SPIRITUALITY IN NURSING Jennifer M Paulsen Learning Objectives Learner will identify that spirituality has many dimensions. Learner will have a greater.

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Spirituality in NursingJennifer M Paulsen Learning Objectives Learner will identify that spirituality has many dimensions.

Learner will have a greater understanding of spirituality.

Learner will identify what spirituality means to them.

Learner will Identify barriers to providing spiritual care to clients.

Spiritual Dimension Spirituality encompasses all aspects of being human and is a means of experiencing life. Spirituality has also been defined as an integral dimension of the health and well being of every individual (Skokan & Bader, 2002).

Spirituality and health have been related from the beginning of time.3Spiritual Dimension ContinuedThroughout time spiritual care has beenone and the same as religious care. spirituality may include religious beliefsand traditions but spirituality is a much broader concept that includes manynon religious beliefs.

ContinuedThe spiritual dimension (spirit) is described as a unifying force within an individual, integrating and transcending all other dimensions. This dimension is also described as God consciousness, or related to a deity or supreme values. It is concerned with the meaning of life, individual perceptions of faith, and an individuals relationshipwith the ultimate source (Young & Koopsen, 2011).Spiritual Nursing Care Spiritual nursing care is an intuitive, interpersonal, altruistic, and integrative expression that is contingent on the nurses awareness of the transcendent dimension of life but that reflects the patients reality.

Spiritual expressions such as love, hope, and compassion constitute the most basic and universal approach to spiritual care and can be integrated into all aspects of nursing care.

(Sawatzky & Pesult, 2005).

Theory BaseJean Watsons Theory of Human Caring An Inner Spiritual Dimension Theory

Jean Watsons Theory of Human Caring

Based on spiritual, existential, and phenomenological orientation. Caring is considered the essence of nursing practice.Requires nurse to be involved personally, morally and spiritually.Development of a helping-trusting relationship.The instillation of faith-hope.Assistance with the gratification of human need.Transpersonal teaching-learning.The formation of a humanistic altruistic system of values.Provisions of a supportive, protective, and/or corrective mental, physical, Sociocultural, and spiritual environment.(Young & Koopsen, 2011)

Spiritual Dimension Theory A spiritual experience is when a person experiences concepts of higher dimensionality without understanding them.our bodies grow in height, width, and depth,, our spirit, or "consciousness", or "soul" grows in spiritual dimensions.a 3d intellect that is manipulant of height, width, and depth can't access spirit.a 4d intellect which also manipulates spirit can. Your spiritual domain, or soul, is the sum of concepts your orthogonal (characteristic of being independent) consciousness can understand. (John LeFlohic, 1999)

Spirituality is often an unrecognized component of nursing, which is unfortunate because spirituality is essential part of healthcare.

Health care and spirituality may not be obvious to some, since healthcare and scientific knowledge foundations have existed separately from religion. Although nursing and medicine have their origins in religion and spirituality ( Young & Koopsen, 2011).

Illness, stress, and loss can trigger profound spiritual questions in peoples lives that address the very core of ones humanity (Taylor, 2007 p. ix).

Nurses and patients experience a very spiritual bond and it results from the sharing of intimate life journeys such as birth, death, life threatening illnesses, emotional turmoil and issues that arise during healing ( Young & Koopsen, 2011). Interdisciplinary Perspective

Assessment of the Healthcare EnvironmentNorth American Nursing Diagnosis Association (NANDA) has identified " spiritual distress," "risk for spiritual distress," and "readiness for enhanced spiritual well-being" as acceptable diagnoses in identifying the focus of nursing care.

The Nursing Interventions Classification identifies"religious ritual enhancement," "religious addiction prevention," and "spiritual support" as appropriate nursing interventions.

The Nursing Outcomes Classification includes "spiritual well-being" as an appropriate outcome of nursing intervention.

(Johnson & Moorhead, 2000)12 Dangers of spiritual or religious nursing InterventionsAssuming all religious patients are the same and need the same spiritual therapy.

Allowing nurse to interrupt the spiritual journey of the patient with false reassurances.

Risk of substituting health goals for strictly spiritual goals.

Assuming all spiritual diagnosis that are alike need the same spiritual therapy.

Attempting to mix two different visions (nurses & patients) of spirituality or religion and forming them into one that may be incompatible.

Nurses with undeveloped levels of spiritual growth providing spiritual guidance to more advanced patients.

(Barnum, 2011)Root Cause AnalysisDefine The problem: The lack of a clear definition of spirituality or a concise framework along with limited training and professional development has resultedIn the neglect of spirituality interventions while providing patient care.

