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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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?

In the United States, Joint Commission on Accreditation of Healthcare Organizations (JCAHP) requires that a spiritual assessment be completed on every patient. Because nurses work closely with the sick and dying, they often find themselves called upon to address a patient's spiritual needs. At the same time, they may be concerned about the appropriateness of such activities, as well as have questions on how to proceed. Although not all nurses feel comfortable providing spiritual care in all situations, they should be sensitive to the spiritual needs of their patients.

Many nurses feel both comfortable and confident in engaging in spiritual care activities such as praying with patients and listening to spiritual concerns.

These activities may be appropriately carried out by the nurse only if acceptable to the patient and the family. In order to provide respectful care, it is necessary to refrain from using the clinical setting or professional authority to promote any type of religion or particular spiritual practices.

It is not appropriate to pray aloud with/for every patient without patient request. Depending on the situation and the relationship the nurse has established with the patient, it may be appropriate to offer prayer. However, it is important to be attuned to the patient's already established spirituality. The clinical setting is not the place for proselytising, nor does the health care professional role properly include such activity.

When a patient is faced with a health crisis, he or she may seek spiritual nourishment, even if this has not been a typical part of the person's day-to-day life. Patients who are members of a particular faith tradition, and those who are not, may want prayer or other forms of spiritual activities to be part of the care they receive from health care professionals. Or they may not. Either way, health care professionals who want to provide spiritually nurturing and ethically sensitive care need to think carefully about the place of spiritual care in professional service.

Chaplains should not be the only providers of spiritual care for patients and their families. Much of the spiritual and religious support comes from other people, including parish nurses, clergy, family and friends of patients, volunteers representing different faith communities or congregations, and others. Although their personal spiritual beliefs may differ from those of the patient, medical staff can also address the spiritual needs of the patient. All medical personnel (believers and non-believers alike) must not let their personal beliefs get in the way of providing quality care for all of the patient's needs.....including spiritual needs.

I know what's "politically correct", but when you are in the Christian faith there is no such thing. Being a Christian effects everything you do and is appropriate in every situation, even in a work place. If you truly know God then you'll know that He's not something you can just leave out of certain "inconvenient" times in your life. Sure, you can't force a patient to pray with you but it is appropriate to ask, whether or not you think the person will accept. If they don't then all you can do is pray silently and go on, but as a Christian, the least you can do is offer hope to someone who is in desperate need of it.

1 Votes
Specializes in Dialysis,M/S,Home Care,LTC, Admin,Rehab.

This is an awesome and really thought provoking question! After consideration, I'd have to say that personally, the short answer would be "it depends".

Firstly, to me, the word pray can be defined in an infinite number of ways, taking on acts and practices such as meditation, blessing ceremonies, contemplation, summoning of deities, chanting, or traditional Eastern philosophies, Western religious prayer, etc. and thousands of other methods determined by religious, spiritual and cultural belief systems.

My goal would be to honor that patient and their family. I would never offer to partake in prayer, or to be part of any personal family rituals. However, if the patient, family and myself formed a bond, and they felt as though my presence and energy would somehow enhance the sacred experience of this person's death as well as to provide a memory for the remaining family to cherish, then I feel it is an obligation, or moreso an honor to be present with them during this time.

While your beliefs and rituals may be completely opposite of the patient's, your heart and spirit are present, sending loving light and healing to all present.

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Specializes in LTC Rehab Med/Surg.

I pray frequently when I start an IV. Or insert a foley. Sometimes it's a prayer for patience, or understanding. It's to myself and not out loud.

I will however, tell the pt to say a prayer when I'm attempting the IV for the third time. They usually smile...and say a prayer.:)

1 Votes
Specializes in Med Surg - Renal.
charlieccrn said:
Unless the RN is interfering with the hospital process, there is no reason to terminate just for offering to pray.

I would wager there were other issues.

Here's the thing, it sounds like the RN in question was addressing his or her OWN spiritual needs instead of the patient's. That's a no-no.

