The nurse observes that a patient who is Jewish and follows an Orthodox way of life. The patient is not eating the food that the dietary department is sending. What would be the best lunch to bring this patient? Show
1) Sliced pork, stuffing, and green peas. Open Resources for Nursing (Open RN) Now that we have reviewed the concepts related to spirituality and discussed beliefs and practices of common world religions, let’s apply the nursing process to promoting spiritual health. AssessmentSubjective AssessmentAgencies often provide a standardized spiritual assessment tool to complete when a patient is admitted. If a standardized assessment tool is not available, the FICA model can be used.[1] The FICA model contains open-ended questions to ask patients about their personal spiritual beliefs in a way that is open and nonjudgmental.
The HOPE tool is also helpful for incorporating spiritual assessment questions into a medical interview. HOPE stands for: H: Sources of hope, meaning, comfort, strength, peace, love and connection O: Organized religion P: Personal spirituality and practices E: Effects of spirituality on medical care and end-of-life issues The first part of the mnemonic, H, pertains to a patient’s basic spiritual resources, such as sources of hope, without immediately focusing on religion or spirituality. This approach allows for meaningful conversation with a variety of patients, including those whose spirituality lies outside the boundaries of traditional religion or those who have been alienated in some way from their religion. It also allows those for whom religion, God, or prayer is important to volunteer this information. The second and third letters, O and P, refer to areas of inquiry about the importance of organized religion in patients’ lives and the specific aspects of their personal spirituality and practices that are most helpful. A useful way to introduce these questions is a normalizing statement such as: “For some people, their religious or spiritual beliefs act as a source of comfort and strength in dealing with life’s ups and downs. Is this true for you?”[3] Read more information about using the HOPE tool. Objective AssessmentIn addition to asking open-ended questions, it is important for the nurse to observe patients for cues indicating difficulties in finding meaning, purpose, or hope in life. It is also important to monitor for supportive relationships.[4] Patients experiencing chronic or serious illness may make statements indicating spiritual distress that should cue the nurse that spiritual care is needed. Examples of these statements/concepts are as follows:
DiagnosesSee Table 18.4 for common NANDA-I diagnoses associated with spiritual health.[6] Table 18.4 Common NANDA-I Nursing Diagnoses Related to Spiritual Health[7]
Sample Nursing Diagnosis StatementsReadiness for Enhanced Spiritual Well-Being Many people experienced feelings of isolation as they sheltered at home during the COVID-19 pandemic. A sample PES statement for this shared experience is, Readiness for Enhanced Spiritual Well-Being as evidenced by expressed desire to enhance time outdoors. The nurse could encourage patients to visit local parks and walk outdoors while wearing a mask and maintaining social distancing. Recall that when a PES statement is created for a health promotion diagnosis, the defining characteristics are provided as evidence of the desire of the patient to improve their current health status.[8] Impaired Religiosity Hospitalized patients may be unable to attend religious services they are accustomed to attending. A sample PES statement is, “Impaired Religiosity related to environmental barriers to practicing religion as evidenced by difficulty adhering to prescribed religious beliefs.” The nurse could contact the patient’s pastor to arrange a visit or determine if services can be viewed online. Spiritual Distress Events that place patient populations at risk for developing spiritual distress include birth of a child, death of a significant other, exposure to death, a significant life transition, severe illness or injury, exposure to natural disaster, racial conflict, or an unexpected life event.[9] Associated conditions that place a person at risk for developing spiritual distress include actively dying, chronic illness, illness, loss of a body part, loss of function of a body part, or a treatment regimen.[10] For example, a patient diagnosed with life-threatening medical diagnoses like cancer may experience spiritual distress as they move through the typical stages of loss. A sample PES statement is, “Spiritual Distress related to anxiety associated with illness as evidenced by crying, insomnia, and questioning the meaning of suffering.” A nurse would implement interventions to enhance coping. Outcome IdentificationGoals and SMART outcomes should be customized to each patient and their situation. When a patient has the nursing diagnosis Readiness for Enhanced Spiritual Well-Being, a sample goal statement is, “The patient will demonstrate hope as evidenced by the following indicators: expressed expectation of a positive future, faith, optimism, belief in self, sense of meaning in life, belief in others, and inner peace.”[11] An example of a related SMART outcome is, “The patient will express a sense of meaning and purpose in life by discharge.”[12] When a patient has the nursing diagnosis Spiritual Distress, a sample goal statement is, “The patient will demonstrate improved spiritual health as evidenced by one of the following indicators: feelings of faith, hope, meaning, and purpose in life with connectedness with self and others to share thoughts, feelings, and beliefs.”[13]A sample SMART outcome is, “The patient will express a purpose in life by discharge.”[14] Planning InterventionsProviding Spiritual CareWhen providing spiritual care, the RN must not impose their religious or spiritual beliefs on the patient. There are several guidelines for therapeutically implementing nursing interventions to support patients’ spiritually:
See the following box for a summary of therapeutic interventions that nurses can implement to provide spiritual support. Review additional interventions for enhancing coping for patients and family members experiencing grief in the “Grief and Loss” chapter. Therapeutic Nursing Interventions to Provide Spiritual Support[18],[19],[20]
Implementing InterventionsNurses should support patients’ spiritual and religious preferences when implementing interventions to support their spiritual well-being. The nurse should respect and listen to the patient’s expression of beliefs and not impose their own beliefs on the patient. Spiritual or religious practices should be accommodated if safe and feasible to do so. If a patient has a spiritual belief, value, or practice that conflicts with their treatment plan, the nurse should explain the rationale for the intervention or treatment. If the patient is not willing to complete the treatment as planned due to their spiritual or religious beliefs, the nurse should attempt to negotiate the treatment plan with the patient and/or health care provider. For example, a nurse can advocate for rescheduling a procedure after the Sabbath or modifying the dietary plan and medication administration times during Ramadan. EvaluationWhen evaluating the effectiveness of interventions in promoting a patient’s spiritual health, refer to the overall goal, “The patient will demonstrate spiritual health as evidenced by the following indicators: feelings of faith, hope, meaning, and purpose in life with connectedness with self and others.”[21] From there, review the patient’s progress toward the personalized SMART outcomes that have been customized to their situation. When performing a spiritual assessment What may help the nurse to identify related nursing diagnosis needed interventions and improve client care?When performing a spiritual assessment, what may help the nurse to identify related nursing diagnoses, needed interventions, and improve patient care? 1) Gathering information about the patient's mental status from the patient's family. 2) Gathering current objective data.
Which question would the nurse ask when assessing a patient spirituality quizlet?When assessing a patient's spirituality, the nurse should inquire about the patient's feelings and views on life, the level of connectedness with the self and others, and the practice of religion.
How does the nurse provide for the client's spiritual needs quizlet?The nurse provides spiritual care by supporting the client's practice of spirituality such as prayer or meditation.
What should the nurse do to ease the clients spiritual distress?The nurse assesses that a client is experiencing spiritual distress.. The nurse must possess a healthy spiritual self-awareness.. The nurse must learn about diverse spiritual beliefs and practices.. The nurse should start going to church more often.. The nurse should establish regular religious services in the facility.. |