Spirituality is a part of holistic nursing care. Spirituality includes transcendence (finding meaning larger than the person’s individual self and life), connection (integration of all aspects of life), balance (harmony), and purpose (an understanding of the impact of a person’s life, including the understanding of life events). Religion is a system of beliefs and practices that usually involves a community of like-minded people, but may be an individual set of beliefs.

Prophetic religions are those that believe in a personal God who rules the universe, including Judaism, Christianity, and Islam. Mystic religions are those that believe that God is a principle rather than a being, such as Hinduism, Buddhism, Sikhism, and Shintoism. Atheists do not believe in the existence of a God in any form. Agnostics do not know if a God exists or not. One’s religion guides conceptualizations of birth, death, illness, and diet. Religion is also closely aligned with culture.

The concern for spirituality in nursing began with Florence Nightingale, but only two nursing theorists (Jean Watson and Margaret Newman) explicitly deal with spiritual concerns. According to Watson, the human soul is the essence of each human being and the meaning of a health state held by the individual is part of the transpersonal caring relationship between nurse and client. Watson’s and Newman’s emphasis on spirituality is strengthened by studies showing a relationship between spirituality and health.

Spiritual nursing care begins with the nurse’s spiritual self-assessment. Client spiritual assessment includes an exploration of the person’s developmental level. A number of tools have been developed for spiritual assessment and they can be used as a paper and pencil assessment or an interview format. Generally, they focus on the importance of spirituality in the person’s life, the person’s connection to self and others, and the meaning and purpose of the person’s life.

Nursing diagnoses related to spirituality are Risk for Spiritual Distress and Readiness for Enhanced Spiritual Well-Being. Spiritual distress occurs when a person is separated from religious ties or challenged by medical treatment. Interventions include calling on the person’s spiritual counselor, praying with the client who has given permission, exploring the client’s religious and spiritual beliefs, listening, and touch. Children do well with familiar religious rituals. Evaluation of interventions is often as simple as asking the client if he or she is comfortable talking about spirituality.