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. Nurses Spirituality Article


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.

Specializes in OB, HH, ADMIN, IC, ED, QI.

"If a resident or family member wants prayer, we find a willing staff person to pray with them.": quote from mlolsonny's reply

While I disagree that (only) in Christian facilities is compassionate praying possible without problems, I do agree with the above. I'd like to add that since there are so many branches of Protestant beliefs, it could be more appropriate to call someone at their church, or one similar in approach. They have many volunteers on lists at every church, to do that. Catholic churches also have that service available. It's wonderful that most hospitals have "spiritual" space designated for this.

Staff time is so limited and job specific, that a staff person who is asked to do that would most likely have to do it on their own time, which is an imposition, even though they might deny that. :redbeathe

Specializes in ICU, Telemetry.

I had a patient multiple times, frequent flyer, COPD/CHF. He was active in his church (Methodist? Presby? don't remember now), and he would often really fight to get dc'd so he could be in Sunday School. He would always tell us that he prayed for all of us every morning when he woke up. Even though I'm catholic, and he was protestant, he'd often ask me to join him in the Lord's Prayer first thing in the morning. If I could, I did. So, keep in mind, he initiated the religious aspects of the nursing care.

One night, I got a call from a friend of mine in ICU. Mr. X was there, and he had taken a sudden turn for the worse and was dying. The family was 2 hrs away, and there was no way they could make it in time, flash edema was just coming out of the guy's mouth like a river. I got there, and he looked at me with this desperate expression in his eyes. I took his hand, placed a hand on his forehead, and told him, "Mr. X, I'm here. Do you want me to pray for you?" He blinked his eyes, and I said the Lord's Prayer. When I said "amen" he never took another breath, and flat lined...he had been waiting for someone to pray over him before he'd let go.

Sometimes, prayer is the last nursing intervention we can provide.

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

nerdtonurse? ...........Thank you for sharing that wonderful testimony of the importance of spiritual care. Religion and religious practices played a very integral part of the spiritual well-being of this man. Because you allowed yourself to take part in his spiritual care on a daily basis, you were able to be there and offer great comfort to him in those last few minutes to allow him to experience a "good death".

Again....thank you for providing such wonderful care! Your patients are lucky to have you.

Specializes in Hospice, Palliative Care, Gero, dementia.

I thought of you, and this thread last night. I was watching (ok, until I fell asleep :D) a lecture from Loma Linda University's Center for Christian Bioethics a lecture presentation by an academic who, if I remember correctly, was also an RN. The lecture was about the role of health care professionals in dealing with patients spiritual distress. She started by giving painful examples, ranging from the person who offers to pray to Jesus to save an atheist who is dying to the RN who who, when asked directly by a patient to pray with them answers very coldly to a physician who ignores a patients questions with spiritual content. (These examples are part of a prior qualitative research study the lecturer did about how HCP deal with spirituality at work)

I'm afraid I didn't catch much more, it was very late when I tuned in, but you might want to check out this center and their offerings -- it seems very much up your alley!

If nothing else, you should check out their website. Some of their material is available as .pdfs and videos.

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

Sounds like that was an interesting lecture.

Thanks for posting the link. They seem to offer quite a few lectures and programs addressing spirituality in health care.

Specializes in ICU, neonatal ICU, emerg..

Spiritual care is undoubtedley a facet of providing holistic care. Religion however always seems to invoke strong emotions of one's own identity in relation to 'God'. As much as i support the practice of being present during prayer if thats what the patient needs, I am cautious about the zeal of the nurse using the opportunity to reinforce her own spirituality in a moment that really is not about her, but about the pt. As long as the patients' need is identified and acted on appropriately, I see no reason for a nurse not to provide spiritual strength. But proselytising is out of place, and more about the nurses need than the patient. More education should be around for new nurses so they understand the rationale for spritual care from a nurse.

Specializes in LTC/ rehab.

I think prayer is a great thing to share with a family. I work in the middle of mormon country and am constantly asked to praticipate in blessing residents. I currently don't hold that authority in my church but generally most of our male staff are able to praticipate. It is so great i think for us to participate because it shows that familys that we are involved and we truly care about the residents.

It is ONLY OK if the patient requests it. Otherwise, NO.

Specializes in Gerontological, cardiac, med-surg, peds.

This is excellent: The Meaning of Life


The report describes a recent incident in which a per diem nurse at Cape Cod Hospital upset a patient's family by discussing "repentance" with the dying patient in a way that allegedly distressed the patient. "Spiritual talk by nurses spurs soul-searching" explores the nature of that incident through quotes from the nurse and others involved, but it also sets the issues in context by consulting a local nurse expert: Kathleen Geagan Ryan, a hospice nurse and ordained interfaith minister. Ryan explains that nurses can provide spiritual counseling by listening and letting patients take the lead, and being sure not to do anything that could be interpreted as imposing their own beliefs, a sensitive thing given the unequal power between nurse and patient...

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

Thanks for this link, Vicky. An excellent article.

