Providing appropriate spiritual care and support to patients, service users and their families within a healthcare setting, and providing that support in appropriate ways, is a minefield where, it could be argued, only the brave or the foolish would rush in. Surely this is the province of the chaplaincy team? Yet, to provide holistic and person-centred care to all patients or service users, regardless of setting, the spiritual dimension of the person must be recognised, met and addressed. This article includes tips that may make understanding and working within a spiritual framework a little easier.
What is spirituality?
Although spirituality and religion are closely linked, they are not the same. Spirituality can be viewed and understood as:
Spirituality is not about gender, clothing, personal hygiene or dietary rules, customs and regulations, although these may form crucial aspects of how spirituality is lived within a religious framework. Neither is it the acquisition of information or factual knowledge from books or journal articles. However, some may develop and express their spirituality through:
How to work within a spiritual framework
Trying to understand a person's spirituality and work ‘spiritually’ within the context of providing holistic and person-centred nursing care, regardless of setting, is one of the hardest, yet one of the more interesting and even rewarding, roles that the nurse can undertake.
The first step in this role is to understand and accept your own spirituality. If you are unable to recognise yourself as a ‘spiritual person’, regardless of how you define and experience this spirituality, are you able to fully understand, accept and respect the spirituality of your patient or service user? Such an understanding requires significant self-awareness and reflection on your own personal identity and values.
Nurses must act within both the letter and the spirit of the Nursing and Midwifery Council (NMC) (2018)Code at all times. Not to do so puts the patient or service user at risk of harm and you, as the nurse, at risk of disciplinary measures.
It is important to understand the differences between spirituality and religion and that there is a multitude of spiritualities including secular, atheistic and ‘new age’, as well as those connected with religious beliefs. Even within a single religious tradition such as Catholicism, there are multiple forms of spirituality.
Always remember that the patient or service user is a person first, with their own family, their own personal history and story, and their own hopes and aspirations for the future. Again, the tendency to refer to someone as ‘the renal patient in bay 9’ must be resisted because such an imposed identity dehumanises and diminishes the person as a human.
Always ask the patient about the cultural aspects of their spiritual identity and practices. Never assume that, as a Catholic, they only eat fish on a Friday or that, as a Muslim or Jew, they only eat halal or kosher foods. Acknowledge that their spiritual journey and expression may be different from yours.
Be aware of and use resources that could be of use to you and your patients or service users, such as the chaplaincy team, and form links with local faith community leaders.
Always ensure that privacy and personal space is respected and promoted. In a fast-paced environment such as A&E this may not always be easy. However, the need for privacy and dignity is a basic human need and right.
It is important to act, engage and communicate with each other mindfully, with respect and with dignity. Never ridicule or belittle a person who tries to engage in spiritual practices. This must include how we work with our colleagues, never forgetting that they, too, have a spiritual identity.
Conclusion
Engaging in the spiritual dimension with a patient or service user is fraught with difficulties and there can be no easy solutions. Yet, such an engagement can also be a great privilege for the nurse and deeply enriching for all.