1. Spiritual Needs: Spiritual Caring and Religious Differences
Chapter 17
Spiritual Needs: Spiritual Caring and Religious Differences
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2. Spirituality and Religion (p. 211-212 )
Spirituality is the life-force that penetrates a person’s entire being. It an essential part of being human.
It includes the beliefs and value system that give people strength and hope. Spirituality is related to experience.
Religion has to do with giving form to that experience.
Spirituality focuses on what happens in the heart.
Religion tries to make rules and capture that experience in a system.
What are some examples of religious rituals?
Can a person be spiritual, but not religious? Religious, but not spiritual?
How does one practice spirituality? (prayer, meditation, appreciating nature, etc.)
Religion provides us with outward signs of what we believe. What are some examples? (rosaries, yarmulkes, hijabs)
Spirituality focuses on what happens in the heart and mind; religion makes rules and captures the spiritual experience in a system.
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3. Spiritual Dimension vs. Emotional Dimension (p. 212 )
Spiritual dimension—refers to the relationship of a person to a higher power and gives insight into the meaning of life, suffering, and death
Emotional dimension—refers to how a person responds to and deals with feelings of joy, anger, sorrow, guilt, remorse, love, etc.
How do people express their spirituality? (often in private; crying, praying, journaling, and meditating)
Many people are unprepared for illness and the prospect of dying; this is why spiritual care is so important.
In what ways can a person’s spiritual dimension affect his or her health? Hope, belief of ever after a better place, attitude about getting better,
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4. Importance of Spiritual Care (p. 212 )
Involves helping patients develop awareness of and maintain the following:
Inner strength
Self-awareness
Life’s meaning and purpose
Relationship to others
Relationship to a higher power
Avoid waiting for crisis situations to occur to be concerned about spiritual care.
The Joint Commission requires spiritual assessments and interventions to support the spiritual needs of patients and families.
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5. Who Needs Spiritual Care? (p. 212 )
Patient situations that may intensify the need for spiritual care
Hospitalization
Patients who are in pain
Patients who have a chronic or incurable disease
Patients who are dying
Families who have experienced the death of a loved one
Patients who are facing an undesirable outcome of illness, such as an amputation
Patients who have lost control of themselves
Parish nurses recognize the relationship between spirituality and health and encourage spiritual growth in their patients.
What effect may patients’ beliefs and values have on their illness?
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6. Gathering Data for Spiritual Issues (p. 212 )
First Step
Providing spiritual care for patients is to strive to be personally comfortable with spiritual matters.
Second Step
Become aware of your own spirituality and the spirit that is the essence of you.
Gather data about your spiritual self. Page 212 Try This.
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7. Meeting the Spiritual Needs of Patients and Their Families (p. 213 )
Ask questions
Show interest
Listen with an understanding attitude
Respond naturally to spiritual concerns
Help patients face reality with hope
Encourage patient’s active involvement
Allow families to participate in care
Avoid false assurances
Be supportive and empathetic with the dying
Caring for someone on a spiritual level is very powerful, as well as difficult.
Why might some people find it difficult to talk about spiritual or religious issues with patients? What are some ways to overcome the difficulties?
Sometimes a nursing intervention at the spiritual level is not a conscious act that is learned in class—it is also instinctual.
How is patient care enhanced when his or her spiritual needs are considered?
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8. Spiritual Care Interventions (p. 213 )
Ask open-ended questions
Actively listen, make eye contact
Be nonjudgmental
Avoid giving advice or lectures
Avoid trying to change a person’s beliefs
Be aware of the patient’s nonverbal messages
Understand the patient’s feelings
What would you do for or say to a woman whose baby was stillborn?
Sometimes, rather than offering advice or making suggestions, offer the patient space and just listen.
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9. Spiritual Care Interventions (cont’d) (p. 213 )
Expect to learn from patients
Stay with the patient after unfavorable diagnosis
Pray with the patient if asked
Read to the patient if asked
Assist with the patient’s participation in religious/spiritual rituals
Protect the patient’s religious/spiritual articles
What questions should a nurse ask a patient who is of a religion that is unfamiliar to the nurse?
