Spirituality in Nursing Care - Essay Example

Spirituality in Nursing Care Introduction Enquiry-based learning is the standard model for investigating the various ways by which students can learn to solve issues and problems. It helps them to establish critical nursing skills after analyzing events. These skills would be beneficial for students in ensuring that they would be incorporated well into the clinical practice. The aim of this essay is to explore the process of Enquiry-based learning (EBL), to exemplify knowledge, and to understand gains from this process. EBL is also a process which seeks to assist students in linking theory with their clinical practice. It also seeks to reinforce student’s team working culture as an importance part of the nursing practice. It is a process based on face-to-face facilitated sessions, student’s self-direction learning, feedback, presentation, and reflection. This essay shall first reflect on the EBL process, and then critically discuss the main issues raised in the EBL presentation on the identified concept. Finally, it shall conclude by considering an example of one patient from my clinical practice and evaluate the implication of the concept in the practice. Reflection on the EBL process The Gibbs Reflection Model shall be used to reflect on the learning process in this EBL experience. This reflection model is based on the description of the event, what I felt about the event, my evaluation, analysis, conclusion, and action plan for the event. Description of the event At the start of our EBL presentation, we met with our facilitator. We presented the concept to the group as a means of familiarizing the members to the concept and as a means of clarifying what we would be carrying out as a group. The group was given the scenario and the trigger word was spirituality. Each group member was then given a clear duty to accomplish in the presentation. There were three main members, including that of the chair, the scriber, and the facilitator. The chair’s role was to maintain order in the group, to agree upon what was achieved during the sessions, and to set dates and times to meet. The role of the scriber was to keep a record of the decisions and agreements of the group, and email it to the members. The facilitator’s role was to ensure that the group was working on the EBL processes and to provide feedback after the presentation. The other group members had various roles to play, mostly on searching for useful information on the topic from the journals, textbooks, or library resources. Feelings At the beginning of the project, I felt nervous and excited at the same time because I did not know how the group work process would work and I was also not sure how I was going to take part in the activity. I was also apprehensive about how other members would react to my contribution. However, even though I was nervous or hesitant, I was confident with my skills of leadership, sharing, task allocation, task completion, of meeting deadlines; and on the useful skills I have gained from my previous group work and my work experiences. I was able to gain more confidence when we started our group meeting and I realised that my point of view was taken into account and all my ideas were welcomed by the group. Then I was also able to contribute to the group work by doing the research and giving feedback to the group. Finally I was pleased by the fact that as an individual I could contribute to the group and that the group was also able to trust me and my work. This gave further support to Reid’s (1981, p. 191) statement when he said that “group work is a mutual support in which an individual and the members of group are engaged on the enterprise of carrying out the group’s common goals”. Evaluation (What was good and bad about the experience?) The presentation was good in general as the aim was clearly explained in the introduction and the reader had good eye contact with the audience. The power point presentation showed materials which were very much related to the topic and were helpful in enhancing the audience’s knowledge of the concept. All the group members were present and the presentation was concluded within the estimated time. This process was a good opportunity for learning because I learned to manage my time and to improve my time management skills. Doing research independently allowed me to expand my knowledge without having to depend only on the lecturer’s knowledge. In addition there was sufficient communication among the group members; as Dallas and Sully (2005) explained, “an effective communication improves the learning development in order to provide a good quality of care”. However I was slightly disappointed with the role-play because it looked more like a reading session rather than a proper role play. At the end of the presentation, the group had some disagreement with the feedback part because we had different opinions about the contributions of each member; this disagreements were however very much beneficial for the group because these permitted us to discuss the issues of non-attendance and other issues we had working with each other. Conflicts are crucial to a group’s development. From these disagreements, new ideas are built and all the abilities and skills of the group are utilized (Martin, 2006). The main aspect of these disagreements is to just disagree on an idea, and not to reduce a member’s capabilities. “The essential information is presented and examined from several points of view. Differences are clarified, ideas are integrated, and each person is validated for individual contributions” (Martin, 2006, p. 137). Analysis (What sense can you make out of the situation?) Looking back at the situation, our group achieved the goal we established at the beginning of our group work. Throughout our meeting we had several occasions to make the point on our progress and also how things were going. Communication among the team members made things easier. In any group activity, communication is an essential element. Through communication, ideas are shared with other members and groups processes and activities can be delegated and accomplished. Communication can take on various forms, including non-verbal and verbal communication. Verbal communication is done through words, either spoken or written; and non-verbal communication is manifested through gestures, facial expressions, and even eye contact (Letsky, 2008). Our communication with each other took on both verbal and non-verbal forms with the non-verbal forms often contradicting the verbal messages that the members shared with each other. These often created conflicts between members when non-verbal gestures were made by some members which other members did not appreciate. In the process, we discovered that it was important for us to be open with each other as members, to be honest with our issues with the other members and not to show our displeasure with other members through non-verbal gestures. Jones (2007) discusses that non-verbal gestures are often the more accurate expressions which people portray. Respondents may not feel comfortable when