Why Is Spiritual Care Important For Nurses
I work with nurses. They’re one of the most industrious people I know. They’re also some of the most caring individuals I’ve met. As I watch them care for their patients day in and night out, I notice they get into deep conversations while replacing an IV or replacing the bedding.
It’s made me wonder, with all that’s on their plate, “why is spiritual care important for nurses?”
They have to deal with doctors and politics, urine and bowel movements, blood and bathing. Why is it important for a nurse to consider the spirituality of their patients, too?
So, why is spiritual care important for nurses? Spiritual Care is important for nurses because addressing the spiritual needs of the person has positive effects on the their stress response, interpersonal relationships, spiritual well-being. Nurse’s who access Spiritual Care for their clients also experience reduced moral distress.
Nurses and Spirituality go hand in hand, but what are the problems that patient’s face spiritually? What might be some examples of nursing spiritual care? Keep reading to see.
Three major spiritual problems occur when you are hospitalized. Nurses play a big role in them.
Hopelessness
When a person enters the hospital environment, they’re disconnected from their known world. Ambiguity and the unknown reign in these first few hours. “Why am I here? What do I have? Will I be ok?” Sometimes I’ve met patients who were just plain desperate – Desperate to find answers and desperate to get healthy so they could go back home.
For a time I visited dialysis patients. For them they usually have to spend 4 hours, 3-4 days a week in the hospital. In between those hospital visits, they spend their days in bed at home trying to recover. One patient I met said,
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I’ve been on dialysis for the last 15 years. I’m 50 years old and this has consumed my life. What’s the point of living like this? I live either in the hospital or in my bed. My life is hopeless.”
Patient Sally (fictitious name)
Without hope, people in their hospital stay struggle to continue in life. They express negative feelings, even suicide. Hope for life is a significant need.
Isolation and Disconnection
Our hospital system is about isolating the disease or problem in order to fix it. Often that means the person gets isolated. When you enter the hospital you feel like you’ve lost your role. Unlike staying at a hotel, you’re disconnected from friends and family beyond your choice.
You’re given a number, placed in a gown, and packed together with other “patients” who have God only know what’s going on with them. Likely, your risk of infection and getting sicker is all the higher.
Nurses have a powerful role with patients. First, they’re humans. People need human to human contact, especially in an environment of detachment, isolation, and observation. They need social connection. Perhaps the strongest asset the nurse can offer is sympathy or empathy.
The most serious problems relationally are the communication gaps that can exist between nurses and patients. Most of the information to the hospital, their diagnosis, when they will be discharged all come from the nurse or the doctor.
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nobody tells me anything. I’m just sitting here all day. One person (social worker) tells me I’m going home on a Tuesday, the next day the doctor wants to run more tests. What the hell is going on here? I’ve got to get back to my kids. I just want my life back.”
Patient Rick (fictitious name)
As my nurse friend Elaine says, “we are the beholders of knowledge.” Nurses are a kind of bridge between the unknown world of sickness and medical culture to the human being laying in that bed. When the relational connection is severed, it’s nurses who can help weave it back together.
As my nurse friend Elaine says, “we are the beholders of knowledge.” Nurses are a kind of bridge between the unknown world of sickness and medical culture to the human being laying in that bed. When the relational connection is severed, it’s nurses who can help weave it back together.
Broken Religious Practices
Another common problem people face when hospitalized is performing religious practices. Often these practices are obligatory for adults and if they can’t do it, then they get anxious. In most cases that I’ve seen, practicing a religious rite or ritual actually reduces their anxiety and helps them cope better.
When religious or spiritual patients struggle with the unknown they rely on the rhythm of holy days, dietary restrictions, fasts, prayers at a certain time of day, holy spaces, prayer beads, sacred texts, visits from their faith community and so on.
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I need to pray to the east on my mat, but I can’t because they are still trying to diagnosis what I have. Without my prayers, I’m lost.
A Muslim patient
Nurses have an important and vital role in offering brief spiritual interventions. By addressing hopelessness, isolation, and broken rituals, nurses can greatly improve the spiritual health of the patient.
Nurses can offer two types of spiritual care when facing the above problems. One is religious spiritual care and the other is non-religious spiritual care.
Religious-Spiritual Interventions
What might be some religious spiritual care interventions a nurse can offer? First, they can treat their religious beliefs without prejudice by checking in with the ways the person connects with the divine. This would include calling the local Spiritual Care Practitioner as early as possible to ensure that the spiritual needs of the client are being met at an early stage.
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Sometimes it’s so boring sitting in that bed all day, I just want a Bible to read or go to the sacred space. Where is the sacred space here? I wish someone from my church would visit me.
A Baptist Patient
In some healthcare settings, the Spiritual Care Practitioner is not available and the patient will need to administer the religious practices of the client. This is where being sensitive to the three problems (hope, isolation, practices) listed above can do wonders for a client.
From the two times, my wife went to the hospital for the delivery of our children, it meant the world to us when the nurse found a CD player so we could play our Christian music. We were scared both times as the delivery of our children took some unexpected twists and turns (1st child took 53 hours to deliver and the second child was an unexpected c-section – even to the amazement of the doula and midwife. Sometimes you can’t predict the outcome, even when the signs are good leading up to the moment).
Non-Religious Spiritual Interventions
But not everyone identifies as religious. How can nurses provide non-religious spiritual care to their clients?
