The Spirituality - Report Example

Introduction In times of crisis, many people reconnect with spirituality, knowing that the resources they can tap into could be useful in dealing with what may on the surface seem like a hopeless challenge. There are many documented cases in which patients have been able to cope successfully through a debilitating illness not because health necessarily improved but because the patient’s coping mechanisms became strengthened thanks to the availability of spiritual resources. While doing all that is necessary in the way of medical support for the patient it is also important for nurses to be aware of the role that spirituality can play in the lives of patients and do what they can to provide necessary supports so that patients’ well being can be maximized in what may be difficult circumstances. When a patient suffers from a chronic condition, it is not only the patient who suffers the physical and mental anguish; family members and friends can also share to various degrees in the turmoil that attends such health problems (Mauk & Smith, 2003). The toll that chronic illness takes on the sick individual and possibly on the family, are not only physical but also can be emotional as well as financial. Chronic illness can also pose a spiritual challenge (Lubkin & Larsen, 2005). The loss of independence that comes with being chronically ill can weigh heavily on the mind; more than that, knowledge that such conditions can lead into permanent disability can also be highly stressful for the person concerned (Lubkin & Larsen, 2005). It is difficult for the person suffering from a chronic disease not to perceive herself as being different from other people; such feelings may trigger the desire to be separate from others, to live in a cocoon, and be isolated and cut off from others (Lubkin & Larsen, 2005). Difficult as it may be, the person suffering from a chronic disease needs to come to terms with having to live life with a limited framework. It can be helpful, however, if the individual concerned comes to the appreciation that with effort an acceptably good quality of life might be achieved and that the quest for such a state merits consideration (O’Brien, 2007). Nurses – the need for spirituality As noted earlier, research supports the contention that in times of major health crisis, clients perceive a greater need to reconnect with a sense of spirituality. This concern may be even stronger for people who are close to death’s door (Dossey, Kegan & Guzetta, 2004). Not a few families have expressed gratitude for nurses’ prayer and weeping for their loved ones (Lubkin & Larsen, 2005). Considering the relatively higher number of hours nurses spend with patients compared with other health care workers, and considering the importance of spirituality to many patients, it only makes sense that some space be carved out for spirituality in the training and nurturing of nurses (Mitchell, Bennett & Ledet, 2006). Nurses need to connect with the holistic roots of their practice, which encompasses consideration of body, mind, and spirit (Mitchell, Bennett & Manfrin-Ledet, 2006). When nurses are anchored well as knowledgeable, that is, in touch with the spiritual needs of their patients, they can much better fulfil the role of sharing such key information regarding spiritual care with other collaborators , including social workers, physicians, physical therapists, chaplains, and pastoral care workers (Puchalski & Miller, 2006). Getting to the bottom of Spirituality The root of the term “spirituality” can be traced to the Latin word “spirare” which is “to breathe life” and embraces such elements as the thoughts and feelings that not only enrich people’s lives with meaning but also help to chart people’s pathways through life (Dossey, Kegan & Guzetta, 2004). Spirituality is the essence of a person and reflects the wholeness and being of each person (Lubkin & Larsen, 2007). Spiritual, however, must not be confused with religion, which is much more narrow in its scope. In effect, while not everyone admits to being religious, in fact, everyone is spiritual (Dossey, Kegan & Guzetta, 2004). The breadth of spirituality is reflected in the myriad ways in which it can be interpreted, such as, transcendence, connectedness with nature, self, or others; some perceive spirituality as a form of energy or connect it with family, community, or universal love (Lubkin & Larsen, 2007). It is so much more likely that nurses that have gained some awareness of their own spirituality can, in comfort, interact positively with other professionals while giving spiritual care the best way they know how (Dossey, Kegan & Guzetta, 2004). The Role of Spiritual Assessment in Good Patient Care As with other aspects of nursing care, good spiritual care ought to start with the gathering of information, that is, the kind of spiritual assessment that includes thoughts, memories and other experiences that have a place of importance in the client’s life. (Dossey, Kegan & Guzetta, 2004). With such information to hand, the care that the client gets can be tailored to personal concerns (Rumblod, 2007). As important as spiritual assessment is, trying to obtain the necessary information about spirituality requires establishing a relationship of personal concern first. With such trust in place, it is then possible for a client to open up candidly about matters of spirituality, including what their concept of God might be and what drives their sense of hope and spiritual beliefs as well as religious practice and rituals(Crisp & Taylor, 2005). The two fundamental theoretical frameworks within which spiritual care is grounded are the bio psychosocial model of care and other patient centred care models (Puchalski & Miller, 2006). What are spiritual needs? Spiritual needs have to do with the kind of meaning and purpose that people have for their lives; it also includes the sense that people have to love others and be loved in return; and it extends to a person’s having to cling on to hope or trust and to be connected to others; to strengthen others and be strengthened by them, and to feel a sense of transcendence ( Lemmer, 2005). A patient whose spiritual needs are ignored is likely to descend into greater suffering (Lemmer, 2005). And if the chronic condition continues to get worse, lack of spirituality to shore up the hardship may leave the client more and more aware of the loss of control and independence, a situation that is likely then to heighten the feeling of spiritual distress (Lemmer, 2005). When physical pain is coupled with spiritual distress, both the client and the family members are likely to feel lost, hopeless, and isolated, leading to the kind of self-doubt that can be debilitating for all concerned (Bomar, 2003). With spiritual support comes a sense of meaning and hope even when a person’s physical condition remains challenging as a patient approaches the final days (Lemmer, 2005). The Need for Receptivity: Listening to the Patient An assessment need not be a cut and dried, impersonal affair. Establishing a connection with a patient so that she feels free to share her stories can fit the bill for both assessment and spiritual care. (Lubkin & Larsen, 2005). When patients open up to share their stories, they are likely to lay bare to the nurse issues of deep meaning to them including what hopes they have for the future or what fears assail them. Other issues that might crop up are those relating to forgiveness and even their thinking on values (Lubkin & Larsen, 2005). When patients are made to feel comfortable, they can open up about what ails them, spiritually speaking and what keeps them going from day to day. They may even share their feelings of acceptance of their condition with a nurse that is open enough and shows a willingness to listen actively ( Lemmer, 2005). Nurses should not consider the understanding and awareness of spirituality as an important but separate element of nursing care; on the contrary, being aware of the care and nurturing of the soul, of the spirit is very much a part of what it means to be a nurse with a holistic perspective (Lubkin & Larsen, 2005). Morethan just being a good extra touch, Wright makes a forceful case that it is an ethical obligation on the part of nurses to provide spiritual care within the framework of holistic perspective (Lubkin & Larsen, 2005). Building a Healing Relationship The relationship that a nurse establishes with a patient should not drive the patient into a position of greater despair; rather, the relationship should be a balm and lay the foundation for a healing connection or relationship between the two (Funnel et al, 2004). In effect, it is not enough for a nurse to create optimum physical or external conditions for the betterment of the patient; it is also imperative to establish the kind of relationship that triggers the healing process (Dossey, Kegan & Guzetta, 2004). In such a case, the healing process becomes one in which the nurse exchanges in a very authentic way not only energy and truth but also the kind of communication that fosters healing for the patient (Dossey, Kegan & Guzetta, 2004). The patient has many hidden capacities and it is up to nurses to help arouse the patient through spiritual care so that in the patient’s feeling of freedom to share information about hopes and dreasm, dignity, and connections with others, the patient may be on his or her towards a more improved health condition (Puchalski, 2007). A person who is able to tap into inner spiritual resources for a sense of hope, has a good chance of getting on the path of healing (Dossey, Kegan & Guzetta, 2004). Spirituality and religion: Keeping hope alive Research studies indicate that most patients consider spirituality and religion to be of great importance to them (Dossey, Kegan & Guzetta, 2004). There are other studies that point to a great need on the part of those facing serious diseases or even death to welcome religion and spirituality into their lives (Mauk & Smith, 2003). Among some of the more common elements of spirituality are prayer, meditation and various other rituals and traditions Dossey, Kegan & Guzetta, 2004).In fact, in times of crisis, prayer has been a great coping mechanism for many people (El-Nimr, Green & Salib, 2004). This includes caregivers, some of whom claim that attending religious meetings provides them with a reason to continue even when the conditions are truly bad (Mauk & Smith, 2003). Prayer remains a key element for many spiritually minded people (Funnel et al, 2004). And the feeling of support and comfort that many religious faiths share have been found to contribute to a patient’s positive feelings and experiences (Mitchell, Bennett & Manfrin-Ledet, 2006) .S3 On the final journey, the need for spiritual support People on the verge of death realize more than ever how that last journey could be made bearable when one has some measure of spiritual support (Puchalski, 2007). Without spirituality, life at times, seems meaningless. The understandings that spirituality brings into people’s lives includes that of meaning and value, which