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University of Cebu – Banilad College of Nursing _____________________________________________________ A Resource Unit On Spiritual Care Nursing _____________________________________________________ Submitted to: Ms.Ma. Charisma M.

Elep Clinical Instructor – Elective Submitted by: Carulasan, Alvin Jay Castillo, Renette Thelma Dongallo, Ma. Roxanne Dorog, Odette Tashana Dumagat, Apple Glaize Endino, Noreen Fernan, Sean Red Gabales, Achim Juba, Sheila Marie Jumao-as, Rheyna Lamban, Zari Angelique Louise Luib, Estela-Berna BSN 3 – A GROUP 2 ______________________________________________________ February 10, 2011 DATE

CRITERIA RESOURCE UNIT:  Content  Format and Mechanics  Acknowledgment of Sources  Organization  Creativity  Punctuality PRESENTATION:  Content  Mastery and Delivery  Acknowledgment of Sources  Stage Deportment and Teamwork  Organization  Classroom and Time Management 50 % 20 % 10 % 10 % 5% 5% 100 % 50 % 10% 15% 10 % 10% 5% 100 %

Ethics b. we will be able to: 1. 8. Specifically. Spiritual need d. Spiritual care c. Recognize nurse‟s own limitations in spiritual care nursing. Enumerate the nurse‟s role in spiritual care 4. the BSN III students will be able to render basic knowledge. Site the implications of referral or utilization of team members in spiritual care and in other aspects of care.General Objective: After 45 minutes of lecture-discussion. 6. Religion f. Identify ways in mobilizing the patient‟s spiritual resources and patient‟s expressed needs. 9. Develop awareness and respect of the patient's culture. 10. social and spiritual preferences. Determine the ethics attributed in spiritual care nursing. Define related terms: a. List ways on documenting spiritual care . beginning skills & positive attitude towards spiritual care in nursing. 3. 7. Spirituality e. Culture 2. 5. Explain the significance of understanding own (nurses) spirituality and the degree to which one's spiritual needs are being met. Present the importance of developing a relationship of trust between a nurse and a patient.

" (Simsen. fundamental spiritual issues emerge that question their very existence. Ethics are moral principles adopted by an individual or group to provide rules for right conduct. beginning skills & positive attitude towards spiritual care in nursing." (Colliton.492). 1985:10) e. p. a code of ethics and a philosophy that governs a person's activity in pursuit of that which he holds as supreme. p. b.Spiritual care is an essential component of nursing practice and often the arbiter of how someone responds to his or her illness and associated life experiences. his God. SPECIFIC OBJECTIVE Specifically. p. Lecture – Discussion -projector/DLP -white marker board EVALUATION Post test to be given by the instructor 1. "The lack of any factor or factors necessary to maintain a person's dynamic relationship with God/Deity (as defined by that person). d. Spiritual need . "That requirement which touches the core of one's being where the search for personal meaning takes place. Religion . 1975. Ethics b.Any factor that is necessary (requisite. c. Spiritual care . Define related terms: a." (Simsen 1985. Spiritual care -board eraser -cartolina -permanent markers -scotch tape Human Resources: Time and effort of the clinical instructors and c. Ethics – pertain to the beliefs we hold about what constitutes right 3 minutes conduct.1088)." (Stallwood. we will be able to: CONTENT TIME ALLOTMENT METHODOLOGY RESOURCES Materials: For lecturediscussion a. the BSN III students will be able to render basic knowledge. Spirituality e.GENERAL OBJECTIVE: After 45 minutes of lecture-discussion. indispensable) to support the spiritual strengths of a person or to diminish the spiritual deficits. Religion . Spiritual need d.10). Spirituality-“the spirit is that part of man which is concerned with the ultimate meaning of things and with a person's relationship to that which transcends the material.a framework of spiritual beliefs. It would appear that when people encounter certain life events like serious trauma and illness. 1981.

