Quantitative studies have assessed nurses’ attitudes toward and frequency of spiritual care [SC] and which factors are of influence on this attitude and frequency. However, we had doubts about the construct validity of the scales used in these studies. Our objective was to evaluate scales measuring nursing SC. Articles about the development and psychometric evaluation of SC scales have been identified, using, Web of Science, and CINAHL, and evaluated with respect to the psychometric properties and item content (...) of the scales. Item content was evaluated by each of the five authors with respect to the following questions: Does the item (1) reflect a general opinion about SC instead of a personal willingness to offer SC; (2) reflect general psychosocial care instead of specific SC; (3) focus solely on religious care; (4) contain the words ‘spiritual’ (care/needs/health/strengths, etc.); and (5) contain multiple propositions, or have an unclear meaning? We found eight scales. Psychometric analysis of these scales was often meager and the items of all but one scale suffered from two or more of the five problems described above. This leads us to conclude that many quantitative results in this area are based on findings with questionable scales. Suggestions for improvements are provided. (shrink)

Spirituality is a highly contested concept. Within the nursing literature, there are a huge range and diversity of definitions, some of which appear coherent whereas others seem quite disparate and unconnected. This vagueness within the nursing literature has led some to suggest that spirituality is so diverse as to be meaningless. Are the critics correct in asserting that the vagueness that surrounds spirituality invalidates it as a significant aspect of care? We think not. It is in fact (...) the vagueness of the concept that is its strength and value. In this paper, we offer a critique of the general apologetic that surrounds the use of the language of spirituality in nursing. With the critics, we agree that the term ‘spirituality’ is used in endlessly different and loose ways. Similarly, we agree that these varied definitions may not refer to constant essences or objects within people or in the world. However, we fundamentally disagree that this makes spirituality irrelevant or of little practical utility. Quite the opposite; properly understood, the vagueness and lack of clarity around the term spirituality is actually a strength that has powerful political, social, and clinical implications. We develop an understanding of spirituality as a way of naming absences and recognizing gaps in healthcare provision as well as a prophetic challenge to some of the ways in which we practise health care within a secular and sometimes secularizing context such as the National Health Service. (shrink)

In July 1993, the Scottish Highlands Centre for Human Caring sponsored a conference with the title Exploring the Spirituality in Caring. The papers given at the conference and included in this volume are offered as a contribution to the debate that must take place in nursing and in the wider context of health care provision. Ann Bradshaw's paper puts the debate in context arguing that nursing is fundamentally a loving response to the human being created in the (...) image of God. (shrink)

A veteran nurse researcher and educator provides a spiritual perspective on the professional nurse's vocation of caring. Grounding each chapter in Scripture, O'Brien explores the Christian nurse's call to love as Jesus loved: without discrimination, reserve and, sometimes, reward.

Creating android and humanoid robots to furnish companionship in the nursing care of older people continues to attract substantial development capital and research. Some people object, though, that machines of this kind furnish human–robot interaction characterized by inauthentic relationships. In particular, robotic and artificial intelligence (AI) technologies have been charged with substituting mindless mimicry of human behaviour for the real presence of conscious caring offered by human nurses. When thus viewed as deceptive, the robots also have prompted corresponding (...) concerns regarding their potential psychological, moral, and spiritual implications for people who will be interacting socially with these machines. The foregoing objections and concerns can be assessed quite differently, depending upon ambient religious beliefs or metaphysical presuppositions. The complaints may be set aside as unnecessary, for example, within religious traditions for which even current robots can be viewed as presenting spiritual aspects. Elsewhere, technological cultures may reject the complaints as expression of outdated superstition, holding that the machines eventually will enjoy a consciousness described entirely in materialist and behaviourist terms. While recognizing such assessments, the authors of this essay propose that the heart of the foregoing objections and concerns may be evaluated, in part, scientifically – albeit with a conclusion recommending fundamental revisions in AI modelling of human mental life. Specifically, considerations now favour introduction of AI models using interactive classical and quantum computation. Without this change, the answer to the essay's title question arguably is ‘no’ – with it, the answer plausibly becomes ‘maybe’. Either outcome holds very interesting implications for nurses. (shrink)

Background: The holistic approach views the human as a bio-psycho-socio-spiritual being. Evidence suggests that among these dimensions, the spiritual one is largely ignored in healthcare settings. Objectives: This study aimed to evaluate Iranian nurses’ perceived professional competence in spiritual care, the relationship between perceived competence and nurses’ personal characteristics, and barriers to provide spiritual care. Research design: A cross-sectional study was conducted in the year 2014. Participants and research context: The study population consisted of (...) nurses working in teaching hospitals in Kashan city. Using a stratified, systematic random method, 250 samples were selected from a total of 1400 nurses. An indigenous instrument was used to assess the nurses’ competencies in spiritual care. Ethical considerations: A research ethics committee approved the study. All the participants were briefed on the study aims, were assured of the confidentiality of their personal information, and signed a written informed consent. Results: Among a total of 250 nurses, 239 answered the questionnaire completely, and in total, 23%, 51%, and 26% had poor, moderate, and favorable competence in spiritual care, respectively. No significant differences were found between the mean competence scores of spiritual care in terms of gender, marital status, employment status, and level of qualification. Significant difference was found between nurses’ overall score of competence in spiritual care and receiving training on spiritual care, nurses’ position, and the ward they worked in. Discussion: Confirming the findings of the international literature, this study puts light on the situation of nurses’ perceived competence and barriers to providing spiritual care in Iran as an eastern and Islamic context. Conclusion: Three-quarters of the nurses had moderate or unfavorable competence in spiritual care. Due to the crucial role of spiritual care in quality of care and patient satisfaction, nurses should be trained and supported to provide spiritual care. (shrink)

Palliative Care Nursing: Caring for Suffering Patients explores the concept of suffering as it relates to nursing practice. This text helps practicing nurses and students define and recognize various aspects of suffering across the lifespan and within various patient populations while providing guidance in alleviating suffering. In addition, it examines spiritual and ethical perspectives on suffering and discusses how witnessing suffering impacts nurses' ability to assume the professional role. Further, the authors discuss ways nurses as witnesses (...) to suffering can optimize their own coping skills and facilitate personal growth. Rich in case studies, pictures, and reflections on nursing practice and life experiences, Palliative Care Nursing: Caring for Suffering Patients delves into key topics such as how to identify when a patient is suffering, whether they are coping, sources of coping facades, what to do to ease suffering, and how to convey the extent of suffering to members of the health care team.Palliative Care Nursing: Caring for Suffering Patients helps practicing nurses and students define and recognize various aspects of suffering across the lifespan and within various patient populations while providing guidance in alleviating suffering. (shrink)

