Nurses talking religion with patients - fine line - page 5

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   dnp2004
    Quote from vashtee
    Where I live, it is assumed you are Christian (of some sort) - not even atheist. I've decided to quit correcting people when they assume I am Christian because they look at me like I killed their cat if I tell them I am Jewish.

    Anyway, with regards to a patient's spiritual care - My assessment consists of me asking if they'd like to see clergy (we are told that we can get someone of pretty much any faith). My intervention consists of contacting the clergy person and ensuring they came. I suppose if someone knew I was Jewish and wanted me to pray with them, I would. Otherwise, I consider it out of my scope of practice. The hospital hires clergy for a reason, and I am busy enough as it is without trying to wear yet another hat.

    "Killed their cat", Ha Ha Ha!!! ! But seriously, I am amazed the reaction you are getting with regards to Judism. I mean, it is the root of and very similar to Christianity and Islam. Not to mention the fact that most Christian Churches I have attended read from the Old Testament during Sunday School and sermons. So I am surprised you have had to quit correcting people.

    You know even at my age, on this website, I learn something new everyday!
  2. by   Eromeus
    I'm just a nursing student, but I have had my share of encounters with the religious as a CNA in the bible belt. And, personally, I don't bring up religion unless the patient approaches me about it first. That's my rule with religion, politics, or anything that could be controversial. You are there for the patient, not to proselytize or explain your belief system to them.

  3. by   jm394
    I think this has been a good discussion with some very level-minded responses. My feeling is that a nurse should be interested in holistic well-being. This may include mental health, which in turn may include a sense of existential peace. Now, obviously the nurse in the article did nothing to improve the patient's feelings of existential contentment. I think that the nurse should take a counselor/social worker/psychologist-style approach and focus on the patients' needs not their own. Let them talk, ask questions that keep them talking, facilitate their expressed needs, etc... But proselytize, never. You're being paid to ease their lives in this world, not to worry about the state of their afterlife...
  4. by   wonderbee
    In my experience with dying patients, it is often the families that are upset by the issues that the dying have to confront. The patients sense this and want to spare the family at the cost of their last opportunities to face their fears with resolve. Getting the priest, the minister or even a kindly nurse signals the reality of impending death. Families are still in denial. The dying can't afford to be and many have already crossed that bridge. The needs of the patients are at odds with the needs of the families. It's a fine line. Who is the patient?

    Every man on his deathbed faces the eternal question "what is next?". If the patient wants to explore that avenue with another individual, we have to make it safe for them to do so. Some nurses are comfortable and well equipped in that role and some are not. It should be patient-led but we have to leave cues that it's ok to talk about it.
  5. by   Overland1
    Discussing religion is an issue that can go in at least one of many ways. If the patient initiates the discussion (i.e., "I want to see a priest"), then that is one thing. If a patient asks if he/she is going to Hell when he/she dies, then turfing that to a minister or pastoral care person is the best way to go. Sometimes a patient and/or family member(s) will ask a nurse to pray with them; do this if reasonably comfortable with it and able to do so (do not neglect another patient's ABC's while you join them in a lap around the beads).

    Where I work, we have an incredibly good Pastoral Care team; I offer their services whenever appropriate.
  6. by   firstyearstudent
    From the article it sounds like the family is just angry that their family member was hurt by misunderstanding in a conversation and just wants to blame someone. It doesn't sound like the nurse was proselytizing or initiating any kind of religious dialogue. It sounds like she was just trying to provide some comforting words in response to his comment. I have seem this happen many times with patients and especially family when they go downhill. They are angry and they want someone to take it out on.
  7. by   anoro
    Thanks blue note, there is a big difference between offering support to clients/patients and pushing some religion. And WHO is to decide if one
    expressed their own spirituality through any religion anyway! I don't see any connection between spirituality and the dogma of many religions anyway.
  8. by   hpygrl01
    My entire nursing program is based on Jean Watson's carative factors. One has to do with helping the client w/in their spirituality. I feel if you are trying to help them cope w/what they want to talk about, and what they believe they need to do, then it's ok.
  9. by   blue note
    Quote from firstyearstudent
    It doesn't sound like the nurse was proselytizing or initiating any kind of religious dialogue. It sounds like she was just trying to provide some comforting words in response to his comment.
    You call telling a distressed patient "There's only one way, you must go home and repent" comforting?! How do you "misunderstand" that? She is telling her patient that her religion as the only way, and her patient must repent, implying that if she doesn't, she is what? Condemned to burn in hell? How is that acceptable? At best, she was clueless to her patient's needs, and ended up causing her more distress. At worst, she took advantage of a vulnerable patient to proselytize her religion.