worth and uniqueness of every individual. or nature of health problems" (American Nurses Association. and definitions of religion include some notion of a belief in and reverence for a supernatural LectureDiscussion . which provides a worldview. but the greatest and hardest-to-grasp differences among us probably occur in individual concepts of own spirituality.f. fundamental in defining and creating a person‟s reality. personal attributes. Culture – a way of life . In that one statement. Religion is probably the most common and likely source. The Code strongly exhibits all the principles used in deontological 5 minutes thinking. which includes spiritual beliefs and practices.. As the essence of the individual. to value and show consideration for every facet and dimension of all patients entrusted to their care. 1998). determining his/her meaning and purpose in life. and providing guidelines for living(Ersek et al. The Code articulates the ethical relationship of patients and nurses and clarifies their collective position. 2001). The Code demands that the nurse attend to every aspect. People are all different in many ways. Although the Code is best known as an ethical document. and characteristic of every patient. The first provision is "The nurse. 2. facet. Because spirituality tends to be related to a higher power. unrestricted by considerations of social or economic status. Determine the ethics attributed in spiritual care nursing. spirituality is so highly personal and intangible that it can be difficult or impossible to articulate. A very careful reading of the Code is not necessary to realize how strongly grounded it is in autonomy. in all professional relationships. practices with compassion and respect for inherent dignity. Culture f. it relates to spirituality in that it requires nurses. Complexity in the provision of spiritual care occurs partially because people have highly individual views of spirituality and spiritual practices that arise from different sources of authority. as ethical practitioners. the students.

The person whose sense of spirit is related to energy fields. Interventions are by their request or permission.  Nursing staff should be aware that spiritual care is not an attempt to proselytize or win converts to a particular point of view. frequently in the form of cost benefits. The nurse‟s role in spiritual care are as follows: 5 minutes  Nursing diagnosis is intended to identify strengths of the client as well as actual and potential problems. if their own religion. The code informs nurses that they must attend to every aspect. They must treat every patient holistically. physically. they cannot abandon patient.  Our primary goal in spiritual care is to mobilize the patient's spiritual resources.  Recognizing our own limitations and knowing when to make a referral. ethic or sense of spirit will not allow them to sit with a patient who is meditating on an ancestor or an unfamiliar god. it follows that the two are often related and may even be lumped together. emotionally. nurses must work within those parameters.  Spiritual assessment and care should be sensitive and based on a relationship of trust between client and nurse.power or powers. social and spiritual preferences. as well as a respect for their beliefs and religious practices. and characteristic of every patient. They must attempt to not do harm. religious beliefs are only one source of the spiritual. or rocks has spiritually as real as the person who derives spirituality from Christianity or Buddhism. Most importantly. nurses mist find alternatives to accommodate the patient's needs. or psychologically. Enumerate the nurse‟s role in spiritual care . although this principle poses difficulty in practice. or utilize other members of the team is as important for Lecture – Discussion 3. However. Rather. rainbows. as already stated. It demands that they do no harm and not abandon the patient. It will involve awareness of the person's culture. it is responding to a client's expressed needs. facet.

