Prayer as a Nursing Intervention

[TOYMECH]

Greetings, Fellow Nurses!

I am doing research into the use of prayer as a nursing intervention (thus, the title of this thread.) I have had the honor of praying with patients and families at the bedside and I am sure that many of you can say the same. What I am looking for is both anecdotal and research-based evidence that prayer is an effective and valid nursing intervention.

If you have stories to share, I will be delighted. I will also appreciate any suggestions regarding published material on this subject.

While I believe that there is probably nothing better that I can do for a patient and his or her family than to ask God for His intervention, I would like to hear from the experience of others in the profession that it really is effective.

Thank you in advance for your comments!

[Koyaanisqatsi-RN]

Prayer is as worthless an intervention as "disturbed energy field" treatments.

It's an embarrassment to the field of nursing, and any medical profession to include stuff like this as part of official nursing practice, and i'm hoping you do not associate the two together, at least publically, lest we lose even more credibility than we already have as nurses.

If you want to pray with a family (and I'm entirely sure that it can be effective to help people feel better, in the same way that meditation or mindfulness training can be) then do it as a friend of the family, not as an actual practitioner. Doing it as a personal belief is a nice gesture that I'm sure is appreciated by any family that asks for it, but only in that situation. If they don't ask for it, don't do it. They may not be religious, or may be of a different religion. And again, you aren't going to find any "Evidence based practice" in favor of prayer because there literally isn't any. It's not science, it's not anything more than a nice gesture.

I'm obviously not traditionally religious, but I have certainly "prayed" with patient's families when they have asked me to with them. I do believe it is a nice thing to do when specifically requested, just the same as I have helped other patient's and families with meditation when asked.

[ONCRN84]

I work in a Catholic hospital... prayer is certainly used often but I don't think it's necessarily for health benefit. I think we use it more for emotional/mental benefit. It may not improve the patient's health or outcome, but it does comfort the patient and family (if they're of a faith that believes in it). I pray silently for patient's and their suffering families all the time. I also pray to have good nights =)

[tnbutterfly - Mary, BSN]

prayer is certainly appropriate as a professional nursing intervention. we are to meet all of the needs of the patient.....physical, emotional, and spiritual.

joint commission on accreditation of healthcare organizations (jcaho) 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. 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.

chaplains should not be the only providers of spiritual care for patients and their families. 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.

[Not_A_Hat_Person, RN]

There have been studies done about the effect of prayer on sick people, including whether or not they knew they were being prayed for. In one study, people who knew they were being prayed for declined. They thought they were beyond help.

I don't like the idea of prayer as a nursing intervention. It's one thing if a patient asks you to pray with them. However, too many nurses would see it as a justification for preaching to their patients.

[bookwormom]

I see two different approaches being discussed:

1) Praying with the patient, at his or her request, as supporting the patient's spirituality. I think this makes sense, if the nurse is comfortable with it. Otherwise, the nurse should attempt to provide appropriate resources for the patient.

2) Praying for the patient, independent of his or her spiritual orientation, but not at his or her request and not out loud. I would support this also, if the nurse is comfortable with it, but I wouldn't call it a nursing intervention per se.

I did have an unusual experience one time. A child was brought into the hospital and died soon after. The background info was confusing and conflicting. (Abuse/neglect?). The large family was wailing in the room and the patriarch of the family asked me to join hands with them and lead them in prayer. I just couldn't, being uncomfortable at that time with leading public prayer (I was a lot younger then), and knowing that the family might have had a role in the child's death. I did join hands with them, and I asked the patriarch himself to lead the prayer. I had no relationship with the family, couldn't even identify each of them, because I was just moving through the unit in an administrative role. It was very tense. It was a long prayer he led, and as for myself, I was just silently praying for the child. The nursing intervention was to support the family according to their needs; the personal prayer was my personal response to a human tragedy.

[leslie :-D]

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.

if we are to refrain from using clinical settings (i don't understand refrain from using "professional authority"), are you only referencing home care then?

chaplains should not be the only providers of spiritual care for patients and their families. 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 read where jcaho requires spiritual assessment, but nothing was said about nurses providing spiritual care.

and again, i need to ask, if we are to refrain from using clinical settings to provide spiritual care, then you are agreeing then, that we should not be doing this in a hospital or any other medical facility, yes?

leslie

[leslie :-D]

chaplains should not be the only providers of spiritual care for patients and their families. 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.

tn, would you provide data to support this? (the bolded)

to my knowledge, that has never been the case...

if i'm understanding your statement correctly.

how can we nurses, provide for spiritual distress, and still be non-denominational?

