You are obtaining a health assessment on a patient and you ask them about their spiritual needs. The patient states that he does not want to answer any questions like that because they are private.
Like many nurses, perhaps you’re uncomfortable with the notion
of providing spiritual care. You might feel like the intensive-care
nurse who said, “When a patient brings up a spiritual need, the
only thing I know to do is call the chaplain. I worry that I’ll say
the wrong thing.”
Every person has a spiritual nature. The spirit is part of and
affects every aspect of the whole person, so its care should
concern all nurses. Spiritual distress can be as agonizing as
physical pain, and unfulfilled spiritual needs can hinder a
patient’s progress. By providing interventions that relieve
spiritual distress, you can help free the patient’s energy for
physical, emotional, and social healing.
Don’t assume you have to be religious to give spiritual care.
Although some patients have formal religious beliefs, many seek
meaning in other ways. Spiritual interventions don’t have to be
difficult or intimidating. By applying some key concepts, you can
become more comfortable with effective spiritual interventions.
Respond to spiritual needs as they arise
A patient with a spiritual concern might not want to wait for an
appointment with a chaplain, so be ready to recognize and respond
to spiritual concerns as they arise. You can provide spiritual care
at virtually any place or time—for instance, you can discuss
spiritual matters while ambulating the patient.
Nine simple spiritual interventions
You can meet many spiritual needs through simple interventions. One
nurse colleague, whom I’ll call Julia, found this out when she was
hospitalized with a difficult pregnancy. Afterward, she told me,
“My understanding of what we as nurses do to give spiritual care
changed. The simplest things made an enormous difference to
me.”
The nine simple interventions below will help you care for your
patients’ spiritual needs.
1 Be there
Your mere presence is meaningful when you intentionally focus on
the patient. You don’t even have to say anything; you can connect
with the patient by being silent and trying to understand what he
or she is experiencing. Concentrate on valuing, accepting, and
empathizing. By giving your time in silent companionship and
establishing an atmosphere of empathy and serenity, you can soothe
deep spiritual pain.
2 Listen actively
Encourage the patient to talk by affirming what he or she says,
asking open-ended questions, and offering reflective comments. When
a patient expresses a spiritual concern, acknowledge this by
saying, “That sounds troubling. Help me understand what you mean.”
Maintain a matter-of-fact manner.
Reflect your understanding of the patient’s concerns by stating,
“It sounds like you’re thinking a lot about what lies ahead.” On
the day Julia realized she was facing 16 weeks of hospitalized bed
rest, one nurse “took the time to listen to all my fears. She told
me she didn’t have the answers to my questions, but she helped me
remember my faith and think about how to leave my fears in God’s
hands.”
Listening to patients doesn’t require much response on your part.
Simply encouraging the patient to talk may be an effective
spiritual intervention.
3 Use touch
Gentle touch is reassuring and comforting. When you touch your
patient, you provide comfort, warmth, and connection. But first
make sure the patient is open to physical touch. Ask, “Do you mind
if I take your hand?”
Besides holding the patient’s hand, you might touch the arm or
place your hand on the shoulder to show concern and caring. Even
the touch you provide when performing a procedure can be a
spiritual intervention if you intentionally focus on the patient
and think about conveying comfort through your touch.
4 Reflect and remember
Help your patient think about previous experiences. Ask “What types
of things have comforted you in past situations like this?” Help
the patient remember the support he or she has received in the past
from family, friends, or spiritual beliefs.5 Laugh
In a 2007 study of 100 hospice patients, every patient listed
laughter as a spiritual need. During Julia’s hospitalization, she
had “a fun-loving, cheerful nurse who came in and talked about
things other than my condition. She engaged my family and me in
planning a party in my room. She made the days go by fast.” This
nurse met a spiritual need by creating happy experiences.
6 Share the experience
Join the patient in questioning the meaning and difficulties of
life. Acknowledge that much about life’s purpose and why people
suffer is beyond your understanding. As you explore such issues
together, follow the patient’s lead. Learn to be comfortable with
the patient’s tears and accept crying and other emotional
expressions (including your own) calmly.
7 Pray or encourage the patient to pray
Prayer is one of the spiritual interventions patients request most
often. It helps us connect with the spiritual dimension. If your
patient asks you to pray, adapt your prayer to the patient’s
beliefs and needs. Ask “What would you like me to pray for?” Use
everyday language, and keep your prayer simple and short. Pray for
the patient’s concerns. If you don’t believe in prayer or for some
other reason don’t wish to pray with the patient, ask a coworker to
do
What not to do
When providing spiritual care, be careful not to inflict additional
suffering. Follow these guidelines:
• Don’t try to be something you’re not or to know something you
don’t.
• Don’t give empty reassurances, such as “Everything will be all
right.” You don’t know if everything will be all right.
• Don’t debate religion or try to impose your own religious or
spiritual views on the patient.
• Don’t try to “fix” your patient’s spiritual problems or answer
unanswerable questions. It’s fine to explore difficult questions
with the patient. But if you offer pat answers, you’ll only
belittle the patient’s concerns and may increase feelings of
isolation.
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