SpiritualityIt is the life force that gives meaning to a how a person understands, views, and lives life. Spirituality can be . . . determined by culture . . . determined by life experiences unrelated to culture . . . Influenced by both culture and personal experiences that are opposite to the cultural norm.

1. SPIRITUALITY
APPLICATION
IN NURSING PRACTICE
Safad R. Isam
Msn,CollegeOfnursing,universityofBaghdad

2. Caring :::Are actions that directed toward
the welfare of the patient and family while
focusing on health promotion, disease
prevention, health restoration and
management of chronic disease.

3. Caring
Caring focus addresses the whole patient, bio-
psychosocial and spirituality, and facilitates the
movement toward a high level of wellness.
Nursing faculty and students recognize that people
are holistic beings = physical, mental, spiritual,
emotional

4. Spirituality
It is the life force that gives
meaning to a how a person
understands, views, and lives
life.

5. Spirituality is About ::
 Hope and strength.
 Trust.
 Meaning and purpose.
 Forgiveness.
 Love and relationships.

6. Spirituality is About ::
 Peoples’ values.
 Belief and faith in self, others,
 Morality.
 Creativity and self-expression.

7. Difference between
religion and spirituality . .
Religion : a system of beliefs and practices that a person
can use to express their spirituality. Not required for
spirituality
Examples
Islam—Qur’an, prayer
Christians—cross, Bible
Jewish—Torah, festivals
Buddhism—kharma, Buddha

9. Spirituality & Culture
Spirituality can be
◦ . . . determined by culture
◦ . . . determined by life experiences unrelated to culture
◦ . . . Influenced by both culture and personal experiences
that are opposite to the cultural norm.

10. Spiritual Development
We grow spiritually, just like we grow cognitively, physically, and morally.
Review of Fowler’s Stages of Faith (1984)
◦ Faith is defined as universal human phenomenon that leads persons to need
and find meaning and understanding of themselves in relation to their world
◦ Not necessarily tied to a religion

11. 7 Stages
Undifferentiated (infant - toddler) love, hope
Intuitive-projective (3-7) fantasy filled
Mythic-literal (up 12) sort out fantasy/real
Synthetic-conventional (adolescent-adult) incongruities,
experiences
Individual-reflective-examine owns faith/beliefs apart from
childhood
Conjunctive-appreciation for past/value self
Universalizing-infrequently reached, inclusive of all
people/faiths, unshackle society burdens.

12. APPLICATION
INTO
NURSING PRACTICE

13. SPIRITUAL CARE :
Is that care which recognizes and responds
to the needs of the human spirit when faced
with trauma, ill health or sadness and can
include the need for meaning, for self-worth,
to express oneself, for faith support, perhaps
for rites or prayer or sacrament, or simply for
a sensitive listener.

14. Appropriate Roles for the Nurse
Catalyst
◦ Encourages spiritual and religious questions
◦ Encourages patient’s personal discovery and dialogue
◦ Stimulates social connection
◦ Not a spiritual advisor or necessarily knowledgeable
about patient’s religion

15. Appropriate Roles for the Nurse
Secular priest
◦ Treats the “whole person” not just the disease
◦ Responds with compassion
◦ Affirms patient’s unique worth and dingity
◦ Stands by patient in face of suffering and death

16. Inappropriate Roles of the Nurse
Spiritual or religious teacher/leader
◦ Ethical and boundary issues
Proselytizing
◦ Power position, unequal balance
◦ Boundaries
◦ Missionary service as possible exception

17. Recognize Common Spiritual Dilemmas
Unfairness—Why me?
Unworthiness—I don’t want to be a burden
Hopelessness—What’s the point?
Guilt and punishment—I’m being punished but I led a
good life
Isolation and anger—No one understands me
Vulnerability—I am afraid
Confusion—Why is this happening to me?
Abandonment—God (or family) doesn’t care

18. Nurse Preparation to give spiritual nursing care
◦ Adopting a caring attitude and disposition.
◦ Recognising and responding appropriately to people’s needs.
◦ Using observation to identify clues that may be indicative of
underlying spiritual need .
◦ Giving time to listen and attend to individual need.
◦ Being aware of when it is appropriate to refer to another
source of support e.g. chaplain, counsellor, another staff
member, family or friend.

19. NURSING PROCESS /
SPIRITUAL NURSING CARE
::::: ASSESSMENT :::::
FICA Model ( Puchalski, 1996)
Faith (believe, tradition, etc.)
Important (How important to you.)
Community (mosque, church, support,
involvement.)
Apply/Address (beliefs apply to health, how
can we address those needs,)

20. ::::: DIAGNOSIS :::::
Risk for Spiritual Distress
Spiritual Distress
Readiness for Enhanced Spiritual Well-Being

21. ::::: IMPLEMENTATION ::::: CIRCLE
MODEL

25. ::::: EVALUATION :::::
Patient/client will be
-less anxious
-verbalize feelings, concerns, and fears.
-report feeling peace
-open to discuss spiritual concerns, issues, etc

26. Spiritual health
is a PROCESS
Focus on the client outcome
NOT
the nurse’s desired outcome.