Spiritual Care
in Nursing
Marcia Schnorr, RN, EdD
Certified Lutheran Lay MinisterParish Nurse
Sielunhoito Hoitotyossa
Spiritual care in nursing
 Is included in most nursing texts
 Is often over-looked or discouraged in
traditional nursing
 Is the foundation for parish nursing
(diaconal nursing)
St. Paul Lutheran Church (Rochelle, IL USA)
Spiritual Distress is
 “the state in which the individual
experiences or is at risk for experiencing a
disturbance in his belief system that is the
source of his strength and hope.”
(Carpenito)
Defining characteristics
 Expresses concern with the meaning of
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life, suffering, and/or death
Expresses concern about belief system
Expresses anger toward God
Expresses concern about his/her
relationship with God
Questions meaning of own existence
Characteristics continued
 Unable to participate in usual religious
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practices
Seeks spiritual assistance
Demonstrates gallows humor
Displaces anger toward religious
representatives
Suffers from sleep disturbances
Characteristics continued
 Alterations in mood or behavior
 Separated from cultural or religious ties
 Feels hopeless and helpless
 Others…
Assessments
 Religious cues (verbal, literature, jewelry,
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behavior…)
Emotional cues
Assessment guides
Item on “intake history”
Other
Stoll’s Spiritual Assessment
(Concept of Deity)
 Is religion or God significant to you? If so,
can you describe how?
 Is prayer helpful to you? What happens
when you pray?
 Does a God or deity function in your
personal life? If yes, can you describe
how?
 How would you describe your God or what
you worship?
Stoll’s Spiritual Assessment
(Source of Hope and Strength)
 Who is the most important person to you?
 To whom do you turn when you need
help? Are they available?
 In what ways do they help?
 What is your source of strength and hope?
 What helps you the most when you feel
afraid or need special help?
Stoll’s Spiritual Assessment
(Religious Practices)
 Do you feel your faith (or religion) is important to
you? If yes, would you tell me how?
 Are there religious practices that are important
to you?
 Has being sick made any difference in your
practice of praying? Your religious practices?
 What religious books or symbols are helpful to
you?
Stoll’s Spiritual Assessment
(Relation Between Spiritual Beliefs and Health)
 What has bothered you the most about being
sick (or in what has happened to you)?
 What do you think is going to happen to you?
 Has being sick (or what has happened to you)
made any difference in your feelings about God
or the practice of your faith?
 Is there anything that is especially frightening or
meaningful to you now?
Other useful interview questions
 What Bible character do you identify with?
Why?
 Do you have a favorite hymn? If so, what
is it and why?
 Is there a Bible verse that is especially
meaningful to you? If so, what is it and
why?
Planning
 Short-term
 Long-term
 individualize
CIRCLE Model
Implementation
 C aring
 I ntuition
 R espect for religious beliefs & practices
 C aution
 L istening
 E motional
Caring
 Demonstrating care and compassion
 Possessing an attitude that cares
 Caring enough to take/use the available
time
Intuition
 Making an effort to hear what the person
feels
 Encouraging the person to express
feelings
Respect for Religious Beliefs
and Practices
 Making appropriate referrals
 Praying
 Encouraging devotional activities
 Providing for specific rites, sacraments,
and observations
 Offering religious conversation
Caution
 Declining to proselytize
 Avoiding judgments
 Giving choices
Listening
 Making an effort to hear what the person
feels
 Encouraging the person to express
feelings
Emotional Support
 Working through feelings
 Showing love
 Touching
Evaluation
 Relational
 Physical
 Emotional
 Intellectual
 Religious/Spiritual
Case studies
 Jeff and Vicki
 Les and Deb
 Laura
 Others
Jumalalle olkoon kunnia!
To God be the glory!