Teaching Spiritual Care as an Aspect of Nursing Practice Peggy Matteson, PhD, RN, FCN Minister of Health, United Congregational Church, Middletown, RI Chair, Dept. Nursing, Salve Regina University, Newport, RI
What? We are teaching nursing students Care of the body, mind, and spirit What is spiritual care?
What is spiritual care? Interventions, individual or communal, that facilitate the ability to express the integration of the body, mind, and spirit to achieve wholeness, health, and a sense of connection to self, others, and a higher power. (ANA/HMA, 2005)
Why? Why should we be teaching spiritual care as a integral part of nursing care?
Definition of nursing Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations. Nursing s s Social Policy Statement (2nd edition),
Nursing: Scope and Standards of Practice The nursing needs of human beings are identified from a holistic perspective and are met within the context of a culturally sensitive, caring interpersonal relationship (pg 10) Holistic Based on an understanding that patient is an interconnected unity and that physical, mental, social, and spiritual factors need to be included in any interventions. The whole is a system that is greater than the sum of its parts.. (ANA, 2004 pg 48)
The art of nursing embraces dynamic processes that affect the human person, including, for example, spirituality, healing, empathy, mutual respect, and compassion. compassion. (ANA, 2004, pg 12)
What is spiritual care? Interventions, individual or communal, that facilitate the ability to express the integration of the body, mind, and spirit to achieve wholeness, health, and a sense of connection to self, others, and a higher power. (ANA/HMA, 2005)
What is the difference between spiritual care and psychological care? Spiritual care refers to issues of life in terms of ultimate meanings, values, relationships with the Higher Power Psychological care refers to issues of human relationships.
Assumptions about spirituality: Each person has a spiritual dimension. Expression of spirituality differs depending on race, gender, social status, religion, ethnicity, and experience. Spirituality is expressed and enhanced in formal and informal ways, religious and secular ways. The environment shapes and can enhance or diminish one s s expression of spirituality.
Spirituality How a person orients themselves to a Higher Power and tries to find the meaning of life. Is private and expressed in a uniquely personal way. Gives each person a perspective with which to view life. Is often expressed to the world through religious beliefs and practices.
Religion An orderly system of beliefs, values, symbols, and ritual used to express a group s s orientation to a Higher Power A community of believers agrees upon this system. Usually includes a structure for development of a personal spirituality.
Comparison between Spirituality and Religion Spirituality 1. Personal 2. Invisible 3. Inner thoughts and feelings (internal) 4. Individualized Religion 1. Community 2. Objective and measurable 3. Standard worship and rituals (external) 4. Systematic
Nursing Diagnoses - Spirituality Domain 10 Life Principles Spiritual Distress Risk for Spiritual Distress Readiness for Enhanced Spiritual Well-Being (NANDA, 2009)
Assessment Variety of tools developed in different disciplines for different reasons. In our BS curriculum focus on screening for spiritual distress
Spiritual Distress Definition: Impaired ability to experience and integrate meaning and purpose in life through connectedness with self, others, art, music, literature, nature, and/or a power greater than oneself. (Herdman, 2009)
Defining characteristics Connections to Self Examples are: Anger; Expresses lack of acceptance; Expresses lack of serenity; Guilt Connections with Others Examples are: Expresses alienation; Refuses interactions with significant others; Refuses interactions with spiritual leaders; Verbalizes being separated from support system Connections with Art, Music, Literature, Nature Examples are: Disinterested in nature; Inability to express previous state of creativity Connections with Power Greater than Self Examples are: Expresses being abandoned; Expresses hopelessness; Expresses having anger toward God; Expresses suffering
Risk for Spiritual Distress Definition: At risk for an impaired ability to experience and integrate meaning and purpose in life through connectedness with self, others, art, music, literature, nature, and/or a power greater than oneself. (Herdman, 2009)
Definition: Readiness for Enhanced Spiritual Well-Being Ability to experience and integrate meaning and purpose in life through connectedness with self, others, art, music, literature, nature, and/or a power greater than oneself that can be strengthened. (Herdman, 2009)
Definition: Impaired Religiosity Impaired ability to exercise reliance on beliefs and/or participate in rituals of a particular faith tradition.
Risk for Impaired Religiosity Definition: At risk for an impaired ability to exercise reliance on religious beliefs and/or participate in rituals of a particular faith.
Readiness for Enhanced Religiosity Definition: Ability to increase reliance on religious beliefs and/or participate in rituals of a particular faith tradition
Evolution in Our Curriculum Content 1 credit workshop: Spiritual Care in Nursing Practice Health Assessment Course and Foundations of Nursing course How are your spirits? Concepts integrated into all other courses
Follow Nursing Process Assess Diagnose Outcomes identification Plan Develop intervention with patient Implementation Meet basic needs of being a Healing Presence with patient Refer to acceptable and appropriate nursing and interdisciplinary colleagues: Facility-based spiritual care provider Patient s s Spiritual leader clergyperson (pastor, priest, rabbi, shaman), lay minister, or Faith Community Nurse Evaluation
Faith Community Nurse (FCN) A registered professional nurse, actively licensed with the state, who serves as a member of the staff of a faith community. The FCN promotes health as wholeness of the faith community, its groups, families, and individual members, and the community it serves through the practice of nursing as defined by the nurse practice act in the jurisdiction in which the FCN practices. (ANA/HMA, 2005)
References ANA, (2003). Nursing s s Social Policy Statement. 2 nd ed. Silver Spring, MD: Nursesbooks.org. ANA, (2004) Nursing: Scope and Standards of Practice. Silver Spring, MD: Nursesbooks.org. ANA & HMA, (2005). Faith Community Nursing: Scope and Standards of Practice.. Silver Spring, MD: Nursesbooks.org. Herdman, T. H. (Ed.). (2009). NANDA international Nursing Diagnoses: Definitions & Classification 2009 2011.. West Sussex, UK: Wiley- Blackwell. Hodge, D. R. (2003). Spiritual Assessment: A Handbook for Helping Professionals. Botsford, CT: North American Association of Christians in Social Work. Miller, J.E. & Cutshall, S.C. (2001). The Art of Being a Healing Presence. Fort Wayne, IN: Willowgreen. Taylor, E. J. (2002). Spiritual Care: Nursing Theory, Research, and Practice. Upper Saddle River, NJ: Prentice-Hall, NJ. Taylor, E. J. (2007). What Do I Say? Talking with Patients about Spirituality. Philadelphia: Templeton Foundation Press. Comes with a DVD.