Nurses talking religion with patients - fine line - page 2

Nurses who talk about God and spirituality with their patients can walk a fine line between comforting the ill and stepping on theological toes. That's the lesson Cape Cod Hospital per diem nurse... Read More

  1. by   blue note
    The other poster about the athiest....if you want to pursue the whole athiest/agnostic discussion it's probably more appropriate to do that in private.
    I don't - was merely responding to your husband's comment. The idea that atheists would suddenly become believers in the face of death is simply not true. I don't agree that preferring to stay out of religious discussions with a patient makes one a less caring nurse. I don't think nurses should go there unless the patient brings it up first. And then, it depends on what they need. If you're a nurse who feels comfortable doing more than just listen, then go on ahead, but consider the news story that started this thread.

    As for the difference between discussing spirituality and religion, people define those in different ways and for some, they are the same thing. That is why I think nurses should remain non-judgmental and neutral. After all, your patient could very well be a non-believer who won''t appreciate being urged to pray more.
  2. by   Suz_808
    Quote from 101st_LVN
    I also agree with your last paragraph, but with one adjustment--it is a relationship. Look in your mental health books. I believe mine referred to it as the "nurse-client relationship". It is not a friendship, but the nature of nursing should include more empathy and genuine concern than a pure business-client relationship.
    I agree totally.
  3. by   Suz_808
    Quote from blue note
    The idea that atheists would suddenly become believers in the face of death is simply not true.
    You are right. To say they all don't is also simply not true. It's a saying, not an absolute truth. The point was just on an intellectual basis of what an athiest actually means. I see both sides. I looked at your websites. Austin Cline, who wrote the article you are referring to, states that not all athiests are non religious and their protest is with the bad things that happen with religion. Religious athiests....I have never heard that before. The other one, Freedom from Religion, separation of church and state, totally agree with that, just wonder why it's just an athiest/agnostic group. Just can't work out what their main theme is...separating church and state or promoting the whole anti-religious movement. One does not rely on the other and in fact you lose followers if they have to be athiest or agnostic. And where does that leave the agnostics, they just aren't committing one way or the other.....yet have joined a group that is working at debunking one side of their indecision. Check Websters for the definitions. I honestly think the religious athiests are an oxymoron.

    As I said I was only commenting on the intellectual side of it and how it just doesn't make sense to me argued that way. But it doesn't have to, I was just thinking you might enlighten me. If this works for you, great.

    On all the other points you mentioned you could probably gather from my posts that I agree with you, I think we pretty much said the same thing. When I said I never bring up religion to any of my patients, that did include the athiests.
  4. by   oramar
    Here is what I always did. I let the patient bring their religious beliefs up and let them lead me where they wanted the discussion to go. This was their illness and I never used their illness as an excuse to impose my beliefs. I never had a problem in that area EVER. On the other hand, if I were the patient and someone said something to the effect that "I should repent" I would know they had stepped over the line. However, I doubt I would have used that as an excuse to make trouble for a perfectly good nurse. I think the family was way over reacting.
  5. by   NickB
    Quote from awsmom8
    Why do some nurses feel the need to add to spiritual care and religion to their already fast paced day?
    Because it is taught in Nursing School.
  6. by   Teresag_CNS
    I ask patients if they have spiritual beliefs that give them comfort, and build on those if so. There are many ways to incorporate the spiritual into nursing care without proselytizing. One does have to draw the line at offering advice to repent or praying without being asked to.

    Frankly, I think the distinction between what is appropriate and what is not is pretty clear: if the person does not agree to the discussion or the support you are offering, then it is wrong.
  7. by   Teresag_CNS
    Quote from NickB
    Because it is taught in Nursing School.
    No. Because it is part of holistic care. Because no one else on the health care team will do it. Because it helps the person cope with illness and loss. Because attention to the individual's spirituality is part of caring. Because it's usually the nurse who identifies the need to call the chaplain or clergy. Because patients' families appreciate it.
    Because taking vitals, passing medicines and doing various treatments are only a fraction of nursing care. Because nurses know patients as individuals, not merely "cases." Because we know that isolation and fear are the enemy. Because it comforts.
  8. by   NamasteNurse
    I believe that this is definitely an appropriate topic for nurses. However, as I am being taught in my classes, it's a time for therapeutic conversation, not a lecture or opinionated nurse time. At death, it's appropriate to question values, life experiences and beliefs. As a nurse I would ask questions to allow the pt to talk it through themselves and simply supply a sympathetic ear. There are plenty of ways to engage in this discussion without asserting your own opinion and certainly not your own prejudices or judgements. Death is a time for gentle reassurances and listening. Run your life and your profession by the golden rule and you'll never go wrong!!