    Imo, she crossed way over the line, and the family was right to complain about her.
  10. by   firstyearstudent
    Maybe I'm missing something here, but this is verbatim from the article:

    According to a petition letter Peterson wrote in the hopes of getting her job back, she said she was trying to mirror the patient's comment "Christianity is narrow" by saying, "Yes, it is. If God were to be what the Bible represents then the access to him would be through repentance. Many other religions aren't so exclusive."

    But the patient's family complained that the patient cried and said the nurse had told her, "There's only one way, you must go home and repent," Peterson wrote.

    Who knows what was actually said and how it was meant...

    Personally, I try to avoid any talk about religion. I'm a non-theist Quaker, so atheists hate me because I'm religious and believers hate me because I'm an atheist. Anything I say is sure to offend someone.
    Last edit by firstyearstudent on Apr 21, '09
  11. by   blue note
    I am inclined to believe the patient - maybe the family is just complaining, but then, the nurse is trying to get her job back. But let's grant that the nurse was telling the truth and she told the patient, "If God were to be what the Bible represents then the access to him would be through repentance. Many other religions aren't so exclusive" - she is still telling the dying patient she has to repent to have access to God, albeit in a less obviously proselytizing way than what the patient claimed.

    Even the hospice nurse and ordained interfaith minister quoted in the article said that repentance is a loaded word. Plus, saying other religions aren't so "exclusive" doesn't sound very tolerant to me. The nurse says the hospital admin overreacted because the complaint was religious in nature, but I think that sometimes, very religious people can be tone deaf when it comes to how their words are coming across to others, especially to those who do not share their beliefs.

    Also, I am an atheist but I do not hate religious people because they are religious. I only hate it when they try to impose their religious beliefs onto others, and show a lack of respect towards other religions and non-believers.
  12. by   firstyearstudent
    Who knows, maybe you are right. I really have no clear idea of what went on in that conservation and maybe I am reading less into the report than you are. I can't say unless I had more information.

    Religious people can be dogmatic, but it sounds like the patient is also religious (which is why they probably brought the subject up in the first place) and makes me wonder what they are choosing to hear in the conversation. Or maybe the patient didn't bring the conversation up and was just trying to shut the nurse up. Who can say based on this article.

    If the nurse said that to me I would interpret it as saying, Many religions have different beliefs, but if you consider yourself a Christian you should repent because that is what they believe. It may or may not be appropriate advice, but it seems at least logical.

    But then that's just my personality. I wouldn't be offended by anyone's spiritual advice (unless it went on too long...). I'd listen to it, figure out if there was anything worthwhile there and then take it or ignore it. I probably wouldn't get upset even if they told me I'd burn in hell (actually, I'd probably laugh if they told me that).

    Personally, I'd never give any patient spiritual "advice" because I don't feel confident in the practice of any religion other than Quakerism, and Quakers don't really give advice in this way because we believe that spirituality reveals itself to each individual without the benefit/interference of spiritual authorities (even the bible). Quakers don't even have ministers. I might only recommend that the patient meditate on their concerns and keep themselves open to receiving an answer (from a diety, from a universal force, from their own subconscious, whatever -- who knows, I wouldn't take a guess, I'm agnostic on all of it).
    Last edit by firstyearstudent on Apr 22, '09
  13. by   shrinky
    I agree that there is a difference between religion and spiritual matters. No, we should not push our religion on anyone. However there is a time and place for a nurse to discuss spiritual matters when a patient or family member wants or needs some comfort. Spiritual pain is very real and sometimes cannot wait for a chaplain to arrive and our role includes the whole person which includes the spirit, mind and body. Would you not deal with emotional needs or do we have to find a social worker to deal with them? Are we not concerned with the home life of a patient when we start discharge planning or do we wait for someone else to find that out? Sorry, but I will continue to treat the whole person and not just a disease entity, or the outer person and neglect the inside which always affects the outside, the health or wellnes or lack of in a person. :redpinkhe