Nurses talking religion with patients - fine line

  1. 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 Julie Peterson learned when discharging a dying patient last month. After the patient's family complained that Peterson had distressed the patient by talking about repentance, the hospital told Peterson it wouldn't be contracting for her services anymore.

    Per diem nurses are not considered hospital staff and are not entitled to all the job protections that come from being a union member of the Massachusetts Nurses Association, according to MNA officials.

    But, fellow nurses and friends of Peterson say the mother of five is a compassionate caregiver who wouldn't have knowingly upset a patient. And they say patients at the end of their lives often want to discuss Big Picture issues, including God and the afterlife, with the caretakers by their bedside.


    Full Story:
    http://www.capecodonline.com/apps/pb...NEWS/904170307
    Last edit by brian on Apr 18, '09
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    About Brian, ADN

    Joined: Mar '98; Posts: 15,418; Likes: 16,382
    allnurses.com founder; from US
    Specialty: CCU, Geriatrics, Critical Care, Tele

    64 Comments

  3. by   ♪♫ in my ♥
    I'm firmly of the opinion that discussions of spiritual matters should be left to those in the appropriate role... I do not believe that nursing is one of those roles.

    And it certainly is no place to be proselytizing, witnessing, or anything similar.
  4. by   101st_LVN
    Quote from ♪♫ in my ♥
    I'm firmly of the opinion that discussions of spiritual matters should be left to those in the appropriate role... I do not believe that nursing is one of those roles.
    I disagree. Spiritual matters (especially when a patient is facing end-of-life issues) is a health issue, which means it is a nursing issue. Depending on the specific role of the nurse, it may not be appropriate--but not solely based on being a nurse. As a nurse, my priority concern is the physical well-being of my patient, but I should also be concerned about their mental and spiritual health. I do not believe I should try to "proselytize" at work, but I do believe spiritual beliefs are a part of psychosocial assessments for a reason.
    I personally try to avoid politics, sports and religion unless circumstances dictates otherwise--but that is in keeping with my specific role; not because I'm a nurse.
  5. by   eldragon
    I see too many nurses and other employees trying to push their religious ideals on residents where I work, in a long term care facility. I believe that- unless the patient is in their right mind and asks for spiritual guidance, which can then be satisfied appropriately by calling on clergy - the employees should remain professional and stay out of it.

    There is a patient where I work who has been suffering with severe dementia for years and in fact has resided at the facility for well over 5 years. Everyone is aware of her state of mind and inability to make decisions of any kind. This woman was agnostic in her youth and according to her daughter, very set in her ways and disgusted by organized religion. That does not deter more than a few Christians where I work from hoping that she can still "be saved."

    To me, it's as if they believe she was somehow uneducated and made a poor choice based on having too little information, when if fact, she was an educated woman who most probably did a good bit of research on theology and made her decisions based on her own spiritual search. (According to her daughter).

    It infuriates me to see people continuing to haul this woman into church services. She would never go in there voluntarily.

    It's easy enough to understand the dilemma when you put yourself in another persons shoes, in another place. What if you were a devout catholic and suffered with dementia and now everyone thinks they should convert you to their religion, which is........say Jewish. Or Muslim. Or Buddhist. Or Jehovah Witness. The list goes on and on.

    And when someone is preaching, they are preaching their beliefs. I just think it's opportunistic.
  6. by   NickB
    Damn, if that is the case, then I guess Potter and Perry better take out that whole chapter in their book on Spirituality.

    People seem so scared of religion sometimes that if baffles me. I don't think any one person has a right to speak of religion anymore than somebody else. To say that it should be left to a clergyman is just plain wrong. Imagine a dying patient in their bed, scared to death, and they ask you to pray with them. You feel comfortable doing this but tell them they'll have to wait until you can find someone who is aloud to pray with them. I don't think that fits in the nursing model of patient care. We're not all about medicine. In fact, that is the secondary role of the nurse. The primary role of the nurse is advocating for the patient and the patient's comfort. If they want you to pray with them then do it. If you don't believe in God or their God, sack up and tell them and then find someone who does.
  7. by   blue note
    To say that it should be left to a clergyman is just plain wrong. Imagine a dying patient in their bed, scared to death, and they ask you to pray with them.
    I think if a patient specifically asks for it, then a nurse could if he or she is comfortable with it. However, for the nurse in the article to say, "There's only one way, you must go home and repent" crosses the line imo. As an atheist, I wouldn't be upset - I'd be angry if someone were to tell me that. Even if the patient had been the one to broach the subject, I think this case clearly illustrates the pitfalls when a nurse gets into discussions about religion. I also agree that preaching your religion to someone who is ill and/or under your care is opportunistic.
  8. by   ♪♫ in my ♥
    Quote from NickB
    Damn, if that is the case, then I guess Potter and Perry better take out that whole chapter in their book on Spirituality.
    Well, perhaps they should.

    I know from some other threads that many disagree with me and that's OK. From my perspective, however, I am not comfortable discussing with patients my religious views or theirs. I'm fine asking them questions and letting them talk... I'm not fine with me talking about it. Listening, sure...