Increasing attention is being paid to spirituality in nursing practice. Much of the literature on spiritual care uses the nursing process to describe this aspect of care. However, the use of the nursing process in the area of spirituality may be problematic, depending upon the understandings of the nature and intent of this process. Is it primarily a descriptive process meant to make visible the nursing actions to provide spiritual support, or is (...) it a prescriptive process meant to guide nursing actions for intervening in the spirituality of patients? A prescriptive nursing process approach implies influencing, and in some cases reframing, the spirituality of patients and thereby extends beyond general notions of spiritual support. In this paper we discuss four problematic assumptions that form the basis for a prescriptive approach to spiritual care. We conclude that this approach extends the nursing role beyond appropriate professional boundaries, making it ethically problematic. (shrink)

Incorporating patients' spiritual beliefs into health care decision making is essential for ethically good care. Gadow's three-level ethical framework of ethical immediacy, ethical universalism, and relational narrative is presented as a tool for enhancing nurses' ability to explore and deepen understandings of patients' spiritual beliefs, given that these and their experiences are often expressed in a language that seems foreign to nurses. The demographic and cultural shifts that lead to the necessity to understand patients who use (...) principles and metaphors that, while commonly understood within their spiritual tradition, may seem incomprehensible to outsiders, are here set in the Canadian context. A case study on palliative sedation is used to illustrate how the ethical framework can help to reveal the spiritual certainties, principles and narratives patients bring to their health care experiences. (shrink)

Background Ethical care provided by nurses to earthquake victims is one of the main subjects in nursing profession. Objectives Given the information gap in this field, the present study is an attempt to explore the nurses’ experience of ethical care provided to victims of an earthquake. Research design and method A hermeneutic phenomenological study was performed. The participants were 16 nurses involved in providing care to the injured in Kermanshah earthquake, Iran. They were selected using purposeful (...) sampling, and in-depth and semi-structured interviews were carried out. The transcribed interviews were analyzed based on the hermeneutic approach using the analysis method proposed by Diekelmann et al. Ethical considerations The study was approved by the Research Council and Ethics Committee of Urmia University of Medical Sciences, Iran. Findings Data analyses revealed four themes and 10 sub-themes that illustrated nurses’ experience of ethical care during earthquake. The themes were (1) Respecting humanistic values (sacrifice, stepping beyond task description, and voluntary work), (2) Commitment to ethics (honesty, confidentiality, and trustworthiness), (3) Respecting dignity of victims (respecting cultural values, maintaining privacy, having humanistic perspective, and effective communication), and (4) Spiritual support (helping patients to do religious rituals Psychological support). Conclusion The results showed the nurses’ experience with providing care to earthquake victims. The findings underlined ethics and ethical values in providing nursing care during disasters. It is suggested that special courses on the importance of nursing ethics in critical situations be incorporated into nursing curriculums and in-service educations. (shrink)

BackgroundThe nursing profession considers conscience as the foundation and cornerstone of clinical practice, which significantly influences professional decision-making and elevates the level of patient care. However, a precise definition of conscience in the nursing field is lacking, making it challenging to measure. To address this issue, this study employed the hybrid approach of Schwartz Barcott and Kim to analyze the concept of conscience-based nursing care.MethodsThis approach involves a three-phase process; theoretical, fieldwork, and analytical. A systematic (...) literature review was conducted using electronic databases during the first phase to find relevant papers. The content of 42 articles that met the inclusion criteria was extracted to determine the attributes, antecedents, and consequences of consciousness care using thematic analysis. Based on the working definition as a product of this phase, the plan of doing the fieldwork phase was designed. During this phase, data were collected through interviews with nurses all of whom were responsible for patient care in hospitals. In this phase, 5 participants were chosen for in-depth interviewing by purposeful sampling. Data were analyzed using directed content analysis. The findings of the theoretical and fieldwork phases were integrated and the final definition was derived.ResultsThe integration of the theoretical and fieldwork phases resulted in identifying four key characteristics of conscience-based nursing care. Firstly, it involves providing professional care with a conscientious approach. Secondly, ethics is at the core of conscience-based care. Thirdly, external spirituality plays a significant role in shaping one's conscience in this context. Finally, conscience-based nursing care is both endogenous and exogenous, with professional commitment being the central focus of care.ConclusionConscience-based nursing care is an essential component of ethical care, which elevates clinical practice to professional care. It requires the integration of individual and social values, influenced by personal beliefs and cultural backgrounds, and supported by professional competence, resources, and a conducive organizational atmosphere in the healthcare field. This approach leads to the provision of responsive care, moral integrity, and individual excellence, ultimately culminating in the development of professionalism in nursing. (shrink)

The vast majority of contributions to the literature on spirituality in nursing make extravagant claims about transcendence, eternity, the numinous, higher powers, higher levels of existence, invisible forces, cosmic unity, the essence of humanity, or other supernatural concepts. Typically, these assertions are made without the support of argument or evidence; and, as a consequence, alternative ways of theorizing ‘spirituality’ have been closed off, while the lack of consistent scholarship has turned the topic into a metaphysical backwater. In this paper, (...) I adopt a different premise, rejecting unsupported claims, and surveying the ‘spirituality’ terrain from a naturalistic and reductionist perspective. I argue that, if we rid ourselves of non‐naturalistic assumptions, we will discover theoretical and clinical resources in health psychology, social psychology, neuropsychology, and pharmacopsychology – resources which confirm that it is possible to conceptualize the study of existential concerns, and how health professionals might respond to them, in a properly scientific manner. In order to illustrate the potential usefulness of these resources, I will take palliative care as an example. (shrink)

Background: Moral distress is increasingly recognized as a problem affecting healthcare professionals, especially nurses. If not addressed, it may create job dissatisfaction, withdrawal from the moral dimensions of patient care, or even encourage one to leave the profession. Spiritual well-being is a concept which is considered when dealing with problems and stress relating to a variety of issues. Objective: This research aimed to examine the relationship between spiritual well-being and moral distress among a sample of Iranian nurses (...) and also to study the determinant factors of moral distress and spiritual well-being in nurses. Research design: A cross-sectional, correlational design was employed to collect data from 193 nurses using the Spiritual Well-Being Scale and the Moral Distress Scale-Revised. Ethical considerations: This study was approved by the Regional Committee of Medical Research Ethics. The ethical principles of voluntary participation, anonymity, and confidentiality were considered. Findings: Mean scores of spiritual well-being and moral distress were 94.73 ± 15.89 and 109.56 ± 58.70, respectively. There was no significant correlation between spiritual well-being and moral distress ( r = −.053, p =.462). Marital status and job satisfaction were found to be independent predictors of spiritual well-being. However, gender and educational levels were found to be independent predictors for moral distress. Age, working in rotation shifts, and a tendency to leave the current job also became significant after adjusting other factors for moral distress. Discussion and conclusion: This study could not support the relationship between spiritual well-being and moral distress. However, the results showed that moral distress is related to many elements including individual ideals and differences as well as organizational factors. Informing nurses about moral distress and its consequences, establishing periodic consultations, and making some organizational arrangement may play an important role in the identification and management of moral distress and spiritual well-being. (shrink)

