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. Nursings 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.
(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 ones 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
groups 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)

Readiness for Enhanced

Spiritual Well-Being
Definition:
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)

Impaired Religiosity
Definition:
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
Patients 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). Nursings Social Policy Statement. 2nd 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: WileyBlackwell.
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.