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 worked with a Neurosurgeon who prayed before each surgery. The rest of us in the room could pray with him or not.

When I was working nights in ICU, I was asked by a family if they could hold a prayer circle for their little girl. She had an Astrocytoma and was in a coma. The praying neurosurgeon was her doctor.

It was held at night so not to bother the rest of the patients. I provided them with a phone to connect up with the rest of their church group and pulled the curtains around the little girl and her family.

About 24 hours later the little girl woke up. Her neurosurgeon sent her for a MRI.The tumor had shrunk considerably. She left the hospital about 10 days later, alert, walking, and with no trace of the tumor.

When patients ask me to pray with them, I do. I may not be their faith ( I am Jewish), but after that little girl, I figure everything counts. Ethically, I do not offer; but if I am asked, I will. After you have have seen one miracle, ....

1 Votes
Specializes in Peds, Med-Surg, Disaster Nsg, Parish Nsg.
GaleSRN said:
I worked with a Neurosurgeon who prayed before each surgery. The rest of us in the room could pray with him or not.

When I was working nights in ICU, I was asked by a family if they could hold a prayer circle for their little girl. She had an Astrocytoma and was in a coma. The praying neurosurgeon was her doctor.

It was held at night so not to bother the rest of the patients. I provided them with a phone to connect up with the rest of their church group and pulled the curtains around the little girl and her family.

About 24 hours later the little girl woke up. Her neurosurgeon sent her for a MRI.The tumor had shrunk considerably. She left the hospital about 10 days later, alert, walking, and with no trace of the tumor.

When patients ask me to pray with them, I do. I may not be their faith ( I am Jewish), but after that little girl, I figure everything counts. Ethically, I do not offer; but if I am asked, I will. After you have have seen one miracle, ....

What a beautiful story. Thanks so much for sharing!

1 Votes
RN2Adore said:
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?

Good for you as a nurse. Why should I, as a Buddhist patient, have to appreciate your holistic care when I don't believe in "your god"?

1 Votes
khminh said:
Good for you as a nurse. Why should I, as a Buddhist patient, have to appreciate your holistic care when I don't believe in "your god"?

You misunderstand what holistic care is. It means to care for all aspects of the patient physically, mentally, emotionally and spiritually in a way that bests help the patient but it does not mean imposing your beliefs on them. For example if I was caring for your parent I might hop on-line to see what kind of special things Buddhists do when someone is sick or what they call their spiritual leader or if there is a nearby temple that I could contact IF your parent requested it. I would ask your family member how I can help assist with caring for them spiritually AS BUDDHISTS! I would never take it upon myself to impose what I believe. I wouldn't know how to pray with them according to their religion (not sure if that's even a thing in Buddhism) but I would find someone who does if they requested it. Even though my belief system may be different it has nothing to do with caring for my patients' spiritually. As a nurse I am responsible for providing patient-centered care and I will do that regardless of what my patient is, what they believe or what they are being treated for.

1 Votes
Wuzzie said:
You misunderstand what holistic care is. It means to care for all aspects of the patient physically, mentally, emotionally and spiritually in a way that bests help the patient but it does not mean imposing your beliefs on them. For example if I was caring for your parent I might hop on-line to see what kind of special things Buddhists do when someone is sick or what they call their spiritual leader or if there is a nearby temple that I could contact IF your parent requested it. I would ask your family member how I can help assist with caring for them spiritually AS BUDDHISTS! I would never take it upon myself to impose what I believe. I wouldn't know how to pray with them according to their religion (not sure if that's even a thing in Buddhism) but I would find someone who does if they requested it. Even though my belief system may be different it has nothing to do with caring for my patients' spiritually. As a nurse I am responsible for providing patient-centered care and I will do that regardless of what my patient is, what they believe or what they are being treated for.

You are the shiny image of nurses. I'm not sure if how committed you are to your faith. In my opinion, the idea of being a devout Christian and a dedicated nurse seems oxymoron.

When I was a naive immigrant, I always had good thinking about Christians, especially the ones in healthcare. After I encountered proselytizers and read the Bible myself, I realized that I have been an idiot.