the gestures shown do not match the words expressed. In these instances, conflicts are expected. In these instances, clarifications are important in order to ensure that non-verbal gestures are understood by recipients and other parties involved (Jones, 2007). By understanding how communication works in the group, it is possible to ensure that members interact well with each other in an open, respectful, and clear manner. In the process of working with each other, I found out the importance of team work and how this teamwork helps us accomplish tasks faster and easier. It also gave us a chance to handle better the difficult tasks given to us. Daft and Lane (2007) discuss that the best way to meet the challenges of any group work and task is through the coordinated and committed effort of the members of the group. Each team has designated members with assigned tasks and with all these members working to achieve and perform his task, the greater goals of the group can be accomplished (Daft and Lane, 2007). By working well with each other as members of a team, we were able to accomplish our greater goals as a group. Conclusion In this EBL process, I discovered that I was now able to understand more about the approach of spirituality in nursing practice and the research carried out on this topic has improved my awareness and my understanding about spirituality. I also found out that I think I could have done more research in order to contribute to the group work process. I know now that with a strong foundation for practice in the form of research, our activities could have been richer in ideas and in other innovative information. From the process, I know that I would have responded in the same way – be motivated to work with the members as a team and be intent on considering feedback to improve group dynamics. I believe that with foresight, I would have tried to be more involved in the group process, to try to assist other members who are having difficulty carrying out their tasks. The role-play incident particularly needed improvement and with our contribution as a group, we could have done that part better and we could have made the process a more enjoyable process. In order to prevent this oversight to happen again, I would try to open lines of communication with other group members – to ensure that they would not be shy or be hesitant in communicating their issues with the other members of the group. Action plan For the next time, I would invite group members to highlight the difficulties they are having so it can be discussed and resolved quickly. One other important thing is that the group will have to fully investigate the concepts by giving a clear introduction instead of focusing on theories. I will also try to speak up and if possible try to be a chair at least for one session. For next time, I think I need to attend some leadership and team-building seminars and trainings in order to enhance my leadership and team-working skills. As a better leader and member, I know I would be able to contribute more to the group and thereby ensure that all group works and tasks are accomplished well. In instances when situations similar to the incident would arise again, I know I need to be a better member by contributing more research and more input to the brainstorming process. By sharing my ideas in a proactive way, I can ensure that my presence in the group is significant and useful. EBL Process Introduction In administering traditional nursing care, nurses are often concerned with the physiological and the psychological needs of their patient. They assess, diagnose, treat, and provide general nursing care for the patient based on the latter’s illness or disease. In the current context, nursing care has taken on a more holistic approach to the administration of patient interventions. And even as their patients may not particularly adhere to any religious practices, all of them are still basically spiritual (Dunn, 2008). Nurses must therefore be engaged in such spiritual aspects in their persona, especially those who do not adhere to any religion but still adhere to their spirituality. Definitions of spirituality Spirituality is a difficult concept to define. Nevertheless many authors and practitioners in varying field of practice have attempted to define it. Among social work educators, they define it as a person’s individual spiritual style; as an individual’s way of seeking, finding, using, and expanding his personal meaning in a larger context (Ellor, Natting, and Thibault as cited by Moberg, 2001). In effect, spirituality refers to a person’s individual understanding and appreciation of his life and its meaning in the universal plain. It seeks a bigger and more profound understanding of his place in the world based on his goals and the meanings which he seeks to establish out of his life. Spirituality may also be defined as an inner characteristic which ensures a person’s connection with himself, with other people, and with nature (Musgrave, et.al., 2002). It may also be defined as something which involves a person’s acceptance of and his communion with a higher being. It refers to a basic quality of all people which includes the acceptance of something bigger and greater than oneself and the faith that asserts life (Miller, 1999). Thomas Moore discusses how people are surrounded by spirituality every day and how it is founded and how it grows from the mundane. Ojnik (n.d) sets forth that in the nursing practice, spirituality is the starting point which provides a way for service providers to encourage patients to participate in the healing process. This definition is more useful because it defines spirituality as the most important thing – something which can also be applied in the practice. These differences in definitions exemplify that spirituality is complex and that it has a significant range. Some definitions link it with aspects affecting the spirit, and others are more inclined towards psychology than spirituality. All in all, they are concerned with things which cannot be measured. The sociological and psychological view of spirituality Sociology views spirituality in terms of people. According to psychology, people have a strong impact on other people who, in turn, are also influenced by other groups in which they live (Leonard and Carlson, n.d). Furthermore, sociology describes spirituality as the spiritual traditions of groups of people; it is also the social morality within relationships (Meraviglia, 1999). On the other hand, psychologists view spirituality as the expression of a person’s internal goals and desires, focusing on one’s self, not on God (Leonard and Carlson, n.d). In other words, as sociology takes a more people-centred view of spirituality, psychology takes a more individual and personal understanding of spirituality. Psychology also refers to spirituality as the personal understanding of the different aspects of existence which transcend the physical domain, while also covering the physical realm (Benor and Benor, 1993). Sociologists, very much like psychologists and medical health professionals have considered