What religious practices or rituals are important to you?
What dietary restrictions or inclusions do you follow?
How does your religion view pain and suffering?
Does your religion prohibit people of the opposite sex from giving care?
Some areas to consider for nursing interventions include food (preferences and meal times), gender of patient and staff, special days of the week or holy days, religious articles in the room, and anything else a patient might share with the nurse.
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10. Pastoral Care Team (p. 213 )
Made up of ministers, priests, rabbis, consecrated religious women, representatives of other religious organizations, and laypersons
Educated to meet spiritual needs, in addition to religious needs, in a health care setting
For what reasons might a patient request to see a member of the pastoral care team?
If you were a patient, would you like to see a member of the pastoral care team? If so, under what conditions?
Patients with spiritual needs are often scared or emotional and do not want to be left alone.
If the nurse is unable to stay with a patient in need, another staff member should always be called.
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11. Personal Religious and Spiritual Needs (p. 214 )
Spiritual Practices
Religious Rituals and Practices
Atheists and Agnostics
Spiritual Distress
What is the difference between an atheist and an agnostic? (Atheists believe that there is no God or supernatural; agnostics believe that God’s existence can be neither proved nor disproved.)
Do atheists and agnostics have spiritual needs? How could a nurse provide spiritual care for these patients?
Discuss how spiritual distress may be exhibited.
How might the health care setting trigger spiritual distress in patients? (They cannot fulfill the rituals and practices of their faith, or there is conflict between the health regimen and their spiritual beliefs.)
A pastoral care team member may need to be called for patients experiencing spiritual distress.
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12. Patients’ Spiritual Practices (p.214 )
Help individuals develop awareness of self, understanding of the meaning and purpose of life, and their relationship to a higher power
Examples
Gardening
Reading inspirational book
Listening to music
Meditating
Watching select TV shows and movies
Communing with nature
What other spiritual practices may be used?
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13. Religion and the Patient (p. 214 )
The religious self refers to the specific beliefs held by an individual in regard to a higher power
Religious Denomination
An organized group of people who share a philosophy that supports their particular concept of God or a higher power, as well as worship experiences
Agnostics
Hold the belief that the existence of God can be neither proved nor disproved
Atheists
Do not believe that the supernatural exists, so they do not believe in God
Christians may find comfort and solace in their refuge in God, including passing into another life after death
How do some patients meet their spiritual needs?
The nurse may feel unsuccessful in meeting the total needs of the patient who is an atheist because atheists do not believe in the supernatural.
Encourage patients to express personal feelings about life, death, separation, and loss.
Avoid imposing personal beliefs and values on the patient.
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14. Value of Rituals and Practices (p. 214 )
Rituals are a series of actions that have religious meaning
Bring the security of the past into a crisis situation
Concrete symbols such as pictures, icons, herb packets, rosaries, statues, jewelry, and other objects can affirm the patient’s connection with a higher power
The value of patients’ rituals and religious practices is determined by their faith
There have been studies that have shown that people who have faith can recover more quickly from illness, surgery, and addiction and are less likely to die prematurely from any cause.
When patients are not allowed to practice their religious rituals, practices, and responsibilities, they may feel guilty and uneasy.
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15. Patient and Prayer (p. 214 )
Prayer is a spiritual practice of some individuals whether or not they are members of an organized religion
Can put a patient in touch with a personal God
Can decrease anxiety as effectively as a drug
Helps some patients cope with their illness or situation
Honor the request of the patient who wants to pray privately.
If the patient requests prayer, the nurse needs to assist the patient or seek assistance in this matter.
What should you do when a patient express an interest in praying?
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16. Question 1
Which amendment of the U.S. Constitution guarantees the free exercise of religion? 1. First 2. Second 3. Third 4. Fourth
ANSWER: 1
RATIONALE: The First Amendment of the U.S. Constitution guarantees the free exercise of religious choice. Starting with the pilgrims, America has had a long history of religious freedom and tolerance.