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"I agree that a health setting is not the place for prosletising too, but if a patient asked me about my faith I think it overides what I do as a nurse. Although great care is needed here."

This was in an earlier post. I am a teacher of nursing assistants, and I would just like to get a little more clear about this matter, on how to explain these things to future nurses who have a strong personal faith. So, what if a patient did ask a Christian CNA or nurse about their faith? What if they asked the nurse to pray with them so that they could be saved? If the patient themselves brought it up, and they wanted the nurse (assuming the nurse was comfortable with this) to pray for their salvation, could said nurse have her license suspended because people thought she was "proselytizing"? (I do not live in the deep South, so this sort of thing I imagine is frowned upon.) What are the professional boundaries that must be respected if a nurse wants to keep her/his license?

1 Votes
Specializes in Med Surg - Renal.
conscientiousnurse said:
"I agree that a health setting is not the place for prosletising too, but if a patient asked me about my faith I think it overides what I do as a nurse. Although great care is needed here."

This was in an earlier post. I am a teacher of nursing assistants, and I would just like to get a little more clear about this matter, on how to explain these things to future nurses who have a strong personal faith. So, what if a patient did ask a Christian CNA or nurse about their faith? What if they asked the nurse to pray with them so that they could be saved? If the patient themselves brought it up, and they wanted the nurse (assuming the nurse was comfortable with this) to pray for their salvation, could said nurse have her license suspended because people thought she was "proselytizing"? (I do not live in the deep South, so this sort of thing I imagine is frowned upon.) What are the professional boundaries that must be respected if a nurse wants to keep her/his license?

If a patients asks a nurse to "pray with them so they could be saved" then that nurse should immediately get ahold of the chaplain so he or she can facilitate the "saving" process. This isn't just a quick prayer.

Here's the thing. Patients are labile. A nurse walks into a room one day and the patient wants to be "saved by my Christian nurse" so she does it. A couple days later the patient has been NPO all day, waiting hours to be picked up from a procedure and has to wait a few extra maddening minutes for a call light to be answered. Now she's tweaked off and wants some revenge. How difficult would it be for this patient to report to the nurse manager about "some Christian nurse trying to save me"?

Patients are not your friends or your spiritual companions. Nurses advocate for their patients, they don't "save" them.

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Thanks for your input, MN nurse. So I could tell my students that they risk their license if they do this?

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Another question is: would it be appropriate in such a case, to offer to the patient to contact an evangelical-type clergyman (not the nurse's own pastor, but any such clergyman of the patient's choosing?)

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

Yes, offering to contact the chaplain or any clergy of the patient's choosing is quite acceptable. That is meeting spiritual needs.

1 Votes
Specializes in Med Surg - Renal.
conscientiousnurse said:
Thanks for your input, MN nurse. So I could tell my students that they risk their license if they do this?

I highly doubt it. I think they might risk getting in dutch with their superiors.

In general, it's the wrong way to go about things.

1 Votes
Specializes in Med Surg - Renal.
conscientiousnurse said:
Another question is: would it be appropriate in such a case, to offer to the patient to contact an evangelical-type clergyman (not the nurse's own pastor, but any such clergyman of the patient's choosing?)

Yes. That sounds like a nurse doing their job.

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I personally don't feel there is anything unethical about the nurse praying with the patient in a situation like this where the initiative was clearly on the patient's side, and they specifically asked the nurse to do this. Some nurses would be willing to even put their job on the line in order to meet this person's spiritual need right away, rather than jumping through what appear to be political hoops and delaying them by having to go get the chaplain or clergy. What if the patient was about to die, and you delayed their request to go find the chaplain, etc., and by the time they got there it was too late? What if a nurse decided to go ahead and pray with them, or give them a sample prayer, asking the patient to pray on their own when the nurse left the room? And what if the nurse documented everything about her assessment of spiritual distress, the request for prayer, and what the nurse did, in the chart? Or, what if the nurse waited till her lunch break or after she clocked out for the day, and came back to fulfill this request on his/her own time?

1 Votes