NURS 750 Week 1 Discussion Board Forum 1 on Spirituality and the Nurse's Role Example

Discussion Board Forum 1: Spiritual Care at the Incubator

NURS 750 Spiritual Care, Discussion Board Forum 1

Thread by [Student Name]

The unit, the families and the classmates replied to are composites written for a model discussion; the textbook, studies and Scripture cited are real.

"Is God punishing me?" A mother asked me that at two in the morning, standing beside the incubator of a baby born at twenty-four weeks who had just been reintubated. I am a neonatal nurse practitioner in a level IV neonatal intensive care unit, and I had come to the bedside to adjust the ventilator, not to answer a question about God. The chaplain was not in the building. The bedside nurse looked at me, and I realized that whatever I said next would be spiritual care, good or bad. This week's chapters convinced me that spiritual care in the unit belongs first to nurses and advanced practice nurses, with chaplains as essential partners rather than the only providers.

O'Brien (2018) distinguishes spirituality, the broad human search for meaning and relationship with God or the transcendent, from religion, the beliefs, rituals and community through which many people live out that search. The mother at the incubator was not asking a religious question about doctrine. She was asking a spiritual one about meaning and guilt. O'Brien's description of the nurse as a spiritual caregiver rests on presence: the nurse is the one who is there at two in the morning. That fits the unit. Chaplains see a family for an hour; nurses are at the bedside for twelve.

The evidence is more complicated than I expected. In a 2026 discrete choice study, 45 caregivers of 39 infants in a NICU ranked sixteen domains of high-quality care, and they placed team members' education and training first, with communication and symptom management also high; cultural, spiritual and religious aspects of care were among the lowest ranked (Cyrus et al., 2026). One reading is that parents do not want spiritual care. I read it differently. When forced to choose, parents choose competence and honest communication, and spiritual care that arrives as a separate service may seem optional. Spiritual care that arrives through competent, honest communication is not a separate item at all. Parents may rank spiritual care last on a list and still need it most in the moment no list anticipated.

Other research suggests spiritual resources matter to how parents cope. In a study of 120 mothers of infants in a NICU in Türkiye, mothers' spiritual orientation was associated with their beliefs about their ability to parent their hospitalized infant, explaining 13% of the variance, and positive religious coping explained a further 6% (Küçük Alemdar et al., 2025). Confidence in the parenting role is exactly what our unit tries to build. If a mother's faith supports that confidence, then supporting her faith is part of family-centered care.

That night I told the mother that nothing she had done caused her son's prematurity, that many parents ask the same question, and that I would stay while she prayed if she wished. She did. Moses was told to remove his sandals because the place where he stood was holy ground (English Standard Version Bible, 2001/2016, Exodus 3:5). O'Brien (2018) borrows the phrase for the subtitle of the course text. The space beside an incubator, with its alarms and tubing, is holy ground too, and nurses stand on it every shift.

Reply to Danielle

Danielle, you wrote that spiritual needs should be referred to the chaplain because nurses lack the training and risk imposing their own beliefs. I agree that chaplains bring expertise we do not, and that we must never impose belief. But referral alone leaves most spiritual needs unmet, because they rarely arrive on the chaplain's schedule. The Society of Critical Care Medicine's 2026 guidelines on end-of-life care in pediatric and neonatal intensive care were written by a panel that included spiritual care professionals and bereaved parents alongside nurses and physicians, and its recommendations on bereavement support and palliative care education treat family support as the whole team's work (Derrington et al., 2026). Parents' own words point the same way. In a study of mothers and fathers whose infant or child died in a NICU or pediatric intensive care unit, the most common regret among both was not spending more time with the child, and mothers also wished they had held the child more (Brooten et al., 2019). Making room for holding, blessing or baptism before a death is spiritual care, and it usually falls to the nurse at the bedside. Could your unit train nurses to recognize these needs and partner with the chaplain, rather than only refer?

Reply to Marcus

Marcus, I appreciated your honesty about praying with patients in the emergency department when they ask, and your worry that you might be doing it clumsily. You are not alone in your willingness. In a survey of 381 mostly Christian nurses given a scenario in which a patient asked for prayer, 97% said they were willing to pray, and their descriptions of how they would do it fell into five parts: opening, setting the stage, the request itself, a wrap-up and a close (Mamier et al., 2023). That structure might ease your worry, since it begins by asking what the patient wants prayed for and ends by returning to care, which keeps the prayer centered on the patient rather than the nurse. Parents grieving a child also describe religious practice as a source of strength. In a qualitative study of 96 parents after an infant's or child's death in intensive care or the emergency department, religious activities were among the most frequent coping strategies for both mothers and fathers (Caicedo et al., 2019). Prayer offered well at the bedside may be the first step in coping that continues long after the family leaves.

References

Brooten, D., Youngblut, J. M., Caicedo, C., & Dankanich, J. (2019). Parents: Wish I had done, wish I had not done, and coping after child NICU/PICU death. Journal of the American Association of Nurse Practitioners, 31(3), 175-183. https://doi.org/10.1097/JXX.0000000000000110

Caicedo, C., Brooten, D., Youngblut, J. M., & Dankanich, J. (2019). Parents' wishes for what they had or had not done and their coping after their infant's or child's neonatal intensive care unit/pediatric intensive care unit/emergency department death. Journal of Hospice & Palliative Nursing, 21(4), 333-343. https://doi.org/10.1097/NJH.0000000000000559

Cyrus, K. E., Creel, A. M., Fang, Z., Autrey, A. K., & Surcouf, J. W. (2026). Values in the neonatal intensive care unit: Insights into caregiver priorities. The Journal of Pediatrics, 296, Article 115198. https://doi.org/10.1016/j.jpeds.2026.115198

Derrington, S., Broden Arciprete, E. G., Lin, M. C., Oczkowski, S. J. W., Alladin, A., Anani, U. E., Borchik, A. K., Collins, C. A., Delgado-Corcoran, C., Dickerman, M. J., Harrod, C. G., Henner, N., Kon, A. A., Lewis-Newby, M., Lord, B. T., Masters, A. A., McCarthy, S., Moynihan, K. M., Munoz-Blanco, S. M., . . . DeCourcey, D. D. (2026). Society of Critical Care Medicine 2026 guidelines on the care and management of pediatric and neonatal intensive care patients at the end of life. Pediatric Critical Care Medicine, 27(4), 518-536. https://doi.org/10.1097/PCC.0000000000003914

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

Küçük Alemdar, D., Bulut, M., Cengiz, D., & Eren, Ö. (2025). Spiritual orientation and religious coping styles of mothers whose babies were hospitalized in a neonatal intensive care unit in Türkiye: Relationship with stress levels and parental beliefs. Journal of Religion and Health, 64(4), 2901-2917. https://doi.org/10.1007/s10943-025-02316-4

Mamier, I., Park, C. G., & Taylor, E. J. (2023). How Christian nurses respond to patient requests for prayer: An observational study. Journal of Christian Nursing, 40(4), 222-229. https://doi.org/10.1097/CNJ.0000000000001061

O'Brien, M. E. (2018). Spirituality in nursing: Standing on holy ground (6th ed.). Jones & Bartlett Learning.