In the deep south, spirituality and religion are terms frequently used interchangeably. There are overlapping characteristics in both religion and spirituality, but they are defined differently. In order to provide spiritually competent care, it is important to understand your own views, as well as, the impact of community culture.
I have worked all my 24-year nursing career in the state of Alabama. According to the Pew Research Center, Alabama is currently ranked as #1 (tied with Mississippi) as the most religious state in the U.S. Religion is a strong thread in the cultural fabric in this state and a key consideration in providing culturally competent nursing care. I considered religion and spirituality as interchangeable throughout many of my nursing years. In 2016, I found myself in spiritual distress eventually- leading to a deeper understanding of spiritually competent nursing care.
In May 2016, I checked into an inpatient facility for treatment of alcoholism. I don’t think anyone enters detox without having to experience a significant degree of negative life consequences- such as loss of job, relationships and sense of self. Through my drinking, I did a great job of isolating myself from all the people, places and things I held most dear. After 10 weeks of inpatient rehabilitation, I realized I also lost my sense of spiritual connectedness. My treatment team would frequently to assess my spiritual condition by questions similar to these:
-Who or what provides you with strength, hope and peace on a daily basis?
-What is helping you through this experience?
-How do you express yourself spiritually?
-What personal spiritual goals do you hope to reach during treatment?
Important note: Our spiritual journey is unique to us- just as our patients’ spiritual journey is unique to them. The intent of this article is not to provide a “right or wrong” path to spirituality because it is different for every individual. To care for an individual in spiritual distress simply requires a nurse to support individuals in their own spiritual growth.
Prior to my spiritual crisis, I had inner laced religion and spirituality. I felt I was competent in supporting another’s spiritual needs but had little self-awareness of my own spirituality. I am certain living in a state where 53% of the population reports affiliation with a specific religion shaped my own perception of spirituality. In order to provide truly competent spiritual nursing care, I had to first understand the differences in religion and spirituality.
The Difference in Religion and Spirituality
Religion and spirituality are not the same, but the two often overlap. Spirituality reflects an interconnectedness with something bigger than ourselves and the search for life’s meaning. Christina Puchalski, MD, Director of the George Washington Institute for Spirituality and Health defines spirituality as “the aspect of humanity that refers to the way individuals seek and express meaning and purpose and the way they experience connectedness to the moment, to self, to others, to nature and to the significant or sacred”. Both religion and spirituality refer to the belief systems and philosophies of people and are often used in similar contexts. Belief in a religion may be very spiritual to an individual. However, an individual may be spiritual without affiliation to an organized religious system.
Characteristics of religion include:
A formal, organized system of beliefs with practices, activities and rituals to facilitate closeness to the sacred or transcendent.
Being a member of a group and following the teachings of others
Interconnectedness linked to church, temple, mosque, synagogue, etc.
Teaching and philosophies often based on the past
Belief in a religion may be very spiritual to a person
Characteristics of Spirituality:
A sense of relationship with believing in a power greater than ourselves
Subjective and individualistic
Spiritualism is a feature of the individual, not the group
About finding one’s own path
Inwardly directed
Less formal and emotionally oriented
Not authoritative
May be spiritual without affiliation with a religion
The Experience of Spiritual Distress
I experienced spiritual distress when I was unable to find sources of meaning, peace, strength and connectedness. I felt as if I was in a deep and dark hole and lost all hope I could get out.
I am now more aware when other individuals are having signs and symptoms of spiritual distress. A person may ask questions about the meaning of life, their belief system or pain and suffering. They may also suffer from feelings of sadness, depression, anxiety, anger and depression. A sense of isolation, emptiness and feeling alone is common with spiritual disconnect.
Meeting Spiritual Needs
It is important to be aware of your own spirituality to support another experiencing spiritual distress. As nurses, we must meet patients “where they are” and not where we think they should be. By projecting our own beliefs and ideas about where the patient should be spiritually, we could potentially inflict more suffering. This can be challenging for healthcare providers in a highly religious state or area. Here are a few guidelines when providing spiritual care:
Don’t assume you know what is best for the patient and do explore what or who can help in reconnecting (meditation, prayer, journaling, art, nature etc.)
Don’t give empty reassurances (“it will be alright”)
Don’t debate religion or impose your own views
Don’t try to “fix” your patient’s spiritual problems or answer “ unanswerable” questions
Actively listen to the patient
Ask “Who or what provides you with strength, hope and peace on a daily basis?