It is difficult to respond to spiritual needs of others if we ourselves are experiencing unresolved spiritual concerns or distress. Explain the significance of understanding own (nurses) spirituality and the degree to which one's spiritual needs are being met. Intervention in spiritual matters is easier for nurses who have an awareness of their own spirituality.spiritual care as it is for other aspects of care. since this will ensure that care is systematic. Watkins 2000). Sometimes we will need to seek out help and support for ourselves so that we are more able to help others. All nurses need to be aware of their personal values and beliefs and be sensitive to the fact that they may inadvertently lead to assumptions about a client‟s wishes or needs. Nurses who do not have personal awareness of their own spiritual nature are advised to take steps along the path of spiritual development. and the degree to which our own spiritual needs are being met. It is acknowledged that nurses who reflect their own personal spirituality and who continually monitor the meeting of their own spiritual needs are best able to understand the meaning of spiritual health. LectureDiscussion . False assumptions can be a source of concern and may damage the spiritual well-being of clients. Healing relationships can be mutually beneficial. whether it is based on religious convictions or not.  The importance of documenting spiritual care in nursing plans must be recognized. Confidence and competence in providing spiritual care include an understanding of our own beliefs and values. The experience of 5 minutes working this closely with other human beings helps nurses to discover more about themselves and moves toward deeper understanding of their own spirituality (Olson 1997. Personal spiritual awareness enables nurses to provide care that is truly holistic (Ronaldson & Potter 2004. and consistent. One way to start this process is for nurses to ask themselves questions they ask of clients when undertaking spiritual assessment. Watkins 2000. Such nurses are more comfortable in helping relationships and in dealing with client‟s spiritual issues (Ronaldson 1997. Ronaldson & Potter 2004). 4. Ronaldson & Potter 2004). well thought out.

The concept of providing spiritual care is derived from nursing theory. is to listen for the call for wholeness and embrace holism and a holistic view of life and self and then convey this into caring for others. particularly when caring for the patient with a life-threatening illness. The challenge for nurses is to embrace holism and a holistic view of life and self and then convey this into caring for others. If the spiritual care is inept. This may result from an inadequacy in nurse education that does not prepare nurses to provide spiritual care. they are providing spiritual care. One must be able to face the reality of one's own mortality. but in many cases 4 minutes are unable to respond to these needs. 5. Fitzgerald (1987: 15) offers the motto 'know thyself' to any nurse who wishes to be more comfortable with spiritual matters. By helping patients express their beliefs and by staying with them during the events of their illness. Nurses strive to incorporate holistic care that includes spiritual care into their nursing practice. Although nursing has recognized that patients have spiritual needs. spiritual care is seen as part of the psychosocial assessment or in the domain of the pastoral care workers. The challenge adds Jacik (1987: 15). In addition. nurses are in the best position to deliver this important aspect of nursing care.Narayanasamay (1993: 196) supports Conrad's claim and posits there is concern within nursing that spiritual care of the patients is inadequate and suggests this is due to the lack of sufficient educational preparation of nurses in the provision of holistic nursing care. believe that they can help another die well by realizing human life is temporary and human beings are mortal. which states humans are biological-psychologicalspiritual beings. Jacik (1989: 276) agrees and adds that nurses can only adequately provide the spiritual care if they have examined their own beliefs and discovered how the truths and religious principles have guided their own lives. Nurses learn early to become good listeners and communicators. the practice of spiritual care by nurses is often infrequent Lecture – Discussion . In reality though. Recognize nurse‟s own limitations in spiritual care nursing. and accept life as transient. the patient is left on their own to struggle with their spiritual needs. Nurses may be aware that patients have spiritual needs.

needs a healing relationship. Ways in mobilizing the patient‟s spiritual resources and patient‟s 5 minutes expressed needs:  Listening to the patient express key concerns  Praying with the patient  Reading to the patient favorite portion of religious readings  Spending time with the patient  Making referral to the chaplain  Assess patient‟s spiritual needs and the provision of spiritual care  Counseling a patient about spiritual concerns  Be aware and sensitive to patient‟s spiritual needs  Empathizing and responding is therapeutic when it comes to meeting the needs of the human spirit: the need for love and relatedness. and hope  Perform meditation. and describes the very act of maintaining a bond with the patient in distress as an extension of 'unconditional love'. Present the importance of developing a relationship of trust LectureDiscussion . This may be due to the assumption by many nurses that this domain should be dealt with by pastoral care workers. The nurse. Lecture – Discussion 6. watching and being there. is in a privileged position . Thomas (1993: 12) believes these patients are not so afraid of death. art and music or calling a long-lost friend as important aspects of spiritual care. however. it is the nurse who is ideally placed to comfort and support the patient in spiritual distress. In reality. as they are of being left alone. particularly those suffering a life-threatening illness.and an underutilized facet of care. rather than a physical nature. in having the closest contact with clients. but we can accompany the patient some of the way just by staying. meaning and purpose. possibly more than any other. These patients are often more concerned with issues of a spiritual.Ideally placed to form healing relationship. As nurses we cannot prevent death from occurring. Nurse‟s Spirituality – understanding own and the degree t which one‟s 5 minutes spiritual needs are being met The client in spiritual distress. Identify ways in mobilizing the patient‟s spiritual resources and patient‟s expressed needs 7. guided imagery.

