Through my eyes: one nurse's View on the power of Faith During Illness

1. Stephanie Scully, RN BSN New Castle Presbytery Health Ministry Chair/ Editor Christiana Care Cardiac Surgery Nurse Through my eyes:one nurse's View on the power of Faith During Illness

2. Why Present this Topic to Church Leaders • The Book of Order • Services for Wholeness • “Healing was an integral part of the ministry of Jesus which the church has been called to continue as one dimension of its concern for the wholeness of people. Through services for wholeness, the church enacts in worship its ministry as a healing community.”

3. Objectives • To display the importance of trust and meaning while caring for ill patients • To describe the spiritual roots of nursing • To define spiritual health, spirituality, and faith in the context of science • To understand the concepts of holism and holistic health in relation to a person’s well-being • To explain the manifestations, causes, and ways to manage spiritual distress in the hospital setting • To identify ways in which religious leaders can most effectively promote spiritual health in the hospital and home setting • To recognize the importance of addressing spiritual care needs in the community after hospitalization

4. The Roots of Nursing: A Religious Background Revealed

5. Roots of Nursing • Florence Nightingale • 1820-1910 • The mother of nursing • Protestant training • A Call from God • Spirituality • Entailed the development of courage, compassion inner peace, creative insight, and other “God-like qualities” • Endorsement of contemplative prayer

6. Roots of Nursing • Other connections to religion • Betty Neuman and Jean Watson • Spirituality impacts development • Define holistic health • Watson • Nurses should respect and appreciate the spiritual meaning in a person’s life

7. Roots of Nursing • Early 1980s- the turning point • Trend away from religion and spirituality focus in nursing • Providing holistic care • 1978- NANDA • Nursing diagnosis • Spiritual Distress

8. SPIRITUAL HEALTH

9. Spiritual Health • Holistic nursing perspective • Biopsychosocial being • Spiritual core • Components of the self • All integral to and influences the others: • Physical • Mental • Social • Spiritual • Spiritual aspects contribute to individuality and create meaning in people’s lives.

10. Spiritual Health • What is Spirituality? • The quality or essence that pervades, integrates, and transcends one’s biopsychosocial nature • An experience for connection to life, a way of interpreting life events; a source of hope, joy, comfort and guidance on life’s journey • Includes all behaviors that give meaning to life and provide strength to the individual • Provides balance

11. Spiritual Health • Characteristics of Spirituality • Holism • Sense of wholeness and harmony • Spiritual Need • Seeking meaning • Spiritual Quest • A higher level of consciousness • Spiritual Well-Being • Positive affirmations, celebrate wholeness

12. Spiritual Health • Faith • More than a set of beliefs • Way you act out your beliefs • Making meaning– central idea • What needs do faith and spirituality fulfill? • Meaning to life • Sense of security • Guide daily life • Acceptance vs rejection • Support • Strength

13. Spiritual Health • Why is understanding spirituality of an individual important? • A person’s inner strength comes from different sources • Navajo • Harmony • Christians • God • Tailor your care • Caring for patients (hospitalized or not) means caring for families and friends as well

14. Spiritual Health • Statistics • Of the major religions in the world… • 33% are Christian • 21% are Islamic • 16% are Atheist, Agnostic, or nonreligious • 14% are Hindu • In the United States… • 76.5% are Christians • 13.2% are Nonreligious/ secular • 2.3% are Jewish • 0.5% each are Hindu, Islamic, Agnostic, and Buddhist

15. Spiritual Health • Relation to Nursing • Crisis and change • Transitions are times of anxiety and vulnerability • Front row seat • Comforting patients **EXAMPLE: PRAYER SHAWL , DEATH/DYING RITUALS I HAVE SEEN

16. Spiritual Health • Why should healthcare providers assess spirituality in the healthcare setting? • Greater well-being • Coping mechanisms • Physical manifestations • Lower levels of mortality • Less heart disease • Lower blood pressure • Less depression • Lower stress levels • Less alcohol and tobacco abuse • Greater well-being and optimism • Positive health habits

17. How Religious/ Spiritual Beliefs Affect Individuals and Their Health

18. Impact on Patient Care • Why does spiritual distress occur? • Questions about meaning • Problems coping • Anger • Sleep disturbances • Separation from religious practices • Treatments challenging beliefs

19. Impact on Patient Care • Challenges hospitalized patients face • End of life decisions • Family members’ beliefs • Blood transfusions • Medications • Minor surgeries **EXAMPLE: Blood refusal form, discussions about heart valves

20. Impact on Patient Care • Manifestations of Altered Spiritual Function • Verbalization of distress • Altered behavior • Nervous • Introspective • Emotion response • Seek information • Denial of situation • Signs of guilt, fear, depression, or anxiety

21. Impact on Patient Care • Nurturing the Spirit • Assessing spiritual status- questions • What is strength for you? Where can you get it? • Who gives you strength? • How can you increase your inner strength? • What does peace mean to you? Where do you feel at peace? • Who makes you feel more peaceful? • What situations increase your sense of peace? • When do you feel most secure? • Where do you get your security from? Does someone make you feel more secure? • How can you increase your security?