Spirituality has been a part of nursing for many centuries and represents an essential value for people, including nurses and patients. Cumulative evidence points to the positive contribution of spiritually on health and wellbeing. However, there is little clarity about what spirituality means. The literature reveals that nurses have ascribed a diversity of interpretations to spirituality. However, no studies have investigated how registered nurses construct their understanding of spirituality using a critical discourse analysis approach. Therefore, the aim of this (...) study was to uncover how registered nurses construct their understanding of spirituality using a critical discourse analysis approach. Twenty registered nurses from a non‐denominational public hospital and a faith‐based private hospital were interviewed about their understanding of spirituality and practice of spiritual care. A critical discourse analysis approach was used in the examination of the interview texts to uncover underlying social and power features. Links were made between the linguistic features the registered nurses used in their interviews and the broader social context of the study. Three discourses emerged from the interview texts. These include constructing spirituality through personal religious beliefs discourse, holistic discourse and empathetic care discourse. The findings of this study have implications for nurse education and policy makers. (shrink)

Background: Spiritual development is one of the most important aspects of socialization that has attracted the attention of researchers. It is needed to train nursing student and novice nurses to provide high-quality care for patients. There is ambiguity in the definition of spiritual development and its relations, especially in the eastern countries. Research objectives:: To explore the concept of spiritual development in Iranian nurses. Research design: Qualitative content analysis approach. Data were gathered from semi-structured interviews. (...) Participants and research context: The participants were 17 Iranian Muslim nurses selected using a purposeful sampling. The place of interviews was on their choice. Ethical considerations: Based on the principles of the Helsinki declaration, the focus was on preserving the participants’ autonomy, confidentiality, and anonymity. The participants were told the study purposes and trends, and their rights were emphasized; they were then asked to sign written consent forms. Formal research approval was obtained from Kerman University of Medical Sciences. Ethical approval was granted by the University Ethics Committee before the study was conducted (K/92 etc). Findings: Three themes for spiritual development were defined: obligation to religion, commitment to ethics, and commitment to law. From the results, factors such as connection to the limitless divine power, personal and society-oriented ethical codes, and commitment to the law are proposed. Discussion: There are some differences between these findings and previous study, especially in the relation of the spirituality, religion, and law. Some studies, mostly Iranian, support these findings partially. Conclusion: The results suggest that it is better to teach nursing education based on humanistic principles, ethics, and law to the new generation of nurses to improve community health and development. More studies are needed to examine the relation between these themes. (shrink)

In this paper, the historical alignment of nursing with divinity‐based perspectives and modern New Age nursing theories are explored. The nature of divinity in nursing is examined, together with the complexities and issues that arise in adopting a spiritual basis for care. The work of the key theorists in this area (Rogers, Newman, Parse, Watson, Dossey) is reconsidered and fundamental epistemological problems inherent in this approach reviewed. Specific concerns with the interpretation of holistic care, (...) adoption of doxastic logic, faith‐based rationales, influence of Caucasian Judeo‐Christian and New Age values, misappropriation of science, use of pseudoscience and development of divinity as social consumer product are discussed. Practical problems with using a spiritual basis in contemporary nursing practice are also explored and the alignment of divinity‐based nursing theories with the modern antiscience movement is examined. Overall, the re‐emergence of divinity‐based nursing and spiritual basis for care may be problematic, and would seem to counter the development of an inclusive profession. Additionally, the alignment of nursing with antiscience movements rejecting biomedicine has significant public health implications. This is argued as a regressive step for the advancement of the profession. (shrink)

Those matters that are judged to be spiritual are seen as especially valuable and important. For this reason it is claimed that nurses need to be able to offer spiritual care when appropriate and, to aid them in this, nurse theorists have discussed the nature of spirituality. In a recent debate John Paley has argued that nurses should adopt a naturalistic stance which would enable them to employ the insights of modern science. Barbara Pesut has criticized this (...) thesis, especially as it is applied to palliative care. This paper re-examines this debate with particular attention to the meaning of 'spirituality' and the justification for accepting spiritual and religious theories. It is argued that when we take into consideration the great diversity among religious and spiritual ideas, the lack of rational means of deciding between them when they conflict, and the practicalities of nursing, we find that a spiritual viewpoint is less useful than a naturalistic one, when offering palliative care. (shrink)

Spirituality in Nursing: Standing on Holy Ground addresses the relationship between spirituality and nursing practice across a variety of settings and broad perspectives related to caring for the ill and infirm, from care of special population like children, families and older adults to spiritual care during disaster situations. The current edition examines both historical and contemporary issues pertaining to the spiritual needs and care of the sick and includes topical discussions of areas such (...) as the nurse's role in spiritual care, the nurse-patient relationship, spiritual needs of special populations, and spiritual needs in areas such as mass casualty disasters and parish leadership. The author brings her considerable experience as a parish nurse to each discussion, lending a unique perspective to each of the issues addressed in this text. (shrink)

Nurses and midwives are the majority of healthcare professionals globally, including Africa, and they provide care at all levels of the health system including community levels. Nurses and midwives contribute to the care of patients with rigid or dogmatic religious beliefs or those with suicidal ideations. This review paper discusses acute and chronic diseases that have suicidal tendencies such as terminal cancer, diseases with excruciating pain, physical disability, stroke, end-stage renal failure, and diabetics who are amputated. It was (...) reiterated that nurses and midwives taking care of these patients should be alert and observant to identify their suicidal tendencies. The paper also discusses religious or spiritual inclinations that negatively affect healthcare access and adherence, especially to biomedical or western medicine. It was emphasized that some religious beliefs do not allow their followers to employ biomedical treatment and nurses and midwives should not impose their faith on patients and their families. The paper ends with a discussion on the specific roles of nurses and midwives in the care of patients with suicidal ideations such as assessment, counseling, administering medication, observation, social interaction, ensuring safety measures, and providing an enabling environment for the family to part of the care and for the observation of religious coping strategies. Nurses and midwives should enhance their knowledge and skills on suicide and increase public education on suicide prevention and identification of those at risk. (shrink)