What I hate about Christians, specifically Christian nurses in this case, is that their assumption about the state of my soul.

Nursing is a science-based art of healing in my mind. Until a Christian nurse can prove to me that I am spiritually sick, she doesn't have a right to "invite" me to pray to Jesus. I don't believe in sin; I don't believe in Yahweh or Jesus; I don't believe in the Bible; I don't live by biblical morality. Nurses who are bible thumping believers don't get it. By asking me to pray with her, she assumes that I worship the same deity as she does. By that, the implication is that I would face a fate worse than death until I accept her spiritual worldview.

Around this board, you can tell how Christian nurses are. It seems like they have to exercise restrain so that they don't have to insult non-Christian patients. I'm not sure if I want nurses who have such burdens to take care of me. What if at the moment I lose my last breath, the nurse whispers in my ears "Think about Jesus so that you can avoid hell"? Why should I subject my dignity and intellectual autonomy to such nurses?

I don't like being mean to people, but sometimes enough is enough. A nurse cannot take care of my well-being on one hand and implies that I would burn for eternity if I don't submit to her view.

Not all devout bible believing nurses are capable to empathy. You are the exception. I love your humbleness when you are not shy from saying you don't know. I would love to be under your care.

1 Votes
khminh said:
You are the shiny image of nurses. I'm not sure if how committed you are to your faith. In my opinion, the idea of being a devout Christian and a dedicated nurse seems oxymoron.

When I was a naive immigrant, I always had good thinking about Christians, especially the ones in healthcare. After I encountered proselytizers and read the Bible myself, I realized that I have been an idiot.

What I hate about Christians, specifically Christian nurses in this case, is that their assumption about the state of my soul.

Nursing is a science-based art of healing in my mind. Until a Christian nurse can prove to me that I am spiritually sick, she doesn't have a right to "invite" me to pray to Jesus. I don't believe in sin; I don't believe in Yahweh or Jesus; I don't believe in the Bible; I don't live by biblical morality. Nurses who are bible thumping believers don't get it. By asking me to pray with her, she assumes that I worship the same deity as she does. By that, the implication is that I would face a fate worse than death until I accept her spiritual worldview.

Around this board, you can tell how Christian nurses are. It seems like they have to exercise restrain so that they don't have to insult non-Christian patients. I'm not sure if I want nurses who have such burdens to take care of me. What if at the moment I lose my last breath, the nurse whispers in my ears "Think about Jesus so that you can avoid hell"? Why should I subject my dignity and intellectual autonomy to such nurses?

I don't like being mean to people, but sometimes enough is enough. A nurse cannot take care of my well-being on one hand and implies that I would burn for eternity if I don't submit to her view.

Not all devout bible believing nurses are capable to empathy. You are the exception. I love your humbleness when you are not shy from saying you don't know. I would love to be under your care.

I'm sorry you feel you've had a few bad experiences with some Christian nurses, but are you going to continue to flog these ridiculous stereotypes here indefinitely? Most of the Christian nurses in the US would never consider doing what you claim you are so afraid of experiencing.

You've mentioned repeatedly that you and your family are Buddhists. Buddhists in Myanmar are viciously butchering Rohingya refugees simply for being of a different faith (Muslim). Should people in the US be afraid to have you as a nurse because you might murder them for not being Buddhist? Since you're a Buddhist, you must be just like those Buddhists, right? That's the logic you're applying to Christians, so it must apply as well to you and your family.

1 Votes
elkpark said:
I'm sorry you feel you've had a few bad experiences with some Christian nurses, but are you going to continue to flog these ridiculous stereotypes here indefinitely? Most of the Christian nurses in the US would never consider doing what you claim you are so afraid of experiencing.

You've mentioned repeatedly that you and your family are Buddhists. Buddhists in Myanmar are viciously butchering Rohingya refugees simply for being of a different faith (Muslim). Should people in the US be afraid to have you as a nurse because you might murder them for not being Buddhist? Since you're a Buddhist, you must be just like those Buddhists, right? That's the logic you're applying to Christians, so it must apply as well to you and your family.