    "Do unto others as you would have others do unto you". Easy.
  9. by   sleepyRN2
    it is sensible for a nurse not to embark on a religious tete-a-tete with a client, and if the client insists on such talks to occur then it is the nurse's obligation to defer it to someone who is more qualified; that's the priority intervention. otherwise, a nurse risks treading on someone's religious views, beliefs, or worse comes to worse, he may inadvertently impose some unwanted views on the said client.
  10. by   pagandeva2000
    I don't think it is fair to generalize that ALL atheists will call upon God in crisis anymore than to believe that Christians will go to the grave without recanting their belief in God.

    I was not present during this conversation between the nurse and patient, but I can sure see how this can lead to problems. For one, it is true, not every facility has an available chaplain. And, even if one was around, the patient may not want to wait for this person to be paged or for him/her to arrive. Like anyone else, conversation is usually spontaneous. It does take a special skill to discuss spiritual/religious issues to patients (and even collagues and associates outside of work). I usually tend to go with asking what belief system the person has and elaborate more on the positives of that one. It also doesn't hurt that I happen to love reading about different faiths, and can probably expound a bit on most conversations in a neutral way.

    The problem to me is that there are some fundamentalists that use these opportunities to prophestyze their faiths. This is not as comforting as they may believe it is. Suddenly, this person is faced with the belief that they may have followed the 'wrong' belief and feels that they have no time to revise their ways...thinking it is too late because they didn't walk the walk. And, like the atheist in the foxhole theory...the patient may feel that even if he/she actually did change their frame of thought on these matters, that God will not take them seriously because now, they are dying.

    I have issues with discussing my personal faith because most people are intimidated by us metaphysical folks. They believe that we are into spellcasting, hexes and curses, worship Satan and other sterotypes. This may lead the patient to become afraid of us caring for them, when actually, I have no intention of converting them to my way of thinking. This can lead to more stress in their final hours or during their acute illness and that is not what I am here for. Therefore, I don't discuss my spiritual views with patients. I will take a moment of silence, build on what they believe in and/or obtain a chaplain to come and pray with them because I honor their faith, even if it is not of my own. I was taught in my early days of study to take the time to learn of as many religions as possible in an objective manner in order to make my own decision, one I am comfortable with...but that does not ever mean that I have the right to impose mine on anyone else. "Repentance" is a strong word. I would rather say to bring a person to peace than that.
  11. by   pagandeva2000
    Quote from oramar
    Here is what I always did. I let the patient bring their religious beliefs up and let them lead me where they wanted the discussion to go. This was their illness and I never used their illness as an excuse to impose my beliefs. I never had a problem in that area EVER. On the other hand, if I were the patient and someone said something to the effect that "I should repent" I would know they had stepped over the line. However, I doubt I would have used that as an excuse to make trouble for a perfectly good nurse. I think the family was way over reacting.
    I'm not sure if the family was over reacting if they saw that the patient was under extreme duress in their last days. It is bad enough that they may be suffering physical pain, but to be afraid of what is going to happen in the afterlife when it seems to be so imminent...well, that may be an issue. If this nurse used those words, it may have caused a great deal of stress to the patient. Or, maybe this is a family who is using gains to manipulate people by raising a ruckus, who knows? But, I remember that pain after my mother died...whether I was doing the right thing, did the Creator love me, etc...and I am alive with no known health issues. It took me close to a year to reconcile with myself. I can only imagine the ordeal for a person who has limited time.
  12. by   LaneyB
    There is a major difference between assessing a patient's religious needs and pushing your own beliefs on the patient. I agree that as a nurse it is appropriate to ask if they have any spiritual needs, but to launch into a discussion about your own beliefs is incredibly inappropriate.

    I talked to my husband about this and he wanted me to add "there are no athiests in foxholes." - just his opinion.
    If you have not personally faced your own death, you can't give the seriousness of thought to what they are


    Also, the atheist in a foxhole line is so outdated and offensive to atheists. I really wish people would stop using it. They have a nice website that lists many, many soldiers who are indeed atheists in foxholes. It is not his opinion - it is an old, misinformed cliche.
  13. by   LaneyB
    pagandeva2000

    I completely agree with your above posts. You summed it up perfectly.

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