Articles; 5,923 Posts

Specializes in Peds, Med-Surg, Disaster Nsg, Parish Nsg.
HazeKomp said:
#1 we have no chaplain. period. So leaving spiritual care to that nonexistent person is not an option.

#2 As part of my admission assessment, I inquire concerning their religious preferences and if there is anything that I need to know about their spiritual or cultural practices to take good care of them. And I feel this is an important part of the assessment process. IF the patient does have a preference, I like to know a little bit more about their level of spiritual involvement. Ex. If they say they are Catholic, I ask what parish they attend. If they tell me the name of their parish, it communicates one level of involvement. If they tell me they don't have one, but they were "raised Catholic" it indicates another level. Why does this matter to me as a nurse? Let me give you an example. I work Labor & Delivery. A severely premature infant was going to be delivered shortly, a non-viable, "too early for NICU" baby. There was a chance the infant would not be stillborn, but would live briefly before dying from the prematurity. I knew the couple were Catholic. I knew they considered themselves "raised Catholic" but did not have ties with any congretation here in Las Vegas. I also knew that culturally, Catholicism was a very great influence to their parents' generation. I asked them if the baby was born alive, if they would like the baby baptized. They said it did not matter to me. I then asked if having the baby baptized would be of any comfort to their parents, the grieving grandparents. They both looked at each other like a bell had gone off in their heads, then turned to me and said, "Oh yes, please do baptize our baby. It will mean the world to my mom." The baby was baptized at delivery. And, indeed, the very devout Catholic grandparents were most grateful. (and, no, I am not Catholic. I just love to learn about other religions.)

I think the key to whether it is appropriate for a nurse to offer to pray with the patient is a full assessment of the patient and their family, and empathy for their current status and feelings. Some folks would call it "nursing judgement. Other folks would call it "listening to The Spirit". Others might call it "intuition" or "following your gut instincts."

One should NEVER shove ones own personal beliefs onto a patient in the clinical setting! There have been many times I have offered to pray with or to pray for a patient. But there have also been many, many times I have kept my mouth shut to them, and just held them up in prayer in my own heart.

Haze

What a wonderful story and a perfect example of assessing and meeting spiritual needs!

And you bring up a very important point..... If there is not a chaplain at the hospital (or hospice, nursing home, etc.), who meets these needs? Like you said, we can't leave that responsibility to a nonexistent person. And just because there is a hospital chaplain, there is no guarantee that he/she will be available.

missjennmb

932 Posts

There was a post about someone praying for patients even if they did not want it (didnt quote because I'm on dial up and it would take 20 min to get back to that post). I think thats crossing the line. One thing that really concerns me is that, when I reach a point of not being able to promote my own interests, will they still be respected by those around me. Speaking on a personal level, if I were a patient, I would be genuinely offended if someone asked me if they could pray with me, and when I declined it, chose to pray for me anyways, because I was in a hospital bed and unable to walk away.

I think that praying for someone who ASKS for it, or asking someone who has stated on admission that they are of a certain faith, if they would like to pray is fine if you are comfortable with that. I have not prayed for anyone in my life, but I have many times held someone's hand while they prayed and it seemed to give them strength. However, it is unfortunate but in some areas and with some people, bringing up religion is a toxic issue. For instance, in my local area, to even hint that you are not-Christian (be that due to being Jewish, Wiccan, Athiest, whatever) can cause you great trouble (ostracized, shunned, spoken badly to, the works). If I were in the hospital and someone asked if they could pray for me, I would probably lie and tell them to go ahead, even though it goes against my personal beliefs and would make me extremely uncomfortable because I would be afraid that it would be held against me if I "came out" and said that I was not a Christian. It may sound extreme, but I have been mistreated more than once for merely sharing my beliefs when asked although I've thankfully been able to walk away from those situations and did not have to depend on those people for my care. Those situations are, what I imagine management is trying to avoid.

Unfortunately, as with most things, those "at the top" tend to go overboard in trying to avoid issues like that I've mentioned. Perhaps referring back to admission assessments (my hospitals have always had the religion stated in the chart somewhere) and keeping prayer commentary to those who have a religious belief or otherwise request it or bring it up first would be wise.

Columnist

tnbutterfly - Mary, BSN

83 Articles; 5,923 Posts

Specializes in Peds, Med-Surg, Disaster Nsg, Parish Nsg.

DarkRainyDays.....I am sorry you have had such bad experiences. I agree that we as nurses should not force prayer on anyone. As far as relying on the admission record to pick up on the "religious folks", many will fall through the cracks as this question re. religious affiliation is all too often overlooked.