Background: Spirituality has always been present in the history of nursing and continues to be a topic of nursing interest. Spirituality has ancient roots. The term ‘spirituality’ is interpreted as spirit and is translated as breath and soul, whereas spirituality (immateriality) is spiritual nature. Historically, the term spirituality is associated with the term religiosity, a definition that persists today, and often the two terms are used interchangeably. In the healthcare context, the construct is still. Objective To clarify (...) the concept of spirituality in nursing. Research design In this article spirituality was explored using Rodgers' evolutionary and inductive method of concept analysis. Participants and research context For this analysis, a sample of 71 articles published in English, from 2008 to 2018 from PubMed/Medline, CINAHL Plus with full text, PsycINFO, SciELO databases were retrieved. It was also accomplished an empirical search of dictionaries and e-books. Ethical considerations This study was conducted according to good scientific practice. Findings It emerged that “spirituality” is a dynamic process and has a range of attributes. The cultural dimensions, the religious and spiritual traditions, the ethnic diversity and the influence of the historical and social contexts represent the societal and historical conditions ingrained in the Western thought that influence the emergence of spirituality as a concept. Antecedents, attributes and onsequences appeared to inform and strengthen one another over time. Spirituality is a significant concept for the discipline of nursing with profound consequences for caring patients and for work organizations. (shrink)

This article explores and examines the fundamental need for nurses to include the promotion of the spiritual dimension of the health of human beings as well as the physical, mental and social facets if they truly wish to engage in holistic care. The author attempts to define the phenomenon of spirituality, aware of the dilemma that many individuals face when thinking and reflecting on this very personal and intangible issue.To be spiritual is to become fully human, the (...) article argues, and the reverse is also true. Spirituality in health is inextricable in each person’s search for the discovery of the truth about self and the meaning and purpose of life. Healthy communities are the product of healthy individuals who sow spiritual seeds such as unconditional positive regard, acceptance, respect and dignity for the benefit and advancement of individuals and humankind as a whole.The global nature of the phenomenon of spirituality is also shown by using examples of people who demonstrate compassion and communion with other human beings, in other countries in times of suffering, war and disaster. Compassion and empathy is expressed and experienced for victims of earthquakes that happen miles from home and far removed from personal or religious beliefs. Yet at such times we are all connected in the tapestry of life by our own human spirituality and earthiness.Abstract themes like compassion and justice are treated in the text within the context of spirituality. The author argues that being just and fair means that all patients have the right to achieve spiritual healing regardless of their belief systems, culture or creed. The works of some spiritual philosophers are used to reflect on this integral aspect of human caregiving.Historical symbols of spirituality are examined. The need for nurses to explore and reflect on the paradoxical concepts involved in their own spirituality is highlighted. Nurses are the essential providers of care and, therefore, the paper argues, guardians of that essential humanity that ensures that patients never become less than full human beings, whatever their condition, faith, culture or belief, or whoever they may be. The author contends that this responsibility is uniquely essential to being a nurse. (shrink)

This article reports the results of a qualitative study that used a deep interview method. The aim was to gather lived experiences of clinical nurses employed at government-funded medical centres regarding the non-materialistic and spiritual aspects of the profession that have had an important impact on their job satisfaction. On analysing the participants' concepts of spiritual satisfaction, the following themes were extracted: spiritually pleasant feelings, patients as celestial gifts, spiritual commitment, spiritual penchant, spiritual rewards, and (...) spiritual dilemmas. Content analysis of the data indicated that nurses who viewed these dimensions of job satisfaction as a significant factor considered nursing as an opportunity to worship God while providing care for patients, and regarded their aim as achieving patients' contentment by providing nursing care compatible with scientific care methods. (shrink)

As members of the largest and most trusted healthcare profession, nurses are role models and critical partners in the ongoing quest for the health of their patients. Findings from the American Nurses Association Health Risk Appraisal suggested that nurses give the best patient care when they are operating at the peak of their own wellness. They also revealed that 68% of the surveyed nurses place their patients’ health, safety, and wellness before their own. Globally, several nursing codes of (...) ethics include the requirement of self-care. Often, these codes embed the responsibility to protect and promote one’s own health within the clearly described obligation to provide safe patient care. The American Nurses Association Code of Ethics for Nurses is unique in that it states explicitly that nurses must adopt self-care as a duty to self in addition to their duty to provide care to patients. One of the basic assumptions of Watson’s Philosophy and Science of Caring is that caring science is the essence of nursing and the foundational disciplinary core of the profession. Watson’s theory of human caring provides support for the engagement in self-care. Two important value assumptions of Watson’s Caritas are that “we have to learn how to offer caring, love, forgiveness, compassion, and mercy to ourselves before we can offer authentic caring and love to others” and we also must “treat ourselves with loving-kindness and equanimity, gentleness, and dignity before we can accept, respect, and care for others within a professional caring-healing model.” Embedded within several caritas processes is an outline for a holistic approach to caring for self and others that can guide nurses to improve their mental, physical, emotional, and spiritual health. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Spirituality in Nursing PracticeRegina Conway–PhillipsPersonally, I am a Christian and follow the principles of Unity, a new thought community that espouses that each individual creates their own reality and that God’s presence is within each individual. I am a spiritual being and I am sustained by my faith.Professionally, I have been a nurse for over 38 years in various capacities including clinical, administrative and academic. When I (...) worked at the bedside in the clinical capacity, I always believed that a person’s spirituality was most evident when dealing with an illness. In practice, I frequently prayed with and for patients that I was caring for regardless of their religion.In my administrative capacity I always encouraged my staff to feel free to incorporate their faith and belief into their practice. As an administrator I felt it important to be an example to my staff and allow them to see a professional practice in a spiritually faith–based capacity.Now, in my role as an academician, I stress to each of my students that it is important for them to get to know themselves. I challenge my students to know and understand what they believe about themselves and others, what they value and why. I encourage them to really reflect and be very honest with themselves about their worldview and what influences has shaped this worldview, their faith, beliefs and values. I explain that it is important for them to know themselves before they can help others. In the health care field it is important for my students to feel comfortable when they encounter a patient in need of spiritual support.Religion and spirituality are terms that are often used interchangeably in the health care setting. Although related, these terms have different meanings to health care practitioners, administrators, academicians and patients. Religion, religiousness, or religiosity is often referred to as membership and participation in the organizational structures, beliefs, rituals and dogma of religious faiths such as Judaism, Christianity, or Islam. While spirituality has been defined as believing in a Higher Power that guides ones life and is a source of unconditional love, peace and strength; as a result, one is able to cope with life’s situations and maintain a positive attitude and assurance that all is well.When presented with the opportunity to submit a story about how I, as a health care provider integrated faith into my practice, I jumped at the opportunity because I think it is an important factor in the care of others, be they patients, peers, students or oneself. One of the concepts I explored in my dissertation research was spirituality. I have always operated from a spiritual faith–based perspective both in my personal and professional life as a nurse and more recently as an academician. Personally, [End Page E3] I define myself as a spiritual being, governed by spiritual laws, guided by spiritual principles, living a human experience. I am a Christian and a beloved child of God, placed on this earth at this time to fulfill the divine potential and purpose I was sent to serve. I believe that every human being on the face of this earth is a spiritual being whether they acknowledge, believe it or accept it themselves. As such I believe we are all one with God and one with each other and I believe that everything in our lives happen for a reason and in due time. My faith and beliefs were never more clear to me than my experience in loosing my 84–year–old mother on January 18, 2013 after a four year battle with lung cancer.Professionally, I have been a nurse for over 38 years in various capacities including clinical, administrative and academic. When I worked at the bedside in the clinical capacity, I always believed that a person’s spirituality was most evident when dealing with an illness. In practice, I frequently prayed with and for patients that I was caring for regardless of their religion. I always felt it was a privilege to witness others resilience and faith. But it was as a cancer nurse navigator that I got to truly develop as a spiritual care... (shrink)

