NURS 715 Week 5 Discussion Board Forum 2 on Spiritual Care and the Calling of Nursing Example

Discussion Board Forum 2: A Christian Worldview of Nursing in Practice

NURS 715 Theoretical Application for Advanced Practice Nursing, Discussion Board Forum 2

Thread by [Student Name]

The unit, the patient encounter and the classmates replied to are composites written for a model discussion.

Last month, a 70-year-old man on my unit, two days after a heart attack, asked me quietly whether God was punishing him for the years he had spent away from church. I was in the middle of discharging another patient. I told him that was a good question for the chaplain, filled out the referral and moved on. The chaplain did not reach him before he went home. I have thought about that moment many times since reading Called to Care. What troubles me most is that I am a Christian who believes spiritual care matters, and I still did not give it. If a nurse with my convictions misses the moment, the problem is not only belief but the way our work is organized and the skills we bring to it.

Shelly and Miller (2006) describe nursing as a calling in which caring for the whole person, body and spirit, participates in God's care for the world, and they argue that spiritual care is not an optional extra but part of what nursing is. I agree, and I suspect most Christian nurses would. Yet on busy shifts, spiritual care is the first thing to go. My patient did not need a theologian; he needed a few minutes of attention, a question about what he meant and perhaps an offer to pray with him if he wished. I had the time to fill out a form but not to sit down. I suspect the form felt safer, too, because it handed the question to someone trained to answer it, while sitting down would have exposed my uncertainty about what to say.

Research helps explain the gap between belief and practice. Ho et al. (2026) surveyed 575 hospital nurses in Taiwan and found moderate to high spiritual care competence, with emotional intelligence and empathy both significant predictors; spiritual care education was associated with higher competence, while longer clinical experience was associated with less favorable attitudes toward providing it. If experience erodes willingness and education builds competence, then spiritual care is a skill that can be taught and maintained, not a gift some nurses simply have. The problem on my unit is not that nurses do not believe in spiritual care, but that nothing in our work protects the few minutes it requires.

A DNP-prepared nurse could change that in three ways. First, add a brief spiritual screening question to the admission assessment, so spiritual needs are identified early rather than when a patient raises them at a busy moment. Second, offer short, practical education on how to respond when a patient asks a spiritual question, including what to say in two minutes and when to call the chaplain. Third, partner with the chaplaincy so referrals for cardiac patients are seen within a day, and track how often spiritual needs identified at admission are actually addressed before discharge. In the Gospels, Jesus repeatedly stopped for the person in front of him, even when crowds pressed in, as when he paused to find the woman who had touched his garment (English Standard Version Bible, 2001/2016, Luke 8:45-48). Nursing systems should make that kind of stopping possible, so that the nurse's calling and the nurse's workload stop pulling in opposite directions.

Reply to Rebecca

Rebecca, you wrote that the biggest barrier to spiritual care is that nurses do not feel confident discussing faith, and that more personal devotion would help. I agree that a nurse's own spiritual life matters, but research suggests confidence also needs skill. Hassan et al. (2026) surveyed 312 critical care nurses in fourteen intensive care units across three hospitals and examined the relationships among nurses' perception of spirituality, their competence in spiritual care and their actual practice, testing whether competence mediated the path from perception to practice. That design captures exactly your concern: a nurse may value spirituality deeply yet not act on it without the competence to know how. If competence links belief to behavior, then devotion alone may not be enough; nurses also need practice in how to open a conversation, listen without fixing and close respectfully. Paul prayed that the Philippians' love would abound more and more with knowledge and discernment (English Standard Version Bible, 2001/2016, Philippians 1:9), which joins love with skill rather than setting them against each other. In my own unit's last competency day, we practiced six clinical skills and none of them involved a conversation about meaning or faith, even though such conversations happen every week. Would your unit be willing to add a short simulation on responding to a patient's spiritual question to its annual competency day?

Reply to Samuel

Samuel, your post described how drained you feel after a week of caring for dying patients and asked how anyone sustains spiritual care over a career. Burton (2026), writing in the Journal of Christian Nursing, argues that nurses who neglect their own spiritual and emotional needs become vulnerable to compassion fatigue, spiritual depletion and burnout, and that sustainable caregiving requires a shift from task-oriented performance to Christ-centered presence, supported by self-compassion and spiritual renewal. That argument helped me understand my own failure with the patient in my thread: I was performing tasks, not being present. Your exhaustion after a week of deaths sounds like the depletion Burton describes, and it is not a sign of weak faith. Presence takes less time than we fear, but it requires a settled heart. Jesus himself withdrew to desolate places to pray between periods of intense ministry (English Standard Version Bible, 2001/2016, Luke 5:16), which suggests that rest and renewal are part of the work, not a retreat from it. For a DNP, this points to organizational support too, such as protected time after a patient death or access to chaplains for staff. Some hospitals offer a brief pause at the bedside after a death, in which staff stand in silence for a moment, and nurses report that it helps them close one encounter before opening the next. What helps you most to recover your sense of presence after a hard week?

References

Burton, C. M. (2026). Spiritual strategies for preventing compassion fatigue and burnout. Journal of Christian Nursing, 43(3), 162-165. https://doi.org/10.1097/CNJ.0000000000001384

English Standard Version Bible. (2016). Crossway. (Original work published 2001)

Hassan, E. A., Ali Elbiaa, M. A., & Elsayed, S. M. (2026). The interplay between spiritual care practice, perception, and competency among critical care nurses: Structural equation modeling study. BMC Nursing, 25(1). https://doi.org/10.1186/s12912-026-05176-9

Ho, Y. H., Wu, P. L., Pai, H. C., & Kuo, Y. W. (2026). Empathy and emotional intelligence as predictors of spiritual care competence in holistic nursing: A cross-sectional study. Journal of Holistic Nursing. Advance online publication. https://doi.org/10.1177/08980101261475446

Shelly, J. A., & Miller, A. B. (2006). Called to care: A Christian worldview for nursing (2nd ed.). IVP Academic.