Some other quotes from the article:

"Nurses who talk about God and spirituality with their patients can walk a fine line between comforting the ill and stepping on theological toes."
But it's not hard to see how this situation--which is common with dying patients who want to discuss sensitive "Big Picture issues" like "God and the afterlife" at a very difficult time--could present a great challenge.
You cannot impose your belief in any way. My mantra is to listen and let the patient lead. ... It's not an equal relationship. If you have an agenda, patients pick up on that. I call it the truth serum of the dying person. They just see through anything.
Good practice would seem to vary depending on the patient and the situation, and the piece might have explored just what practical training nurses get in handling these daunting situations, and whether more or different training would make sense to help nurses handle hard questions. What if the patient asks, "Am I going to hell?" Perhaps the nurse could consider the type of response often ascribed to therapists: "What do you think?" But what if the patient asked, "What do you believe about God?" A question in response does not seem adequate there. Would any honest description of the nurse's own beliefs amount to imposing them? Should the nurse simply decline to describe his own beliefs, even if that distresses the patient? Or could the nurse describe his beliefs, so long as he was careful to stress that he was not suggesting the patient should share them, but instead explore her own? At times, the divide between helping the patient explore her spirituality and offering her spiritual guidance may dissolve in practical application.
Specializes in Peds, Med-Surg, Disaster Nsg, Parish Nsg.

Just want to give an update on the incident that prompted me to start this discussion.... Nurse Caroline Petrie was suspended after offering to pray for the recovery of an elderly patient. A follow-up article was written in June, however I just now read it.

The article is entitled Let Doctors Pray for Patients, BMA to Hear

Here are some excerpts from this article.

Doctors' attempts to discuss spiritual affairs with patients or to offer prayers for them should not trigger NHS disciplinary action, the British Medical Association will be told this week.
Most of the BMA motions effectively support that position (that she could continue to pray for patients as long as she asked them first if they had any spiritual needs), but insist spiritual discussions should not be grounds for disciplinary intervention by NHS managers.
"Offering to pray for a patient should not be grounds for suspension." Spiritual matters should be raised, it suggests, "with respect for the views and sensitivities of individuals".
The GMC guidance is the one preferred in most of the motions before the BMA conference. It urges the department "to exercise some joined-up thinking so that while always respecting the views and sensitivities of others, there should be freedom of speech to have appropriate consensual discussions of spiritual matters within the NHS".

Here is another related article...Doctors Demand Right to Pray

Graham Spencer, a retired medical scientist who worked at Bristol's Frenchay Hospital, supported Mrs Petrie's case at the time and is in favour of the idea. "I can think of the time in Bristol when there was an [service] every evening from the hospital chapel, conducted by a nurse for five minutes," he says.
Dr Stephen Blair, a member of the British Medical Association's Consultants Committee, says: "What we want to do is to reinstate exactly what has been everybody's practice for many years.

"That is to care for people physically, spiritually, emotionally and mentally."

Specializes in psych nursing/certified Parish Nurse.

Hi, Since I can't address hospital nursing at this point--not being there, I offer some reflections:

Perhaps we forget the role of the nurse is "total assessment"; and includes the appropriate spiritual nursing diagnoses, too. So many are "fearful' due to institutional bias, not understanding their own issues for many reasons--or able to deal with them--much less those in others, and the list goes on and on. With the modern concepts of Western medicine (realize, it has actually only been around for about one hundred and fifty years) excluding the spiritual dimension of humanity-hard-wired into our psyches (yes, even for the "atheist"--another topic for another day)... and also well-knowing the sensitivities of those "hurt" by "organized religion" (bless you very much--all of you; I tried to address this on another blog site--knowing how horrendously awful it is to be "persecuted" by the very ones who are supposed to be ministering... yet challenging these hurt ones to "go beyond the hurt" because it is only hurting themselves--not others). I also am well aware God put us all in the faith traditions He wanted us in--or we wouldn't be there. Jesus' words? "In my house are many mansions." I have a strong respect for the personal journey in life--yet, it would be unfair of me not to challenge (here I use that word not in an aggressive way) thoughts/beliefs that lead to personal disintegration of one sort or another (I am a Catholic educator as well--although my knowledge of many other faith traditions is alive and kicking, too)... without the intent of "proselytizing" (for it is always presented as "possibilities") but for further reflection--we each really ARE responsible for each other's welfare... not to "take over"--but to offer possibilities not before entertained. The final choice ALWAYS must rest with the individual--with respect for each other intact. Many times this comes in form of "exploration and debate" with people--a spiritual AND intellectual tool (for both people).

"Hurt" in this process would come out of artificial boundaries of finding lack of time to adequately explore the issues on both sides... or interference from outside sources that were not overcome... or the "other" running before the process was completed (after all, these issues ARE both challenging and sometimes scary)... having had these experiences many times--I, too, feel great sorrow when misunderstandings and misinterpretations occur--I am a person who cares deeply--and do not want to offend. But they just do. Each of us has many things to learn about "forgiveness" and surrender to those things out of our control--as well as taking responsibility for any of our own flaws.

Intellectual and deep spiritual conversations/debate are rare in this country/world. There seems instead to be either flight from it (for fear of offending?), or else so much "heat" no one wants to "take it on." I'm empathetic with these--but we are truly much lessened because of it. I value most highly those friends of mine who "plunge right in" loyally standing-by the next day after one of the heated discussions. That, indeed, is real human respect.