Ethics in Spiritual

Nursing Care
Spiritual Well-being
Spiritual well-being is an assertion of life in relationship with
God, the self, others, the community, and the environment
that nurtures and celebrates wholeness. People who
appreciate spiritual well-being tend to feel alive, purposeful,
and satisfied. The dimension of spirituality and the related
concepts of spiritual well-being and spiritual health have
been important to nursing throughout history.
Spiritual Distress
Spiritual distress is conceptualized as impairments in 7
constructs of a person's sense of spirituality: (1)
connectedness, (2) faith and religious belief system, (3) value
system, (4) meaning and purpose in life, (5) self-
transcendence, (6) inner peace and harmony, and (7) inner
strength and energy. 
Quality of life
at the end of life
Patient quality of life is essentially an individual matter and a
reflection of a particular patient’s goals, experiences, values
and preferences for treatment.
The last stages of life can be very stressful for the dying
person and those caring for him/her. You will observe
changes that may be upsetting and unfamiliar. Learning
about the dying process will help. Many physical changes
occur during the process of dying that affect the emotional,
social, and spiritual aspects of a person’s life.
 Spiritual Care
at the End-of-Life
Pastoral/spiritual care is of particular significance in end of
life care. 'In palliative care, responsibility for spiritual care
is shared by the whole team, with leadership given by
specialist practitioners such as pastoral care workers. The
palliative care approach to spiritual care may, however, be
transferred to other contexts and to individual practice.'
Nursing Role in Spiritual
Care
Understanding own Spirituality
Too often nurses and other health care providers fail to
recognize the spiritual dimension of their patients because
spirituality is not scientific enough, it has many definitions,
and it is difficult to measure. In addition, some nurses and
other health care providers do not believe in God or an
ultimate being, some are not comfortable with discussing the
topic, and others claim that they do not have time to address
patients' spiritual needs (McSherry and Jamieson, 2013;
Ronaldson et al., 2012).
Understanding own Spirituality
The human spirit is powerful, and spirituality has different
meaning for different people. Nurses needs to be aware of
their own spirituality to provide appropriate and relevant
spiritual care to others. They need to take care for the whole
person and accept a patient's beliefs and experiences (Cockell
and McSherry, 2012).
Research shows that nurses who develop spiritual caring
practices early in their career development are able to identify
methods to incorporate these practices into routine care and
do not perceive variables such as a lack of sufficient time or
patient census as barriers (Ronaldson et al., 2012)
 Watson( 2010); WCSI (2014)
Spiritual Caring:
• Mobilizing hope for the patient and nurse
• Finding an interpretation or understanding of the illness,
symptoms or emotions that is acceptable to the patient.
• Assisting the patient in using social, emotional, or spiritual
resources.
•Recognizing that caring relationships connect us human to
human, spirit to spirit.
Resolving One’s Spirituality Concerns
and Distress
• Presence and listening to the patient's story and concerns
are the most important responses to spiritual distress; and
• Referral to chaplaincy can be important for some patients
who may be reluctant to request spiritual care or express
spiritual distress.

Unfortunately, many healthcare professionals are

uncomfortable with addressing spiritual concerns. Patients
often express spiritual distress to nurses as trusted
confidantes. Competence in caring for patients with serious
illness requires basic understanding of spiritual assessment,
understanding diverse spiritual and religious beliefs, and
close collaboration with chaplains, community members of
clergy, and other psychosocial professionals. Nurses are
often the vital link to recognizing spiritual distress and