The spiritual dimension of nursing

Higher Concern

By Sharon Gray

(September 17, 1998)

People suffering illness or undergoing a traumatic experience often become more aware of their spiritual side, perhaps turning to a higher power for comfort or perhaps questioning the existence of God.

Nurses often deal with patients who have spiritual questions and needs, and yet traditional nursing education includes little on how to deal with this. Doreen Westera, Nursing, is trying to address this deficiency by developing a course called Spiritual Dimensions of Nursing Practice. It will be offered for the first time this spring through distance education.

"Although nursing's roots are very much connected to spiritual care, we tend to have lost that with the current emphasis on science," said Ms. Westera. "Recently there's been a move to integrate spirituality within a number of the helping professionals, and that's what I'm trying to do by developing this course at Memorial."

Spirituality is a broad concept, and Ms. Westera said that her course emphasizes the difference between spirituality and religion.

"Although for many people the expression of their spirituality is manifested in various religions and religious practices like prayer and worship, for other people spirituality is not connected to religion at all."

To explore the different dimensions of spirituality, Ms. Westera is working with the Centre for Academic Media Studies to develop six videos to be used in the course.

"In one of the videotapes we interview a couple of writers to show one way in which spirituality is not connected to religion but to artistic expression."

Nurses need to be able to do spiritual assessments in the same way that assessments are done of physical and mental health. Ms. Westera said that there are a number of spiritual assessment models, and the one she is using in her course was developed by a nurse. The assessment is made by asking questions such as "What is your concept of God?" and "Who do you go to for help when you have a problem?"

Besides spiritual assessment, nurses can also provide spiritual care.

"Evidence from research shows that nurses who have looked at their own spirituality are better equipped to care for people who are dealing with spiritual issues," said Ms. Westera. "For that reason one assignment in this course is having people describe their own spirituality and how it is expressed in their own lives. Personal exploration is crucial to giving spiritual care."

"Although nursing's roots are very much connected to spiritual care, we tend to have lost that with the current emphasis on science."

If a nurse feels comfortable praying with clients, this is one way that spiritual comfort can be offered. Or the nurse can refer the client to a pastoral care worker.

"But nurses are with clients more than any other helping professional, and sometimes because of the rapport they have they are the best person to deal with spiritual concerns. After all, they are the ones there late at night when issues may come up. Nurses don't have easy answers in giving spiritual care, but any nurse can help the client work though issues."

Another aspect to nursing and spirituality is the concept of parish nursing in which nurses work with faith communities. Ms. Westera is personally involved in this type of work along with colleagues Lorna Bennett and Doreen Dawe. The three nurses have a small volunteer practice with the Salvation Army College for officer training.

"I've always believed my teaching is better when I have clients so I do clinical work in a variety of ways, but this is one I've become very interested in," said Ms. Westera, who was raised in the Salvation Army Church but now attends a Baptist church.

In conjunction with their interest in parish nursing and spirituality, the three colleagues are also developing a study on spirituality in adolescence. Ms. Bennett and Ms. Westera did a survey in 1990 of teenagers and one of the discoveries they made was that although teens are by and large not strongly connected with organized religion, they also had a strong personal connection with a higher being. When asked who they turned to for help with personal problems, a significant proportion said they turned to God.

"We want to know such things as what the prayer experience is like for teens, there's very little research been done on spirituality for that age group," said Ms. Westera.