Actually, I'm strong enough with my spiritual autonomy. I am aggressive toward Christians because I have seen with my own eyes how they tend to end a conversation with some statements like "I hope you're right", "You'll see on your deathbed. It may be too late", "You had better be correct",... I can go on and on.

Those statements don't just come out of thin air. They have biblical root. If you read the Bible, the whole book, you will see.

About people afraid of me taking care of them because of my spiritual background, I really don't mind. Buddhism has dogmas too. Although I cannot find any sayings from the Buddha that encourage violence against non Buddhists, I am willing to admit that some sects of Buddhism can be violent toward them. Since Buddhism does not acknowledge the Buddha as the Creator, there are various schools of Buddhism that teach different things. There is no such thing as a true Buddhist. The Burmese monks who commit violence against Muslims based on their belief are Buddhists just like me and my family. Who am I so say that they are not?

In fact, it's not just about my religion, either. I have been accused to being a thief because I am Vietnamese. At first, I felt insulted. Then my uncle told me that in Southern California, many Vietnamese immigrants gathered to make gangs. They cause troubles, and that makes my ethnicity become a target of criticism.

I am nothing like Vietnamese gangster in Los Angeles. However, I share the same cultural background, so I understand why people may have preconception about me. I am my own individual, but I also belong to a group. I don't like being grouped in a certain faction. However, humans are tribal by nature. That is the reality, and I have to face it.

Through my action, a lot of prejudices go away naturally. I don't have to talk people out of those preconceived notions. A lot of Christian nurses on this forum don't seem to take criticism very well when I pointed out their so-called good intentions may insult people of a different faith. Those actions have roots in the Bible.

I can go on to dissect biblical doctrines that those nurses endorse. I can quote the whole chapter in tha book to point out their cognitive dissonance. It will not be pretty, so I will not do it here.

I am not a Dalai Lama's follower. I'm not perfect. My faith is not perfect. I am all right with criticism. If there is something about my religion that makes me less competent with my job, I hope patients and my colleagues tell me so that I can change it.

If you think I exaggerate things, check out Maajid Nawaz. He is a devout Muslim, and yet he has seen the flaws in the Koran. He admits that Islam needs to reform and that extremists have justification in the scriptures. He encourages Muslims to face that and find a solution. He works with Sam Harris, an atheist, to build a bridge between Muslims and non Muslims.

You have been on this board longer than I am. Perhaps you can show me where any Christian nurse has guts to tell other nurses to deal with the doctrine of the Bible. When a nurse tries to save a patient's soul, it's not out of thin air. The Bible has verses about non believers and punishment for them. If that nurse admits that there are verses in the scriptures that speak bigotry against non Christians and is willing to revise her belief so that her patients can receive her utmost respect and care, we would not have this endless debate about whether or not a nurse should initiate prayer to her patients.

As soon as an atheist nurse exposes Christian nurses' behavior by criticizing their belief, other Christians immediately say, "That nurse is not a true Christian". History has mixed discovery about Jesus. There is zero evidence showing that he is incarnation of Yahweh. Until it is proven that Jesus is truly the son of God, I have no reason to accept the claim from "good" Christian nurses that "true Christians bring people to Christ through action." Sorry, living in America for 15 years, I have met many kind people from various religious backgrounds. There is absolutely no difference between religious people and atheists in terms of compassion.

I don't become a Christian or an atheist because I see kindness in Christians or atheists.

If there is a Christian nurse in this forum who is able to face the reality of her religion, if you can show me any nurse who has the courage to deal with the flaws in the Bible, if the Christian nurse is willing to put her belief aside for the patient's sake, if you can just give me a quote from such a nurse, I promise you I would back down. I came here only because I want to support atheist nurses. It's not fair that Christian nurse charge at them like a bee hive.

By the way, in the past, I went to church with this elderly resident who was under pain management because I felt like she needed encouragement so that she could maintain her will to live. She was a faithful Christian, and church was important for her. She knew I was a Buddhist, so she didn't ask me, but I voluntarily put my belief aside to go to church with her. Even though she didn't make it, I attended her funeral because she hoped that I would be there to say goodbye.

