Spirituality & The Nursing Profession

The nursing profession frequently are being asked to integrate a spiritual component to the care provided (Sawatzky & Pesut, 2005). As such, spirituality has become a prime clinical issue as far as its relevance to overall patient care. One of the most interesting elements regarding spirituality and the nursing profession are the ways in which the nursing field has responded to the issue. The responses have been varied and because of this, the nursing field must assess and examine whether it is viable to incorporate into every circumstance. Several nursing theories including the need theory, the self-care deficit nursing theory and Hans Selye's stress theory all provide the basis for the argument that spirituality does indeed assist the field of nursing, even with the modern push towards more evidence-based-practice.

Needs Theory & Willpower

The focus of Virginia Henderson's Needs Theory is that an individual has several components including biological, spiritual and sociological and that the patient needs assistance in achieving and attaining both their health, independence and subsequent death. Henderson states that health and its promotion are the most important aspects of the nursing profession and that individuals unequivocally realize their best health when they have the knowledge and willpower to do so ("Nursing Theories," 2013). Given the constructs surrounding what Henderson proposes in her theory, the clinical issue of spirituality can be explained by this theory. While spirituality is observed as a mixture of psychology and religion by most accounts, there is an argument to be made regarding individuals achieving their best health as asserted by Henderson, when spirituality is integrated into the proverbial mix. Therefore, an individual's wellbeing or rather promotion of both health (mental, physical and emotional) is contingent on having a profound spiritual foundation. Spirituality then is the spiritual piece that Henderson refers to in her assessment of what individuals need in order to survive in this world. Moreover, spirituality assists in providing each individual "the willingness to let go of the old and untangle the mental knots very gently and patiently" (Hay, 2009). Due to the presentation that Henderson makes regarding an individual's health, spirituality helps an individual attain the aforementioned components.

The Self-Care Deficit Nursing Theory & Spirituality

The self-care deficit nursing theory was developed by Dorothea Orem and encompasses a wide ranging amount of concepts, but the premise of the theory is that patients are to be reliant upon self. In other words, when individuals are as independent as they possibly can be, they recover faster than they ordinarily would without the determination to care for themselves. Spirituality is by and large referred to as an individual quest or journey that one makes toward their creator. Orem's theory then is centered on the individual fervent drive to arise from their debilitation or sickness. This determination that Orem speaks of in the overview of the theory (self-care) has a spiritual component to. Smark (2009) argues that there is a definite correlation between spirituality and psychology; and that much of the resilience of self-care is the result of willpower and an individual's capacity to learn from their adverse situations. Spirituality is a coping mechanism that allows for understanding and enlightenment for the betterment of individuals (p.19-21). In essence, by having a spiritual component and focus point, the individual who is being cared for by a nurse can seek to better themselves by maintaining a positive attitude and believing that they will get better.

Smark (2009) goes on to say that spirituality is "an essential feature of recovery [and] an important source of hope and meaning when redefining one's life after the catastrophic event that" (p.21) an illness often is. Researchers have examined and continue to examine the benefits of spirituality on individuals and consistently find that it has a positive effect, but also that the individual must incorporate the spiritual component into their lives on their own. Basically, while the nursing profession can guide and reason to the patient why spirituality is vital to the rehabilitation process, the patient has to make the step towards the world of spirituality on their own. This is one of the core tenets of what Orem's theory is centered on.

The Underlying Spiritual Dynamic of Selye’s Stress Theory

The definition of a balanced theory in nursing is a framework that has been incorporated into the field from another area of study. Selye's theory on stress is explained as General Adaptation Syndrome where an event either internal or external seeks to harm the wellbeing of an individual and the body goes through a three stage process as a result. The three stages are: alarm, where the body actually encounters the stressor and must react with the fight or flight response mechanism that is a part of the human makeup; resistance, where the body tries to fight the stressor and exhaustion, where the organism expends his or her resources and is worn down by the stressor. To combat the stressor, Selye suggests a variety of terminology including adaptation, which stimulates change following the response to the stressor; coping and resilience ("Nursing Theories," 2013). Given Selye's theory on stress, it can be reasoned that spirituality is great for all three components that Selye speaks of in his terminology.

