Nurse religiosity and spiritual care.

AIMS: To describe how the religiosity of Christian nurses motivates their practice and manifests during patient care, especially spiritual care. BACKGROUND: Nurses around the world are often religious. This religiosity inherently affects nursing practice. Ethical codes, however, direct that nurses ought to never proselytize their religion while caring for patients. Little is known about how the religion of nurses affects their nursing practice. DESIGN: Cross-sectional phenomenological study. METHODS: Data were collected during semi-structured interviews in 2009-2011 with 14 Christian nurses in the USA. Data were coded and thematically analysed after transcription. FINDINGS: Informants described how they approached patients with religious conversation or spiritual care interventions that were overtly Christian in nature. With some awareness of the potential for harm in presenting their Christian beliefs and practices, these nurses also observed for patient cues before raising religious discourse and maintained caution so as to respect patient autonomy. Religiosity also was a personal resource for these nurses as they cared for very ill patients. The following themes were described: religious determinants and influences, perceptions of divine promptings and protection, religious approaches to spiritual care, respecting patient spirituality/religiosity and religious preparation for daily work. CONCLUSION: Understanding these religious motivations and religious spiritual care practices of Christian nurses provides evidence that can stimulate debate for policy makers and scholars. It can also inform educators teaching spiritual care and administrators supervising religious nurses.

How Christian nurses converse with patients about spirituality.

AIMS AND OBJECTIVES: To describe the experience of conversing with clients to provide spiritual care from the perspective of Christian nurses identified as exemplary spiritual caregivers. More specifically, findings presented here describe the goals and strategies of these nurses when conversing with patients about spirituality. BACKGROUND: Although verbal communication is pivotal to most spiritual care interventions recognised in the nursing literature, there is scant empirical evidence to inform such spiritual care. There is evidence, however, that many nurses have discomfort and difficulty with conversations about spirituality. DESIGN: Cross-sectional, descriptive, qualitative design framed by phenomenology. METHODS: Semi-structured interviews were conducted with 14 southern California registered nurses working in varied clinical settings. Data were coded and thematically analysed by three researchers who established equivalency. Methods to support the trustworthiness of the findings were employed. RESULTS: Themes providing structure to the description of how nurses converse with patients about spirituality included assessing and establishing connection, overt introductions of spirituality, finding spiritual commonality, self-disclosure, spiritual encouragement, spiritual advice or religious teaching, and prayer. Requisite to any spiritual care conversation, however, was 'allowing them (patients) to talk'. Informants tread 'gently and softly' in approaching spiritual discourse, assessing for any patient resistance, and not pushing further if any was met. CONCLUSION: Findings illustrate compassionate nursing with specifiable goals and strategies for conversations about spirituality; they also raise questions about how nurse religious beliefs are to ethically inform these conversations. RELEVANCE TO CLINICAL PRACTICE: The Invitation, Connection, Attentive care, Reciprocity mnemonic is offered as a means for nurses to remember essentials for communication with patients about spirituality.

Spiritual care in Christian parish nursing.

AIM: This paper reports the development of a substantive theory to explain the process parish nurses use to provide spiritual care to parishioners in Christian churches in a context where patients and nurses share a common set of values. BACKGROUND: Despite a surge of interest in spirituality and spiritual care in nursing, consensus is lacking on how care should be conceptualized and provided. METHOD: Grounded theory method was used to explore and describe the processes 10 American parish nurses experienced and used as they gave spiritual care. Data were collected between 1998 and 2001. Participants were interviewed and audiotapes transcribed verbatim. Constant comparative methods were used to analyse more than 50 separate incidents reported by the nurses. FINDINGS: From its initial emergence as the core category, 'Bringing God Near' became a Basic Social Process theory of giving spiritual care for these parish nurses. This Basic Social Process became a theory through writing theoretical memos that described how the 'main concern' of the nurses to give spiritual care was resolved. Phases within the process include: trusting God, forming relationships with the patient/family, opening to God, activating/nurturing faith and recognizing spiritual renewal or growth. The essence is bringing God near to people as they face health challenges. Findings from the study and spiritual care literature are integrated in the discussion. CONCLUSION: The parish nurses' spiritual challenge is to respond to what God is directing the nurse to be and do to strengthen people spiritually. This spiritual care can help restore the patient's sense of well-being, and encourage growth in faith. Those interested in providing and teaching spiritual care in the church context will find this theory useful as a conceptual guide.