Spirituality and

1
Spirituality and nursing practice in a secular
society
John Paley University of Stirling
2
Four questions

• Sociological
• Metaphysical
• Clinical
• Political

3
Sociological question

• What accounts for the current drive to attach
  the labels spiritual need and spiritual care
  to a wide range of secular situations?

4
Metaphysical question

• How can existential distress be construed by
  those who reject supernatural accounts of the
  world, and who have no truck with gods, the
  afterlife, transcendence, or spiritual realms?

5
Clinical question

• Given that health care, in secular societies, is
  delivered by people with different beliefs
  (including those without faith), how can health
  professionals achieve a consensus on how to
  respond to religious and spiritual beliefs among
  their patients?

6
Political question

• In a secular society (and assuming that
  spiritual care is not just a synonym for
  psychosocial care), is the claim that nurses
  should deliver something called spiritual care
  to their patients justifiable, ethically or
  politically?

7
Four questions

• Sociological
• Metaphysical
• Clinical
• Political

8
Examples of spiritual need

• A retired teacher missing the job
• A 47 year-old man being blackmailed about a
  gambling problem
• A 56 year-old woman suffering personality change
  as a result of dementia
• A vegan refusing hospital meals containing meat
  and dairy produce
• A 38 year-old man worried about supporting his
  family following a myocardial infarction
• A man with aphasia after a CVA not wanting to
  have a gastronomy tube inserted, despite the
  entreaties of his family

9
Expressions of spiritual need

• I got the results back that afternoon I got
  such a shock!
• We were absolutely gobsmacked.
• The main issue is how long have I got?
• Well, its just something Ive got to accept.
• Dont lie down, get up and fight it, cause it
  can be beat and you are the only person that can
  beat it.

10
Signs of spiritual need

• Feeling isolated and unsupported
• Feeling useless
• Lacking in confidence
• Relationship problems
• Feeling of losing control
• Expressing frustration
• Fear, hurt, doubt or despair

11
Spiritual care

• Listening to the patient
• The patients story
• Enablement
• Relationships
• Caring and compassion
• Shared decision making
• Experiential learning
• Reflective practice
• Caring for the carers
• Valuing staff
• Holistic care
• Cleaning the toilet seat for the next person
• Spiritual care is just good care

12
Semantic rebranding

• It might be useful to have a generic term for
  certain needs, certain expressions of need,
  certain signs and symptoms, certain aspects of
  nursing care.
• But why this one?

Spiritual
13
Associations and connotations
14
Meaning

• Lexical meaning
• The technical sense
• A dictionary definition
• Associative meaning
• The vast network of concepts, experiences and
  images which the word additionally evokes

15
Ideology

• A set of ideas, beliefs, opinions and values
  which
• exhibit a recurring pattern
• are held by significant groups
• are in competition over plans for public
  policy...
• ... with the aim of justifying or challenging
  social and political arrangements

16
The spirituality ideology

• Secures and maintains a space for religious
  sensibilities in a world experienced as divested
  of its mystery.
• Serves as guarantor of group identity, against a
  background of health service reforms experienced
  as threatening.
• An occupation finesse executed by the clergy, and
  to a lesser extent nursing, to extend the range
  of a jurisdictional claim over patients.

17
Deflationary and inflationary

• Deflationary
• Relationships
• Listening to patients
• Spiritual care is just good care
• Inflationary
• Harmony with the universe
• Higher levels of being
• Interconnectedness of mind, body and spirit

18
Professor McSherry

• We are entering the age of spirituality and
  spiritual enlightenment.
• Spirit is the animating and intangible principle
  that gives liveliness to the physical organism as
  well as the literal breath of life.
• Spirituality involves a transcendental or
  existential relationship with an ultimate other.
• Spirituality is an invisible force that brings
  unity and harmony to self, others and the larger
  universe.
• The spiritual dimension is a mysterious and
  transcendent force that transcends the rational
  and intellectual capabilities of our human state,
  uniting us with the whole of creation.

19
Religion and Belief Matter

• We are all Spiritual beings trying to be Human.
• The ancient wisdoms and religions have known for
  millennia... that mind, body and spirit are all
  interconnected.
• The spiritual dimension tries to be in harmony
  with the universe, and strives for answers about
  the Infinite.
• Our SPIRITUALITY is the very root of our being.
• The Ancient Wisdom traditions understand that
  mind, body and spirit were all one and were
  interdependent upon each other in order for
  someone to enjoy good health.
• SPIRITUALITY enables to experience some higher
  or Other state.

20
Methodological agnosticism

• Whatever your convictions (or lack of them),
  check your private views in at the door.
• Evaluate the spiritual beliefs and practices of
  patients as you would any other lifestyle choice.
• Let the evidence determine whether spiritual and
  religious beliefs bring health benefits.
• Your personal attitude towards these beliefs
  (they represent metaphysical truths, or they
  represent positive illusions) are irrelevant to
  health care.