The standards for culturally responsive nursing care include: showing reverence for religious differences, showing respect for the individuality of the patient, keeping an open mind, assuming nothing, asking questions, and paying attention to verbal and non-verbal reactions of the patient.
If excellent care for all patients is to be available, it is necessary that nurses learn to relate to patients of different faiths and cultures. Even when the patient’s background is similar to the nurses’, it does not mean the patient shares the same beliefs as the nurse. Treating the patient as an individual is important because of differences such as religion, culture, gender, education, socioeconomic status, and family traditions. Nurses need to appreciate and respect the patient as an individual.
The Role of Spirituality in Nursing
When nurses deal with patients who are going through any form of physical or emotional illness, spiritual distress often follows. Even though nursing care focuses primarily on healing the body and mind, it is important to realize that when the spiritual side is not at ease, the body and mind would also not be at peace. When a patient is suffering from a terminal illness, they ask questions like, “Why is this happening to me?”, “What did I do to deserve this?”, “Has God forbidden me?” etc.
During this time, they may not be taking their medicines on time. Their focus is not on the physical things but on something that is more intangible.
In situations like these, it is not physical or emotional treatment that will help the patient find peace. It becomes very important for a nurse to cater to the spiritual needs of the patient. And a nurse is the most appropriate person to do this since they spend the most time with the patient. During times of spiritual distress, it is often a nurse that can comfort the patient by bonding on a spiritual level. This bonding and connection enables the patient to spiritually confide in the nurse.
Nurses play an important role in honoring the religious diversity of patients and families according to Kathleen Penzes’, MN, RN-BC, NEA-BC, executive director of women’s services and nursing administration at St. Joseph Hospital of Orange, a faith-based organization. “It’s part of our nursing background to honor the spirituality of our patients, so some of the initial nursing assessment questions address religious beliefs and preferences,” she said.
Over the years, Penzes has learned people’s religious beliefs usually come into play when they’re ill or dying. “We will make whatever accommodations they request to honor those beliefs,” she said. “Some of our patients have an end-of-life plan, analogous to the birth plans some families develop when they’re expecting a child, and those plans may involve bringing extra people into the clinical setting.”
When end-of-life rituals involve large gatherings, music or chanting, Penzes and her colleagues do what they can to minimize disruption to other patients. “While it can be a challenge in settings such as critical care to make accommodations, our nurses understand they can make exceptions to the guidelines to honor their patients’ religious beliefs,” she acknowledged.
Spirituality in Nursing Today
How does nursing today view spiritual care? For a long time, nursing literature concerning spiritual care was directed towards belief systems and religious practices. If considered at all, it was defined in a narrow way as relating to religious functions and intervention officially to calling the hospital chaplain.
Regardless of that, nurses often face spiritual need and recognize the more obvious expressions of it. Statements such as “God must be punishing me” or questions like, “Nurse, do you think there is anything after death?” were recognized as spiritual concern.
Spiritual care can be a natural part of total care which fits easily into the nursing process of assessment, planning, implementation and evaluation. Placing spiritual need and spiritual care within this framework has proved to be helpful, for practical reasons. The types of knowledge used in the nursing process – practice wisdom, ethics of practice, and scientific knowledge – are all relevant to evaluating spiritual needs and planning spiritual care. It can also then be documented in nursing care plans, to guarantee continuous care.
Meeting the Challenge
Spiritual care can still be a scary prospect for many nurses. The differing beliefs, requirements and hopes of patients are a major challenge. Nursing involvement already provides some spiritual assistance. Just being with patients, listening to their concerns, sympathizing and responding, is therapeutic when it comes to meeting the needs of the human spirit – the need for love and understanding, meaning and purpose, and hope. Nurses often fail to recognize and document this necessary care.
There are nursing texts that give an overview of the religious/spiritual requirements of a number of major faiths. This is important because in many societies culture and religion are closely woven together. A working knowledge of major religions – especially their beliefs regarding issues such as health and illness, suffering and death – will be highly relevant to nursing care. Knowledge of customs, ceremonies, cleanliness/hygiene rules, and food laws will be of practical value.
Nursing acknowledges that spiritual needs are as important as physical needs for a person’s well being. Increased awareness and preparation, together with a united approach, will be shown to enhance the quality of care and strengthen their contribution to the ongoing development of the profession. It will require teamwork and unity in order to provide comprehensive, consistent and ongoing spiritual care. There is strength in a diverse yet united approach to the challenge of spiritual care in nursing practice.