translates into a sense of dignity even in the face of horrendous difficulties (Puchalski, 2007). Care that is focused on the client must needs include the totality of dimensions encompassing the physical, the emotional, the social, and of course, the spiritual. This is simply because there are interconnections among the dimensions (Puchalski, 2007). Easing the dying journey includes deploying knowledge and skill and the need to do what is necessary for the departing one at each successive phase of what might otherwise be a lonely and gruelling journey into the hereafter (Dossey, Kegan & Guzetta, 2004). The knowledge that nurses need include an understanding of the cultural and religious underpinnings of a person’s life in particular as such beliefs relate to death. For instance, for some patients, it is a matter of taboo to discuss the final journey whereas others have the strength and feel a need to openly discuss this final journey into death. Knowing how a patient feels about such discussions, therefore, is crucial so that one can do right by the patient. In fact, some individuals find a great deal of comfort from their religious faith and are able to surrender knowing that what awaits them on the other side is not so dreadful (Dossey, Kegan & Guzetta, 2004). In effect, a nurse’s efforts to understand the client’s religious or spiritual background can help deliver a service that is not only tailored but also one that is likely to be appreciated for the insights that it involves because of the cultural fit (Dossey, Kegan & Guzetta, 2004). In many hospitals it is the duty of nurses to give care that includes taking of administrative processes and providing medication to ease patients’ pain. More than these, however, the information nurses share among themselves can help bring emotional serenity to the patient and make the care holistic in nature. In this regard, the needs of the family, in terms of their spiritual orientation cannot be ignored either (Chang& Johnson, 2008). With palliative care, nurses are able to provide an environment within which patients can die in dignity and come to terms with their situation even if it involves a measure of pain and suffering (Chang& Johnson, 2008). It cannot be overemphasized the extent to which a nurse’s support for the family and patient can be appreciated both before the event of dying and its aftermath. Part 2 of essay Working in the field of Oncology at a ward at the Royal Princess Alfred for two weeks provided me with a great deal of insight regarding what patients go through when on their journey towards death. It was my feeling that a greater emphasis on spirituality would have greatly served the needs of the patients. The service at the hospital certainly included efficiency in giving medication and maintaining records of fluid balance charts and the patients’ vital signs but it seemed quite impersonal and devoid of the kinds of communication one might expect in an environment where spirituality was valued. Research supports the need for greater emphasis on spirituality in oncology wards because of the ever-presence of death and bereavement in this setting (Callister et al, 2004). All nurses are aware of the importance of making physical assessments. They know the importance of giving medical interventions to help patients cope. There has been a lack, however, when it comes to providing spiritual care (Conner & Eller, 2004). Among the reasons nurses have given for not doing enough in the area of spirituality include the lack of adequate tools to carry out spiritual assessments, lack of proper education and preparation in that regard, and the inability to discern between religiosity and spirituality (Dunn, Handley & Dunkin, 2009). Some others see the issue of spiritual care as not necessarily belonging in the nurses’ domain but rather in that of pastoral care workers O’Brian, 2007). While they do what they can to ease patients’ distress, nurses may be going through their own personal or professional challenges including the pressure of having so many patients under their care. Proper in-service training opportunities for nurses in the area of spiritual care in the face chronically ill patients would be a step in the right direction. Nurses need to have the opportunity to attend seminars and lectures from experts and those with cultural knowledge and spiritual knowledge especially as it relates to the hospital setting. Shi et al (2001) suggests that four levels are necessary to provide proper training in spiritual care and that these include a clarification of the concepts of spiritual care, the provision of a spiritual plan that is rooted in a particular culture, nurses’ own understanding of their personal value systems and spiritual needs and the clarification of the symbolic meaning and effects of carrying out religious rituals. Conclusion Nurses, like other professions, continually seek ways by which they can improve the service they provide. In this regard, one area that seems very important but seems to be lacking is that of spirituality in the health care setting. The situation is confounded in part because of the increasing secularisation of society and the confusion that attends religion and spirituality. The understanding that one does not have to be religious to be spiritual may be just the liberating element that many nurses need, as well as the right training so that they can add spirituality to the to the range of tools at their disposal as they help chronically ill people make their journey into the hereafter. Read More

