A New Perspective on Spiritual Care

The latest ANS featured article is titled “A New Perspective on Spiritual
Care: Collaborative Chaplaincy and Nursing Practice” authored by DorAnne Donesky, PhD, ANP-BC, ACHPN; Emily Sprague, BSN, RN and Denah Joseph, MS, MFT, BCC. In this article the authors explore the domains of religion, spirituality, and culture as commonly conceptualized by chaplains and offer explanations of specialty-level chaplain interventions, primary spiritual interventions provided uniquely by nurses, and interventions that require the cooperation of both professions. Here is a message in which Dr. Donesky describes how this work evolved:

As a nursing professor fascinated by interprofessional education and practice, one day I had the opportunity to shadow palliative care chaplain Denah Joseph as she wen, t about her daily activities. I watched her provide hope and comfort to the patients and loved ones in each room using the language and rituals that were most familiar and reassuring to them. Her therapeutic interventions extended far beyond religious beliefs and addressed existential suffering, relational challenges, cultural misunderstandings, personal legacy and meaning, and psychosocial distress. Recognizing that spirituality is an important part of holistic nursing practice, I asked Denah how she thought we might share her clinical wisdom with the nursing community. In response, she shared with me a document where she listed spiritual interventions she was collecting and testing.

Meanwhile, an undergraduate nursing student contacted our graduate nursing school, asking if she might volunteer as a summer research assistant.  Emily Sprague attended a faith-based university and embraced the suggestion that we explore the application of Denah’s knowledge development to nursing practice. Together, Emily and I explored the best way to translate Denah’s knowledge and interventions, developed through the action/reflection methodology common to chaplaincy practice, for practical application to nursing practice.  We were surprised by the conflation of religion and spirituality in the nursing literature, and the recommendation by trusted advisors to focus on ethics rather than spirituality. These experiences reinforced our commitment to explore Denah’s interfaith spirituality interventions from a nursing perspective.

Given the ubiquity of the Religion, Spirituality, and Culture (RSC) model within interfaith chaplaincy practice, we decided to use the RSC model as a theoretical foundation for our paper (see figure in the article). We used exemplar stories based on composite patient experiences to illustrate the spiritual interventions that Denah had developed. Some of the interventions are appropriate for nurses to deliver as “primary spiritual care,” others are only appropriate for chaplains to deliver as “specialty spiritual care,” and we found that some complex spiritual interventions require nurses and chaplains to collaboratively contribute their expertise simultaneously (see table in the article).

The resulting paper has been embraced for interprofessional journal club conversations by nurses and chaplains who want to enhance their collaborative practice. It has been welcomed by chaplains who feel validated in their practice. And it provides a foundation for additional inquiry and interprofessional scholarship within the domains of primary and specialty spiritual care, and the intersection of nursing and chaplaincy collaborative practice.