How nurses today view spiritual care

'Holistic Nursing' was introduced in the nursing profession in the 1980s and  became one of the key terms frequently used in the '90s in patient care.

A good friend of mine, nursing theorist Dr. Barbara Dossey, is one of the experts in Holistic Care Nursing defines holism as being "concerned with the inter-relationship of body, mind and spirit in an everchanging environment" (Dossey, 1995)

But even before Holistic Care Nursing was coined, the great founder of modern nursing, Florence Nightingale was a firm believer of holistic care. She fused her traditional Christian values of respect, care, compassion to the 'modern' nursing values of autonomy, non-maleficence and professionalism. She said, "The needs of the spirit are as critical to health as those individual organs which make up the body".

As nurses care for their clients, we have observed that when our clients are  exposed to emotional or spiritual hurts or stresses, it will actually manifest in many physical ailments - which we term as psychosomatic in nature. These stresses are non-tangible factors in patient care but are also important for nurses to attend to.

Spiritual and psychosocial needs are less tangible because they are often complex and difficult to measure. When needs are more difficult to measure or are less tangible, they are also less prioritized or are neglected. Moreover, some spiritual needs go outside of its religious framework, and this when happens, often go unnoticed.

Nurses need to understand the nature of each client's spirituality and how different persons express it, if he/she want to take care of the person holistically. Personal spirituality does not mean religion or its religious framework alone, but goes beyond that which is concerned with the meaning of things and with the person's relationship to that which transcends the material (Simsen, 1985).

Filipinos are known to be both religious and spiritual with around 80% Christian believers and the rest from other denominations & beliefs or non-believers. How do Filipino nurses do holistic nursing care which includes the client's spiritual needs?

Often times nurses encounter addressing spiritual needs of their clients such as the need for prayer or spiritual counseling. When this happens, nurses usually refer their client to another member of the team, the chaplains. But whenever there are no chaplains, nurses should be also prepared on how to address these needs. There are also clients who have strict religious beliefs that may affect how nurses deliver care to them.

When nurses do spiritual care to their clients, the primary goal is to mobilize client's spiritual resources and it should never be an attempt to win converts in any particular religion or to convince your patient that one religion or spiritual belief is above the other. It is also not an attempt to negate the spiritual views of the client nor to assert spiritual views of the nurse.

Spiritual assessment and care should be sensitive enough to the needs of the client and is also based on the relationship of trust between the nurse and the client. That degree of trusting relationship enables the nurse to thoroughly assess the client and be able to have objective respect for their spiritual beliefs and religious practices.

Nurses should also be sensitive in their communication with their clients regarding spirituality being careful not to influence their clients to be more centered towards the spiritual/religious beliefs of the nurse. During such times, the nurse must remain unbiased, objective and understanding.

As Holistic Care Nursing expands continuously over the next years more nurses acknowledge that spiritual needs are as essential as physical needs for a person's well-being. However, increase in awareness, preparation and continuous collaboration with the healthcare team is necessary to delivery quality care which is based on the client's personal needs.

This is a growing challenge to all nurses everywhere. Confidence in providing spiritual care and the nurse's ability in recognizing and meeting diverse spiritual needs will make them more flexible and responsive to clients.