Ethical and spiritual discussion respond
Spiritual care to me means acknowledging and addressing a patient’s spiritual worries, doubts, and questions. According to Shelly & Miller (2006, p264) “Spiritual care means putting people in touch with God through compassionate presence, active listening, witness, prayer, Bible reading and partnering with the body of Christ (the church community and the clergy). It is never coercive or rude.” “Christian spiritual care means facilitating a person’s relationship with God through Jesus Christ” (Shelly & Miller, 2006, p264). I have mixed feelings about witnessing to my patients because I am worried about being ‘coercive or rude’, and have seen witnessing done badly more often than not. I cringe at how some people come off. I have prayed with my patients, a Christian prayer to God, for guidance, wisdom, and peace. In a secular society, I watch what I say. I have asked leading questions about patient’s beliefs and if they believe in God/Jesus, then I will talk relatively openly to them, but if they do not, I do not witness to them.
According to Shelly & Miller (2006, p265), a compassionate presence means “we meet patients where they are, provide the assistance needed at the moment and constantly nudge them toward the goals God intends for them. Compassion means to feel with another person.” I can agree with this. I can give nudges, and comments, but not a lecture which only serves to turn them off. I like the example Shelly & Miller (2006) give about the angel coming along side of Elijah and helping him get back on his feet again so he could go on. That’s one of the reasons I went into nursing and how I would like to be remembered.
I wholeheartedly agree with active listening; “active listening includes hearing what a person is not saying as well as the actual thoughts and feelings articulated.” (Shelly & Miller, 2006, p266). I try to do this with everyone I come into contact with, not just in the nursing field. “After careful, active listening, there are times when a word of witness is appropriate and helpful.” (Shelly & Miller, 2006, p267). I fail at witnessing because I don’t know when it is ‘appropriate and helpful’.
I agree with the aspect of Christian community. “Partnering with the body of Christ—the church community and the clergy—is another important aspect of spiritual care (Shelly & Miller, 2006, p274). But this is mixed because sometimes it is just a cop out, as it is easier to just call the clergy than talk to the patient myself. I also will call clergy from other religions to give support for the patient according to their own beliefs.
Shelly, J. A., & Miller, A. B. (2006). Called to care: A Christian worldview for nursing (2 nd ed.). Downers Grove, Il. Inter Varsity Press. Retrieved from http://gcumedia.com/digital-resources
All human beings experience deep, existential concerns that are intensified when we suffer. Questions such as, ‘why do I exist?’, ‘why am I ill?’, ‘will I die?’, and ‘what will happen to me when I die?’ are all examples of the concerns that connect us. Illness can drive us to make our lives meaningful, develop coping strategies, and experience hope. When we support others whose needs are finding meaning, purpose, and hope, we are providing spiritual care.
Shelly and Miller (2006) beautifully, and succinctly state that the definition of spiritual care is ‘giving hope to the hopeless’ (p. 262). Matthew 9: 2-8 tells us about Jesus healing a paralyzed man. Christ first addressed this man’s depression, saying, ‘Son, be of good cheer’ (King James Version). Jesus is giving this man spiritual care before anything else. He did not heal his paralysis first, he healed his depression first; he spoke kind words to him, and then told him his sins were forgiven. Christ addressed this man’s spiritual needs first, thus giving him hope. If God addresses our spiritual needs first, before physical needs, why don’t we? Shelly and Miller (2006) go on to explain that nurses who provide good spiritual care facilitate the ‘restoration of an individual’s relationship with God’ (p. 295).
This truth led me to consider what it means to provide spiritual care to patients who do not believe in God. Does it mean if I provide good spiritual care, it will help lead them to the Lord? Does it mean that I cannot hope to provide good spiritual care to an atheist? How do I support someone who is looking for meaning, purpose, and hope, if they don’t believe in God? If spirituality is the feeling of deep connection we have towards one another, and with the universe in general, then we all are spiritual, whether we believe in God or not. However, my Christian worldview leads me to understand that a sense of interconnectedness cannot exist without God. How can we be connected, if there is nothing that connects us? I think the provision of spiritual care for an atheist would have to include an assessment of the nature of what it is that gives them hope, comfort, meaning, and purpose.
I agree with Shelly and Miller (2006) that spiritual care means putting people in touch with God, by providing a supportive, compassionate presence. As an example, the nurse theorist, Jean Watson, explains that helping a patient with their toileting needs is a sacred act (https://www.watsoncaringscience.org/). Who or what is it that facilitates that compassionate, supportive presence, if not God?