On ancient maps unexplored lands were simply labeled ‘there be dragons’ indicating the fear that attends the unknown. Despite three decades of theoretical and empirical work on spirituality in nursing, evidence still suggests that nurses do not feel competent to engage in spiritual care. In this paper I propose that one of the reasons for this is a theory–theory gap between religion and spirituality. Generalized anxiety about the role of religion in society has led to under‐theorizing in (...) nursing about religious care. As a result, when religion and spirituality overlap at the point of care, nurses are left without the substantive knowledge required for practice. Robust religious theorizing should include thick accounts of lived religion and integrative work that enables nurses to understand commonalities across religions that are relevant to practice. As a starting point to this integrative work, nurses can be introduced to the nature and lexicon of lived religion, religious perspectives on suffering, and religious reasoning that holds meaning and mystery in tension. Such an approach will better prepare them for the realities of practice where the complexities of spirituality and religion come to play. (shrink)

Moral strangerhood is due in part to competing worldviews. The profession of nursing is experiencing a paradigm shift which creates ethical dilemmas for both Christian nurses and Christian patients. Nursing's new focus on spirituality and spiritual care presents itself as broadly defining a desired state or patient outcome — spiritual integrity — supposed to be applicable to all patients of all faiths. Analysis of nursing's definition of spirituality reveals assumptions and values consistent with an (...) Eastern/New Age worldview which may cause hostility towards Christian patients stereotyped as dogmatic or noncompliant. (shrink)

Background: Attention to patients’ spirituality, as a moral obligation of care, is now widely accepted in nursing practice. However, until recently, many nursing programs have paid little attention to spirituality. Objective: The objective of this study was to identify the impact of two different curricula, used to teach undergraduate nursing students, on increasing nursing student awareness of spirituality in the care of patients. Research design: A quasi-experimental post-intervention two-group design was conducted in 2009–2010 and (...) 2010–2011 academic years. Participants and research context: The study included a total of 130 volunteer senior-year students. The students were assigned as “the intervention group/integrated system” that were informed about spirituality or as “the control group/traditional system” that received no information on spirituality. Data were collected via a personal information form and the Spirituality and Spiritual Care Rating Scale was used to assess responses. The study was conducted at the Department of Nursing of the Faculty of Health Sciences, Cumhuriyet University, in Central Anatolia/Turkey. Ethical considerations: Permission to conduct the study at the nursing school was obtained from the schools’ management teams. The rights of the participants were protected in this study by obtaining informed consent. Findings: The results revealed that the intervention group had a higher mean score on the Spirituality and Spiritual Care Rating Scale than did the control group. The students in the intervention group defined the terms of spirituality and spiritual care more accurately than did the control group students. Discussion: Nurses are professionally and ethically responsible for providing spiritual care. Nurses’ competence in meeting the spiritual needs of their patients should be improved by undergraduate education on spiritual care. Nursing scholars reported a significant difference in the knowledge and attitudes toward spirituality of nursing students as a result of the integration of spirituality into the undergraduate nursing curriculum. Conclusion: Spirituality should be more widely included in nursing education. (shrink)

In this discussion paper we consider the influence of ethnicity, religiosity, spirituality and health literacy on Advance Care Planning for older people. Older people from cultural and ethnic minorities have low access to palliative or end-of-life care and there is poor uptake of advance care planning by this group across a number of countries where advance care planning is promoted. For many, religiosity, spirituality and health literacy are significant factors that influence how they make end-of-life decisions. (...) Health literacy issues have been identified as one of the main reasons for a communication gaps between physicians and their patients in discussing end-of-life care, where poor health literacy, particularly specific difficulty with written and oral communication often limits their understanding of clinical terms such as diagnoses and prognoses. This then contributes to health inequalities given it impacts on their ability to use their moral agency to make appropriate decisions about end-of-life care and complete their Advance Care Plans. Currently, strategies to promote advance care planning seem to overlook engagement with religious communities. Consequently, policy makers, nurses, medical professions, social workers and even educators continue to shape advance care planning programmes within the context of a medical model. The ethical principle of justice is a useful approach to responding to inequities and to promote older peoples’ ability to enact moral agency in making such decisions. (shrink)

Religion and spirituality are integral to the philosophy of palliative care, shaping its approach to spiritual care. This article aims to examine the discourses within palliative care research to illuminate prevailing assumptions regarding spiritual care. Eighteen original articles were analyzed to examine how spiritual care is understood within palliative care. The analysis, informed by Foucault, aimed to identify recurring discourses. The finding reveals that, in palliative care research, spirituality is viewed (...) as enigmatic yet inherently human and natural, assuming that every individual has a spiritual dimension. The analysis points to healthcare professionals being expected to hold certain qualities to put spiritual care into practice. The analysis also reveals that in the analyzed articles, the concept of spiritual care is rooted in a Christian context, with the belief that all individuals possess inherent spirituality or religiosity, a concept often associated with Christian theology. The included articles often utilize theological terms and emphasize a monotheistic viewpoint. Spirituality is articulated as a complex, distinct concept, challenging clear definitions and professional responsibilities. Further, a moral formation of healthcare professionals is described, interpelling and ascribing qualities that healthcare professionals need to provide spiritual care. (shrink)

In the nursing literature, a number of qualities are associated with loving care. Reference is made to, among other things, humility, attentiveness, responsibility and duty, compassion, and tenderness. The author attempts to show that charm, in the Marcelian sense, also plays a central role. It is argued that the moral foundation of charm is a unity of agape and eros. An impartial giving of the self for others is clearly of fundamental importance in an ethic of care. (...) Including charm in the discussion points to the fact that eros also plays a crucial role. Eros produces a passion for people and for life. It is a physical and spiritual energy that animates a person in all facets of her life, including her caring work. (shrink)