Ask “How do you express yourself spiritually and what is helping you through this experience”.
Do you think nurses fall short of addressing patients spiritual needs? Does the culture in your area impact the spiritual care you provide?
In my first week of school for my doctoral program, we were talking about "other ways of knowing." I divulged that I am a confused agnostic...I truly have no idea what's going on, and mostly just spend my spiritual time fumbling around in the dark looking for the light switch. One of my fellow students asked, in a completely sincere voice, "If you don't believe in God, then how do you know right from wrong? How do you know if you are making good decisions?" I've never met someone so different from myself. She needed the Bible to guide her through her day. I tried to explain that I "just know" but it came out sounding lame. What's your response to that type of question? I'll save it for the next time someone is baffled by my lack of faith.
You can tell that "those people" that the Code of Hammurabi existed hundreds of years before the laws of Moses and his laws are actually predicated on the previous secular code. The only thing he added differently was the mention of a God and added the twist of monotheism. People needed ethics and laws as soon as people started to settle in cities....they didn't have the time to wait for Moses:)
You can tell that "those people" that the Code of Hammurabi existed hundreds of years before the laws of Moses and his laws are actually predicated on the previous secular code. The only thing he added differently was the mention of a God and added the twist of monotheism. People needed ethics and laws as soon as people started to settle in cities....they didn't have the time to wait for Moses:)
Oh, my goodness. Do you mind being my nurse when I am sick? I would love to have your knowledge about religion.
That is an excellent answer to the Christians who question non believers' ethics.
Specializes in Palliative, Onc, Med-Surg, Home Hospice.
On 3/5/2019 at 1:16 AM, vetpharmtech said:
The deep south is full of Southern Baptists, who really believe that non Christians would be burned for eternity if they don't believe in Jesus regardless of how decent they are.
Do you think that a Christian nurse in the deep south can respect a patient's spiritual autonomy without proselytizing to him/her?
Seeing the tension between atheists and Christians, I am cynical about the attitude toward non-Christian patients in the South. I am not even an atheist to have this feeling.
It is refreshing to see a nurse who has more nuances like you do.
You continue to make assumptions about Christians and the south. In the past, people have attempted to tell you that some of your beliefs are not accurate but you continue with your anti-Christian attitude.
I am a pagan. I don't hide that fact (I just don't run around telling everyone that I am). As a patient, it is in my chart that I am pagan. The only person I have ever had issues with wasn't a health care worker. My nurses (most of whom are Christian, a couple I know personally who are very devout) and guess what, the care they have provided for me is top notch. Thy have never prosyletized to me, they have never given me substandard care, even though their religious beliefs differ from mine.
As a matter of fact, most of the Christian I know are live and let live kind of people. Yes, there are some jerks. But there are also non-Christians who are a bit jerky. There are non-Christians who stereotype all Christians. Both sides are wrong if they are doing this.
Bravo. I'm not an atheist, but reason to be moral is similar to Penn Jillette. My religious belief is a booster, not an authority to command me by giving me stick and carrot like Abrahamic religions do. The desire to love and not to hurt is innate.
You continue to make assumptions about Christians and the south. In the past, people have attempted to tell you that some of your beliefs are not accurate but you continue with your anti-Christian attitude.
I am a pagan. I don't hide that fact (I just don't run around telling everyone that I am). As a patient, it is in my chart that I am pagan. The only person I have ever had issues with wasn't a health care worker. My nurses (most of whom are Christian, a couple I know personally who are very devout) and guess what, the care they have provided for me is top notch. Thy have never prosyletized to me, they have never given me substandard care, even though their religious beliefs differ from mine.
As a matter of fact, most of the Christian I know are live and let live kind of people. Yes, there are some jerks. But there are also non-Christians who are a bit jerky. There are non-Christians who stereotype all Christians. Both sides are wrong if they are doing this.
I don't want to derail the topic. However, since you bring up the issue. Take a look at this
Can you believe that Christians actually said this? They praise how the Bible was not burned while 23 people in Alabama were killed by the tornado.
I got upset seeing this in my feed. Where is the sense of humanity in these people?
The shocking thing is that it is the fire department, which is supposed to represent all people, post this article. I cannot believe that people continue to suffer due to natural disaster and this group constantly praise their god for protecting the bible and the cross.
