Spiritual care is not as complex as we may think

The skills that draw us to the profession provide a good foundation, says Macmillan’s Barry Quinn

I have often asked patients, their families and healthcare professionals what makes a good nurse. Over the years the answer has remained constant: a good nurse is one who demonstrates patience and compassion, who listens and tells the truth with sensitivity – someone who shows they care.

When answering this question, people seldom refer to clinical skills. Is that because these skills are taken for granted, or is it that the skills of being human are the ones people remember and value? I think it is the latter.

In training our nurses and healthcare workers of the future, we work with them to develop both the clinical and human skills they need. However, it is the desire to care and make a difference that attracts people into our professions, and it is these human skills that keep them there.

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The humanity of the patient and of the healthcare worker lie at the heart of person-centred healthcare. If the ability to engage with this humanity is weakened by structures and policies, nurses vote with their feet. 

Connections with people

By responding to all that makes us human we become engaged with the spiritual component of who we are – our spiritual core. Victor Frankl (1959) argued that every human being longs to have connections with people that bring meaning and value to their lives – and by that definition such connections are spiritual.

Spirit comes from the Latin word ‘spiritus’, meaning breath or that which gives breath; in other words, something that gives value or meaning.

I can think of many people that I have cared for and learned from over the years who do not have a link to an organised religion, but I cannot think of any person who does not have their own set of values.

‘In order to respond to the spiritual needs of another we need to be aware of and respond to our own spiritual needs’

Frankl suggests that we all need to find a meaning in life. The things that matter to us can include love, honesty, fairness, feeling valued and wanted, being there to support another person, or they could be being part of a family, neighbourhood, community or team, playing an important role in society, being creative, belonging to a religious group or having a relationship with a greater being or deity.

So rather than simply asking a person whether they have any religious beliefs, it may be more helpful to ask them what is most important to them at this point in their life. 

Taking care of our own spiritual needs

At a recent conference I attended on end of life care, nurses, doctors and chaplains spoke of the increasing challenges of working in a changing and demanding healthcare system. Everyone present agreed that nurses and doctors care for their patients, but we don't do enough to care for one another.

In order to nurse another human being we must first nurse ourselves, according to Verena Tschudin (1997). In order to respond to the spiritual needs of another we need to respond to our own spiritual needs and the things we value. It is through attending to this often hidden but core aspect of nursing care that we can come to appreciate the person at the heart of healthcare, and be better attuned to their needs.

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Alastair Campbell (1984) suggests that every nurse is invited to take on the role of the ‘skilled companion’. We are part of another person's story at key moments in their life and use our clinical knowledge to care for them. But just as important are our skills of being a companion and walking with the person for part of their journey. We do that by attending and responding to their needs and values; this is central to attending to another’s spirit.

Attending to spiritual needs is not as difficult as we may think. It simply requires the skills of a good nurse and the values that brought us into the profession. We need to demonstrate the values of care and compassion, the ability to pay attention in the moment, to be present to those we have the privilege to nurse, walk with and support.

Barry Quinn is Macmillan director of nursing for cancer and palliative care, Bart’s Health NHS Trust, London, and consultant editor of Nursing Management

References

• Campbell A (1984) Moderated Love: A Theology of Professional Care. SPCK. London
• Frankl V (1959) Man’s Search for Meaning. Hodder & Stoughton. London
• Tschudin V (1997) The emotional cost of caring. In Brykczynska G (Ed) Caring: The Compassion and Wisdom of Nursing. Arnold, London