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

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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 Mental Health, Gerontology, Palliative.
On 9/16/2022 at 10:25 AM, Daisy4RN said:

...I see nothing wrong with asking and nobody should be suspended for doing so as it it part of the job. 

There is a massive power imbalance between nurse and patient. To offer prayer when the person may or may not believe in your god is wrong on every level. Not to mention, what if the person is muslim, hindu, Sikh, Wiccan, Pagan, you going to be able to prayer their prayers with them?

Offering prayer has not been apart of any job I have had. If my patient told me that the nurse in the prior shift offered to pray with them but they felt like they couldnt refuse. The first thing I would be doing is empowering them and if they wanted to complain about the nurses actions, assisting them to do so. if the patient didn't want to make a complaint I would be going to my charge to talk this through with them and making a formal complaint as a nurse. 

 

Specializes in Travel, Home Health, Med-Surg.
On 9/23/2022 at 11:22 PM, Tenebrae said:

There is a massive power imbalance between nurse and patient. To offer prayer when the person may or may not believe in your god is wrong on every level. Not to mention, what if the person is muslim, hindu, Sikh, Wiccan, Pagan, you going to be able to prayer their prayers with them?

Offering prayer has not been apart of any job I have had. If my patient told me that the nurse in the prior shift offered to pray with them but they felt like they couldnt refuse. The first thing I would be doing is empowering them and if they wanted to complain about the nurses actions, assisting them to do so. if the patient didn't want to make a complaint I would be going to my charge to talk this through with them and making a formal complaint as a nurse. 

 

Maybe not in your country but here in the US it is mandated by Joint Commision to perform a spiritual assessment on every pt. If this is done than the nurse knows what religion a pt beliefs/practices. I have never worked a hospital job in 20+ years that did not require this.  Simply asking opens the door for a pt to say yes. no, or offer more info re: their spiritual needs (if any). Also, here in the states patients do not suffer a "massive power imbalance". They in fact have all the power and have zero problems complaining about anything, (and I do mean anything), they certainly don't need help from anyone! Here in the US providing spiritual care is it a part of the job!

Specializes in OR, Nursing Professional Development.
1 minute ago, Daisy4RN said:

Also, here in the states patients do not suffer a "massive power imbalance".

I disagree. While there are those that "have zero problems complaining about anything, (and I do mean anything)" there are also those who do not want to rock the boat and will go along with whatever the health care professional decides. 

It is a requirement to provide a spiritual assessment; it is not a requirement to provide the spiritual care oneself. There are others better suited to that (I.e., chaplain). I can guarantee the vast majority of patients want someone affiliated with their own faith over this dabbling in paganism RN.

Specializes in Travel, Home Health, Med-Surg.
3 hours ago, Rose_Queen said:

I disagree. While there are those that "have zero problems complaining about anything, (and I do mean anything)" there are also those who do not want to rock the boat and will go along with whatever the health care professional decides. 

It is a requirement to provide a spiritual assessment; it is not a requirement to provide the spiritual care oneself. There are others better suited to that (I.e., chaplain). I can guarantee the vast majority of patients want someone affiliated with their own faith over this dabbling in paganism RN.

While I have of course come across a (very) few who do not want to rock the boat a professional nurse can easily distinguish those types of people.  I agree (and have stated many many times on these threads) that no one should be pushing off their own beliefs on patients who do not wish to hear it. I disagree that Chaplains are better suited in all cases, yes definitely some but not all. First they need to be able to speak to people which is not always the case and even then people usually want a clergy of their own faith/belief if possible. Hence the need for assessment/asking! Some nurses are perfectly capable of providing spiritual care and esp if the same religion as the patient and sometimes even if they are not if patient accepts/requests offer. 

 

Specializes in CRNA, Finally retired.
tnbutterfly - Mary said:
Should nurses be allowed to pray with patients?

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.

Do you really believe that nurses are letting their personal beliefs interfere with patient needs?  If a patient wanted to pray, I just put my head down out of respect.  The only problems I've seen with nurses foisting their religious beliefs on patients went the other way;  patients were uncomfortable when evangelicals foisted their views on their patients.  It's not even a Christian thing; it's the belief of the evangelicals that they must prosletyze or get left behind at the pearly gates.

Specializes in Mental Health, Gerontology, Palliative.
Rose_Queen said:

It is a requirement to provide a spiritual assessment; it is not a requirement to provide the spiritual care oneself. There are others better suited to that (I.e., chaplain). I can guarantee the vast majority of patients want someone affiliated with their own faith over this dabbling in paganism RN.

I wonder how happy many of people here would be praying with the satanist patient, or the wiccan, muslim or buddist patient?

My obligation as an RN is about supporting a patient to best get their religous needs met. That has included

- Getting in buddists for a patient who is end of life and has requested it

- multiple phone calls for people who are wanting the chaplain

- phoning specific priests and pastors

- DId have a pagan patient who asked me to call the covens high priest

- And yes, I have quietly stood while patients prayed

There has been the assertion that spiritual care involves praying for patients. IMO comprehensive spiritual and culltural care involves being prepared to work outside of our belief systems to ensure our patients needs are getting met. If you (generic you) won't call in an Iman, Coven high priest etc at the request of the patient, are you really providing comprehensive spiritual and cultural care?