Adaptation can best be described as the patient's acceptance of the issue. The nursing profession is per the theory responsible for ensuring that the best measures are taken by the patient regarding dealing with the issue. This means that they must make sure that the patient has plans to reconstruct their daily lifestyle to adhere to the changes that are happening with them whatever the illness may be. Moreover, it is important to note that the nursing profession and the spirituality dynamic is not necessarily about curing, but about getting the individual to adapt spirituality into their everyday operation. Selye's theory on stress then is an assimilation type theory for nurses to follow in their assistance with patients.

Thornton (2008) describes that the goal of the nursing profession in utilizing spirituality is to be committed to enriching the entire life to of the patient and themselves. Nursing with the holistic component is a way of practicing and being as well as living that seeks to rejuvenate and transform the stresses that result from ailments and illnesses. The healthcare system should have an attitude that seeks to exhibit a healing force and presence. It is an attitude of profound love to convey a coping objective (p.34-35). Coping per Selye relates to an individual's ability to deal with the ailment or illness that they have. It should be the motivation of the nursing profession to endeavor and strive to be models of optimum health for patients that are trying to cope with their issues. Perhaps the most profound aspect of Selye's stress theory and its link to spirituality is the fact that it draws upon the belief that individuals who have a spiritual element operating in their lives are better able to cope with situations and circumstances that arrive. Spirituality helps individuals feel better and may even prevent further problems and the theory indirectly states that with its terminology references on adaptation, coping and resilience.

It has often been said that one of the key parts when discussing resilience of patients is their spirituality. Having the spirituality component enhances a person's life despite the experiences that they have. Thus, an individual who is resilient is an individual who is driven to recover quickly from misfortune or dilemmas that occur and resilience assists and works in conjunction with the other components of Selye's theory on stress and spirituality. Given this assessment, it can be concluded that Selye's theory on stress is the best choice for the nursing profession to implement into their understanding to best deal with the clinical issue of spirituality.

Why Selye’s Theory Works Best?

When discussing the clinical issue of nursing, it is crucial to note that most, if not all literature deals with the nurses themselves having a spiritual component and being amenable to faith diversity. The nurses need to have a spirituality component working in their lives in order to assist the patient as best as they can in dealing with their predicament. This is why Selye's stress theory out of the three mentioned works the best. The other two theories are good in their application, but are not practical when considered against the borrowed theory of Selye.

Selye's stress theory also is definitive in predicting behavior because the nursing profession is a stressful one and stress undeniably unfolds. Therefore, having a holistic dynamic underlying the profession both from the nurse's perspective and the patient's mechanics of adaptation, coping and resilience is a winning combination for the field. Moreover, Selye's theory puts the reins of a predicament in the hands of the patient. The patient must tackle their proverbial ills and struggles by systematically incorporating spirituality into their lives. While the other theories assert this premise, because Selye explores the concept of stress within his theory, there is no way around not trying to combat and thwart stress. In other words, when stress presents itself in any given situation or circumstance, if Selye’s theory is applied to the nursing profession, then nurses can assist and educate patients on the need in having a spiritual component operating in their lives.

References

Hay, L. (2009). You can heal your life. Carlsbad, CA: Accessible Publishing Systems Pty Ltd.| HayHouse.

Nursing Theories. (2013, September 9). Retrieved from Current Nursing website: http://currentnursing.com/nursing_theory/

Sawatzky, R., & Pesut, B. (2005, March). Attributes of Spiritual Care in Nursing Practice. Journal of Holistic Nursing, 23(1), 19-33. doi:10.1177/0898010104272010

Smark, T. (2009, December). Spirituality and mental health: exploring the relationship. Australian Journal of Pastoral Care and Health, 3(2), 19-27. Retrieved from http://www.pastoraljournal.findaus.com/pdfs/ar6.pdf

Thornton, L. (2008). Holistic Nursing: A Way of Being, a Way of Living, a Way of Practice! NSNA IMPRINT, 33-39. Retrieved from http://www.nsna.org/Portals/0/Skins/NSNA/pdf/Imprint_Jan08_Feat_Holistic.pdf