Initial Spiritual Screening and Assessment: Five Things to Remember

Abstract

To deliver holistic and person-centered palliative care (PC), the spiritual dimension must also be assessed. However, many nurses do not screen for or assess patient spirituality. This article presents five things that PC nurses can consider in order to improve their spiritual screening and assessment practices. These points are as follows: (1) Understand that spirituality is manifest in a myriad of ways and is not the same thing as religiosity. (2) Screen for spiritual distress, and then later conduct a spiritual history or assessment. (3) Remember that spirituality is not just something to assess upon admission. (4) Know that there are many ways to assess spirituality (it is not merely how a patient verbally responds to a question about spirituality or religiosity). (5) Remember that assessment can also be therapeutic.

Making Time and Being Present

“…A thorough spiritual assessment upon admission can be a productive activity that elevates the awareness of healthcare providers of the spiritual needs of the patient and provides an opportunity to promote spiritual wellbeing. Continually assessing for spiritual needs, as suggested by Taylor (2020), may be especially fitting to home care practice as rapport and trust are established over time, and the patient health status may change. You may choose to be overt in expressing your religious faith or spirituality.…”

“…Thoughtful listening of patients' concerns requires overcoming personal barriers such as anxiety, defensiveness, and a judgmental perspective. Nonjudgmental listening to patient narratives about their life can be therapeutic and healing (Taylor, 2020). Being present by sitting and listening, crying with patients or families, and demonstrating empathy are strategies that offer oneself as a vulnerable, safe, healthcare provider.…”

Cultivating Students' Practice of Prayer with Patients

“…If the patient agrees to prayer, the next step is asking what the person would like to pray about and how prayer is preferred. Educators also can help students learn to watch for cues from the patient (Taylor, 2020).…”

“…Taylor (2020) recommends students and nurses who are evaluating the potential for prayer in the healthcare setting engage in a self-check: “If any motivation to offer a prayer is clouded by a need be a savior, to comfort or glorify oneself, or to control or convert the patient, it then becomes unethical and even harmful to the nurse-patient relationship” (para 5).…”

“…In demonstrating how to pray with a patient, educators can model how to approach the patient. When assessing whether a patient would like prayer, Taylor (2020) suggests asking the patient in a respectful manner, “Would a prayer be helpful?” If the patient agrees to prayer, the next step is asking what the person would like to pray about and how prayer is preferred. Educators also can help students learn to watch for cues from the patient (Taylor, 2020).…”