Not a few families have expressed gratitude for nurses’ prayer and weeping for their loved ones (Lubkin & Larsen, 2005). Considering the relatively higher number of hours nurses spend with patients compared with other health care workers, and considering the importance of spirituality to many patients, it only makes sense that some space be carved out for spirituality in the training and nurturing of nurses (Mitchell, Bennett & Ledet, 2006). Nurses need to connect with the holistic roots of their practice, which encompasses consideration of body, mind, and spirit (Mitchell, Bennett & Manfrin-Ledet, 2006).

When nurses are anchored well as knowledgeable, that is, in touch with the spiritual needs of their patients, they can much better fulfil the role of sharing such key information regarding spiritual care with other collaborators , including social workers, physicians, physical therapists, chaplains, and pastoral care workers (Puchalski & Miller, 2006). Getting to the bottom of Spirituality The root of the term “spirituality” can be traced to the Latin word “spirare” which is “to breathe life” and embraces such elements as the thoughts and feelings that not only enrich people’s lives with meaning but also help to chart people’s pathways through life (Dossey, Kegan & Guzetta, 2004).

Spirituality is the essence of a person and reflects the wholeness and being of each person (Lubkin & Larsen, 2007). Spiritual, however, must not be confused with religion, which is much more narrow in its scope. In effect, while not everyone admits to being religious, in fact, everyone is spiritual (Dossey, Kegan & Guzetta, 2004). The breadth of spirituality is reflected in the myriad ways in which it can be interpreted, such as, transcendence, connectedness with nature, self, or others; some perceive spirituality as a form of energy or connect it with family, community, or universal love (Lubkin & Larsen, 2007).

It is so much more likely that nurses that have gained some awareness of their own spirituality can, in comfort, interact positively with other professionals while giving spiritual care the best way they know how (Dossey, Kegan & Guzetta, 2004). The Role of Spiritual Assessment in Good Patient Care As with other aspects of nursing care, good spiritual care ought to start with the gathering of information, that is, the kind of spiritual assessment that includes thoughts, memories and other experiences that have a place of importance in the client’s life.

(Dossey, Kegan & Guzetta, 2004). With such information to hand, the care that the client gets can be tailored to personal concerns (Rumblod, 2007). As important as spiritual assessment is, trying to obtain the necessary information about spirituality requires establishing a relationship of personal concern first. With such trust in place, it is then possible for a client to open up candidly about matters of spirituality, including what their concept of God might be and what drives their sense of hope and spiritual beliefs as well as religious practice and rituals(Crisp & Taylor, 2005).

The two fundamental theoretical frameworks within which spiritual care is grounded are the bio psychosocial model of care and other patient centred care models (Puchalski & Miller, 2006). What are spiritual needs? Spiritual needs have to do with the kind of meaning and purpose that people have for their lives; it also includes the sense that people have to love others and be loved in return; and it extends to a person’s having to cling on to hope or trust and to be connected to others; to strengthen others and be strengthened by them, and to feel a sense of transcendence ( Lemmer, 2005).

A patient whose spiritual needs are ignored is likely to descend into greater suffering (Lemmer, 2005). And if the chronic condition continues to get worse, lack of spirituality to shore up the hardship may leave the client more and more aware of the loss of control and independence, a situation that is likely then to heighten the feeling of spiritual distress (Lemmer, 2005).

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