My faith is important, but my humanity is even more important. I will not let my religious bias interfere my compassion for a human.

Do you think that a Christian nurse is capable of doing so when she believes that non believers are destined in a lake of fire?

1 Votes
Specializes in Chaplaincy to Nursing.

There seems to be two questions, that of prayer and that of spiritual assessment and the extent to which both are the domain of the nurse. I will give my thoughts on both separately.

Spiritual Assessment: While not a monolithic or streamlined process, there is a formulaic aspect to spiritual assessment that is usually learned in Clinical Pastoral Education. I think it would be beneficial for nurses to cross train with chaplains to acquire this competency as a secondary function. They should only exercise this function when the chaplain isn't around as it is their specialized domain.

Prayer: Unless a person's beliefs or deity were so antithetical to mine that it would cause moral injury to myself, I cant imagine a context that I would deny a request from a patient to pray. That said, this should only occur if the patient asks. Nurses should not proactively seek to provide prayer (though exceptions may exist if conversation has gotten theological during care) as this is the chaplain's specialty. 

Background: CPE graduate, M.Div, pre-nursing student.

1 Votes
Specializes in Hospice/Home Health.

I think that it would be ignoring one of the most important facets of a patient's care to not inquire of their spiritual/religious beliefs.  We need to get to know our patients thoroughly so that we can properly care for them. If the patient and nurse had discussed faith and the nurse offered to pray, then I think it would be akin to offering the patient water or an extrapillow; part of the holistic approach to care.

3 Votes
Specializes in Mental Health, Gerontology, Palliative.

I have had situations where a patient asks me to pray with them. 

I will usually say something along the lines of "thank you for that privlidge, I am an agnositic and probably not the best person to be praying with you. Would you like me to call a minister or chaplain?"

Patients are usually OK with that. 

I let if be known that I am happy to stand with the patient while they pray. To me its important to be real and authentic and very disrespectful to my patient to pretend to be something I'm not. 

As a patient I once had to politely ask a nurse to back off when she tried taking things down a religous rode I wasnt willing to go. 

I have had situations where a patient asks me to pray with them. 

I will usually say something along the lines of "thank you for that privlidge, I am an agnositic and probably not the best person to be praying with you. Would you like me to call a minister or chaplain?"

Patients are usually OK with that. 

I let if be known that I am happy to stand with the patient while they pray. To me its important to be real and authentic and very disrespectful to my patient to pretend to be something I'm not. 

As a patient I once had to politely ask a nurse to back off when she tried taking things down a religous rode I wasnt willing to go.

For me its over stepping a pretty large line to offer to pray for patients. Simply because patients are in such a vulnerable state and there is a massive power imbalance. If a patient asks you I have less of an issue. 

Specializes in Psych, Addictions, SOL (Student of Life).

So many years ago that I barely remeber it was Grandfather was dying of ALso. The paralysis had progress to involve his respiratoryt drive and a well meaning nurse noting he was catholic and a member of The Church took it upo themselves to call in a priest for last rights. While the priest was performing the right my grandfather woke from his coma screamed at the priest to get out and take his witchcraft with him closed his eyes and promptly died. 

I have never presumed to pray over someone but have prayed with them at their request.

 

1 Votes
Specializes in Travel, Home Health, Med-Surg.
On 9/10/2022 at 12:53 PM, hppygr8ful said:

So many years ago that I barely remeber it was Grandfather was dying of ALso. The paralysis had progress to involve his respiratoryt drive and a well meaning nurse noting he was catholic and a member of The Church took it upo themselves to call in a priest for last rights. While the priest was performing the right my grandfather woke from his coma screamed at the priest to get out and take his witchcraft with him closed his eyes and promptly died. 

I have never presumed to pray over someone but have prayed with them at their request.

 

I am sure that the nurse had good intentions (depending on where they got the info re: he was Catholic) but should have called family to ask first. I would never call any clergy if family were available to do so or at least ask. I also would ask if pt wanted prayer prior to praying. I see nothing wrong with asking and nobody should be suspended for doing so as it it part of the job.