Spirituality has long been considered a dimension of holistic palliative care. However, conceptualizations of spirituality are in transition in the nursing literature. No longer rooted within religion, spirituality is increasingly being defined by the universal search for meaning, connectedness, energy, and transcendence. To be human is to be spiritual. Some have argued that the concept of spirituality in the nursing literature has become so generic that it is no longer meaningful. A conceptualization that attempts to be (...) all‐encompassing of what it means to live a human life has a tendency to render invisible the differences that make life meaningful. For palliative patients in particular, a generic approach may obscure and relativize the important values and beliefs that inform the critical questions that many patients grapple with at end of life. A different approach to conceptualizing spirituality can be achieved through the use of typologies. Rather than obscuring difference, categories are constructed to illuminate how spirituality is understood within a diverse society and how those understandings might influence patient–provider relationships. What follows in this article is a dialogue illustrating one typology of spirituality constructed from a review of selected nursing literature. The hypothetical narrator and three participants, representing the positions of theism, monism, and humanism, discuss their understandings of spirituality and religion, and how those understandings influence the intersections between nursing ontology, epistemology, and spiritual care. (shrink)

This article aims to help readers to learn about health care related cultural and religious beliefs and spiritual needs in Chinese communities. The recall diary of a severe acute respiratory syndrome (SARS)-infected intern working in Hoping Hospital in Taiwan during the 2003 SARS epidemic is presented and used to assist in understanding one patient’s spiritual activities when personally confronted with this newly emerging infectious disease. The article also gives an overview of the 2003 SARS epidemic in Taiwan, (...) and discusses people’s general perceptions towards infectious diseases, their coping strategies concerning disease, and their spiritual beliefs, the psychological impact of the 2003 SARS outbreak in Chinese communities, Chinese myths about infectious disease, and the religious activities of a SARS-infected intern in Taiwan. Recommendations are given on how to achieve quality holistic nursing care. (shrink)

The aim was to synthesize the findings of empirical research about the unmet nursing care needs of older people, mainly from their point of view, from all settings, focusing on (1) methodological approaches, (2) relevant concepts and terminology and (3) type, nature and ethical issues raised in the investigations. A scoping review after Arksey and O’Malley. Two electronic databases, MEDLINE/PubMed and CINAHL (from earliest to December 2019) were used. Systematic search protocol was developed using several terms for unmet (...) care needs and missed care. Using a three-step retrieval process, peer-reviewed, empirical studies concerning the unmet care needs of older people in care settings, published in English were included. An inductive content analysis was used to analyse the results of the included studies (n = 53). The most frequently used investigation method was the questionnaire survey seeking the opinions of older people, informal caregivers or healthcare professionals. The unmet care needs identified using the World Health Organization classification were categorized as physical, psychosocial and spiritual, and mostly described individuals’ experiences, though some discussed unmet care needs at an organizational level. The ethical issues raised related to the clinical prioritization of tasks associated with failing to carry out nursing care activities needed. The unmet care needs highlighted in this review are related to poor patient outcomes. The needs of institutionalized older patients remain under-diagnosed and thus, untreated. Negative care outcomes generate a range of serious practical issues for older people in care institutions, which, in turn, raises ethical issues that need to be addressed. Unmet care needs may lead to marginalization, discrimination and inequality in care and service delivery. Further studies are required about patients’ expectations when they are admitted to hospital settings, or training of nurses in terms of understanding the complex needs of older persons. (shrink)

Background: Patient safety, which is a patient’s right, can be threatened by nursing errors. Furthermore, nurses’ feeling of “being a wrongdoer” in response to nursing errors can influence the quality of care they deliver. Research objectives: To explore the meaning of Iranian nurses’ experience of “being a wrongdoer.” Research design: A phenomenological approach was used to explore nurses’ lived experiences. Nurses were recruited purposively to take part in semistructured interviews, and the data collected from these interviews were (...) analyzed using Van Manen’s thematic analysis. Participants and research context: Eight nurses working in three private or governmental hospitals in Tehran, Iran. Ethical consideration: The research design was approved in each participating hospital, and all interviews were carried out at a predetermined time in a private place. Findings: Five themes were extracted from the data: “wandering in unpleasant feelings” (with two subthemes: “unpleasant physical feelings” and “unpleasant emotions”), “wandering in the conscience court” (with three subthemes: “being the accused,” “being the victim,” and “being the judge”), “being arrested in time,” “time for change” (with three subthemes: “promoting accountability,” “promoting learning,” and “strengthening supportive relationships”), and “spiritual exercise.” Discussion: Some of our results are supported by the model of self-reconciliation and the recovery trajectory of “second victims” theory. Conclusion: The meaning of “being a wrongdoer” has positive and negative aspects. Feelings of wandering provide nurses the opportunity to reflect on and re-embrace the professional and moral responsibility of nursing. Nursing managers can convert their “defeats” into a prelude to learning, increase their accountability, and improve the quality of nursing care. (shrink)

In order to care ethically nurses need to care holistically; holistic care includes religious/spiritual care. This research attempted to answer the question: Do nurses have the resources to offer religious care? This article discusses only one aspect - the provision of religious care within the Taiwanese health care system. It is assumed that, if hospitals do not provide enough religious services, nurses working in these hospitals cannot be fully ethical beings or cannot (...) respect patients’ religious needs. The relevant literature was reviewed, followed by a survey study on the provision of religious facilities and services. Aspects considered are: the religions influences in and on Taiwanese society; the religious needs of patients and their families; strategies that patients use to enable them to cope with their health care problems; professional motives for attuning to patients’ religious needs; and hospital provision for meeting the religious and spiritual needs of patients. A survey of nursing executives showed differences between religious service provision in hospitals with and without a hospice ward. The practical implications for hospital management and nursing practice are discussed. (shrink)

Spirituality and spiritual care have long been kept separate from patient care in mental health, primarily because it has been associated with psycho-pathology. Nursing has provided limited spiritual care competency training for staff in mental health due to fears that psychoses may be activated or exacerbated if religion and spirituality are addressed. However, spirituality is broader than simply religion, including more existential issues such as providing non-judgmental presence, attentive listening, respect, and kindness. Unfortunately, healthcare (...) personnel working in mental health institutions are not well prepared to address spiritual concerns or resources of their patients. Therefore, a mixed-method pilot study was conducted using a self-assessment survey tool to examine spiritual care competencies of mental health staff in Norway and to understand the perspectives of mental health staff in the Scandinavian context. Five questions and comments related to survey items provided rich qualitative data. While only a small pilot with 24 participants, this study revealed a need for spiritual care educational materials targeted specifically for those who work in mental health, materials that address the approach of improving attitudes, enhancing skills, and increasing knowledge related to spirituality and spiritual care of patients. (shrink)