transcendence while seeking to define spirituality. These sociologists also set forth that spirituality implies connection and wholeness (Payne and McFadden, 1994). They also describe spirituality as a life experience which is highly significant, one which is engaged in symbolic immortality and which lifts a person beyond superficial self-interests (Eisenhalder, 1994). In effect, sociologists tend to view spirituality in terms of its overall and more transcendent impact on involved individuals; whereas, psychologists view spirituality based on smaller and more personal scales of experience. Both viewpoints present contrasting views of spirituality, but are both founded on the transcendent levels of experience for individuals involved. The Implications of Spirituality in Practice I will give an example of my clinical practice experience to illustrate the implications of spirituality in practice and how it can be a part of care. In my placement, I took care of a patient who was dying from lung cancer with her cancer metastasized to other parts of her body. Moreover, she was also not responding treatment. My patient was extremely depressed since she knew that her cancer metastasized and that she was nearing the end of her life. To counter the effects of her depression, she was taking antidepressants. These drugs were however ineffective. Applying spirituality in the nursing practice meant that I had to observe therapeutic communication in relating with my patient. I did this by communicating with the patient, by listening to her and to her emotional concerns, and by simply being there for her as a health care giver during the last days of her life. Supporting patient spiritual needs help patients cope with their illness. As Vance (2001) stated “the role of spirituality in promoting health and improving patient’s response to illness is receiving increasing attention”. In this case, my role as a nurse transcended the physical realm of care, and on to more deeper and spiritual applications of the nursing practice. Spirituality in the nursing practice implies presence (Golberg, 1998). Spirituality implies that a nurse must provide a presence which is empowering; in other words, spirituality motivates people to change, to accept, and to grow (Roach, 1991). It also implies that even if medicine would not be able to provide medical cure or remedies, spirituality is about sharing in that hopelessness with the patient (Cassidy, 1988). And in staying with patients and standing one’s ground, the nursing and medical care can become a more spiritual experience. In so doing, spirituality implies that the nurse would view the patient as a whole person, not just a patient who is defined by her disease (Golberg, 1998). Other practitioners also point out that spirituality in the nursing practice implies a relationship between nurse and patient as something which is committed, but carefully defined (Campbell, 1984). In other words, the effective nursing practice under the realm of spirituality is still one which has boundaries -- boundaries which help protect the patients and the nurses from over-involvement. Spirituality in the nursing practice also implies empathy and compassion. A nurse must express empathy to the patient. Such empathy also includes one’s presence – being there for the patient both on a mental and physical level (McCavery, 1985). It involves respect and truth-telling with the patient, as well as active listening; in many respects it is about suffering alongside the patient, sharing in his pain and his difficulties (Golberg, 1998). With the current patient, I did my best to empathize with her, to express my compassion for her pain, her suffering, and her concerns about death and dying. Giving hope is also part of spirituality in the nursing practice. Giving hope to the patient already includes previously discussed actions. But to some extent, it also involves the process of reading the medical notes and explaining such notes to the patient (Oakley, 1986). This process can somehow serve as an interpretation of the patient’s symptoms and experience – giving her a better understanding of her disease, including its negative and positive implications. I discussed with the patient her illness. I explained how the cancer was affecting her body and her systems. In the process, she was able to understand that she is fortunate to still be alive and that she will be grateful for whatever time she has left. Love is also implied in the spiritual applications of nursing care. Love is about the giving of oneself with the hope of fulfilling God’s teachings and commandments (Golberg, 1998). In so many ways, the process of giving here is one which does not expect anything in return. Campbell (1984) also discusses love in the context of spirituality and nursing care. He goes on to discuss about professional love – one which goes beyond empathy, fellow feeling, and identification with one’s patient. There is a thin line between controlled professional love and cold detachment. The respect for the individual patient has to be maintained based on each patient’s quality (Campbell, 1984). A nurse professional is able to maintain the precarious balance between reason and emotion which family members may have difficulty balancing. A full devotion of love for the nurse negates the therapeutic nursing process. Cassidy (1988) summarizes love in the professional nursing practice as one which is a combination of competence, empathy and communication. In some instances, health professionals may find themselves at the losing end of the spiritual nursing practice, but the gains in more than sufficient for the patient and the health professionals. With the current patient, I tried my very best to make the last few days of her life comfortable. I listened to her, asked her if she needed anything, read to her, watched television with her, and just stayed with her as long as I could. I found that just being there for her expressed my love for her while still ensuring my professional role as her nurse. Touching is also an implied aspect of the spiritual application of nursing care. Touch conveyed comfort (Oakley, 1986). This gesture brought the patient comfort in the last days of her life. She even mentioned that she was glad that someone was holding her hand, as if not wanting to let her go. She expressed that some of her family members were afraid to touch her, as if she was too fragile to touch. My touching her hand, massaging her feet, and caressing her head brought her much comfort. Sometimes, it helped her sleep. Touching is an important element of the nursing practice. Even when it is considered outside the spiritual context, it conveys rich meanings and emotion to the patient – and these, in the end, support the therapeutic application of nursing care. Conclusion The spirituality dimension is obviously important as an aspect of holistic care. It is vital to access a patient’s spiritual needs because these may help the patients to cope with their illness. Spirituality helps people to find and understand the meaning of their lives. 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