Thursday, June 24, 2010

Nursing and Spiritual Care

Missed this at the time:

Patients missing out on spiritual care, say nurses
Published: 12 May 2010

Patients are missing out on important spiritual care despite it being a nursing ‘fundamental’, according to nurses who responded to a new RCN survey published today (28 April).

The survey of over 4,000 nurses found that only a small minority (5%) felt that they could always meet the spiritual needs of patients, and the vast majority (80%) felt that spirituality should be covered in nurse education as a core aspect of nursing.

The most important spiritual need identified by nurses was having respect for privacy, dignity and religious and cultural beliefs (94%). Spending time with patients giving support and reassurance especially in a time of need (90%) and showing kindness, concern and cheerfulness when giving care (83%) were also key concerns.

Today’s survey shows how important nurses view meeting the spiritual needs of patients. Almost all (90%) feel that providing spiritual care improves the overall quality of nursing care, and the vast majority (83%) believe spirituality is a fundamental aspect of nursing, even for patients with no religious beliefs.

Other findings include:
• the overwhelming majority (80%) feel that the need for spiritual care also applies to atheists and agnostic
• 91% of nurses believe that they can provide spiritual care by listening, and allowing patients time to discuss their fears, anxieties and troubles
• almost all (94%) do not believe that spirituality involves only going to church or a place of worship.

Dr Peter Carter, Chief Executive & General Secretary of the RCN, said:
“Nurses are clearly recognising a need in their patients for care which addresses more than just their physical symptoms. Nurses of all ages and generations are telling us that spiritual care is fundamental to why they became a nurse. However, this is not about harking back to an age of daily prayers on wards – instead it is about personalised care and giving nurses guidance and time to get to know their patients as people rather than just their medical conditions.”

The RCN believes that there should be clear guidance for nurses and other healthcare professionals to allow them to approach spiritual issues sensitively and with confidence while being able to meet the needs of patients. Nurses in this survey made it clear that spirituality is the joint responsibility of nurses, patients, chaplains, families and other health professions working together.

Nurses detailed their views on the meaning of spirituality. One said:
“I consider spirituality to be part of the ‘whole’ care one should be giving to patients and families. To me it means ensuring that the ‘mind’, i.e. thoughts, worries etc, as well as the body, is considered when providing care.”

Another said:
“I am a Christian. However, I do not believe it is appropriate for me to impose my beliefs on others while they are in a vulnerable position. What I do believe is that I support them in the particular spiritual needs during that time – whether they be Christian, Muslim, Atheist, whatever. It is their right to be treated as a whole, unique person and it is our duty, as nurses, to treat all our patients holistically, for the person they are and the beliefs that they hold. Physical care has to be tailored to each individual and so should spiritual care.”

full press release here. Two immediate thoughts:
1. 'Spiritual care' could just as well be described as 'holistic care' - giving someone time and a listening ear isn't overtly 'spiritual'.

2. It sounds like nurses themselves would like to work holistically, to attend to patients as whole people, not just as bodies with symptoms. Whether they have the time to do this is another matter (or perhaps it's just that the targets are all to do with bodies?), and there seems to be a call for the skills and knowledge to offer more spiritual care. In turn, that might mean that part of the chaplains role is enabling and encouraging nursing staff to offer spiritual care on the job, rather than simply being on the other end of a pager if a patient/family wants someone to talk to.

An experience: At one NHS hospital, having had a consultation for a medical condition which I was quite worried about, the doctor pronounced me fine and then left as quickly as he possibly could. I had lots of questions, and would have been much more reassured and less anxious if I'd had the time to ask them - or at least felt that I had the time to ask them. It felt like my questions weren't an inconvenience a person who clearly had better things to do than talk to me. The body was treated but the rest of me seemed to be incidental. I have to say our GP is excellent in this regard, though he must be sick of the sight of me by now!

Ht Christian Research, who have updated their website, it now looks much better, well done them.

1 comment:

  1. What this says to me is that there is no such thing as "spiritual" need, simply "emotional" need (perhaps they are the same?). No one in this piece seems able to define what "spiritual" actually means in terms other than words any of us would normally use to describe human emotional states. Obviously everyone (regardless of faith) can relate to and agree with this even Atheists (who are usually Human too! ;).

    If anything "spiritual" seems to be just a more acceptable word for the reinforcement of the idea that there is more to well-being than the things medical science can address, this is an obvious assertion since there are plenty of things that medical science doesn't yet fully understand, less and less as time goes on of course. More sceptically, "spiritual" seems to be a cover story in order to insert religion into a process that involves lots of vulnerable people, akin to the shaman of old and inviting the possibility of "miracles" (for an appropriate fee), something that I'm sure is appealing to people in an appropriate emotional state.

    What the participants seem to be talking about is "counselling", the message I read is that they want to be talked to and reassured. Plenty of studies confirm that what's required to do this is a listening ear and an authority figure; a less mysterious matter of being properly informed about a medical condition, probability and expected outcomes, an entirely natural (human) desire?