adolescence. even when it is emotionally difficult to do so. O‟Brien 2007. and adulthood. Knowledge  Defining spirituality. Healing relationships involve being there and giving oneself in a rich way that is very much more than merely „doing for‟ a client. By actively sharing in the loneliness. Some of the attributes that help the nurse in developing such relationships are:  Ability to accept the client unconditionally as a worthy person  Genuineness  Non-judgmental attitude  Strong communication skills  Ability to convey the sense of being fully focused on the client during times together  Humility  Commitment  Ability to recognize one‟s own personal spirituality Healing relationships involve being there when a client needs support. Awareness and respect of the pt's culture. anxiety and suffering of the client. 8. social and spiritual preferences.  Understanding the unique impact of spiritual/cultural experiences on human development and health in infancy. Develop awareness and respect of the patient's culture. such as being with a client after the baby has died. the nurse in a healing relationship does much more than merely provides physical comfort and treatment.  Understanding a differential diagnosis for spiritual/cultural LectureDiscussion . to listen and to be available (Hood & Leddy 2005. childhood. Stein-Parbury 2005).between a nurse and a patient. a willingness to care. including these phenomenological aspects: experiences/attitudes/practices/beliefs (from here on these items are called simply “experiences”). social and spiritual preferences: 5 minutes 1. The nurse‟s presence itself touches the client‟s spirit by communicating personal spiritual strength.

Understand that differences in cultural identity between physicians and patients can impact delivery of health care. Listening for. including transference and counter-transference. beliefs and practices. vulnerabilities. Understanding of the research data on the impact of patients‟ cultural identity. eliciting. Understanding of their own spirituality and how truly compassionate care giving can come from knowing and respecting the role spirituality has in their own life. Understanding how physician‟s role encompasses patient care and the care of their family during the entire transition between life and death. and strengths as well as their cultural identity. Understanding the dimensions of palliative care (physical. emotional. social and spiritual) at the end-of-life of a patient. Skills   Interviewing patients with sensitivity to communication styles. Understanding the impact of spiritual/cultural experiences on the relationship between the physician and patient. Understanding of spiritual/cultural issues and treatment preferences surrounding the end-of-life affect medical ethics as applied to family practice and internal medicine. Understanding of the role of culturally based healers and care providers.         2. phenomena at the individual and spiritual/cultural system levels. beliefs and practices on their health and access to and interaction with health care providers. Understanding of the variety of spiritual experiences and traditions. with unique perspectives on transpersonal issues. and understanding accurate .

Recognizing possible biases against the spiritual/cultural issues found in the medical literature and understanding their origins. Recognizing when a patients‟ spiritual views or cultural beliefs/rituals are harmful to the patient and making appropriate interventions and referrals (for example to chaplain. beliefs. with an understanding of spiritual and cultural realm of experiences. Effectively listening to and responding to patients about their suffering. Identifying and eliciting patients‟ values. histories. as well as their case formulation. Recognizing and using specific transference and counter transference reactions. Attitudes  Awareness of their spiritual and cultural experiences and the impact of these experiences on their identity and world . and preferences for treatment during the course of illness. beliefs and practices might affect their relationship with patients. spiritual directors or culturally-based healers). cultural identity. as influential caregivers. Learning to work with a multi-disciplinary team delivering end-of-life care and appreciate each member‟s contribution. Identifying how. Demonstrating the ability to deliver difficult news to patients and their families in a caring and compassionate manner. assessing and formulating treatment plans for patients. Diagnosing. cultural identity and beliefs/rituals and their impact on the patient‟s life. including the importance of spiritual issues. diagnosis and management plans.         3.