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17. Question 2
Which of the following is the oldest faith that has a belief in one God? 1. Buddhism 2. Judaism 3. Christianity 4. Islam
ANSWER: 2
RATIONALE: Judaism is the oldest faith that has a belief in one God. The prophet Abraham founded Judaism in approximately the 20th century BC.
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18. Who Is the Religious American? (p. 214 )
Hindu
Jew
Buddhist
Muslim
Lutheran
Catholic
Eastern Orthodox
Quaker
Presbyterian
Methodist
Church of Christ
Mennonite
Seventh-Day Adventist
Assembly of God
Mormon
Baptist
Wiccan
Jehovah’s Witness
Episcopalian
African Methodist Episcopalian
Christian Science
United Church of Christ
Moravian, Evangelical
Salvation Army
Nondenominational
What are the fundamental beliefs and practices of each of these religions?
What are some other religions that nurses could encounter that are not listed here?
What amendment of the U.S. Constitution allows the free exercise of religious choice?
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19. Religion in the United States (p. 215 )
2000 Religious Congregations and Membership Study conducted
All Protestant denominations accounted for 66 million members
2005 Yearbook of American and Canadian Churches
Identified the Catholic Church as the largest single denomination in the United States with over 67 million members
The World Christian Encyclopedia
5.6 million Jews comprise the largest non-Christian, organized religion
World Christian Encyclopedia
Identified 4.1 million Muslims
Starting with the pilgrims, America has a long history of religious freedom and tolerance.
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20. Avoiding False Assumptions and Stereotypes (p. 215 )
It is a false assumption to expect that all individuals of a specific religion or belief system will believe exactly the same just because they are members of that religion or belief system.
Individual differences occur within every religious or belief systems group.
Clarify with the patient the specific beliefs and practices that offer comfort to them, and are preferred by them.
Develop awareness of health issues and decisions that may involve religious or philosophical beliefs.
Avoid making generalizations about people of the same faith. There is much diversity in beliefs and practices, even among members of the same religious denomination.
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21. Judaism (p )
The oldest of faiths that have a belief in one God
The holy books of the Jews are the Torah and the Talmud
Jewish clergy are called rabbis
Worship in buildings called temples or synagogues
Major divisions
Orthodox, Conservative, and Reformed
What are followers of Judaism called?
In 1990 there were almost 18 million Jews worldwide.
The prophet Abraham founded Judaism in approximately the 20th century BC.
What are some interventions to consider when caring for Jewish patients? (Time to rest Friday evening and Saturday; kosher diet.)
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22. Christianity (p. 216-219 ) General beliefs of Christians
The Bible is the sacred book of Christians
Baptism is the rite of admission to the Christian community
Communion is partaking of consecrated (blessed) elements of bread and wine
What are the two sections in the Bible?
Many Christian patients will find comfort in reading or having someone read to them selected passages from the Bible.
Although water is used for baptizing, the method differs among groups (pouring, sprinkling, immersion).
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23. Christianity (cont’d) (p. 219-220 )
Major divisions of Christianity
Catholicism
Western
Catholics of Eastern Rites
Orthodox Eastern Churches
Protestantism
What are some interventions to consider when caring for Catholic patients?
Catholic: fast or refrain from meat on Fridays during Lent; receive anointing of sick if seriously ill; nurse may baptize if death is imminent.
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24. Islam (p. 220-222 ) Followers of Islam are called Muslims
Muslims believe in one God, Allah
Qur’an (Koran) is the holy book, contains the words of Allah as he spoke to Muhammad
Believe in paradise, hell, final judgment, prayer, fasting, and giving to the poor
Two main divisions
Sunni and Shi’ite sects
Muslims comprise approximately 20% of the world’s population.
Salvation depends on one’s commitment to Allah and his teachings in the Qur’an (Koran).
What are the Five Pillars that are essential and obligatory practices for all Muslims?