22. Impact on Patient Care • Barriers • A persistent barrier to the incorporation of spirituality into clinical practice is the fear of imposing particular religious beliefs and values on others • Remain open • Let the client guide the discussion and tell you what THEY need **EXAMPLE: COWORKER’S STORY

23. The Gaps I See: Nursing and Spiritual Assessment, Is it a Reality?

24. The Gaps I See • Spiritual Assessments • Questions nurses ask • **EXAMPLE: CHRISTIANA’S ASSESSMENT • Reality vs. Practice • Shift from vocation to profession • Justifying a nurse’s “VALUE” • Increase in economic orientation • Where YOU can help • Filling the gaps • My sacrifice • My suggestion • Increase awareness of spiritual health • Increase the population’s spiritual well-being

25. Importance of Follow-up With Individuals After Hospitalization

26. Importance of Follow-Up • “Hustle-Bustle Nursing” • NANDA diagnosis for “Spiritual Distress” • What can nurses do NOW? • Rapid turnover of patients • What is actually done? • Consult pastoral care • Consult psych • Suggest calling a religious leader • No followup post-discharge • Acknowledge spiritual pain • Be there, now

27. Importance of Follow-up • Spiritual care • Ongoing process • Relationships over time • Community based care– leadership initiatives • Not just “religious based” • Development of a sensitive spiritual relationship • Parish nursing • Health promotion in faith communities • Missionary nursing • Promoting holistic health globally

28. How You Can Help- A Guide for Church Leaders

29. How You Can Help • Key: A warm and trusting relationship • Sharing values • Offering compassion, kindness, gentle words, and a supportive presence can be life changing for someone in need • Spiritual Care • A mutual potentially healing or integrating process in which an individual’s spiritual needs are met

30. How You Can Help • Spiritual Health Promotion • Use of Self • Availability • Spiritual Support • Diverse audience • Support of Spiritual Practices • Special religious considerations • Privacy

31. How You Can Help • Spiritual Health Interventions • Respecting and encouraging a person’s spiritual and religious interest and concerns enhances the healing process • Listen and Support • Empathy and sensitivity • Refer • To others as necessary • Tailor your Care • Infants and parents • Age-appropriate • Presence **EXAMPLE: HOLDING HANDS, PRAYER BEFORE INDUCTION

32. How You Can Help • Caring and spirituality are central among faith-based organizations • CIRCLE Model of Spiritual Care • Caring • Intuition • Respect for religious beliefs and practices • Caution • Listening • Emotional support

33. How You Can Help • Alternative therapies- Spiritual Connection • Prayer and Meditation • Imagery • Especially while hospitalized • Relaxation exercises • Quiet focus • Controlled breathing • Therapeutic touch

34. PROGRESSIVE RELAXATION EXERCISE https://www.youtube.com/watch?v=h9sM24jdZ1w

35. How You Can Help • Physical effects of relaxation techniques over time: • Lower blood pressure • Decrease chronic pain • Increase white blood cell production -> decreased illness • Decreased dysmenorrhea

36. REVIEW OF HANDOUTS • 109+ Ways to say, “I Care” • Thoughtful gifts • Words that can help • Offering special services (i.e. babysitting) • Outings (take me somewhere) • Special Spirit Lifters • Hospital Visitation • A guide to what you can offer • Visiting Someone in the Hospital • Tips and ideas for visiting someone • Major World Religions and Common Health Beliefs • How to address individuals of other religious within the healthcare setting

37. QUESTIONS?

39. References • Assessment Technology Institute. (2010). RN community health nursing (Edition 5.0). Philadelphia: Author. • Catalano, J. T. (2006). Nursing now!: Today’s issues, tomorrow’s trends (5th edition). Philadelphia: F.A. Davis Company. • Clark, M. J. (2008). Community health nursing: Advocacy for population health (5th edition). Upper Saddle River, New Jersey: Pearson Prentice Hall. • Cole Jr., A. J. (2008). Visiting someone in the hospital. The Presbyterian Leader, p. 1-4. • Cole Jr., A. J. (2009). Hospital visitation. The Presbyterian Leader, p. 1-2. • Craven, R. F. & Hirnle, C. J. (2009). Fundamentals of nursing: Human health and function (6th edition). Philadelphia: Lippincott Williams & Wilkins. • Ehman, J. W., Ott, B. B., Short, T. H., Ciampa, R. C. & Hansen-Flaschen, J. (1999, Aug. 9/23). Do patients want physicians to inquire about their spiritual or religious beliefs if they become gravely ill? Arch Intern Med, 159, 1803-1806. • Mulder, K. & Jurries, G. (2002). 109+ways to say, “I care”. The Compassionate Congregation, p. 1-11. • Purnell, L.D. & Paulanka, B. J. (2008). Transcultural health care: A culturally competent approach (3rd edition). Philadelphia: F. A. Davis Company. • Weber, J. & Kelley, J. H. (2007). Health assessment in nursing (3rd edition). Philadelphia: Lippincott Williams & Wilkins.