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

Elvish, BSN, DNP, RN, NP

4 Articles; 5,259 Posts

Specializes in Community, OB, Nursery.

Not only that, but things do change over the course of an admission that may change the patient's desire to have some spiritual need met.

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tnbutterfly - Mary, BSN

83 Articles; 5,923 Posts

Specializes in Peds, Med-Surg, Disaster Nsg, Parish Nsg.
Elvish said:
Not only that, but things do change over the course of an admission that may change the patient's desire to have some spiritual need met.

Exactly......... Just like a patient's physical status and needs change, so do their spiritual needs. For example, if the patient came in for a simple procedure but ended up having a massive stroke leaving them partially paralyzed, this may result in a physical and spiritual crisis. They will have new needs that will need to be addressed.

Assessment is an ongoing process.

VickyRN, MSN, DNP, RN

49 Articles; 5,349 Posts

Specializes in Gerontological, cardiac, med-surg, peds.
tnbutterfly said:
Exactly......... Just like a patient's physical status and needs change, so do their spiritual needs. For example, if the patient came in for a simple procedure but ended up having a massive stroke leaving them partially paralyzed, this may result in a physical and spiritual crisis. They will have new needs that will need to be addressed.

Assessment is an ongoing process.

EXCELLENT point :up:

Specializes in Back ground in Corrections and General n.

GOD is not Dead!

In my own experience, the Lord has used me more than once to provide comfort to my patients through prayer.

If the patient or the patients family want prayer I always evoke the the great promise: "When two or three are gathered to gether in my name I am there also."

In my many years of nursing I have seen many miracles of salvation and healing,were God has used me as the witness.

While working at Northern State Prison during the height of the AIDS crisis,The lord brought Inmates to me who needed to except Jesus prior to their death. I've had patients who weren't part of my assignment in oncology units , walk up to me and ask out of the blue at 0300" Is there really any thing to this Jesus stuff and salvation?"

Prayer for your patients is an essential part of holistic nursing. Think about it. You are the first person everyone sees when they are born and you are the last person they see when they die.

Every time you've had to bag a cadaver you were only caring for an empty shell, the essence the very soul of that person had moved on to stand before God.

Mind you I am no fanatic, I am just one soul who entire life has been committed to the care and well being of others. During my career God has chosen to reveal himself to me. I pray for my patients Calling their names when I can. I pray for all the nurses and doctors,that we may strive to do our best for all those in our care.

Shakespeare said, "Therefore make the stranger feel welcome . For there are more things in heaven and earth then are dreamt of in your philology oh Horasio:saint:"

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tnbutterfly - Mary, BSN

83 Articles; 5,923 Posts

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

Dave, thanks for sharing and thanks for being a willing instrument.

"Prayer for your patients is an essential part of holistic nursing."

marachne

349 Posts

Specializes in Hospice, Palliative Care, Gero, dementia.

I have not read this whole thread, so excuse me if I'm missing something.

I would say that 85% of the time it is wrong to offer to pray for someone without their specifically requesting you to do so.

The only time I would think it appropriate is if you knew the patient well enough to know their spiritual beliefs and what is comforting to them. Offering to pray for someone without that certainty or a request is, to my mind, invasive, immoral, unethical and out of your scope of practice. And it's proselytizing.

As a Jew it is a really really uncomfortable experience to have others assume that they know what is the appropriate expression of spirituality and religiosity for me. People have been trying to convert us for 2,000 years, and it hasn't always been pretty. It feels like an assault. Doing it when I am a vulnerable patient would be terrifying.

I think before one offers anything that is out of the normal realm of nursing, whether it is to share some personal information, or offer to provide a service that is not part of the nursing role, you have to ask yourself first -- "who am I doing this for?"

If someone asks you to pray with them, or for them, that is one thing...and I also believe that it is OK to refuse such a request. Holding someone's hand in silence, or saying you will "keep them in your thoughts" if that is where your comfort zone is makes more sense to me.

Yes, we care for the whole person, body, mind, and spirit, but we do it in a way that is helpful to them, not what we want or think is right.

Specializes in Back ground in Corrections and General n.

I believe in the god of Abraham, Issac and Jacob as well. Christianity is the logical extension of Judaism bases on the law and the profits. I will not deny millions have died at the hands of zealots.

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tnbutterfly - Mary, BSN

83 Articles; 5,923 Posts

Specializes in Peds, Med-Surg, Disaster Nsg, Parish Nsg.
marachne said:

I have not read this whole thread, so excuse me if I'm missing something.

I would say that 85% of the time it is wrong to offer to pray for someone without their specifically requesting you to do so.

The only time I would think it appropriate is if you knew the patient well enough to know their spiritual beliefs and what is comforting to them. Offering to pray for someone without that certainty or a request is, to my mind, invasive, immoral, unethical and out of your scope of practice. And it's proselytizing.

As a Jew it is a really really uncomfortable experience to have others assume that they know what is the appropriate expression of spirituality and religiosity for me. People have been trying to convert us for 2,000 years, and it hasn't always been pretty. It feels like an assault. Doing it when I am a vulnerable patient would be terrifying.

I think before one offers anything that is out of the normal realm of nursing, whether it is to share some personal information, or offer to provide a service that is not part of the nursing role, you have to ask yourself first -- "who am I doing this for?"

If someone asks you to pray with them, or for them, that is one thing...and I also believe that it is OK to refuse such a request. Holding someone's hand in silence, or saying you will "keep them in your thoughts" if that is where your comfort zone is makes more sense to me.

