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COLLEGE |
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COLLEGE |
Transition
to Professional Nursing
SPIRITUALITY
To e-mail the instructor phillips@fiu.edu
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ASSIGNMENT
(FOR WEB-BASED ONLY
STUDENTS): 1. Read How Good Is Your Cotton? What does the story mean? 2.
Read
Examples of
Spiritual Assessments. According to JCAHO, each hospital unit has to assess a
patient’s/client’s spiritual needs. Summarize the content of your hospital (or any hospital’s) spiritual
assessment tool. Does the
spiritual assessment tool provide an adequate assessment of the
patient’s spiritual needs? If
not, how would you revise the tool? 3.
Does your practice setting provide nurses with written guidelines
related to meeting the patient’s E-MAIL YOUR
ANSWERS TO THE INSTRUCTOR (AT LEAST 200 WORDS). |
CLASS HANDOUT
DEFINITION OF SPIRITUALITY
Belief
in or relationship with some higher power, creative force, divine
being or infinite source of energy:
Attempts
to be in harmony with the universe.
Strives
for answers about the infinite--“goes outside a person's own
power.”
Especially
comes in focus when the person faces emotional stress, physical
illness, or death.
SPIRITUALITY
AS TWO-DIMENSIONAL CONCEPT (Stoll, 1989)
Vertical
dimension--relationship
with the transcendent/God/supreme values that guide life.
Horizontal
dimension--relationships
with self, others, and the environment.
SPIRITUAL
NEED
Person's
need to maintain, increase, or restore beliefs and faith, or to
fulfill religious obligations.
Spiritual
needs underlie all religions:
Need
for meaning/purpose in life.
Need
for love/relatedness.
Need
for forgiveness.
DEFINITION
OF FAITH
Is
universal--a feature of living, acting and self-understanding.
Having faith is believing in or committed to something/someone.
FAITH
DEVELOPMENT
(Fowler, 1981)
Belief
that faith is the force that gives meaning to a person's life.
Faith
is a form of knowing, a way of being in relation to “an ultimate
environment.”
Faith
is a relational phenomena with others in which we invest commitment,
belief, love, risk and hope.
See
Fowler's Faith Developmental
Stages for a summary of faith development.
DEFINITION
OF RELIGION
Organized
system of worship:
Have
central beliefs, rituals, and practices usually related to death,
marriage and salvation.
Have
rules of conduct applicable to daily life.
Religious
development is the acceptance of specific beliefs, values, rules of
conduct, and rituals--may not parallel spiritual development.
THE
NURSING PROCESS RELATED TO SPIRITUALITY
ASSESSMENT
All
persons have a right to their own values and beliefs and the right not
to discuss them with others.
A
spiritual assessment is best taken after the nurse and established a
relationship with the client.
Assess:
The
client’s sources of strength.
If
any particular religious practices are important to the client.
If
being in the hospital will interfere with the client’s religious
practices.
If
the client’s faith is helpful, and in what ways it is important.
If
the nurse(s) can assist the client in carrying out his/her faith
(reading, prayer).
If
the client would like a visit from his/her spiritual or hospital
counselor.
Spiritual
health/well-being
A
feeling of being alive, purposeful and fulfilled.
Religious
component:
Believes
God loves and cares for him/her.
Has
a personal and meaningful relationship with God (God = Supreme Being).
Believes
God is concerned about his/her problem.
His/her
relationship with God assists in not feeling lonely.
Feels
most fulfilled when in close communion with God.
His/her
relationship with God contributes to a sense of well-being.
Expresses
that he/she has lived in accordance with his/her value system.
Expresses
a desire to participate in religious rituals.
Expresses
feelings of forgiveness and forgiving others.
Expresses
hope in life after death.
Meaning
and purpose in life component:
Feels
that life is a positive experience.
Feels
very fulfilled and satisfied with life.
Feels
a sense of well-being about direction life is headed.
Feels
good and hopeful about the future.
Believes
there is some real purpose in life.
Expresses
feelings of being loved and love for others.
Talks
about his/her situation realistically.
Values
his/her inner self more than physical self.
Spiritual
history
Elicits
information on a person's:
Concept
of God/a deity.
Source
of hope and strength.
Significance
of religious practices/rituals.
Perception
of religious beliefs to health.
Signs
of spiritual distress
Affect
and attitude--loneliness, depression, anger, agitation, apathy.
Behavior--prayers,
reading of literature, sleep disturbances.
Verbalization--mentions
religious topics (even briefly), expresses fear of death, anger at religious representatives or deity, questions suffering or the
moral/ethical implications of therapy.
Interpersonal
relationships--visitors and the client's response, relation to other
persons.
Environment--client's
response to religious literature, medals, cards.
NURSING
DIAGNOSES
Spiritual
distress
State
in which the individual experiences or is at risk of experiencing a
disturbance in the belief or value system which provides strength, hope, and
meaning of life (Carpenito,1989).
Spiritual
distress is categorized into:
Spiritual
pain--difficulty in accepting loss or intense suffering.
Spiritual
alienation--separation from religious or faith community.
Spiritual
anxiety--challenge to beliefs and values.
Spiritual
guilt--failure to abide by religious rules.
Spiritual
anger--difficulty in accepting illness, loss, suffering.
Spiritual
despair--feeling that no one cares.
PLANNING
Overall
goals: Assisting
client to:
Fulfill
religious obligations.
Draw
on and use inner resources.
Maintain
relationship with Supreme Being in face of circumstances.
Find
meaning in existence.
Maintain
a sense of hope.
Call
on spiritual resources.
Example:
The
client (Example: will
demonstrate a reduction in religious distress) as
evidenced by:
Expressing
comfort in religious beliefs.
Continuing
spiritual practices appropriate to health status.
Displaying
positive affect.
Verbalizing
a closeness with his/her Supreme Being.
INTERVENTIONS
To
assist the client, nurses:
Should
examine and clarify their own spiritual beliefs and values.
Be
comfortable in assisting in spiritual rituals or, if uncomfortable,
find assistance for client. Do
not
feel guilty about discomfort.
Respect
client's beliefs and maintain a supportive relationship.
Specific
interventions
Focus
on a client's individual spiritual needs rather than his/her general
religious affiliation.
Determine
the meaning the client attaches to the situation (illness).
Orient
clients and their families to spiritual resources available.
Encourage
discussions between the client and physician if conflicts occur
between spiritual beliefs
and medical therapy.
Discuss
nurse/client belief conflicts with a superior and/or other
professionals.