By Shelly and Miller
I. What is Spiritual Care?
Spiritual Care enabled nurses to do what they first become nurses to do – serve God and help other people.
- Spiritual care is a special aspect of ministry.
- If there is physical body, there is also a spiritual body. (1 Cor. 15:40-44)
- Our bodies are extremely important. We are to care for our bodies (Eph. 5:29) and for the physical needs of others (Luke 10:37) but not be obsessed with them (Matthew 6:25). They are the temples of the Holy Spirit and means for glorifying God (1 Corinthians 6:19-20).
- Spiritual Care involves facilitating relationships. Christian spiritual care focuses on helping others to establish and maintain a dynamic personal relationship with God by the grace through faith.
- The 1st RULE of Spiritual Care should be the same as for any medical intervention – DO NO HARM.
- Spiritual Care for the Christians includes only those approaches that will deepen and enhance a person’s relationship with God. It includes worship, compassionate presence, prayer, Bible reading, a vast (huge, enormous, measureless, boundless, gigantic, colossal, stupendous.) treasure store of Christian literature, human touch, music and love and support of the Christian community.
II. Why is spiritual care so important?
- 1st – because illness, emotional trauma and simple discouragement can cloud our relationship with God. A person in crisis is vulnerable and often desperate. Without the support of caring Christians, anything that promises to help will seem attractive. Good SC keeps a person safely in the arms of Jesus.
- Romans 12 instructs us to exercise spiritual care toward one another:
“Let love be genuine; hate what is evil, hold fast to what is good; love one another with mutual affection; outdo one another in showing honor…..”
- By doing so, our spirits reach out and touch spirits of others to encourage them in faith. We represent Jesus to others.
- Spiritual Care is the responsibility not merely pastors and church leaders but of every Christian who supports others through illness and crises. It puts our physical care and emotional support into a context of faith and hope.
- The key to spiritual care is gentleness and respect.
III. ASSESSING SPIRITUAL NEEDS:
What is Spiritual Need?
- It is anything required to establish and maintain a dynamic personal relationship with God.
- We need to have our lives make sense and be purposeful. The need to be needed is spiritual need. We find meaning and purpose through our relationship with God and his people, and through the love and forgiveness we experience from them.
- Spiritual needs may seem elusive (tricky, puzzling). Although we may observe the effects of unmet needs, they can be difficult to pin down or to measure. Yet there is a deep yearning in the heart of each person to seek God and, in doing so, to find love, and forgiveness and hope.
1. To be loved and to love in return
2. To experience forgiveness and extend it to others
3. To find meaning and purpose in life and hope for the future
In Spiritual Care: the Nurse’s Role, Shelly and Fish defines a Spiritual Need as “the lack of any factor or factors necessary to establish and/ or maintain a dynamic, personal relationship with God.”
- Although spiritual needs have a horizontal dimension (in relationship to other people), they are primarily vertical (in relationship with God).
- These include the need for faith, hope and love (1 Corinthians 13:13), for confession and forgiveness (Jas 5:13-16).
- God meets spiritual needs; we don’t. But God works through people, including nurses, to communicate his grace to others.
HOW CAN NURSES PROVIDE SPIRITUAL CARE?
- Christian spiritual care means facilitating a person’s relationship with God through Jesus Christ.
- If we truly believe that we claim to believe, salvation through Jesus Christ is the only cure for spiritual sickness.
- Spiritual Care means putting people in touch with God through compassionate presence, active listening, witness, prayer. Bible reading, and partnering with the body of Christ (the church community and the clergy). It is never coercive or rude.
- Spiritual Care can be appropriate in both secular and Christian settings and for both Christians and non-Christians.
- In practical terms Spiritual Care is usually well received when it is offered in a spirit of gentleness and humility.
- Christian nurses have often provided Spiritual Care in secular settings w/o encountering any resistance from either patients or hospital administration.
- The exciting part of Spiritual Care is seeing God at work, for ultimately it is not use but God who meets spiritual needs. Once you get started, it becomes an adventure in faith and in seeing God’s overwhelming love and sufficiency.
PURPOSE OF SPIRITUAL NEEDS Assessment:
- The purpose is to determine the nature of a person’s relationship to God and other people, and to give the person the opportunity to accept spiritual support.
STEPS in ASSESSMENT:
1) Observation – observing the person and the context that surrounds the person. Use your eyes and ears to find clues about spiritual concerns.
1a) Look around the room.
- Is the TV on?
- Is it just background noise, or does the person you are visiting have
- difficulty taking her eyes off of it long enough to talk?
- Is a Bible or other religious literature handy?
- Does it look as if it has been read much?
- What other reading material lying around?
Notice the picture displayed.
- If you see religious art, what does it seem to convey about God?
- Does the room seem warm and inviting or stark (grim), uncomfortable and disheveled (frightful, horrible)?
- Do you see any odd objects?
1b) Explore the things you observe.
- Ask about the people and places in photographs displayed.
- See if there is a special memory attached to particular pictures.
- Ask about specific reading material, favorite Bible verses, devotional guides.
- Inquire about the history behind a unique piece of furniture or décor.
1c) Note effect and attitudes.
- Does the person appear lonely, depressed, angry, anxious or agitated?
- If so, he or she on medications or receiving counseling to help – or might that be contributing to the problem.
- The SE of some meds. can cause mood swings or depression; chronic depression can often be helped considerably by antidepressant.
- Don’t assume that every emotional problem has a spiritual component, but don’t rule it out, either.
1d) Be alert to behavior that might indicate spiritual need.
- Does the person appear to pray before meals or at other times?
- Does he or she read religious literature?
- Does sleep seem to be a problem?