Shelly, J. A., & Miller, A. B. (2006). Called to care: A Christian worldview for nursing (2 nded.). Downers Grove, IL: IVP Academic. Retrieved from http://www.gcumedia.com/digital-resources
Spiritual care to me means ministering to a patients mind and spirit. It does not necessarily have to exist in conjunction with medical care. I feel like we can provide spiritual care to our friends and family in need. When one of my friends or family members “acts out” or is angry, I try to be calm and use a combination of empathy, compassion, and active listening to help them. In regards to my patients, they all deserve spiritual care. Regardless of their sin, we are to accept them as human beings made from God. I have found that using techniques that were mentioned in the readings, I can provide spiritual care to my patients. By having a compassionate presence, we are letting our patients know that we are feeling with them. By staying with them and holding their hand or listening to their fears, we let them share their most private emotions with us. That is how I feel about my prayers to God. There are times when I just need him to hear me. As God’s children, and as nurses, we can be there to listen to the scared patient before surgery or facing a terminal illness. Being an active listener also encourages spiritual care. Patients in the hospital are being given a lot of verbal and written information about their illness. They usually don’t feel comfortable asking questions because they know that doctors and nurses are busy. By giving a patient active listening time, they can express their concerns. Regardless of religious preference, the power of prayer is amazing. I feel as though it is like a “time-out” before a procedure. It is a time to bless the hands of the medical staff, the patient, and the family. A moment of prayer stops the hands of time for a moment and focuses on the spiritual needs of the patient.
We were created by God with a physical body and our own spirit. As medical treatments nurture our physical body, spiritual care through love and compassion nurture our spirits. I believe that if a person’s spiritual being is in peace, they can handle just about anything their physical needs are. I always thank my patients for allowing me to be a part of their care. I am present for some of the most private, emotional times in people’s lives. They trust and look to us for guidance and to help keep them calm. We can help extend the spiritual care beyond the hospital setting by reaching out to their community resources such as a pastor, church, or prayer group.
I believe spiritual care encompasses caring for the individual holistically – mind body and soul/spirit. It means to aspire to provide care which will inspire hope to enable the patient/client to cope with an illness, trauma, or life change; being cognizant of the variant ways in which one may choose to seek a devout relationship with a higher power/God/Deity by displaying respect and appreciation for that presence regardless of one’s own religion. I feel as though my view is in accordance with the nursing Florence Nightingale implemented – without excluding or abandoning good actions, secular nursing seems best to be observed, as it leaves out the biases, to include diversified cultures and practices in an effort to execute for what nurses are meant – provision of a caring relationship that facilitates health and healing (Shelly and Miller, 2006).
Shelly and Miller. (2006). Nusing – Practice of Care. In J. Shelly & A. Miller, Called to Care: A Christian Worldview for Nursing, Second Edition (pp. 231 – 287). Downers Grove: Intervarsity Press.
All people are made in the image of God, whether or not their beliefs tell them that is true, and therefore, all have value and are loved by God. Spiritual care is approaching every patient with that first thought in mind and providing them with care that goes beyond the task at hand. All of God’s children have a need to be connected with Him (to fill that God shaped hole in our hearts) and that can be accomplished in many ways. Allowing the love of God to shine through us is key. Whatever spiritual care you perform, the goal should be to show the love of Jesus. Shelly and Miller (2006) list spiritual interventions that can fall into the categories of compassionate presence, active listening, witness, prayer, scripture and Christian community. I agree with how they discuss spiritual care. I would be cautious in the area of witness and prayer unless that nurse is particularly gifted in discerning the appropriate time and patient while offering truth and hope with a huge helping of grace and love. Maybe I feel that way because of my area of practice in the ED and trauma world are most always fast paced and we don’t usually have time to build that kind of foundation. The other interventions can be easily incorporated into a fast paced ED, including offering to have the chaplain or their personal clergy contacted opening the opportunity for payer and witness.
Shelly, J. A., & Miller, A. B. (2006). Called to care A Christian worldview for nursing (2nd ed.). Downers Grove, IL: InterVarsity Press.
Have you ever wondered why faith is listed first then hope and last love? A human does need to have faith in something greater than themselves. Hope is needed for the future and it takes love of others to reach out and care for those around us. Spiritual care is learning what the patient believes or the worldview held as truth and then respecting the view held by the patient. The nurse respects and responds to the patient at their level of need. The nurse does not have the answer but is available to listen, guide, and support the patient at whatever stage they are in.
Personally, I like several things in this week’s literature such as, spiritual care given in a spirit of gentleness and humility is usually well received (Shelley, 2006). This is because it is not judgmental in nature but can open the door for conversation. To be able to care for a patient without judgment no matter how their worldview differs from the one held by the nurse is true Christianity.
This has been a touchy subject with me after working in a hospital that was attempting to be politically correct after 9/11. The problem began when they okayed for the Muslim nurses to wear their head wraps but sent out a notice that any nurses who wore a crucifix would have to remove it or be sent home. This was a hospital that had a Catholic priest rounding on a regular basis, fixed fish every Friday along with performing Ash Wednesday. The thought was that the crucifix was offensive to the other faiths and we instructed that nurses were not allowed to pray with any patients. The nurses’ autonomy was being restricted, beneficence was being taken away by holding one religious view greater than another.
Is there a difference or an accord with the description of spiritual care?
A difference or harmony is according to the nurse giving care. If the nurse is combative, negative, pushy, or strongly opinionated this is destructive to the nurse patient relationship. This type of attitude will be detrimental to the healing process since it interferes with the mindset of the patient along with causing conflict with the worldview held as truth to the patient. Each patient is a different situation but each patient only wants someone to listen to their story. The nurses’ responsibility is to be careful not to try to give answers but to only be a receptive listener. The nurse should never be Job’s friends that only spoke death.
Shelley, J. &. (2006). Called to care: A Christian worldview for nursing. Downers Grove: IVP Academic.