Ch16 spirituality

JUDITH M. WILKINSON LESLIE S. TREASKAREN BARNETT MABLE H. SMITH

FUNDAMENTALS OFFUNDAMENTALS OFNURSINGNURSING

Chapter 16: Chapter 16: SpiritualitySpirituality

History of Spirituality in Nursing

• Pre-Christian era• Early Christian era• Post-Reformation• Mid-20th century

What Is Religion?

• A “map” that outlines essential beliefs, values, and codes of conduct into a manner of living.

• Many of the world’s religions hold common beliefs.

What Is Spirituality?

• A “journey” that takes place over time and involves the accumulation of life experiences and understanding.

• An attempt to find meaning, value, and purpose in life.

ClickerCheck

The nurse notes on the admission form that the client has indicated “no religious preference.” He understands that the client:

a.Does not follow the tenets of a specific faithb.Is in denial about his religious beliefsc.Does not believe in God or a “higher power”d.Will not want to pray or visit with the chaplain

ClickerCheck (cont’d)

Correct answer: A

Even though the client may not follow the rituals and customs ascribed to a certain religion, there are no data to suggest that the client does not believe in God or that he would not want to pray with the chaplain.

Core Issues of Spirituality

• Faith• Hope• Love

Core Issues of Spirituality (cont’d)

Cures, Miracles, and Spiritual Healing•A miracle is anything that allows for the presence of the transcendent.•A miracle does not necessarily involve cure.•Miracles commonly proceed according to natural law.•Miracles can have a profound impact on a person’s expectancies.

Relationship Between Religion and Spirituality• Separate and distinct concepts• Completely enmeshed concepts• Religion: an aspect of spirituality• Vague or undefined concepts

Spiritual Beliefs and Health

• Some research suggests religion has a positive influence over physical and mental health.

• Other studies find that some religious values impede positive health outcomes.

• Research does not always answer how or why religion affects health.

Major Religions

Judaism• Orthodox• Conservative• Reform• Reconstructionist

Major Religions (cont’d)

Christianity• Roman Catholicism• Christian Science• Protestantism

– Lutheran– Baptist– United Methodist

• Islam

• Hinduism

• Buddhism• American Indian• Rastafarianism• Atheism

It would be most important for the nurse to instruct the nursing assistive personnel (NAP) to assist clients of which faith to wash their hands before meals?

a.Christianb.Jewishc.Mormond.Muslim

Correct answer: D

Cleanliness is an important value for Muslims. They engage in ritualistic washing of the hands and face and prefer free-flowing water.

What Every Nurse Should Know

Gain self-knowledge• Be open• Welcome challenges• Take time to reflect

What Every Nurse Should Know (cont’d)

Spiritual care demands nonjudgmental attitudes and open thinking.

Barriers to Spiritual Care

• Lack of awareness of spirituality in general• Lack of awareness of your own spiritual

belief system• Differences in spirituality between nurse

and client

Barriers to Spiritual Care (cont’d)

• Fear that your knowledge base is insufficient

• Fear of where spiritual discussions may lead

Assessment of Spiritual Needs and Practices• Tools

– JAREL Spiritual Well-Being Scale– SPIRIT model– HOPE

• Levels of spiritual assessment

Assessment of Spiritual Needs and Practices (cont’d)

• Sources of information about spirituality– Client and family interviews– Client environment– Client questions– Nonverbal communication

NANDA Diagnoses Related to Spirituality• Moral distress• Spiritual distress• Risk for spiritual distress• Readiness for enhanced spiritual well-being

NANDA Diagnoses Related to Spirituality (cont’d)

• Impaired Religiosity• Risk for Impaired Religiosity• Readiness for Enhanced Religiosity• Spiritual Pain (non-NANDA)

Planning Outcomes and Interventions• NOC standardized outcomes• NIC standardized interventions

• Spiritual interventions used to treat and prevent spiritual problems related to client’s illness

• May need to make referrals

Prayer

• Determine whether client wishes you to pray for him or her or with him or her.

• Ask what client would like you to address in prayer.

Prayer Guidelines for Nurses

• Ask how the client prefers to address the Divine.

• Ask the client if any rituals or religious items are needed before prayer.

• Always feel free to pray or not to pray.

Prayer Guidelines for Nurses (cont’d)

• Do not be compulsive about praying or avoiding prayer.

• Know there are appropriate times and places for prayer.

• When a client asks for prayer, know how to reply.

• Focus the prayer around the client’s request.

• Know prayers that are realistic.• If composing prayer is difficult, use existing

prayers from religious text.

• Include request for divine help involving healthcare team.

• Thank the client for being asked to participate in prayer.

ClickerCheck

Would this statement by the nurse be correct?

“We should pray to God that your cancer goes into remission.”

a. Yesb. No

Correct answer: B

The nurse should not be stating the intent of the prayer session. The client should do that.

Think Like a Nurse

Refer to Charles Johnson (Meet Your Patient).• What data do you have about Mr. Johnson’s

spirituality?• What speculations might you make about his

spirituality based on your past experiences and knowledge, and the limited data you have?• How does your religion or spirituality differ from

Mr. Johnson’s? How is it similar?• Can you think of problems these differences and

similarities could cause you in caring for him?

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