Yes, we care for the whole person, body, mind, and spirit, but we do it in a way that is helpful to them, not what we want or think is right.

Just like with physical assessments, questioning the patient is a method of obtaining information regarding the patient's spiritual needs. And one of these questions might be...... "Do you desire someone to pray with or for you?"

marachne

349 Posts

Specializes in Hospice, Palliative Care, Gero, dementia.
tnbutterfly said:
Just like with physical assessments, questioning the patient is a method of obtaining information regarding the patient's spiritual needs. And one of these questions might be...... "Do you desire someone to pray with or for you?"

I see a big difference in assessment and the wording you use above -- "Do you desire someone to pray with you or for you" than "Would you like me to pray for you?" the former is information gathering. To my mind the latter is both making assumptions and potentially putting someone who is vulnerable in an incredibly awkward and uncomfortable position. (although I have to confess, even the former question, without prior questions about their spirituality/religiosity has the potential for being an imposition).

You talk about in your role as a parish nurse, well that is a very specific context. If you were working in a hospital, even one that had a religious affiliation, it would be making a heck of a lot of assumptions w/o the prior questions regarding their spirituality/religiosity -- someone does not have to belong to a religious group to wind up in a hospital w/religious affiliations.

I am sure you do it in a very respectful manner, but I have seen enough of it done in a non-appropriate way that I think giving carte blanche w/o careful education regarding respect for people of other -- or no religious leaning has a certain risk.

I agree that people in health care are often very uncomfortable addressing, or even recognizing spiritual needs, and that is an unfortunate lack, but I think that approaching this subject requires a high level of sensitivity and at least some training (role playing, case studies, etc) there's a reason that chaplains have to have special training, and the good ones are like gold. Nurses are figures of authority, and I don't think that we are always aware of the amount of power we have in our interactions with our patients and families, particularly when they are vulnerable.

I am a hospice nurse. I know the value, particularly at end of life, of meeting the needs of the whole person. But those needs must be defined by the patient. I personally am very uncomfortable when I see nurses wearing huge signs of their religious belief (I'm not talking about something small, but sometimes it seems like the only thing I can see is that person's apparent need to proclaim their religion.)

You can disagree with me, but I am telling you what I feel, and how I would react, as a person with strong, but very personal spiritual beliefs if a nurse made overtures like that to me -- I would be uncomfortable, and I would not trust them to provide care that had my interests at heart.

I don't know where Dave the nurse was going w/his comments, as it seems he didn't finish his thought, but as soon as I see something like "Christianity is the logical extension of Judaism," I become extremely uncomfortable.You asked for people to share their thoughts and experiences. Most of what I said echoes the comments of others, but mine are the only ones you are challenging. Why is that?

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tnbutterfly - Mary, BSN

83 Articles; 5,923 Posts

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

I have commented on several previous posts. I am not challenging your comments, but rather reiterating some of what I wrote in previous posts, since you stated you did not read the entire thread.

I do work in a hospital and talk with patients and families of various beliefs. I agree that not all approach spiritual assessment and meeting spiritual needs in an appropriate manner.

I appreciate your work as a hospice nurse. I too work with patients going through their final weeks and days and know haw painful spiritual distress can be.......sometimes more painful than physical pain.

Many healthcare professionals are very uncomfortable with discussing spiritual needs, and I agree that training is needed in this area. I hope we can use this blog to discuss appropriate ways to meet spiritual needs.

Thank you for your input.

marachne

349 Posts

Specializes in Hospice, Palliative Care, Gero, dementia.
tnbutterfly said:

I have commented on several previous posts. I am not challenging your comments, but rather reiterating some of what I wrote in previous posts, since you stated you did not read the entire thread.

I do work in a hospital and talk with patients and families of various beliefs. I agree that not all approach spiritual assessment and meeting spiritual needs in an appropriate manner.

I appreciate your work as a hospice nurse. I too work with patients going through their final weeks and days and know haw painful spiritual distress can be.......sometimes more painful than physical pain.

Many healthcare professionals are very uncomfortable with discussing spiritual needs, and I agree that training is needed in this area. I hope we can use this blog to discuss appropriate ways to meet spiritual needs.

Thank you for your input.

Thank you for your response. As I said, I agree that there is definitely a place for discussion of spiritual needs. I commend you in your efforts in that regard. I think one of the places that it has to start is helping people see the difference between spirituality and religiosity. Just as many have been helped and healed by religion, others have been hurt.

Maybe if spiritual competence was seen in the same light as cultural competence (or maybe this is even a better place to replace the word "Competence" with "Humility?"

Kudos for doing this work here.

madnurse2b

175 Posts

I am a nursing student, and I have prayed in my way when a patient asked me to pray with them. It gives them comfort, and it doesn't harm me, so why not?

I am however very mindful of the time that I felt my "call" to nursing. I was with my friend for the birth of her first son. She is Wiccan and had chants, and scented herbs, massage, crystal healing all during her labor. All of her "family of choice" were with her as well as her parents, and of course the hospital staff. The staff was very supportive of her choices during her labor. It was a truly magical event. The only mar...her mother who was an evangelical Christian...during a particularly hard contraction her mother chose to point out that it "was all because of Eve" that my friend had to "suffer". My friend pulled an exorcist (yes - her head did spin around!) and screamed at her mother to get out ....we got Mom out..calmed my friend down...talked to Mom...let her back in and all progressed normally. And I knew what I wanted to do with my life (especially since the doc almost didn't make it back for the catch and the RN was really in charge!).

Religion, faith, and spirituality are incredibly intertwined. And completely personal, unless asked it is none of my business.