The Nurse's Role in Providing Spiritual Care - Is It OK to Pray?

There has been recent discussion in one of the allnurses threads about a nurse in the UK who was placed on suspension for offering to pray with a patient. In this instance, the nurse only offered to pray. She reportedly did not follow through with prayer when the patient declined her offer. In this instance, we only know what was written. We can only guess what the entire story might be.

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The Nurse's Role in Providing Spiritual Care - Is It OK to Pray?

This brought up much discussion about whether or not offering prayer falls within the scope of the nurse while providing spiritual care.

Is it appropriate for nurses or doctors to pray with patients?

Should a nurse ever offer to pray with a patient without a specific request from the patient or the family? How can a nurse appropriately provide spiritual care? or should that aspect of care be left to the chaplain?

In the United States, Joint Commission on Accreditation of Healthcare Organizations (JCAHP) 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. At the same time, they may be concerned about the appropriateness of such activities, as well as have questions on how to proceed. 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.

It is not appropriate to pray aloud with/for every patient without patient request. Depending on the situation and the relationship the nurse has established with the patient, it may be appropriate to offer prayer. However, it is important to be attuned to the patient's already established spirituality. The clinical setting is not the place for proselytising, nor does the health care professional role properly include such activity.

When a patient is faced with a health crisis, he or she may seek spiritual nourishment, even if this has not been a typical part of the person's day-to-day life. Patients who are members of a particular faith tradition, and those who are not, may want prayer or other forms of spiritual activities to be part of the care they receive from health care professionals. Or they may not. Either way, health care professionals who want to provide spiritually nurturing and ethically sensitive care need to think carefully about the place of spiritual care in professional service.

Chaplains should not be the only providers of spiritual care for patients and their families. Much of the spiritual and religious support comes from other people, including parish nurses, clergy, family and friends of patients, volunteers representing different faith communities or congregations, and others. 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.

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tnbutterfly - Mary

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Specializes in Geri, psych, TCU, neuro--AKA LTC.

I very frequently give thanks that I work in a christian facility with christian leadership. This has NEVER been an issue for us. If a resident or family member wants prayer, we find a willing staff person to pray with them. We have at times used prayer as a care plan intervention. It can be as simple and non-denominational as "Merciful God, we know that you have your hand on ___'s shoulder. Please show her that you are near, calm her fears, and give her a peaceful night's rest. Amen."

Keep in mind that I'm in a small rural facility that was started Seventh-Day Adventist in the 60s (think no coffee, no pork, no alcohol, etc.) The facility has liberalized, but our residents for the most part haven't. I have no hesitation in asking a resident or family member if there is a pastor I can call....

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Specializes in Community, OB, Nursery.

Thanks for this, tn. I find that we as a society sometimes go overboard in political correctness and in the process ignore people's very real spiritual needs. Just because someone does not believe in [insert your belief here] does not mean that they don't have needs to be addressed.

I find it entirely appropriate to offer prayer to my patients. Not everybody, not every day, but every now and then there comes a patient with which I have a bond, and they demonstrate a need, so I offer. I have never been turned down nor complained about. I do not force myself on anyone but I do let them know that I'm available, or if they want a chaplain/their own clergy, we can arrange that too.

One of the more meaningful experiences I've had was when a patient and her husband - who were Byzantine Catholics - had their priest come and bless their new daughter. I happened to walk in while he was there, and he offered to bless me. I figured it couldn't hurt so I said sure. He sprinkled holy water on my head, said a prayer, and the family chimed in too. It was REALLY cool. I'm not Catholic, but it meant so much to me that the family included me in their faith.

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Specializes in Family Practice, Mental Health.
On 2/9/2009 at 7:20 PM, mlolsonny said:

I very frequently give thanks that I work in a christian facility with christian leadership. This has NEVER been an issue for us. If a resident or family member wants prayer, we find a willing staff person to pray with them. We have at times used prayer as a care plan intervention. It can be as simple and non-denominational as "Merciful God, we know that you have your hand on ___'s shoulder. Please show her that you are near, calm her fears, and give her a peaceful night's rest. Amen."