REIMER‐KIRKHAM S, SHARMA S, PESUT B, SAWATZKY R, MEYERHOFF H and COCHRANE M. Nursing Inquiry 2012; 19: 202–212 Sacred spaces in public places: religious and spiritual plurality in health careSeveral intriguing developments mark the role and expression of religion and spirituality in society in recent years. In what were deemed secular societies, flows of increased sacralization (variously referred to as ‘new’, ‘alternative’, ‘emergent’ and ‘progressive’ spiritualities) and resurgent globalizing religions (sometimes with fundamentalist expressions) are resulting in unprecedented plurality. (...) These shifts are occurring in conjunction with increasing ethnic diversity associated with global migration, as well as other axes of difference within contemporary society. Democratic secular nations such as Canada are challenged to achieve social cohesion in the face of growing religious, spiritual and ethnic diversity. These challenges are evident in the high‐paced, demanding arena of Health care. Here, religious and spiritual plurality enter in, sometimes resulting in conflict between medical services and patients’ beliefs, other times provoking uncertainties on the part of healthcare professionals about what to do with their own religiously or spiritually grounded values and beliefs. In this paper, we present selected findings from a 3‐year study that examined the negotiation of religious and spiritual pluralism in Health care. Our focus is on the themes of ‘sacred’ and ‘place’, exploring how the sacred – that which is attributed as special and set apart as it pertains to the divine, transcendence, God or higher power – takes form in social and material spaces in hospitals. (shrink)

PeterKevern believes that the cognitive science of religion (CSR) provides a justification for the idea of spiritual care in the health services. In this paper, I suggest that he is mistaken on two counts. First,CSRdoes not entail the conclusionsKevern wants to draw. His treatment of it consists largely of nonsequiturs. I show this by presenting an account ofCSR, and then explaining whyKevern's reasons for thinking it rescues ‘spirituality’ discourse do not work. Second, the debate about spirituality‐in‐health is about (...) classification: what shall count as a ‘spiritual need’ and what shall count as ‘spiritual care’. It is about the politics of meaning, an exercise in persuasive definition. The function of ‘spirituality’ talk in health care is to change the denotation of ‘spiritual’, and attach its indelibly religious connotations to as many health‐related concepts and practices as possible.CSR, however plausible it may be as a theory of the origins and pervasiveness of religious belief, is irrelevant to this debate. (shrink)

Background Nurses tasked with providing care which they perceive as increasing suffering often experience moral distress. Response to moral distress in nurse wellbeing has been widely studied. Less research exists that probes practicing nurses’ foundations of moral beliefs. Aims The purpose of this phenomenological study was to gain understanding of nurse meaning-making of morally distressing situations, with particular attention to ethical norms, moral agency and resiliency, and nurse religious/spiritual orientation. Design This exploratory study employed semi-structured interviews using open-ended (...) questions. Qualitative data analysis was assisted by MAXQDA software. Participants and research context Nine pulmonary care nurses during COVID-19 in a tertiary care teaching hospital in the northeastern United States. Ethical considerations The study was approved by the IRB. Participants were consented before the study and confidentiality was preserved. Findings/results The study revealed three main themes of meaning-making, rooted in the identity of the “good nurse”: Being true to one’s own values, pursuing ideal patient care (“doing good”), and conforming to/challenging values of the system and culture. Tensions were found between (a) nurse’s own values (b) duty to institutional norms and duty to nurse’s personal code of ethics, and (c) perceptions of institutional support in response to nurse moral distress. Religion was described as a remote source of nurse moral values, among other sources. Spiritual practices were not experienced as sufficient in coping with moral distress at the bedside. Conclusions The study suggests nurses need more opportunities to engage in reflection on their practice and values. The findings also indicate need for accessible institutional supports for nurses experiencing moral distress and strategic use of chaplains in helping with moral distress. Further research is needed on the interplay of nurse spirituality, moral agency, and reflective practice in the face of morally challenging situations. (shrink)

The tremendous growth in nursing literature about spirituality has garnered proportionately little critique. Part of the reason may be that the broad generalizing claims typical of this literature have not been sufficiently explicated so that their particular implications for a practice discipline could be evaluated. Further, conceptualizations that attempt to encompass all possible views are difficult to challenge outside of a particular location. However, once one assumes a particular location in relation to spirituality, then the question becomes how one (...) resolves the tension between what are essentially theological or philosophical commitments and professional commitments. In this study, we discuss the tension between these perspectives using the idea of a responsible nursing response to spiritual pluralism. We then problematize three claims about spirituality in nursing discourse based upon our location as scholars influenced by Christian theological understandings: (i) the claim that all individuals are spiritual; (ii) the claim that human spirituality can be assessed and evaluated; and (iii) the claim that spirituality is a proper domain of nursing’s concern and intervention. We conclude by suggesting that the widely shared values of social justice, compassion and human dignity may well serve as a grounding for the critique of spiritual discourses in nursing across particularized positions. (shrink)

Children themselves place a high value on their own spiritual care when in hospital. However, the spiritual care of children in hospital is often overlooked. Hospitalisation and medical procedures can be traumatic and overwhelming for children, they often see hospitalisation as punishment for something they did wrong and they can even experience spiritual distress during illness and suffering. The spiritual care of hospitalised children should thus be a priority to help these children making (...) sense of pain and suffering, and assisting them to connect with a loving and forgiving God. Spirituality namely influences a diverse range of human concerns such as beliefs about illness and health, fears, relationships with family and friends and the experience of pain and suffering. Unfortunately, children often harbour misconceptions precisely in these areas. This article will draw directly on the given that children are concrete thinkers, yet able to have an understanding of holiness and God as the Holy One, if they receive the right guidance. The study will explore children’s spirituality and the way in which they experience holiness in the healthcare environment from a nursing science perspective. (shrink)

Although spiritual practices such as prayer are engaged by many to support well‐being and coping, little research has addressed nurses and prayer, whether for themselves or facilitating patients' use of prayer. We conducted a qualitative study to explore how prayer (as a proxy for spirituality and religion) is manifest—whether embraced, tolerated, or resisted—in healthcare, and how institutional and social contexts shape how prayer is understood and enacted. This paper analyzes interviews with 21 nurses in Vancouver and London as a (...) subset of the larger study. Findings show that nurses' kindness can buffer the loneliness and exclusion of ill health and in this way support the “spirit” of those in their care. Spiritual support for patients rarely incorporated prayer, in part because of ambiguities about permission and professional boundaries. Nurses' engagement with prayer and spiritual support could become a politicized site of religious accommodation, where imposition, religious illiteracy, and racism could derail person‐centered care and consequently enact social exclusion. Spiritual support (including prayer) sustained nurses themselves. We propose that nursing's equity‐oriented knowledge encompass spirituality and religion as sites of exclusion and inclusion. Nurses must be supported to move past religious illiteracy to provide culturally and spiritually sensitive care with clarity about professional boundaries and collaborative models of spiritual care. (shrink)

