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JUDITH M. WILKINSON LESLIE S. TREASKAREN BARNETT MABLE H. SMITH
FUNDAMENTALS OFFUNDAMENTALS OFNURSINGNURSING
Copyright © 2016 F.A. Davis Company
Chapter 16: Chapter 16: SpiritualitySpirituality
Copyright © 2016 F.A. Davis Company
History of Spirituality in Nursing
• Pre-Christian era• Early Christian era• Post-Reformation• Mid-20th century
Copyright © 2016 F.A. Davis Company
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.
Copyright © 2016 F.A. Davis Company
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.
Copyright © 2016 F.A. Davis Company
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
Copyright © 2016 F.A. Davis Company
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.
Copyright © 2016 F.A. Davis Company
Core Issues of Spirituality
• Faith• Hope• Love
Copyright © 2016 F.A. Davis Company
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.
Copyright © 2016 F.A. Davis Company
Relationship Between Religion and Spirituality• Separate and distinct concepts• Completely enmeshed concepts• Religion: an aspect of spirituality• Vague or undefined concepts
Copyright © 2016 F.A. Davis Company
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.
Copyright © 2016 F.A. Davis Company
Major Religions
Judaism• Orthodox• Conservative• Reform• Reconstructionist
Copyright © 2016 F.A. Davis Company
Major Religions (cont’d)
Christianity• Roman Catholicism• Christian Science• Protestantism
– Lutheran– Baptist– United Methodist
Copyright © 2016 F.A. Davis Company
Major Religions (cont’d)
• Islam
• Hinduism
Copyright © 2016 F.A. Davis Company
Major Religions (cont’d)
• Buddhism• American Indian• Rastafarianism• Atheism
Copyright © 2016 F.A. Davis Company
ClickerCheck (cont’d)
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
Copyright © 2016 F.A. Davis Company
ClickerCheck (cont’d)
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.
Copyright © 2016 F.A. Davis Company
What Every Nurse Should Know
Gain self-knowledge• Be open• Welcome challenges• Take time to reflect
Copyright © 2016 F.A. Davis Company
What Every Nurse Should Know (cont’d)
Spiritual care demands nonjudgmental attitudes and open thinking.
Copyright © 2016 F.A. Davis Company
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
Copyright © 2016 F.A. Davis Company
Barriers to Spiritual Care (cont’d)
• Fear that your knowledge base is insufficient
• Fear of where spiritual discussions may lead
Copyright © 2016 F.A. Davis Company
Assessment of Spiritual Needs and Practices• Tools
– JAREL Spiritual Well-Being Scale– SPIRIT model– HOPE
• Levels of spiritual assessment
Copyright © 2016 F.A. Davis Company
Assessment of Spiritual Needs and Practices (cont’d)
• Sources of information about spirituality– Client and family interviews– Client environment– Client questions– Nonverbal communication
Copyright © 2016 F.A. Davis Company
NANDA Diagnoses Related to Spirituality• Moral distress• Spiritual distress• Risk for spiritual distress• Readiness for enhanced spiritual well-being
Copyright © 2016 F.A. Davis Company
NANDA Diagnoses Related to Spirituality (cont’d)
• Impaired Religiosity• Risk for Impaired Religiosity• Readiness for Enhanced Religiosity• Spiritual Pain (non-NANDA)
Copyright © 2016 F.A. Davis Company
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
Copyright © 2016 F.A. Davis Company
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.
Copyright © 2016 F.A. Davis Company
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.
Copyright © 2016 F.A. Davis Company
Prayer Guidelines for Nurses (cont’d)
• Do not be compulsive about praying or avoiding prayer.
• Know there are appropriate times and places for prayer.
Copyright © 2016 F.A. Davis Company
Prayer Guidelines for Nurses (cont’d)
• When a client asks for prayer, know how to reply.
• Focus the prayer around the client’s request.
Copyright © 2016 F.A. Davis Company
Prayer Guidelines for Nurses (cont’d)
• Know prayers that are realistic.• If composing prayer is difficult, use existing
prayers from religious text.
Copyright © 2016 F.A. Davis Company
Prayer Guidelines for Nurses (cont’d)
• Include request for divine help involving healthcare team.
• Thank the client for being asked to participate in prayer.
Copyright © 2016 F.A. Davis Company
ClickerCheck
Would this statement by the nurse be correct?
“We should pray to God that your cancer goes into remission.”
a. Yesb. No
Copyright © 2016 F.A. Davis Company
ClickerCheck (cont’d)
Correct answer: B
The nurse should not be stating the intent of the prayer session. The client should do that.
Copyright © 2016 F.A. Davis Company
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?