Creating a spiritual tapestry: nurses’ experiences of delivering spiritual care to patients in an Irish hospice

Abstract

This study aims to describe nurses' experiences of delivering spiritual support in a palliative care setting in the Republic of Ireland. The authors conducted semi-structured interviews with 22 nurses working in the area of specialist palliative care. A content analysis of the transcriptions revealed five sub-themes: understanding spirituality; the art of nursing in spiritual care; education and learning; the challenge of spiritual caring; and the dimensions of time. The resulting creation of a spiritual tapestry provided an overall theme. Nurses in this study were spiritually self-aware and placed a high value on the spiritual element of their caring role. Nurses described their individual understanding of spirituality and discussed how they recognized and addressed a patient's spiritual needs. Time was described as essential to the provision of spiritual support and appeared to be a significant resource challenge to the provision of spiritual care. The challenges of assessing spiritual needs and measuring outcomes of care were also reported. Participants in this study described the creation of a spiritual tapestry that 'weaves' together care and compassion with skills and knowledge in their nursing practice.

Biomedical approaches to care and their influence on point of care nurses: a scoping review

“…Two exploratory descriptive studies are included, McCallum and McConigley [38] described provision of end of life care on a high dependency unit for five Registered Nurses, describes the characteristics of a good death as defined by 15 critical care nurses. Bailey and colleagues [39] used a qualitative descriptive design to describe nurses' experiences of delivering spiritual care to palliative care patients. Three articles did not identify a methodology, first, Coffey, Everett and Brown [40] conducted a literature review and case scenario to illustrate the challenges Critical Care/Burn Trauma nurse experiences when caring for a dying patient.…”

“…Engaging and reflecting in the data is a long but necessary process. [44] The following nine categories emerged in order of dominant codes: nurse presence (123), knowledge (82), experience (61), environment (57), invaluable use of 'self' (48), technology (45), power relationships (44), sociopolitical factors (41), and time (39). After categorizing data each code was re-evaluated to ensure suitability in each category; this resulted in no changes to codes within the categories.…”

“…The patients' emotional, psychological, spiritual, and cultural needs must be met. [17,39,40,45] This is the essence of what makes nurses unique and a valuable resource when caring for patients. Nurses have the capacity to engage and make meaningful connections with their patients through empowered caring because nurse presence is ultimately, what enables nurses to meet the existential needs of those entrusted in our care.…”

“…The integration of lifesaving measures, [39] family presence during cardiopulmonary resuscitation, [34] death with dignity, [17,36,40,45] advanced medical directives, [17,37] and competing paradigms have created tensions for point of care nurses in high acuity areas. These tensions arise when nurses are expected to act in ways that cause conflict.…”

“…Nurses admit distancing themselves from their patients because their focus was the equipment and technology and not the person in the bed. [17,39] Closeness is established when nurses use their advanced knowledge, skill and problem solving ability, their decision-making by focusing their care on the whole person. [17] Bratcher [45] reports that ICU nurses demonstrate closeness by not allowing a patient to die alone, their communication is open, compassionate and meaningful connections are shared between nurse and patient.…”