Let’s face it, nurses are busy people. We have charting to do, medications to distribute and assessments to document. Improving our capability of providing quality patient care is our top most responsibility. Evaluating everything about our patients including their spiritual needs seems like too much to ask, given that we don't often have as much time to spend with our patients as we would like.
Most admission databases do include questions relating to religion and culture, but what happens after the assessment is done? If the patient is lucky, a member of the hospital's pastoral care team or his own clergyman might stop by. Unfortunately, however, the patient’s spiritual needs are neglected. Many of us are spiritual beings, so why is that meeting our patient's spiritual needs is often the last thing on our “to do” list?
Here are some possibilities:
- We might feel that imposing your religious beliefs and cultural practices might be deemed offensive.
- We might be intimidated that our own beliefs will be challenged.
- We might not have come to terms with spiritual views in our own life.
- We might feel that is not part of our practice.
Regardless of the reasons, remember that patients and their families have spiritual and emotional needs, and in situations involving a dying patient, the most that we can do for the family is to “be with them” and guide them spiritually. But how do we do that? How do we reach out to meet the needs of a patient or a patient’s family members?
The following list is intended to help you with this, and remember, patients and their families will remember the quality time you spend more than the time you spend doing routine nursing interventions:
- Appreciate the emotion. When you see your patient crying or maybe just staring out the window, acknowledge it. Offer a hug or simply say, “Is there anything that you would like to talk to me about? I’m a good listener.”
- Appreciate their culture. Part of the admission database includes a cultural assessment; be aware of the patient’s cultural practices. If being silent or praying alone or spending quiet time with family is part of their culture, respect and appreciate that.
- Be respectful. Sometimes I find that it is almost second nature to want to impose our beliefs on our patients. But certain religions have certain customs that should be respected; these customs should be outlined during cultural competency in-services for patient care.
Offer the following:
- Ask the patient if he or she has any questions or if there is anything further he or she would like to discuss with the physician. As nurses, we are valuable links and resources and we can be the liaison between the patient and the physician, or even the patient and case management.
- Offer to contact a member of the hospital’s spiritual team if the patient has no pastor outside of the hospital. Usually the hospital clergy can meet with the patient and you as the nurse can be in on that meeting.
- Acknowledge the circumstance. When a patient learns of a terminal condition, it is obviously frightening. The most negligent thing that we can do is avoid discussing it. If the patient prefers not to discuss it, than you must respect their wishes, but at least provide the opportunity for discussion. Another helpful strategy is to simply say, “I know that this must be hard for you, so I am here to listen. I would like to help you…”
- Round with the Physician. I have found that it is very helpful when we, as nurses, are in the room when the physician rounds. It gives us the opportunity to hear directly what the patient and the physician discuss, and it shows the patient:
- You are a member of the care team.
- You are his advocate, and you are here to support him.
- You heard what the physician and other team members said.
- You cared enough to stop your other tasks to be there for him.
- You are a member of the care team.
This list is by no means all-inclusive, but these tips are intended to help us to be more culturally competent. It is so easy and almost second-nature to do routine nursing tasks, but patients appreciate our being “with them” the most, and I find it to be the most rewarding part of providing quality patient care. Hopefully this list and these suggestions will enable each of us to meet our patients’ spiritual needs.