The first one is Presence.
Just attending to their needs provides a human to human contact and subverts the systemic issues involved while working within healthcare. Systems like the hospital or government are naturally predisposed to dehumanization. That’s why they need people to run them.
It gave my wife assurance and peace when the nurse was consistently attentive to our needs. In fact, given the crisis we felt, there were times the nurse seemed more like an angel than a human.
When in crisis or uncertainty, everyone who helps you becomes a savior amidst your insecure footing. The fact she was just there in the room with us made all the difference.
Part of this presence is direct eye-contact. Eyes are the windows to the soul. I know that there’s a lot on the mind of a nurse, but making that direct connection says “You are not just a patient but a human being.” It challenges the dehumanizing system that healthcare can be.
The second piece to a nurse’s presence is sympathizing with patients and their families. Sympathy is more of a mental understanding while empathy is more of a heartfelt relating. When a nurse has sympathy for the patient’s situation, they can better appropriate and plan out the right interventions for them including discharge planning.
Third, listening attentively and having love and enthusiasm for patients. 1
Every nurse I’ve talked to have days or weeks of working with a patient that is ungrateful, angry, and sometimes abusive. They wrestle with how to stay professional in that circumstance while also protecting themselves from emotional and physical abuse. The best nurses recognize that most often it has nothing to do with them. They have to bear the blunt of all the patient’s displacement of anger and the unknown on to them.
But a good question for nurses is ‘have you lost the love and enthusiasm that brought you to this calling in the first place? Where can you find it again?
Spiritual Care offers many benefits, especially when a nurse offers it at a brief intervention level. As one study stated:
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Spiritual care has positive effects on individuals’ stress responses, spiritual well-being (ie, the balance between physical, psychosocial, and spiritual aspects of self), sense of integrity and excellence, and interpersonal relationships 2
Studies show that assisting someone in their religious coping can reduce anxiety, foster better intimacy, enhance a sense of purpose and meaning in life, and foster personal growth and control. 3
Mindful meditation practice reduces anxiety in the long term 4
Nurses who meditate or prayer in their personal life will likely foster greater professional health on the wards. Having a meditative presence from the caregiver can reduce physical problems considerably, especially anxiety 5
As amazing the nurses can be at times, every caregiver knows deep down that the ultimate healer is not so much the doctor or the nurse, but ourselves.
> “Determination on the part of the patient, not the physician, is what makes healing and joy possible.”
Paul Pearsall
Or as someone wise once said…
> “It is you who must make the effort. The masters only point the way.”
The Buddha
Reduced Moral Distress and a Sense of Well-Being Among Nurses
As a Spiritual Health practitioner, one of the most common responses I hear from a nurse is
> “Thank you for visiting my patient. I knew they needed to talk with someone and really spend the time, but I have five patient’s today and I need to focus on their medications.”
Nurse Jill
Nurses experience moral distress in a lot of ways. Moral distress is when you know what’s right but are constrained to fulfill it. For the nurse, being able to listen actively and provide that emotional support is what they feel is needed but they can’t because of the administration needed.
Addressing the moral distress of the nurse by contacting Spiritual Care is a great way to reduce the risk of caregiver fatigue and burnout. 6
Related Questions
What is Spiritual Care?
Spiritual Care is a counseling service that addresses three domains of human experience amidst crisis or illness: the existential, emotional and transcendent related issues of suffering. Spiritual care is something that every person can offer, but is mainly provided by trained Spiritual Health Practitioners. By caring for whole person, body, mind and spirit, we can improve the quality of life for each person.
What is the definition of spirituality in the nursing profession?
According to the Canadian Nurses Association (CNA) spirituality is “whatever or whoever gives ultimate meaning and purpose in one’s life, that invites particular ways of being in the world in relation to others, oneself and the universe.” They also include themes such as meaning, purpose hope faith existentialism, transcendence, sense of peace and connected-ness among others. 7
Notes:
1. Nurses’ provision of spiritual care in the emergency setting–an Irish perspective. McBrien B International Emergency Nursing. 2010 Jul; 18(3):119-26. ↩
2. Spiritual care activities of nurses using Nursing Interventions Classification (NIC) labels.Cavendish R, Konecny L, Mitzeliotis C, Russo D, Luise B, Lanza M, Medefindt J, Bajo MA, International Journal Nursing Terminology Classif. 2003 Oct-Dec; 14(4): ↩
3. K.I. Pargament, The Psychology of Religion and Coping: Theory, Research and Practice (New York: Guilford Press, 1997) ↩
4.
J. Kabat-Zinn et al., “Effectiveness of a Meditation-Based Stress Reduction Programing the Treatment of Anxiety Disorders,” American Journal of Psychiatry 149 (1992): ↩ . J.J. Miller, K. Fletcher, and J. Kabat-Zinn, “Three-Year Follow-Up and Clinical Implications of a Mindfulness-Based Stress Reduction Intervention in the Treatment of Anxiety Disorders,” General Hospital Psychiatry 17 (1995): ↩
6. Nurses’ provision of spiritual care in the emergency setting–an Irish perspective. McBrien B International Emergency Nursing. 2010 Jul; 18(3):119-26. ↩
7. World Health Organization Quality of Life Spirituality, Religiousness and Personal Beliefs Group [WHOQOL SRPB Group], 2005; Wright, 2005) ↩