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What is the role of nursing & its four parts?

• Promote and enhance human flourishing
- physical = comfort, holding hands
- psychological = listening, "its okay, I'm here"
- Social = help people get to church/temple
- Spiritual = pray, bring religious people

What are three spirituality needs underlying all religious traditions and common to all people

1. Meaning and purpose = meaning of life
2. Love and relatedness
3. Forgiveness = those that have hurt you or ask for forgiveness of those you have hurt

What is Spirituality?

Anything that pertains to a person's relationship with a non-material life force or higher power

What is Religion?

Refers to an organized system of beliefs about a higher power characterized by set forms of worship, spiritual practices, and codes of conduct

What is Faith?

Confident belief in something for which there is no proof or material evidence

What is Hope?

Is the ingredient in life responsible for positive outlook in even life's bleakest moments

What is Love?

The expression and experience of spirituality in and through connectedness with other people

What are 3 religiously significant daily living habits that affect a patients healthcare?

1. Dietary requirements/restrictions = Ex. kosher
2. Birth control practices
3. Medical treatment = Ex. Jehovah witness = no blood

What are five factors affecting spirituality?

1. Developmental = must have some ability for abstract thoughts
2. Family
3. Ethnic background
4. Formal religion = authority (leaders of church), text (scripture), Ethical code, Afterlife (what follows death)
5. Life events = both positive & negative experiences

FICA stands for (Assessment : History)

1. Faith (Do you have a faith belief? What gives life meaning?)
2. Influence/Importance (How does your belief influence you life?)
3. Community (Are you a member of a faith community?)
4. Address (How would you like me to address these issues in your care?)

When assessing spirituality what 3 things do you look for in the environment of the person?

1. Texts (bibles)
2. Garments or clothing = head covering
3. Articles = (jewelry = cross, star of David, statues)

When assessing spirituality what 3 type of behaviors do you look for

1. Rituals (last rights, burning incents, prayers, bible reading, meditation, fasting)
2. Mood changes (might be questioning their faith)
3. Family comments = "They are missing going to church", "I'm praying for you"

List 3 Nursing diagnoses for spirituality

1. Impaired Religiosity
2. Spiritual Distress
3. Readiness for Enhanced Spiritual Well Being

The nursing diagnosis used when an individual experience distress because of difficulty in adhering to prescribed religious rituals and/or able to participate in rituals of a particular faith tradition

Impaired Religiosity

This nursing diagnosis is the state in which a client or group experiences a disturbance in the belief or value system that provides strength, hope, and meaning life

Spiritual Distress

List 3 general spiritual interventions

1. Meeting the other person (human to human)
2. Provide compassionate presence (focus attention to them)
3. Being available for whatever comes up (listen, acknowledge pain, bear witness, just act on it b/c they probably won't tell you)

List six interventions for impaired religiosity

• Facilitate religious practices within limitations
1. Support visits by spiritual leader
2. Privacy (ex. for visits, men examine men)
3. call on institutional services
4. support their rituals
5. diet
6. respect articles

List 10 types of Spiritual Distress

1. Abandonment=human presence, no family members
2. Anger=urge expression, accept feelings
3. Betrayal=contact clergy
4. Guilt=urge seeking forgiveness
5. Despair/depression→suicide = contact clergy
6. Fear=explain dying process
7. Meaningfulness=validate accomplishment
8. Regret=life review
9. Sorrow/Remorse=urge expression, validate feelings 10. Depression=sit & talk, ties to humanity

What can be done for a client feeling abandonment

Be present

What can be done for a client feeling anger

acknowledge the feeling, urge them to express themselves

What can be done for a client feeling betrayal/punishment

contact the clergy

What can be done for a client feeling guilt

urge them to seek forgiveness and contact the clergy

What can be done for a client feeling despair

contact clergy

What can be done for a client feeling fear

explain the dying process

What can be done for a client feeling meaningfulness

help them validate their life accomplishments

What can be done for a client feeling regret

help them review their life

What can be done for a client feeling sorrow/remorse

urge them to express themselves, and acknowledge their feelings

What can be done for a client feeling depression

sit and talk with them, help them understand their ties to humanity

What four things can we do for the Readiness for Enhance Spiritual Well Being?

1. Support individual rituals
2. Support faith reaffirmations
3. Support a spiritual life review
4. celebrate individuality

What should we not do as nurses with spirituality

force beliefs on patient, become their savior

What conflicts with personal beliefs should the ethics committee be called upon

refusing treatment, or insisting on treatment

What are four ethical considerations?

1. Power imbalances between nurse & patient
2. Deep sense of intimacy can blur boundaries
3. Proselytizing is a violation of trust
4. Conflicts with personal beliefs
- refusing treatment
- insisting on treatment

Quality improvement & its four current focuses?

1. difficult to evaluate true issues
2. Current focus
- patient satisfaction
- staff satisfaction
- chaplain referrals
- Completion of spiritual assessments=having clergy be with you

Joint Commission (2)

1. Requires a spiritual assessment but does not mandate it
2. Communication standard
- respect patient rights
- right to religious services
- Prohibits religious discrimination

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