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Spiritual Care and Nursing: How Does This Work?

Nurses Article   (6,724 Views 10 Comments 976 Words)
by jeastridge jeastridge (Member) Writer Expert Nurse

86 Likes; 5 Followers; 86 Articles; 145,844 Visitors; 378 Posts

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In this article the author discusses the ups and downs of being asked to provide spiritual care to a patient.

Spiritual Care and Nursing: How Does This Work?

"Please pray with me," my patient pleaded as I gathered up my bag and prepared to leave our admission visit. The social worker and the patient's caregiver had already stepped outside and were talking on the porch landing. I looked at my patient whose eyes betrayed fear over what was to come after being diagnosed with an inoperable and widely metastatic cancer just a few days before. Still relatively young in his late 50's, he could see and feel that he did not have long to live.

I put my things down and sat beside his bed in the chair I had occupied for the previous two hours while the hospice social worker and I went through the admission process with him. He offered his hand and I held it, praying a simple prayer for comfort and peace.

As professionals, we are called to provide care for the body, the mind and the spirit. It is not often that we are asked to do something as overt as praying with a patient-but it does happen. How we feel about this can vary widely depending on our own faith walk and what we think about sharing that with others.

Admittedly, in this particular situation, we had two hours of talking, listening, getting to know this gentleman; we knew where he was coming from. There were religious symbols in the house and he verbally confirmed his particular faith during our assessment.

Hospice may be singular in the nursing realm in that spiritual care is an expectation, an active part of what we do. But in all fields-everything from office nursing to ICU to surgery-we meet our patients in times of crisis and fear. Spiritual comfort, when requested, can be a very helpful part of excellent nursing care. In practical terms, however, the very thought of praying with someone may send shivers of unease and discomfort down the staunchest nurse's spine. What if they are Christian and we are not? Or Muslim, or Jewish or Hindu, or Buddhist, or Agnostic? How does all that work and how do we help without hurting?

There are no easy answers to this question but let's explore together some ways we can prepare to offer spiritual care if requested.

Listen first

People will very often answer frankly and let you know what would be helpful. Ask a question, "How would you like me to pray?" or "What do you want me to pray for?"Sometimes just holding their hand and having a moment of silence can bridge the space between us and our patients, helping them to know that we are on their side and will help however we can.

Plan ahead for how to respond

If you are uncomfortable with any type of faith discussion, it is important to still allow the patient to feel validated. If you are unable to pray or provide the comfort they seek, have a Plan B ready. Tell them, "I know that this is a difficult time. Let me call the chaplain to talk with you about this. Thank you for sharing with me." Thanking them for sharing helps them not feel embarrassed for asking and lets them know it's ok. In planning ahead, we might also consider using some more universal prayers, things like "The Serenity Prayer" or a beautiful poem that speaks to us or the 23rd Psalm if the patient is Jewish or Christian.

Be respectful

While providing nursing care, part of our professional duty is to give spiritual care-according to the patient's needs and beliefs, not our own. So this would not be the time to proselytize but instead, to respond according to the faith journey that the patient has expressed, letting them guide the conversation. If we believe firmly in our particular faith (and to be a good practitioners of our faith then we surely must!), it can be hard to simply accompany the faith journey without interjecting our own beliefs, but this is one of the ways we show care and compassion in providing spiritual care. We can remain true to ourselves and at the same time be true to our charge as excellent professionals who seek to offer healing to the whole patient: mind, body, and spirit.

Use the gift of presence and touch as part of the whole approach

We have all known the patient who "lays on the call bell" or calls the office every day or has 101 complaints when they talk with us. While frustration can be our knee-jerk reaction, our professionalism calls us to look deeper, to move beyond the surface complaints and to listen with the ears of the spirit, asking ourselves, "So what is really going on here? Is there something I'm missing?" Loneliness, fear, pain are all aggravated by and expressed in illness. As nurses, we cannot underestimate the power of the gentle touch on the shoulder, the eye contact, the active listening that says, "I truly hear what you are saying," or the simple, "I'm sorry you are going through this."

After our prayer, I reviewed our plan for a return visit and reminded my patient of our plan of care and asked him to call with any questions or concerns, hoping in this way to give him tools to manage his anxiety. Then I told him, "We will walk this journey with you." Those words seemed to help and I saw his shoulders relax against the pillow, the tension easing for the moment.

You may have experiences with being asked to provide spiritual care. How did you feel about it? What did you do? Do you have any tips that might help other nurses in the same position?