i just cannot see you doing this, w/o the influence of your christian persuasion.

and to answer op's question, no, prayer should not be an official intervention...

at all.

it really is too subjective and non-quantitative to apply, if we are to remain unbiased and neutral to all of our pts.

leslie

[tnbutterfly - Mary, BSN]

if we are to refrain from using clinical settings (i don't understand refrain from using "professional authority"), are you only referencing home care then?

i read where jcaho requires spiritual assessment, but nothing was said about nurses providing spiritual care.

and again, i need to ask, if we are to refrain from using clinical settings to provide spiritual care, then you are agreeing then, that we should not be doing this in a hospital or any other medical facility, yes?

we should not use the clinical setting...meaning that because the patient is in a clinical setting...... just because the patient is in a clinical setting we should not abuse our professional authority as nurses or other healthcare professionals to force our spiritual views on the patient. spiritual assessment and spiritual care can be done in the clinical setting as well as in the home. we should assess what the spiritual needs are and try to meet those needs. just as we try to meet the physical needs, either directly (getting them a glass of water, for example) or indirectly (calling the doctor and reporting declining condition), we should also strive to meet their spiritual needs. if we assess that they would like prayer, we can either pray with them or contact the chaplain. either way....we have met their need.......not our need. we should always keep our focus on the patient's needs, even if their beliefs differ from our own.

[leslie :-D]

we should not use the clinical setting...meaning that because the patient is in a clinical setting...... just because the patient is in a clinical setting we should not abuse our professional authority as nurses or other healthcare professionals to force our spiritual views on the patient. spiritual assessment and spiritual care can be done in the clinical setting as well as in the home. we should assess what the spiritual needs are and try to meet those needs. just as we try to meet the physical needs, either directly (getting them a glass of water, for example) or indirectly (calling the doctor and reporting declining condition), we should also strive to meet their spiritual needs. if we assess that they would like prayer, we can either pray with them or contact the chaplain. either way....we have met their need.......not our need. we should always keep our focus on the patient's needs, even if their beliefs differ from our own.

ah...and yes.

i agree, totally.

leslie:)

[leslie :-D]

you know how "spiritual distress" is an actual nsg dx?

if you look in your ncp books, what do they have as nsg interventions?

i would be highly surprised to learn that "prayer" is one of them...

meaning, saunders, mosby et al, would not support it.

anyone (esp newbies and students)?

leslie

[tnbutterfly - Mary, BSN]

this is from a ehs nursing care plans site connected with mosby.

nursing diagnosis: spiritual distress

nanda definition: disruption in the life principle that pervades a person's entire being and that integrates and transcends one's biological and psychosocial nature

spiritual distress is an experience of profound disharmony in the person's belief or value system that threatens the meaning of his or her life. during spiritual distress the patient loses hope, questions his or her belief system, or feels separated from his or her personal source of comfort and strength. pain, chronic or terminal illness, impending surgery, or the death or illness of a loved one are crises that may cause spiritual distress. being physically separated from family and familiar culture contributes to feeling alone and abandoned. nurses in the hospital, home care, and ambulatory settings can assist the patient in reestablishing a sense of spiritual well-being.

under therapeutic interventions....

structure your interventions in terms of patient's belief system. patients have a right to their beliefs and practices, even if they conflict with the nurse's.

when requested by patient or family, arrange for clergy, religious rituals, or the display of religious objects, especially when the patient is hospitalized. these help lessen feelings of separation and provide strength and inspiration. if patient belongs to a highly codified or ritualized religion, such as orthodox judaism, clergy is important at times of passage, such as birth or death. in times of crisis the patient may not have the inner strength to call clergy without assistance.

if requested, pray with patient. this provides a sense of connectedness to others.

http://www1.us.elsevierhealth.com/merlin/gulanick/constructor/index.cfm?plan=50

[EowynRN]

Whether it works or not is really subjective, and you will never find a scientific rationale for prayer healing unless you can link it to lowered bp, etc. Either way, it can never be implemented as a main nursing intervention because that's on the road to forcing those of us who are atheist or agnostic into doing things we aren't comfortable with.

I will never pray with a patient, not because I don't respect their prayers, but because I'm not going to disrespect them by doing something I don't believe in. If a nurse is religious and a patient asks for prayer, then it's always going to be welcome and by situation may be appropriate, but to put it down as an actual intervention with scientific rational for making the patient better won't happen because forcing prayer or bringing it the forefront can walk the thin line of appropriate behavior for a nurse so making it a stated intervention is just a liability. It might help the patient's psyche, but it's too much of a controversy to look into it as a real nursing intervention that all nurses should implement.