Keep in mind that I'm in a small rural facility that was started Seventh-Day Adventist in the 60s (think no coffee, no pork, no alcohol, etc.) The facility has liberalized, but our residents for the most part haven't. I have no hesitation in asking a resident or family member if there is a pastor I can call....

Good job mlolsonny.

I went to a nursing school in which we were required to take classes every quarter on religion and spirituality. We were taught about all the different type of religions out there, and what each faith would most likely be seeking if they were to ask for spiritual care. We had to write a report and listen to others in the class give reports on how each religion expected to be treated when they were in the hospital. It was a very exhaustive report, but it was very eye opening as well. Truly "Holistic nursing".

I find it absolutely appalling!!!! That someone would lose their job (in a profession such as ours that involves us so intimately with a person), over the mere act of offering to pray with someone. It would have been different if the nurse had started acting in such a way that the patient felt that the nurse was praying for her anyway, but this nurse did not.

Personally, I would have done the same thing.

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Specializes in Peds, Med-Surg, Disaster Nsg, Parish Nsg.

Thanks for your comments mlolsonny, Elvis, and Planeflyer. I hope others will feel free to post their experiences with providing spiritual care. This blog can be a good place for us to learn from each other about this often overlooked but important aspect of patient care.

I too feel very blessed that not only do I live in the bible belt and work in a hospital that strongly supports spiritual care, but it is also my job as a Parish Nurse to be called upon on a daily basis to provide spiritual support to those in the hospital, nursing home, assisted living, and home environment. I consider it a privilege to be able to help these individuals in this way during their time of crisis.

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I work ICU and on occasion people are in need we offer to get them a "pastor, rabbi or priest" chaplain etc. While I have never offered to pray for a patient, I have had a few patients or family ask me to pray for the patient. I always comply with their wishes. It is

a part of our job. I have co-workers who are not comfortable with these things, but families don't usually approach them about these things, other than to request a chaplain.

Unless the RN is interfering with the hospital process, there is no reason to terminate just for offering to pray.

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I must disagree. It's generally not OK to pray with patients. This is what Chaplains are for. While it may be OK to be silently present with a pt who is praying, if they request that, it can in some circumstances be an abuse of power to offer to pray with a patient.

In my hospital, this kind of behaviour was occurring regularly, with nurses offering to pray with pts who had made no such request from them, and with several nurses informing pts that "bad spirits" were in their rooms or inside them and that they must pray to help get rid of them. This is medieval and very destructive. The nurses who were doing this sort of thing also were known to tell our (mentally ill) pts that all they needed was the Bible, and that if they were really good Christians they would not be so ill.

Contrary to what these nurses believed, nurses are not employed to try to recruit souls but to provide care. I might strongly believe that socialism would improve everyone's lives, but it would be highly inappropriate for me to go about spouting Karl Marx.

I guess it all comes down to staying on the fine line on the correct side of what the pt wants, rather than straying into the murky waters of what a strongly believing nurse may feel the pt needs.

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Specializes in Cardiac/Med Surg.

Well here is my experience. I had a patient who was quite ill on a cardiac floor and one night he really felt like he was not going to get discharged. He was scared and asked me to pray with him. I am Jewish, he is Christian. All I did was hold his hand and several weeks later my nurse manager said to me that Mr So and So (who was also an employee) had come up to thank everyone and said that it meant so much to him that I prayed with him, She was smiling said I went well out of my comfort range but it meant the world to him..made me feel good and I saw him the next week and got a big hug and he reiterated the same............didn't hurt me to do what I did and brought him comfort...BUT I would never ask a patient of any religion if they wanted to pray...