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Joy has been a nurse for 35 years, practicing in a variety of settings. Currently, she is a Faith Community Nurse. She enjoys her grandchildren, cooking for crowds and taking long walks.

86 Likes; 5 Followers; 86 Articles; 145,844 Visitors; 378 Posts

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Wonderful article. You really explained this situation clearly and offered specific actions and questions we can use.

The only part that struck me as a little off was the line "If we believe firmly in our particular faith (and to be a good practitioners of our faith then we surely must!)". This seems to imply if you don't believe firmly in your faith then you're not a good practitioner of it. Doubt is usually at least some part of most believers faith practices, whether we're talking about nurses or patients.

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oncnursemsn has 30 years experience and works as a Oncology nurse.

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I would be humbled and honored if a patient ever asked me to pray with them. I have certainly prayed for my patients and families- but it was only when they were leaving and asked as they were on the way out the door. We hug and off they go. Thank you for your post- and I still pray for my patients!

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Zedrek has 11 years experience and works as a Licensed Psychiatric Technician.

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Working in a psychiatric inpatient unit I see religion come up from time to time with my patients. I've prayed with my patients and talked with them about God. Pretty ironic considering that I am an atheist. Haven't been struck by lightning yet. :D

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86 Likes; 5 Followers; 86 Articles; 145,844 Visitors; 378 Posts

Dear Phil,

I am so glad that you point this out. My wording is awkward, I agree. What I really wanted to convey is that we can provide spiritual care no matter where we are on our journey of faith--that would have been a much better way to put it. I appreciate you helpful comment.

Joy

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86 Likes; 5 Followers; 86 Articles; 145,844 Visitors; 378 Posts

Thank you for your comment. Your love and care shine through!

Joy

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86 Likes; 5 Followers; 86 Articles; 145,844 Visitors; 378 Posts

Working in a psychiatric inpatient unit I see religion come up from time to time with my patients. I've prayed with my patients and talked with them about God. Pretty ironic considering that I am an atheist. Haven't been struck by lightning yet. :D

Hi Zedrek, I so appreciate the honesty in your response. You leave the door open for your patients, providing what they need to help them in their progress toward wholeness. You are able to provide spiritual care as the professional that you are. Again, thank you for sharing! Joy

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As a nurse working in palliative care and also addressing patient's needs at the end of life (when death is more imminent) I agree that any nurse can address spiritual needs if they come up and the nurse is comfortable doing so.

It does seem that religion or spirituality is more involved when a person struggles and/ or transitions in life. Chronic or serious illness, nearing death, perhaps also giving birth or going through a surgery / procedure can invoke a greater need to call on a higher power or to feel connected with a higher power/ nature/ whatever there belief is. I think as a parish nurse your patients automatically assume you are religious and observe the same traditions, making it easier for them to include you.

I am a spiritual person and Jewish. A lot of patients / families struggle with their faith when they face serious illness/ death and want re-assurance. While I am comfortable in my own spirituality and of course within my own religion, I would not feel very comfortable saying a prayer specifically addressing the needs of a Christian. But I do not mind to get the chaplain or provide other spiritual care.

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86 Likes; 5 Followers; 86 Articles; 145,844 Visitors; 378 Posts

As a nurse working in palliative care and also addressing patient's needs at the end of life (when death is more imminent) I agree that any nurse can address spiritual needs if they come up and the nurse is comfortable doing so.

It does seem that religion or spirituality is more involved when a person struggles and/ or transitions in life. Chronic or serious illness, nearing death, perhaps also giving birth or going through a surgery / procedure can invoke a greater need to call on a higher power or to feel connected with a higher power/ nature/ whatever there belief is. I think as a parish nurse your patients automatically assume you are religious and observe the same traditions, making it easier for them to include you.

I am a spiritual person and Jewish. A lot of patients / families struggle with their faith when they face serious illness/ death and want re-assurance. While I am comfortable in my own spirituality and of course within my own religion, I would not feel very comfortable saying a prayer specifically addressing the needs of a Christian. But I do not mind to get the chaplain or provide other spiritual care.

Yes, I agree that being a parish nurse certainly makes it easier. Offering spiritual care is challenging and you put it very well. You seem very caring and that makes a big difference right up front. Thank you for sharing your perspective. Joy

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Nice, but impractical for corrections or psych nursing where that kind of stuff is more about manipulation. I refer those folks to the chaplain.

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