Human death is a mystery. Although scientists have identified the criteria, states, and signs of biological death, undoubtedly the issues of dying and death have a wider meaning. In this book, the authors present current research in the study of the ethical issues, practices and challenges of end-of-life care. Topics discussed include a spiritual perspective of end-of-life experiences; a veterinary oncologist's interprofessional crossover perspective of euthanasia for terminal patients; diabetes and end-of-life care; helping families to cope after (...) the death of a loved one; multidimensional aspects of nursing care for dying patients; spirituality at the end-of-life; challenges of promoting end-of-life care in residential care homes in Hong Kong; and the current situation and challenges of home end-of-life care for the elderly in Japan. (shrink)

Palliative care is provided at a certain timepoint, both in a person's life and in a societal context. What is considered to be a good death can therefore vary over time depending on prevailing social values and norms, and the person's own view and interpretation of life. This means that there are many interpretations of what a good death can actually mean for an individual. On a more general level, research in palliative care shows that individuals have basic (...) common needs, for example physical, mental, social and spiritual well‐being. Therefore, in today's pluralistic Western society, it becomes important that palliative care is person centred to enable individuals to receive, as far as can be achieved, care that promotes as good a life as possible based on the person's own needs and preferences, and in accordance with evidence and current laws. For many years a research group, consisting nurse researchers together with nurses working in palliative care, has developed a model for person‐centred palliative care, the 6S‐model. The model's central concept is Self‐image, where the starting point is the patient as a person and their own experience of the situation. The other concepts: Self‐determination, Symptom relief, Social relationships, Synthesis and Strategies are all related to the patient's self‐image, and often to each other. The model's development, value base and starting assumptions are reported here, as are examples of how the model is applied in palliative care in Sweden. The model has been, and still is, constantly evolving in a collaboration between researchers and clinically active nurses, and in recent years also with patients and close relatives. (shrink)

Nurses are encountering an increasing number of ethical dilemmas in clinical practice. Ethics courses for baccalaureate nursing students provide the opportunity for the development of critical thinking skills in order to deal with these effectively. The purpose of this descriptive qualitative study was to describe ethical reasoning in 70 baccalaureate nursing students enrolled in a nursing ethics course. Reflective clinical journals were analyzed as appropriate for qualitative inquiry. The overriding theme emerging from the data was `in the (...) process of becoming', which includes: practicing as a professional, lacking the confidence as a student nurse to take an ethical stand, advocating for patients, being just in the provision of care, identifying the spiritual dimensions of nursing practice, confronting the `real world' of health care, making a commitment to practice with integrity, and caring enough to care. The development of critical thinking and ethical reasoning within the framework of knowing and connecting is essential in nursing education. (shrink)

Grainger, Joanne This article explores the proposed Victorian Medical Treatment (Physician Assisted Dying) Bill from a nursing perspective. Public trust of the nursing profession will be lessened with the introduction of any law that permits euthanasia or assisted suicide. In Australian society, care of the dying is a compelling social duty and responsibility. In health and social terms, this is known as palliative care, whereby the provision of physical, psychological, spiritual and emotional support to terminally (...) ill people and their families ensures that suffering at life's end is lessened and minimised. (shrink)

The metaparadigm concept of person as a core emphasis for nursing theorizing has attracted considerable attention in western literature, but has received less attention in the context of eastern philosophical contexts. In this philosophical inquiry, we sought to clarify the concept of what it is to be a human being according to ideas deriving from Islamic tradition, drawing on concept analysis as general approach to advance an understanding of how nursing within an Islamic context might operationalize metaparadigm conceptualization. (...) Specifically, we considered person as human being on the basis of its definition, attributes/characteristics and boundaries to explore the anatomy of the concept in this context. Our analysis revealed that Islamic thought is relevant to two distinct understandings of the holistic concept of human being. Reciprocal interaction worldview organizes the dimensions of being human (cognitive, emotion, social and spiritual) into a whole. Simultaneous action worldview emphasizes that the human is a coherent and unified creature in harmony with the universe. In Islamic thought, these two worldviews are integrated and operate concurrently. Nurse–patient interactions arising from an integrated perspective that aligns both of these worldviews will allow for informed applications of knowledge to practice and enhanced patient care. (shrink)

Aim: Explore nurses’ values and perceptions regarding the practice of medical aid in dying. Background: Medical aid in dying is becoming increasing legal in the United States. The laws and American Nurses Association documents limit nursing involvement in this practice. Nurses’ values regarding this controversial topic are poorly understood. Methodology: Cross-sectional electronic survey design sent to nurse members of the American Nurses Association. Inductive thematic content analysis was applied to open-ended comments. Ethical Considerations: Approved by the institutional review board (...) (#191046). Participants: 1213 nurses provided 3639 open-ended comments. More than 80% of participants self-identified as white 58% held a graduate degree; and half were of Christian faith. Results: Values ranged on a continuum expressed through four themes: “Honoring Patient Autonomy without Judgment,” “Honoring with Limitations,” “Not until...,” and “Adamantly against.” Some felt it was a duty to honor the patients’ wishes, set aside own beliefs, and respect patients’ choices often with a spiritual connotation. Nurses held concerns about the process, policy, potential psychological harm, legal risk, and the need to learn more about MAID. Nurse who were adamantly against MAID associated the practice with murder/suicide and against religious beliefs. Disparate values were expressed about changing the MAID legislation to allow patient support with taking MAID medications and allowing MAID via advance directive. Conclusions: Nurses desire more education on MAID. There is not one universally held position on the nurse’s role during MAID. Healthcare policy/standards need to accommodate the wide variation in nurses’ values. Implications: Nurses desire education regarding their role in MAID. Nurses are encouraged to participate in policy discussions as the practice becomes increasingly legal. Managers need to expect that nurses, patients, and families will need psychological support to participate in MAID. Careful construction of policy/standards is needed to minimize conflict, moral distress, and psychological harm amongst nurses. Further research is needed. (shrink)

This article explores how ethics and religion interface in everyday life by drawing on a study examining the negotiation of religious and spiritual plurality in health care. Employing methods of critical ethnography, namely, interviews and participant observation, data were collected from patients, health care providers, administrators and spiritual care providers. The findings revealed the degree to which `lived religion' was intertwined with `lived ethics' for many participants; particularly for people from the Sikh faith. For these (...) participants, religion was woven into everyday life, making distinctions between public and private, secular and sacred spaces improbable. Individual interactions, institutional resource allocation, and social discourses are all embedded in social relationships of power that prevent religion from being a solely personal or private matter. Strategies for the reintegration of religion into nursing ethics are: adjusting professional codes and theories of ethics to reflect the influence of religion; and the contribution of critical perspectives, such as postcolonial feminism, to the understanding of lived ethics. (shrink)