Nurses' Experiences with Spirituality in Acute, Tertiary Care: An Emerging Typology

Purpose:

To explore and categorize nurses’ experiences with spirituality in acute tertiary care evaluating a sociology of religion theoretical framework from a nursing perspective.  

Methods:

A subsample [n = 318] of registered nurses working in adult, pediatric, and psychiatric care at a non-profit university affiliated Medical Center who completed  a larger quantitative online survey design study [N = 554], responded to an optional open-ended question: “Tell me about an experience at work that greatly influenced your understanding of spirituality, positively or negatively?” Drawing on previous work in sociology of religion (Demerath, 2000; Grant, O’Neil, & Stephens, 2004) a team of researchers used directed content analysis ( Hsieh & Shannon, 2005) to respond to the following research question: What are the kind of situations in which spirituality emerges in acute tertiary care and what kind of responses are described by participating nurses?

Results:

Nurse narratives differentiated between engaging and disengaging experiences with spirituality at the workplace. Engaging experiences with spirituality were classified as integrative (four subcategories), quest type, and collective experiences (two subcategories) that often led to some form of nurse spiritual care. Engaging experiences with spirituality either affirm the nurse’s identity as professional caregiver and his or her deeply held values or provide relief from a work that might otherwise be perceived as unfulfilling (Grant et al., 2004). Summarizing the subcategories of the engaging experiences, spirituality surfaced in the context of birth, death and dying, healing and transformation experiences, and in bonding relationships. Spiritual encounters were described by nurses with diverse views on spirituality (traditional versus quest type) and reflected meaningful encounters with patients who shared similar beliefs and with patients who held differing beliefs. While some nurses could not recall any experience or were unsure of what the question asked, disengaging experiences reflected mainly nurse bewilderment: In these instances there was a fundamental disconnect between the patients’ belief system and that of the nurse. Given the inability to bridge the gap, nurses disengaged from their patients or their families leaving them spiritually unsupported. The nurse, then, walked away from this specific patient encounter feeling unsatisfied.

Conclusion:

Nurses describing spiritually engaging situations experienced a facilitating role in the patient and family health-illness transitions promoting peace, coping, and well-being. These nurses expressed growth, both personally and professionally, thus encouraging them to respond to future situations in which spirituality emerged. Disengaging experiences reveal the need for more effective tools to be able to support patients’ spiritual well-being. This study makes a contribution to theory development in the area of nurse spiritual care.