Can you believe that Christians actually said this? They praise how the Bible was not burned while 23 people in Alabama were killed by the tornado.
I got upset seeing this in my feed. Where is the sense of humanity in these people?
The shocking thing is that it is the fire department, which is supposed to represent all people, post this article. I cannot believe that people continue to suffer due to natural disaster and this group constantly praise their god for protecting the bible and the cross.
Meh... I saw this and thought - nothing, there are lots of explanations for it and who knows, it may even be supernatural (although I doubt it). It is the same as the people who have had everything they own destroyed by a hurricane and then thank god for saving them from the hurricane he sent. It does not affect me in any way and makes them happy - we need more happiness in the world (or at least a bit of peace and comfort). If this allows people some peace then who am I to stop them.
The Penn Jillette video I linked to does not explain that humans have been coming together for thousands of years (long before the bible) and if there is no ethical and moral code between them then you cannot do business or work together.
Thank you for the article. I am a Christian but have taken classes (on my own) to be able to provide better spiritual care to those whom I come in contact with. I believe that spiritual care encompasses body, soul, and spirit. It is hard at work r/t time constraints but as much as possible I assess which aspect needs attention and do my best to help as much as possible to bring the three together. I have provided assistance to many people with many different beliefs other than my own. It has never affected my nursing care, or spiritual care, when others' beliefs are different than mine. IMO, we are all human, have the same human needs, and as a nurse/healthcare professional it is not only our job but also a privilege to assist others spiritually (as much as possible). If someone has a belief different than mine and doesn't want to talk to me bc they are more comfortable with "one of their own" (which I have had said to me), no skin off my back, can I call someone for you? I think that sometimes some may feel that Christians try to push their beliefs onto others. Sometimes that may be true but as a whole I don't believe that. I have had people of other beliefs talk to me about their religion/beliefs (Buddhist, Islam etc.) and it doesn't bother me, I simply tell them thank-you but I am a Christian, no harm done. You are right, there is a big difference between spiritually and religion. If we are going to be successful at helping our patients we need to meet them where they are at and assess how (if at all) we can help!
It occurs to me that when we allow others' opinions and beliefs to "upset" us, we're shutting down opportunities (to explore and refine our own beliefs, connect and engage in productive conversations, and develop healthier relationships, etc). We're all entitled to feel our feelings, of course, but how many of us are using our feelings as leverage to better ourselves instead of excuses to stay stuck in old patterns? When I feel my emotions coming up first-thing in response to someone's comment, I try to give myself some space to look at the facts of the situation and put myself in the other person's shoes. This small effort of empathy is pretty much saving me these days from the ravages of chronic stress in the land of social media.
Specializes in Education, Informatics, Patient Safety.
On 3/9/2019 at 10:58 PM, vetpharmtech said:
Bravo. I'm not an atheist, but reason to be moral is similar to Penn Jillette. My religious belief is a booster, not an authority to command me by giving me stick and carrot like Abrahamic religions do. The desire to love and not to hurt is innate.
OP, show that to your questioning classmate.
Thanks so much ya'll, I really appreciate it. I sometimes feel like I'm the only one who isn't a believer. It's nice to get some support.
Thanks so much ya'll, I really appreciate it. I sometimes feel like I'm the only one who isn't a believer. It's nice to get some support.
No problem. I am not an atheist, but I like to be around atheists. Christians, including the ones in health care profession, have too many privileges they don't deserve.
It is wonderful that you stand your ground as an atheist nurse. One of my colleagues is an atheist vet technician, a highly skilled and compassionate professional who cares about everyone around her. It is time for us, non-Christian health care professionals, to push back at Christian physicians, nurses, nurse practitioners, therapists,... and declare affirmative statement "enough is enough. You do not own moral high ground in patient care."
Anyone invoking the term "Christian" that is satisfied that he has successfully captured the ethical/moral, belief and value system of everyone that claims to be a disciple of Jesus of Nazareth is as ignorant as the one who invokes the term "atheist" achieving the same end.
subee, MSN, CRNA
1 Article; 6,140 Posts
You can tell that "those people" that the Code of Hammurabi existed hundreds of years before the laws of Moses and his laws are actually predicated on the previous secular code. The only thing he added differently was the mention of a God and added the twist of monotheism. People needed ethics and laws as soon as people started to settle in cities....they didn't have the time to wait for Moses:)