    Fortunately, there is no shortage of folks around to do that.
    Last edit by ♪♫ in my ♥ on Apr 17, '09
  9. by   Suz_808
    I do think we are stepping out of our field when we start talking specifics with a patient about religion. There can be so many differences in interpretation even within the same religion you could easily put your foot in it. Especially when the patient is facing end of life. I don't have a problem praying with a client if they ask either. I don't go to church and this is probably the only time I actually pray. I think of myself as a spiritual person but I have no time for organized religion. I am honest with my patients and it's never been a problem with them regardless of their affiliation. It's their moment and it doesn't cost you anything to offer comfort, whether that is joining them in prayer or just holding their hand. It's definately not the time to risk saying the wrong thing and inadvertantly causing them pain. "I don't know" is always a good answer to anything specific, because I actually believe no one does and does not cause the patient distress. I haven't found one yet that expected their nurse to be able to answer the meaning of life question. Specifics of religious text should be referred to the experts (ie. clergy.)
    I'm not saying the athiests should pretend to pray, if you feel that strongly about it, it's best you don't because they will know and that's even worse. But I do think people that are dying have an insight into these kinds of things, they have already detected the discomfort/evasion if they bring up religion so would probably not ask anyway. 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 experiencing during this time and it's a very personal thing.
  10. by   blue note
    Quote from Suz_808
    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
    As an atheist, I call that a myth. See this, and this for accounts of atheists in the armed forces who have been in actual foxholes. I just think it is smarter to err on the side of caution on the subjects of religion and politics. The nurse in that article probably realizes that now.
  11. by   101st_LVN
    Quote from Suz_808
    If you have not personally faced your own death, you can't give the seriousness of thought to what they are experiencing during this time and it's a very personal thing.
    I don't know why I'm playing devil's advocate in a discussion on religion; but I am. How many other professions deal with death and dying as much and as often as nurses? (other than EMS, Military, and Law Enforcement) Am I the only one that has gone home and thought about my shift and my patients? Those were heavy moments for me; and my life was not in jeopardy at the time.

    In the middle of composing this post, I realized something. I'm not a big fan of talking about religion during the course of my duties as a nurse; but I am okay with discussing spirituality. It's akin to politics--an Obama vs. McCain discussion likely has (especially after the election) no therapeutic value, so why tempt fate that we may disagree (thus potentially harming the relationship)? A Buddhism vs. Catholicism vs. Protestantism conversation likely has no therapeutic value either. That being said, I will openly admit to encouraging people to pray more, to journal; to find some discipline that allows them time to consider the big picture. I've also advised people to quit drinking, to quit smoking (especially around their asthmatic children), to avoid fatty foods, to stop giving their kids junk food, and to finish all of their antibiotics. I don't tell them they can't have Indian food, or Thai food, or Chinese food, or Italian food. They can talk religion with their spiritual leaders, family and friends outside of my area; but I need to be okay with talking with someone about spirituality as appropriate.
    Quote from ♪♫ in my ♥
    I'm fine asking them questions and letting them talk... I'm not fine with me talking about it. Listening, sure...
    I definitely agree that this is the usually the safest, and easily most appropriate route that these conversations should take.

    Sorry for the rambling.
  12. by   Neveranurseagain
    Nurses need to remain non biased and nonjudgemental--which includes not discussing religion with pt. That's what hospital chaplains are for. Why do some nurses feel the need to add to spiritual care and religion to their already fast paced day?

    How would pt's feel if I discussed that life was suffering and the Four Noble Truths? Call the chaplain if pt's want to discuss religion.
  13. by   Suz_808
    Ok...I think you may have missed my point. What I was saying about the seriousness of the situation was this....I used to work in LTC, on nights, and have shared those last moment experiences with too many people and I definately took those experiences home with me. What I was meaning was that this is not the time to be sprouting your own beliefs or opinions or anything like that. This is their moment, what is important to "them" is what matters. I don't open discussions about religion with my patients but if their needs emotionally concern this, I will go there, but as a comfort of someone to talk to, not a spiritual advisor. I think it's important to be able to do this because sometimes you are the last person this person will ever talk to and one shouldn't take that lightly. I am no fan of anyone that takes this time to "save them".
    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. Understand though, I do not support organized religion. History shows huges holes in many beliefs held by modern day religions. My point is intellectual on what atheism is. Feel free to message me.
    In relation to this thread though, as a professional care giver our therapeutic communication and interactions with our patients are "about them", not about us. Does anyone remember their mental health rotations? TC ! This isn't an even relationship, we are there for them. If you can't be there for them, then be in an area of nursing where it won't come up that much.
  14. by   101st_LVN
    Suz_808, I agree with your first paragraph. My life is based on my faith; but there is something off-putting about using a work or client relationship to try and spread my faith. It's the same bad vibe I had when a doctor (that I didn't know very well) invited me to one of those pyramid business programs.
    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.

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