art and music therapist. chaplain. and volunteers. etc.  Avoidance of stereotyping and over-generalization and an appreciation for diversity of spiritual and cultural identities. psychologist. Regular team meetings and frequent communications among clinical staff and with the patient‟s primary physician ensure that patient and family needs and goals are met and constantly reassessed. pharmacist. nurse.9. Primary Physician • Provides the hospice team with medical history • Oversees medical care through regular communication with the hospice team • Provides orders for medications and tests. institutional care). home health aide. ritual and practices.  Non-judgmental attitude when eliciting a spiritual history and preferences for treatment during the course of illness. view.  Respect for patients from a variety of spiritual and cultural backgrounds. home nursing. belief. Site the implications of referral or utilization of team members in spiritual care and in other aspects of care. hospice physician. social worker. and nutritionist. The patient and family are integral members of the interdisciplinary team.  An appreciation for the systems and venues for health care delivery at the end-of-life (hospice.  Awareness of their own attitudes toward various spiritual and cultural experiences and the possible biases that could influence their treatment of patients. signs death certificate. Members of the hospice team involved directly in interdisciplinary care to the patient and family include the primary physician. • Determines his or her level of involvement on a case-by-case basis with the hospice medical director Lecture – Discussion . Additional team members may include occupational or physical therapist. The hospice team functions as an interdisciplinary team with a coordinated 4 minutes plan of care.

and consult with patient and family regarding disease progression and appropriate medical interventions on a case-by-case basis Nurse • Visits patient and family in the home or nursing home on regular basis (biweekly to 3-4x per week. discharge planning (from hospital to home). funeral/burial arrangements • Serves as liaison with community agencies (such as Department of Human Services. symptoms. depending on needs of patient) • May provide on-call services (24 hours a day. nutritional status. write orders. caregiver stress. Department of Aging. safety. bowel functions. and psychosocial-spiritual concerns • Educates patient and family about disease progression. Public Aid office) • Assist family in finding services to address financial needs and legal matters (Power of Attorney. daily care needs. 7 days a week for emergencies) • Assesses pain. and grief Home Health Aide • Assists patient with activities of daily living such as bathing and dressing • Provides a variety of other services depending on assessment of need Social Worker • Attends to both practical needs and counseling needs of patient and family based on initial and ongoing assessment • Arranges for durable medical equipment.Hospice Physician • Provides expertise in pain and symptom control at the end of life • Works closely with the hospice team and primary physician to determine appropriate medical interventions • Makes home visits on as needed basis • May oversee the plan of care. and other aspects of the overall plan of care • Educates and supervises nursing assistants • Provides emotional and spiritual support to patient and family to cope with functional limitations. Wills) • Provides counseling related to family communication . use of medications.

Because documentation can be overwhelming. and grief • Ensures that patient and family religious or spiritual beliefs and practices are respected by the hospice team (e. and maintaining a legal document. meaning. loss of life purpose • Assists patient and family in sustaining their religious practice and in drawing upon religious/spiritual beliefs to cope with illness. List ways on documenting spiritual care • Assesses patient and family anxiety. despair. addressing economic issues. nurses may tend to overlook the documented care is effective. fear of death. rituals to be observed at the time of death. dying. dietary restrictions. providing spiritual care takes time and effort by the Lecture Discussion . need for forgiveness. role changes. Furthermore. documentation of spiritual care is critical for providing quality patient care. relationship with divine. depression. and massage therapy • May provide community education and outreach • May assist with office work 4 minutes Documenting spiritual care: As with all nursing care. caregiver stress • Provides general grief counseling Chaplain • Provides patient and family with spiritual counseling to address questions of hope.10. letters to family.g. disposition of the body) • Serves as a liaison with the patient/family faith community and clergy • May conduct funeral and memorial services for patients and families as requested • Provides hospice staff with spiritual care and counseling Volunteer • Provides respite care to family members • May assist with light housekeeping or grocery shopping • Helps patients stay connected with community groups and activities • Facilitates special projects such as memoirs/legacy work.