Another example is that the chaplain was making rounds and a patient was in the bathroom, the PCA took it upon herself to ask the patient if she wanted the chaplain to come back to pray with her and the patient was very upset that the pca approached her...asked me if she was dying.........I calmed her down and when the pca told me the patient wasn't nice to her when she suggested what she did, I thought about it and told her I would probably of been upset also. The patient was Jewish and if requested spirtual help or whatever a rabbi would of come by...

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I find this really interesting as I am a pastor and a nurse. I think most nurses should steer clear of offering spiritual care, but we certainly need to be aware and make space for the spirituality of our patient.

As a Christian pastor I would not offer my input to a muslim patient, but I would certainly make space for him to express his faith and have input from their ministers.

This means a tension exists between what I belief is truth and what other people believe. I agree that a health setting is not the place for prosletising too, but if a patient asked me about my faith I think it overides what I do as a nurse. Although great care is needed here. I work in the UK where any expression of Christian faith is frowned up!

I would like to write a paper on how non spiritual nurses and even some spiritual ones should maybe not express spiritual care for a patient. Just as we work and train for years to be an RN and then use our skills there is proper training, but also understanding needed to express spirituality in relation to others. I would not dream of undertaking venepuncture without the proper knowledge, should the case not be the same for our patient's spiritual care? Again, here we have another problem! Spirituality is more than knowledge, as it comes out of experience. For me, if I did not know God and he know me, I would not be safe to undertake spiritual care.

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If you are comfortable with the patient's faith/religion, no good reason not to pray with/for them. I, personally, don't know about Wicca, Hinduism, Buddism, Islam, nor could I do a rosary. If I didn't know about them, I would try to contact someone of the faith. I have worked with all those before. Only real problem I can think of was when I made a comment that showed I was religious and an athiest husband jumped all over me.:angryfire I would steer clear of debates.

If the patient/family want to pray and you are in the room, there should be no reason not to participate, especially if you are asked.

If I notice that is what is happening, I will either stand quietly until they are through, or quietly do only what is necessary and slip out so I don't disrupt.

I have walked into a room and found the Muslims on their prayer rugs:bowingpur, Catholics with prayer cards :icon_roll and rosaries (the patron saint of Labor and Delivery is a man! Who would have thought it??), Pentacostals having a "Praise Jesus!" meetings:yeah:, and other Protestant denominations having simple prayers at the bedside.:mad: It has made me more accessable when I also participate or show respect.

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I must disagree. It's generally not ok to pray with patients.

Huh?

Sorry I really disagree!

The whole thing of being a nurse is to care for the whole person. That means every part of them. It is not up to me to cut out their spirit or religion away from them, that is part of what makes up their whole, and respecting their whole will lead to a better outcome. That means Buddhist, catholic, baptist, or whatever. And all you have to do if asked is hold their hand, close your eyes, and a silent moment given up for their sakes. Myself, I would prefer to go get their preferred preacher/teacher/ whatever, but if my patient would feel better in anyway, I will take that moment with them or their family.

The only ones that usually resent that would be....... Well I won't go there, cause it's not like you have to say or think anything when you close your eyes.

And btw read the report that patients that are prayed for regardless if they know it or not, get better faster.

Now as far as evil spirits in the room. Wow, I've been a nurse for 25 yrs in all kinds of facilities and never even heard a rumor like that. And I'm american Indian who practiced on reservations where those things can be easily thought of.

Now before you misunderstand, don't think I into religion or a bible thumper, or even an Indian shaman (choke,,,not even an Indian word)!.

Matter of fact I am not into any religion, but respectful of all! I have my own belief and spirituality, and in my own way do not generally agree with organized religion.

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Specializes in Geri, psych, TCU, neuro--AKA LTC.

In one of my nursing classes, it was presented that if a patient asks for prayer, we should all know a very "generic" prayer that wouldn't be offensive to any faith. Although I am a practicing evangelical, it isn't my place as a nurse to evangelize, but to minister to all the broken people with whom I work (Patients, family, AND staff).

It has been a very rare occasion that I have offered prayer, but when asked, I do my best not to offend.

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