Commentary on Chan MF (2009) Factors affecting nursing staff in practising spiritual care. Journal of Clinical Nursing 19, 2128–2136

Abstract

In recent times, when criticism is levelled at nursing for accepting spirituality unchallenged, Chan’s (2009) paper is timely as it appears to address these concerns, adding to the research on nursing and spiritual care. Having explored existing studies on nurses’ personal characteristics and their association with spiritual care, Chan’s research offers some interesting findings on nurses’ attitudes to practising spiritual care. Chan (2009) concludes that the results are indicative that current spiritual care practices where the study took place were positively correlated with spiritual care perceptions. Chan’s (2009) study found a significant association between the demographic variables and the spiritual care practice scores. In line with the finding of Cavendish et al.’s (2004) study, married people attained higher scores than singles on the spiritual care scales. The implications of Chan’s findings are that spirituality should be prominent in nurse education as an integral feature of holistic care. If nurse education promotes student engagement with spirituality, including the debates about the nature of spirituality and its significance to patients as they face critical junctures in their lives (Narayanasamy 2002), it then makes sense to assume that nurses are likely to transfer this acquired knowledge to practice. Poignantly, Chan (2009) acknowledges the debate and tensions surrounding spirituality, including the lack of consensus about what spirituality really means and in doing so makes a striking comment that spirituality refers to ‘a family of different, yet connected meanings’ in terms of meaning making in one’s life (Chan 2009, p. 2129). This resonates with several perspectives, including one where ‘spirituality is the essence of our being and one that gives us meaning and purpose to our very existence’ (Narayanasamy 2010, p. 37). In this regard, if nurses are dismissive of spirituality as patients’ lived experience, especially when they are facing critical junctures in their lives, then they are neglecting an important dimension of humanity and hence leave a person in a state of dispiritedness or brokenness. Attention to the body, mind and spirit is likely to restore the holistic nature of the person. Despite mounting evidence that spirituality is integral to health, some fail to acknowledge the ontology of spirituality as a human experience and that spirituality is the only lifeline for some when everything fails, including medicine and its perceived power to heal. However, protagonists of spirituality in nursing draw attention to the importance of spirituality in the light of empirical evidence from studies based on patients and nurses. While it is unequivocal that spirituality is important to people’s lives, it is less clear whether it is the nurse’s sole responsibility to address all aspects of spirituality in practice. Given the concerns in the literature about nurses’ knowledge and competence in spiritual care, this is possible because of the impoverished nurse education in this area. In this regard, although Chan’s (2009) paper strongly suggests the potential of nurse education in addressing nurses’ professional development in spirituality and spiritual care, it is doubtful whether nurses should be given the task of dealing with spirituality in practice. In line with numerous studies, Chan’s (2009) study requires nurse educators to know the ‘why’ about spirituality, but they need to consider how best to ensure that spirituality is embedded in the nursing curriculum. To achieve this, we need to consider ‘what’ and ‘how’ in the teaching of spirituality for nursing. As acknowledged by Chan (2009), the lack of consensus about what constitutes spirituality