Mean what you say and say what you mean. professional. nursing supervisor. Example: The patient had indicated that she missed her pet cat and wished she could see him. Example: Patient expressed anger toward God because of illness but also described feeling guilty because “I shouldn‟t be angry at God. parish nurses or lay visitors    . Patient eats beans with lunch and dinner.” Follow professional standards for nursing care. This could include organizational chaplains or clergy. be sure to include anyone who becomes involved.” Encouraged patient to discuss feelings about this. Tips for quality charting of spiritual care:  Document patient spiritual beliefs accurately.” Be clear about what it is that you want others to know. When care deviates from legal. arrangements were made to have daughter. Because providing quality spiritual care for patients is interdisciplinary.nurse. bring pet into hospital for visit. After discussion with Barbara Brown. provide a valid reason for the alteration. it is difficult for administrators and managers to make claims about needing resources to provide more staff so that spiritual care can be provided. and patient indicated would like to speak to rabbi. Avoid generalizations or vague notes. If only 25% of the work nurses perform is indicated in the patient records. Proper documentation of spiritual beliefs reflects respect for the patient and facilities implementation of appropriate interventions and avoidance of disrespectful interventions. Name anyone who becomes involved in the patient‟s care. Beth. Star of David Synagogue. Bringing pet to hospital visit could have therapeutic effect on patient‟s spirit. or organizational standards. Changes in reimbursement occur only if documentation data indicate that providing spiritual care is cost effective. Contacted Rabbi Goldberg. Example: Patient is a vegetarian and does not eat meat based on religious beliefs. such as “patient is spiritually distressed. who stated will visit this evening.

Write legibly. make a narrative note. RN. . If the size of the box cannot accommodate the information needed to be documented. Example: Discussed discharge plans with Elaine Sculley. who will be following up with patient at home.  from the patient‟s faith community. Use approved abbreviations. thereby contributing to quality spiritual care. Writing so others can read your notes minimizes the risk of errors. Use the abbreviations approved at your organization because using unapproved abbreviations can lead to confusion. For instance does “sc” stand for spiritual care or sickle cell? The same goes for flow sheets. parish nurse from Christian Community Church. Mosby Elsevier Hutchison. 4th Edition. 3rd edition. and Patricia K. K. Ladner. Retrieved from http://scribd. Retrieved from http://books. and P. Retrieved on 02-04-2011 .com. Retrieved on 02-05-2011 Smeltzer.BIBLIOGRAPHY BOOKS Delaune. Marge (2008) Spirituality in Nursing Care. Philippines. Delmar Learning Fortinash. Fundamentals of Nursing: Standards and Practice.html.Holoday Worret (2008) Psychiatric Mental Health in Nursing. (2007) Nurse‟s Role in Spiritual Care. PA129&lpg=PA12 9&dq=nurs e's+ role+in+spiritual+care&source=bl&ots=a6cS9vRrEr&sig=ydcEKOD4nrJROm6Z_IXhjS06yPU&hl=tl&ei=tIZOTcjIIMaHcd24vIEM&sa=X&oi=book_result &ct=result&resnum=9&ved=0CGsQ6AEwCA#v=onepage&q=nurse's%20role%20in%20spiritual%20care& (2006). Retrieved on 02-04-2011 Wikipedia (2009) Holistic Care in Nursing. Singapore.html. Retrieved from http://wiki_holistic_nursing. Williams and Wilkins Lippincott Company ELECTRONIC SOURCES Scribd (2009) Spiritual Care in Nursing and Ethics. Sue C.