- Does he joke inappropriately?
- For e.g.: On the night before his open heart surgery, Edwin began telling jokes about hell and remarking that he might go there – a loud cry for spiritual help!!
1e) Listen carefully.
- Does she mention God, prayer, faith, church or religious topics (even briefly?)
- Does he want a visit from the pastor?
- Does she express fear of death?
1f) Notice interpersonal relationship.
- How do family member interact?
- Who visits?
- How does the person respond to visitors?
- Does the person appear to be a loner?
- If so, does that seem to be a deliberate choice or the result of poor interpersonal skills?
- Could the person be a victim of emotional or physical abuse?
- The next step in the nursing process is discovering the meaning behind your observation. Observations can be deceiving. They need testing.
- Asking open-ended questions about item surrounding a person may reveal surprises or allow for further discussion.
- We cannot assume that what we observed on the surface is really what is going on in a person’s soul.
- E.g.: The most pious (religious, self-righteous) church member may be sitting in pyramids or hiding ceramic gods in the closet. The foul-mouthed rebel may be desperately seeking God.
- If you are caring for someone as a nurse, pastor, church visitor or mentor, it might be helpful to work though a written spiritual assessment guide to clarify spiritual resources, needs and concerns.
- An Assessment Guide provides a review of the strength and meaning of a person’s religious practices that can open doors to helping the person establish and maintain a dynamic personal relationship with God.
- This is not the time to make judgments or give instructions; it is simply a time to gather information.
- You will then be able to intervene more specifically at the person’s level of faith and understanding.
BREAKING THE SPIRITUAL BARRIER
Remember, we are all spiritual beings. We can bury our spiritual needs beneath a veneer (facing) of composure but the needs remain. Deep down inside, most people yearn for spiritual care and support from others. Don’t hesitate to offer spiritual care to others when their spiritual needs do not appear obvious. Assess carefully. Keep your eyes and ears open for cues. Avoid pressuring others, but remain available, even when your offers for help are rejected. We are much more likely to err (to make a mistake, be incorrect, act in bias) on the side of caution than to be offensive in our expressions of caring.
PRIMARY BARRIERS TO SPIRITUAL CARE:
1) Hidden NEEDS. Needs may not appear obvious – either because people hesitate to express them or because we fail to hear them when they do.
2) Fear of treading on private territory, thereby offending the other person. Inappropriate topics – sex, politics, and religion.
3) Lack of time.
4) Feeling unprepared or ill-equipped.
How can we get beyond the FEAR FACTOR in meeting spiritual needs?
- Find a prayer partner. Pray together regularly. Share what you are learning from Scripture and how it applies to your daily life.
- Join a small BS or prayer group. Learn to share your own spiritual struggles, as well as listening to others.
- The next time someone asks you to pray about a concern, ask, “May I pray for you right now?” You can even do that over the phone.
- When someone asks, “Why did God allow this to happen?” follow-up on the question. You don’t have to provide the correct answer – God knows that. Ask more about what your friend is feeling and how that affects her relationship with God.
How can you make time for spiritual care in hectic schedule?
- Put your relationship with God first in your own life.
- Get up earlier to spend some quality time with the Lord in prayer, meditation and bible reading. Or find a time during the day when you will be undisturbed.
- Convince yourself that this time is important – confirm your commitment to God in prayer.
- You can’t offer to other what you do not have yourself.
- As you develop a plan for those in your care, put spiritual needs at the top of the list.
- When you assess a spiritual need, follow up on it.
- When you find yourself thinking, I don’t have time for this, stop and pray about how the Lord would have you use the time you do have.
IV. Doing Spiritual Care
- Compassionate Presence
- When to pray?
- How to pray?
- Can we ever pray for healing?
- The Bible
- The Power of Touch
- Caring for the Caregiver
- Caring for The Family
- Caring for Yourself
How does spirituality affect our health?
- The research shows that religion is good for our health. Recent medical research at respected institutions such as Harvard and Duke has appeared in both the professional literature and the popular media. It indicates that the regular church attendees:
1) live longer;
2) have a lower risk of dying from arteriosclerosis, emphysema, cirrhosis of the liver and suicide; and
3) recover faster when they do get sick.
4) their diastolic pressure are lower than non-attendees,
5) their mental health is better and
6) their marriages are more stable.
- Furthermore, studies show that prayer “works”. God wants us healthy and instructs us to pray for healing
What does the bible say about health and healing?
- The biblical understanding of health is closely linked with the Hebrew concept of shalom.
Shalom – often translated as peace, it is much more than the absence of conflict.
- It refers to God-centered community where people live in good relationship with their neighbors, caring for another’s physical, emotional and spiritual well-being, economic welfare, social interaction and environmental safety.
v The biblical concept of health is closely r/t the concept of salvation, for the goal of salvation is to bring us into the Shalom of God (Isaiah 53:4-6; 61:1-4; John 14:27).
v The Greek word sozo means both “health” and “salvation”.
v E.g.: of this in Matthew 9. First Jesus healed a paralytic by forgiving his sins; then he demonstrated that healing had occurred by telling him to get up and go home. The woman who had suffered with a hemorrhage for 12 years touched the fringe (edging, border) of Jesus’ clothing, believing he would heal her. He turned to her and said, “Your faith has made you well (Matthew 9::22). In both of those situations, the persons healed found more than relief from physical symptoms. They were restored to the worshipping community. They received both salvation and physical healing.
v Jesus gave us mandate to care for the sick and needy (Luke 10:9, 37).
Called to Care: A Christian Theology of Nursing by Judith Allen Shelly and Arlene B. Miller
Spiritual Care: A Guide for Nurses and Caregivers by Judith Allen Shelly