Collect Data: Thenursing diagnosisreadiness for enhanced spiritual well-being has onlybeen approved as a nursing diagnosis since 2009.

Identify Possible Causal Factors: Lack of education and awareness regarding spirituality.Spirituality is not ordinarily addressed in nursing school or places of employment. It may be related to lack of confidence from provider. Lack of time could also be an issue.

Identify the Root Cause: Lack of education.

Recommend and Implement Solutions: Mandate spirituality education in nursing schools, Organizations should offer spirituality training and awareness programs.

14Until there is a clear definition of spirituality, health care providers and educators will fall short of being able to formulate related nursing diagnoses and thus will fail to address spirituality as an integral part of care for patients and their families (Sessanna,Finnell & Jezewski, 2007).Inferences and Implications Inferences & Implications ContinuedNursing and care providers are mandated by the Joint Commission on Accreditation of Health Care Organizations (JCAHO) to attend to and address a patients spiritual needs. this is difficult because there is no definitive agreement within the health science literature as to what spirituality is and what patients spiritual needs require (Sessanna,Finnell & Jezewski, 2007).

American Nurses AssociationHealth Teaching and Health Promotion: Provides health teaching and addressesSpirituality in regards to a healthier lifestyle.Uses health promotion and teaching methods to address readiness to accept or learn Spirituality.Ethics:The nurse maintains confidentiality.The nurse acts as a client advocate.The nurse delivers spiritual care in a nonjudgmental way and is sensitive to patients spiritual needs.

Outcomes Identification Involve patient and family in formulating expected outcomes from spiritual interventions.Modifies expected outcomes based on evaluation of patients spiritual needs.Includes a time frame for attaining measurable goals. (American Nurses Association, 2004)

Quality & SafetyPatients emotional and spiritual needs are important, strong evidenceshows that lack of attention to these needs affect health outcomes and hospital financial outcomes. Therfore it is apparent that emotional and spiritual needs should be considered for a component of overallhealth care quality (Clark, Darin & Malone, 2003).

Data analysis reveals a strong correlation between the degree to whichstaff addressed emotional/spiritual needs and overall patient satisfaction.

The emotional and spiritual experience of hospitalization remains a prime opportunity for quality improvement.Improvement is possible through additional resources, appropriate referrals to chaplains and a team dedicate to improving patients spiritual and emotional care (Clark, Darin & Malone, 2003).

Spiritual care can help patients with healing and limit suffering.

Spirituality may enhance ones quality of life while delivering sense of meaning and purpose. Spirituality is an Inspiration to self and others.

Comfort can be found in spiritual relationships with self, others or a higher power.

All patients spirituality journey is unique and it may not be easily understood by all.

Although a patients spiritual needs are difficult to measure, it is fundamental for nurses to identify these needs.

Nurses and health care providers need to be aware of their own spirituality so they can provide optimal care while they are caring and nurturing their patients spiritual needs.

Potential Spiritual OutcomesConclusionSpirituality is a concept that is difficult to define. Spirituality has different meanings for different people for example, some individuals view spirituality as a connection with God and their religious beliefs. Others view spirituality as an emotional connection within themselves, the universe and other people.

References Iowa Outcomes Project (2000), Nursing Outcomes Classification, 2nd ed.,ed. M. Johnson and S. Moorhead (St. Louis, Mo.: Mosby), Sawatzky, R., & Pesult, B. (2005, January 21). Attributes of spiritual care in nursing practice.Journal of Holistic Nursing,23(19), 19-32. Stevens Barnum, B. (2003).Spirituality in nursing(2nd ed.). New York, NY: Springer Publishing Company. Taylor, E.J. (2002). What do I say? Talking with patients about spirituality. Philadelphia:Templeton Foundation Press.Young, C., & Koopsen, C. (2011).Spirituality, health, and healing: An integrative approach(2ndnd ed.). Sudbury, MA: Jones and Bartlett.Clark, P. A., Drain, M., & Malone, M. P. (2003, December). Addressing Patients' emotional and spiritual needs.Joint Commission Journal on Quality and Safety,29(12).Sessanna, L., Finnell, D., & Jezewski, M. (2007, November 20). Spirituality in nursing and health related literature: A concept analysis.Journal of Holistic Nursing,25(252), 252-261.

American Nurses Association (ANA). (2004). Scope and standards of practice. Washington, DC: ANA

Questions for ReflectionIn what ways do you feel that spirituality affects health and healing?

Do you believe in the mind-bodyspirit connection?

Has this seminar changed your perspective on spirituality in nursing?