Many Muslim women are required to be covered from head to ankle at all times.
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25. Hinduism (p )
Based on a vast body of scriptures, including the Vedas and the Bhagavad-Gita
More a way of life than a religion
Belief in reincarnation
One is reborn to a higher or lower level of existence based on one’s moral behavior in the prior phase of existence
There is no common creed or doctrine in Hinduism; it is based on the accumulated treasury of spiritual laws discovered by different people in different times.
Most Hindus venerate many gods and goddesses.
Most Hindus are vegetarian.
Check dietary restrictions and respect personal or spiritual objects of Buddhist and Hindu patients.
Hinduism is based on the belief that people are reincarnated. Because the cow is a sacred symbol of reincarnation, eating beef is considered sacrilegious.
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26. Buddhism (p. 225 ) A religion, a philosophy, and a way of life
Much of Eastern beliefs have evolved from Buddhism
Originated in India
Spread to China, Japan, Korea, Tibet, Burma, Sri Lanka, Laos, Cambodia, and Vietnam.
As it spread, the core beliefs were adapted to the culture of the host country.
Siddhartha Gautama (Buddha) founded Buddhism in the sixth century BC in India.
What two core beliefs of Buddhism remained constant?
Buddhists believe that suffering is caused by a desire for material pleasures.
Buddhism is characterized by meditation and chanting. Many Buddhists are also vegetarian.
Explain all medications and their actions to Buddhist patients. If medications are refused, the refusal must be charted.
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27. Nursing Interventions for Eastern Religions/Philosophies (p. 225 )
Develop awareness that not everyone sees the world as you do
Avoid stereotyping individuals and considering them all the same
In patient care, the practical/vocational nurse can come in contact with a Japanese Buddhist, Korean Buddhist, and Tibetan Buddhist, among others, as well as American/Canadian patients who have blended Buddhism with their chosen religion.
Ask about dietary preferences and restrictions, respect religious items, and avoid removing religious items from the patient’s body.
Include all patients and family members in plans for care of the body after the patient’s death and discuss facility policies.
Always make sure appropriate consent forms are signed for procedures, surgeries, and blood transfusions.
Which religions prohibit members from accepting blood transfusions? (Christian Scientist and Jehovah’s Witnesses)
Which religions have times of fasting? (Islam, Catholic, Baha’i, Hindu)
Herbal treatments and folk medicines should be discussed with Buddhist and Hindu patients.
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28. Question 3
You are admitting an Amish patient. Which of the following is true regarding Old Order Amish? 1. They worship in churches. 2. They believe in health insurance. 3. They believe in social security. 4. They rely on mutual aid in time of need.
ANSWER: 4
RATIONALE: The Amish rely on mutual aid in time of need. Old Order Amish worship in private homes. They do not believe in health insurance or social security. They also believe that sudden fright or blood loss may cause loss of the soul.
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29. Question 4
Kristy is taking care of a Jehovah’s Witness patient. All of the following are true regarding Jehovah’s Witnesses except: 1. they refuse to take whole blood products, including plasma. 2. communion occurs once a year. 3. cremation is unacceptable to them. 4. they believe the Second Coming has begun.
ANSWER: 3
RATIONALE: Cremation is acceptable to Jehovah’s Witnesses. They also believe the soul dies at death and baptism is necessary for salvation.
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30. Question 5
Gabrielle has delivered a stillborn baby. She is Catholic and requests that you baptize the baby. You should do all of the following except: 1. baptize the baby as requested. 2. allow water to flow over the stillborn while stating, “I baptize you in the name of the Father, the Son, and the Holy Spirit.” 3. report the baptism to the pastoral care team and family. 4. do not document it in the chart, as this is not the baby’s chart.
ANSWER: 4
RATIONALE: You do want to document it in the patient’s chart. You may baptize the stillborn, using water and the standard statement. You should report the baptism to the family and pastoral care team so that they will know that it has been done. This gives the family some comfort during a very difficult time.
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